A textbook STEMI/NSTEMI was mis-triaged and catastrophically delayed; a procedural error created a second heart attack; staff then used physical force, theft, and threats to silence the patient and dump him. The episode spans gross malpractice, multiple Florida felonies, and apparent EMTALA violations—now the subject of police, regulatory, and civil action.
- Key Laws & Guidelines Implicated
| Category | Potential Violations |
|---|---|
| Criminal (Florida) | Theft §812.014; Battery §784.03; Assault §784.011; Extortion/Coercion §836.05; Evidence Tampering §918.13; Culpable Negligence §784.05 |
| Patient-Care Statutes | Florida Anti-Dumping / Emergency Treatment §395.1041; Patient’s Bill of Rights §381.026 |
| Federal | EMTALA (42 U.S.C. §1395dd); HIPAA Right-of-Access (45 C.F.R. §164); ACA §1557 anti-retaliation |
| Clinical Guidelines | ACC/AHA 2025 & ESC 2023 ACS protocols: PCI < 2 h for instability; < 24 h troponin-positive NSTEMI; post-PCI troponin 0-3-6 h; ICU-level monitoring; renal hydration for contrast |
Fla. Stat. § 812.014 – Theft (Petit or Grand, Depending on Property Value) +3,500 USD
Staff members physically removed and withheld the patient’s phone and laptop without consent, intending to deprive him of their use unless he complied with hospital demands to turn over the recording of the doctor admitting that new damage was done to the heart during the PCI. Any unauthorized taking or retention of personal property—with intent to appropriate it, even temporarily—meets the statutory elements of theft.
Fla. Stat. § 784.03 – Battery (Misdemeanor/Felony) The nurse’s act of forcibly grabbing the phone from the patient’s hand (unwanted physical contact) is sufficient to constitute battery. Florida requires no bodily injury for this charge—any intentional, non-consensual touching satisfies the statute.
Fla. Stat. § 784.011 – Assault (Misdemeanor) Threats of $10,000 “HIPAA fines,” forced expulsion, and denial of care for 4a MI—coupled with the presence of security guards—created a well-founded fear of imminent harm or further force. Such intentional threats, when coupled with apparent ability to carry them out, fit the definition of simple assault.
Fla. Stat. § 836.05 – Extortion (Felony) Staff threatened to continue withholding the patient’s phone/laptop (injury to property) unless he signed an AMA form against his will. Using threats to compel a person to act (or refrain from acting) constitutes extortion under this statute.
Fla. Stat. § 787.02 – False Imprisonment (Felony) By detaining the patient’s belongings and positioning security guards to block his movement until he signed paperwork, staff restrained his liberty “without lawful authority,” satisfying the elements of false imprisonment.
Fla. Stat. § 918.13 – Tampering With or Fabricating Physical Evidence (Felony) Deleting or attempting to delete recordings/photos documenting substandard care—or otherwise concealing those files—constitutes altering or destroying evidence that may be needed in an investigation or legal proceeding, which is a third-degree felony.
Fla. Stat. § 784.05 – Culpable Negligence (Misdemeanor/Felony) Discharging a post-PCI cardiac patient in unstable condition, despite clear signs of medical emergency, shows a reckless disregard for human life or safety—potentially meeting the threshold for culpable negligence.
Fla. Stat. § 395.1041 – Florida “Anti-Dumping” / Emergency Care Law (Civil & Criminal Penalties) This statute mirrors EMTALA: hospitals must provide emergency screening and stabilizing treatment and may not delay or deny care for non-medical reasons. Terminating care after a coerced AMA and theft of property violates these requirements and can trigger fines or misdemeanor charges.
Fla. Stat. § 381.026 – Patient’s Bill of Rights and Responsibilities (Civil/Administrative Enforcement) Guarantees patients the right to receive emergency care, participate in decisions free from coercion, retain personal effects, and voice grievances without reprisal. Staff conduct—property seizure, intimidation, retaliatory discharge—directly contravenes these statutory rights and subjects the facility to state administrative sanctions.
