(The emergency medicine specialist consulted for this story said "shock lung" is not a common term, but one that suggests not one problem but a "cascade of problems." The cumulative effect of all problems associated with Tiffany's lacerated liver -- the seepage of blood, the buildup of fluids in her lung tissue, her increased heart rate, chemical reactions in her body -- would diminish the integrity of her blood vessels. Water leaks into areas where it should not be, and it creates a barrier between blood and oxygen.)
For several hours at St. Joseph, the surgeon who had operated on Tiffany Troch continued to work on her, trying several different treatments for "shock lung."
"Mrs. Troch, she's not responding," the doctor told Tiffany's mother. "I'm doing everything I can. I'm treating her as if she were my own daughter." Nothing worked.
Tiffany went into cardiac arrest and died just before 6 a.m., Good Friday, 13 hours from the time she arrived at St. Joseph.
"I wanted to talk to that [first] surgeon who had walked away from Tiffany earlier," Mark Troch says. "They got him on the phone for me after she died. He said, 'I thought the hematoma was developing. I told them [emergency room staff] to monitor her and, if there was any change, to call me. They never called. . . . Frankly, there was a breakdown in communication.' He said at no time, when he examined her, was my daughter in any danger. I said to him, 'Doctor, if my daughter has an internal injury, are you saying I shouldn't bring her to St. Joseph's?' And he said, 'Frankly, they should have sent her to Shock-Trauma.' "
Debbie Troch's father, James Hobbs, released his anger at the hospital after he learned his granddaughter had died. "What happened?" he barked at the attending surgeon. "There was a breakdown in communication," he was told.
The Troches say the emergency room doctor used the same phrase to describe what happened during the course of Tiffany's treatment. But what they meant by that -- a "breakdown in communication" with Tiffany's parents? among doctors? -- is not clear. Nor is it clear whether the doctors believed better communication would have changed the outcome.
The day after Tiffany died, her father spoke on the telephone with the chief of surgery at St. Joseph. Mark Troch says he was told the hospital already was conducting an investigation into the handling of Tiffany's injury, though Lori Vidil, the hospital's director of public relations, says the investigation was prompted after Tiffany's parents raised questions about her care.
Vidil says St. Joseph Hospital was "very sad" at the death of Tiffany Troch, but would not answer specific questions about the case, citing "patient confidentiality" and the fact that the Troches "have retained legal counsel." Bruce Ezrine, attorney for the parents, confirmed last week that he has requested the records of Tiffany's treatment from the hospital. The Troches, meanwhile, have buried their daughter. "You can't imagine, no one can imagine, how upset my husband and I are," Debbie Troch says. "We were helpless after we brought her to St. Joseph's. She was in their hands."