Tiffany Tate suffered a stroke and was rushed to the hospital in an ambulance.
Her ambulance was gone – so she died.
Four years ago, Tiffany started her day just like any other.
With a teenage girl and an eight-month-old baby at home, she got ready for work and set out to cover the breakfast shift in the Medical College of Wisconsin cafeteria.
Some of the other kitchen workers remembered Tate mentioning that she had a headache and felt weak, but she blamed her new medication for back pain and disregarded it.
Leaving her break shortly after eight in the morning, Tate felt much worse. A co-worker ran to get a piece of bread with honey. She came back to find Tate leaning against a countertop. The left side of her face fell and she was uttering her words.
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A national killer
It is estimated that every nine minutes, someone in Australia suffers a stroke, making him one of Australia's biggest killers and a leading cause of disability, according to Healthdirect Australia.
Dr. Jill Gamberg of Double Bay Doctors explains that the stroke occurs when the blood supply to the brain is interrupted.
"Blood can stop moving through an artery because it is blocked (an ischemic stroke) or if the artery burst (a hemorrhagic stroke)," she told The Victor Harbor Times.
"The longer a stroke is not treated, the greater the chance of brain damage," he added.
"[Immediate] Emergency medical treatment improves the chance of survival and successful rehabilitation. "
The morning Tate suffered the stroke, she was at work.
His workplace was on the grounds of Milwaukee Regional Medical Center and 320 yards from Froedtert Hospital, one of the region's most advanced stroke treatment centers.
Both were just a short drive from the ambulance.
She was taken to either.
It turns out that emergency departments in hospitals in the United States were quietly deploying a controversial tactic, transforming potential patients.
Officially, it's called an ambulance bypass.
Hospital staff basically drive ambulances out of the emergency room door because of overcrowding. Sometimes this is due to an influx of patients; other times, hospitals may not have the most efficient systems to move patients around the hospital, creating bottlenecks.
Tate's ambulance was redirected to a hospital four miles away, which offered only limited care with the stroke.
In the United States, federal law requires the hospital to treat patients who arrive in the emergency room and make sure they are stable before releasing or transferring them.
But if they arrive in an ambulance that asked not to come, this does not apply.
Maria Raven, a physician in the emergency room and a professor at the University of California and San Francisco, who studied hospital diversion, believes that Tate should have been taken to Froedtert.
"In my opinion, they should not be an Integral Stroke Center if they manage to close," Raven told USA Today. "You can be one or you can not be one. People can not control when they have the course. "
While Milwaukee County officially ended the diversion in 2016, the longstanding practice continues elsewhere in Wisconsin and across America.
Although ambulance diversion was first introduced in the 1980s, it is still happening in emergency rooms in the US and the UK.
In fact, weekly statistics from Britain's National Health Service show that 11 hospitals abandoned ambulances last week alone. According to the Daily Mail, ambulance diversions were set 38 times last week – a 500% increase from just six in the same week last year.
In the United States, a 2017 study also found that African-American patients were at greater risk of dying from heart attacks and strokes based on the fact that hospitals in predominantly minority neighborhoods performed deviations more frequently than others.
All of these combined factors collectively reduced Tate's chances of survival.
A TRAGIC RESULT
Despite its proximity to one of the best centers for stroke treatment, the Tiffany Tate stroke resulted in his death.
If she had been taken to the doors of the emergency room, the doctors would have been required by law to care for her, even with the amusement in place.
Instead, she was taken to the Aurora West Allis Medical Center, where she could not handle the case. She was transferred to Aurora St. Luke Medical Center. By the time she arrived, about three and a half hours had passed since her stroke symptoms began.
Medical records show doctors trying (and failing) to reach the clot in Tate's neck through an artery in his leg.
Despite her attempts to save her, Tate's family and some medical professionals still questioned why she was not treated at the hospital she was closest to.
"It did not make any sense to me," his brother, David Tate, said in an interview. "Damn, she was in Froedtert. She works there. She was right there.
While it is impossible to know if Tate would have survived if she had gone straight to Froedtert, experts believe that the delay in taking her to a high-level stroke center has reduced her chances of survival.