(Chronological narrative blending medical facts, guideline breaches, and alleged legal violations)
1. 911 Call & Largo ER (Sun 05 / 25 @ ≈ 05:30 AM)
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Symptoms: crushing chest & head pain, blood-pressure spikes, profuse sweating, projectile vomiting, and position-dependent paralysis (unable to move at one point inside the scanner, was even unable to open eyes when asked to open when pulled from the tube, they lifted both arms, which fell with gravity ).
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Key labs: high-sensitivity troponin-I 14 → 248 → 2 ,764 ng/L within hours—well into NSTEMI “Very-High-Risk” territory (ACC/AHA 2025 & ESC 2023: PCI < 2 h for hemodynamic instability, < 24 h at absolute latest).
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Deviation: Instead of activating a cardiac pathway, staff routed the patient to tele-neurology; every CT/MRI run flat triggered further paralysis—textbook proof of falling cardiac output.
2. Two-Day Delay & Worsening Instability (Mon 05 / 26 – Tue 05 / 27)
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Despite troponin > 100× ULN and repeated BP surges (> 220/120 mm Hg), no cath lab mobilized.
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Morning of Tue 05 / 27 (≈ 09:00 – 09:30): BP again in the 200s/100s, severe head pain, mid-back pressure, dizziness supine—still no intervention.
3. Belated PCI & Procedural Injury (Tue 05 / 27, midday)
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Dr. James Skorczewski, DO began PCI after telling the patient: “You are not going to dictate your care.”
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Mid-procedure admission: “I kinked a small side branch—you’re going to have a heart attack. We’ll give you fentanyl and morphine in recovery.”
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No immediate rescue maneuver; no stent-patency check; no ICU-level post-procedure monitoring ordered.
4. Recovery-Bay Tourniquet Injury
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Staff wrapped an upper-arm BP cuff to ≈ 160 mm Hg and left bedside; hand turned purple-red with petechiae—nerve & micro-vascular damage; cuff only released after the patient yelled out about the damage it caused his hand.
5. Night-Shift Legal Threat (Wed 05 / 28 ≈ approx 03:00 AM)
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Patient calmly informed night RN he would pursue legal action unless basic care resumed (serial troponins + IV fluids to protect single kidney).
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Orders finally written; IV fluids to protect single kidney, first post-PCI troponin drawn ≈ 12 h late → 8 ,638 ng/L (> 14 × pre-PCI 600 ng/L) = massive Type 4a peri-procedural MI.
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Still no echo, repeat cath, telemetry upgrade
6. Morning-Shift Retaliation & Device Seizure (Wed 05 / 28, shift change)
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Charge Nurse stormed in with security guards:
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Demanded to hear the audio in which the doctor admitted to kinking the artery.
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Threatened “$10 k HIPAA fines” per recording (false; HIPAA does not bind patients).
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Snatched the unlocked phone from patient’s hands and confiscated the laptop; a guard mocked, “What laptop?”
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Ultimatum: “If you want your devices back, you have to sign this paper.” — classic extortion (§836.05) and coercion; AMA signed under duress.
7. Forced Discharge & Attempted Re-Admission
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Escorted off the property while tachycardic (~180 bpm) and dizzy; collapsed on hot asphalt.
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Tried to re-enter ER; security insisted patient had “left AMA”, which was not true, he was forced to sign with threats to property— EMTALA/§395.1041 patient-dumping.
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Took an Uber home, EMS picked up from home, and transported him to Morton Plant Hospital.
8. Morton Plant Encounter (Wed 05 / 28 – Thu 05 / 29)
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Dr. Akash Patel, MD (same group as Skorczewski) consulted; repeated the phrase: “You are not going to dictate your care.”
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Troponin remained 5,477 → 3,544 → 3,263 ng/L (> 5× baseline) yet no echo, MRI, or repeat cath; discharged on Thu 05 / 29 with active Type 4a MI unaddressed.
9. Ongoing Harm & Evidence Trail
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Estimated infarct mass ≈ 8–10 g myocardium lost (rule of ~1 g per 1,000 ng/L).
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Digital forensics show GPS/time-stamp where the nurse seized phone; backups preserve audio admission by Dr. Skorczewski. Records show 4a MI unaddressed
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Police report filed that should address assault, theft, and evidence tampering; formal complaints being prepared for AHCA, The Joint Commission, and HHS/OCR.
