“Serious dysfunctions” concluded the Minister of Health Agnès Buzyn about the care by the Samu of Naomi Musenga, 22 years old and a mother, who died on December 29, 2017. “I am deeply outraged by the circumstances of the situation. death of Naomi Musenga in December. I would like to assure her family of my full support and ask for an IGAS (General Inspectorate of Social Affairs) investigation into these serious dysfunctions, “the minister observed on Twitter on May 8.
IGAS therefore comes from report back. This confirms that “the treatment by the Samu of two successive calls concerning Mrs. Naomi Musenga is not in accordance with good practice and has resulted in a delay in support”. IGAS also emphasizes that:
- The tone used in response to the call and the comments made are particularly shocking.
- The questions asked are not appropriate for the situation. The medical regulation assistant does not listen to repeated calls for help interspersed with moans, repeated mentions of physical suffering.
- The call was not transmitted to the medical regulator of the SAMU while the internal procedures of the SAMU 67 mention the need to transmit without delay any appeal for abdominal pain which is considered as a sign of potential vital emergency.
Recall of facts
What happened to get the case back to the Ministry of Health? Back to the facts. On December 29, 2017, Naomi Musenga, contact the Samu of his Strasbourg accommodation. She complains of severe stomach aches and explains that she is bleeding. The operator on the phone does not take the concern and distress of the young woman seriously. The recording of the conversation illustrates the content of the exchange. “If you don’t tell me what’s going on, I’ll hang up,” said the operator, whose comments are reported by the Latest News from Alsace. “I’m in a lot of pain,” Naomi answers with difficulty. “Yes, well you call a doctor, you call SOS Médecins”, retorts his interlocutor. While Naomi tells her that she thinks she is going to die, the operator answers her with irony: “Yes you will certainly die one day, like everyone else”.
Naomi calls afterwards SOS doctors three times but got the wrong number. She then contacts a close relative who goes to her home and finds her bathed in her blood. She calls the Samu again, who sends her back to SOS doctors. The practitioner who arrives on the scene immediately calls for help for urgent treatment. The victim still alive is finally transferred to the hospital where she makes two stops cardiacbefore being placed in intensive care. Naomi succumbs a few hours later.
Consequences not proportionate to the gravity of the situation
In addition to the failures in the care of the 22-year-old young woman, the IGAS report also points to “consequences not proportionate to the seriousness of the situation” since the formal declaration of a serious adverse event (SAE) no was not made when all the elements were in place. In the conclusions of its report, IGAS recommends accepting the resignation of the head of the Samu service and clarifying the roles in terms of reporting serious adverse reactions, including those already the subject of a complaint or legal proceedings. It also recommends setting up training courses in good medical regulation practices at Samu 67.
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