An intoxicating error

January 22nd, 1980, eighteen-year-old Willie Ramirez was out with a friend in Florida when he experienced a headache.

He arrived via ambulance at a South Florida hospital in a comatose state. He became quadriplegic as a result of a misdiagnosed intracerebellar hemorrhage that continued to bleed for more than two days as he lay unconscious in the hospital. Non neuro consult was ordered because the clinicians decided Willie was suffering from a drug overdose, a common diagnosis in emergency medicine.

The mis-diagnosis resulted in part due to a mis-understanding of a word, which in Cuban Spanish means something wrong because of what one drank or ate. On the day Willie’s intracerebellar bleed began, he had lunch at a fast food restaurant, the newly opened Wendy’s. His mother and his girlfriend’s mother assumed that the severe headache he experienced that night was related to eating a bad hamburger at Wendy’s – that Willie was “intoxicado.”

Willie’s mother told Gail Price-Wise, who researched the incident, “I say him, doctor the amburger intoxiCAted him. I asplain him no alcol, no droogs.”

Willie was sent to the ICU with a diagnosis of “probable intentional drug overdose.”

Ironically, one of the physicians present was from Bolivia, where the Cuban meaning of “intoxicated” in unknown.

After two days in the ICU, a doctor noticed signs that Willie was suffering from neurological disorder. It was too late to prevent permanent damage. Willie’s family and the healthcare provider settled for $71 million, to pay for a lifetime of 24-hour care.

This case is cited widely as an example of a intercultural mis-understanding. Gail Price-Wise did the research to tell the story accurately here. She runs the Center for Cultural Competency and has written a book about the incident, An Intoxicating Error. I relied heavily on her research and writing for this posting.

 

 

 

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