The family of an American student who died in 2024 has launched a lawsuit against a hospital after he was declared dead via a “tele-health provider” on a video screen, rather than someone at the facility, reports CNN.
The lawsuit also argues that the hospital was “inattentive” and “provided substandard care” that resulted in the death of Conor Hylton (26).
The University of Connecticut student, who had been studying dentistry to follow in his parents’ footsteps, died at Bridgeport Hospital Milford Campus in August 2024 after being diagnosed with pancreatitis, dehydration, metabolic acidosis and alcohol withdrawal.
“This shouldn’t have happened. He had so much life to look forward to, and was so proud to be in dental school,” said his father, Dr William Hylton.
The young man’s case seems to underscore the increasing number of patients who don’t see an intensive care unit specialist in person, even in an emergency, experts say. And even as telehealth has grown in recent years, standards for its use, particularly in these circumstances, haven’t kept up.
The area where the Hylton family lived was “medically dense” with hospitals, according to the family lawyer.
Hylton had gone to the hospital nearest the family’s home, not knowing its ICU didn’t necessarily have a critical care medicine specialist on-site when he would need one most.
“You wouldn’t for a minute expect that you would have a telehealth physician in the ICU,” the lawyer added. “You can’t provide the care through a video system. It doesn’t have arms that reach out and do things to you. And nobody knew this.”
The hospital’s owner told CNN: “Yale New Haven Health is aware of this lawsuit and is committed to providing the safest and highest quality of care possible, however, we are unable to comment on pending litigation.”
Hylton initially went to the Milford Campus emergency room on 14 August 2024, complaining of intense stomach pain. He’d been vomiting for days and couldn’t even keep liquids down.
He was admitted with a diagnosis that included dehydration, alcohol withdrawal and pancreatitis, or inflammation of the pancreas.
While his blood pressure sank and his heart raced, Hylton became agitated and restless, and his mental condition declined, prompting a transfer to the ICU at 12.38am.
On the overnight shift, the hospital used a tele-ICU service, meaning there was no ICU intensivist – a board-certified physician with specialised training in critical care medicine – on-site.
It’s unclear whether this was a regular occurrence or what specific responsibilities the telehealth doctor had in the ICU. The hospital declined to provide further details.
There was a “hospitalist” on-site, a doctor who typically specialises in internal medicine or family medicine, who works within a hospital to manage the care of inpatients, the analysis says, but she didn’t see Hylton, according to the lawsuit.
The hospital did not tell his family that Hylton’s condition had deteriorated and that he had been transferred to the ICU without a doctor on-site. Had the family known, the lawyer said, they would have asked for a transfer to the Yale or Bridgeport hospitals, a short drive away.
By 4.30am, Hylton had “slid down in bed, his eyes rolled back”, and he became unresponsive, with seizure-like activity. He received a tube to help him breathe, but eventually went into cardiac arrest
Medical personnel were unable to resuscitate Hylton, and a telehealth provider pronounced him dead, shows the lawsuit.
A government investigation referenced by the lawsuit says there was a delay in Hylton’s intubation, in part because of the lack of an in-person physician.
And when a doctor who was working in the emergency room was called to help with the intubation, he didn’t know how to find the ICU and had to find a nurse to direct him, causing a 10-minute delay.
The investigation documents also say there was “extremely poor communication” and no hand-off process between providers.
Although several CIWA assessments – a bedside tool used to assess and manage the severity of alcohol withdrawal – were conducted before Hylton went to the ICU, there were none when he was in intensive care, allowing for no assessments for pain or a change in mental status there.
Documents included in the lawsuit said a complaint survey in May 2025 found that the hospital was “not in substantial compliance with the requirements of the law pertaining to the standards of patient care”.
The documents also say the hospital violated its own policy by failing to let Hylton’s family know that he was transferred to the ICU and that his condition had deteriorated.
Number of ICU telehealth patients growing
A 2018 study of data from an American Hospital Association survey found that more than 25% of surveyed hospital ICUs used telemedicine, and experts say that number probably grew grew during the Covid-19 pandemic.
Dr Jeremy Kahn said guidelines on the use of telehealth haven’t kept up.
“The Society of Critical Care Medicine does publish some implementation guidelines, but they’re pretty vague,” said Kahn, a Professor of Critical Care Medicine and Health Policy Management at the University of Pittsburgh School of Medicine, who researches the use of telehealth.
“They’re not very specific. So I don’t think hospitals have much specific guidance right now on how to adopt telemedicine and the most effective way, and that is a gap. I think there can be more standardisation around that.”
Kahn said while every ICU uses telehealth a bit differently, he thinks it would be rare to have an ICU use a remote doctor in lieu of someone at the hospital.
Most ICUs use telehealth to supplement the expertise of an in-person physician, he said. Some may also use it to augment care on the overnight shift, when staffing may be slimmer.
Medical ethicist Dr Art Caplan of New York University’s Grossman School of Medicine says that although the use of telemedicine has grown significantly in hospitals, particularly in rural areas where there aren’t as many doctors, its growth has largely gone under the radar, and he agrees that the standards haven’t really kept up.
Ethically, he says, it would be best used by a “trained and tested” remote professional with an agreed-upon certification and training programme, but there is no national standard.
CNN article – Family files lawsuit after man dies in care of telehealth ICU doctor (Open access)
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