Busan teenager’s death exposes staffing shortage and flawed triage across hospitals
The image is grim but familiar: an ambulance idling outside a Busan hospital, its siren silent, its crew on the phone. Inside lies a teenager in seizures, a patient the system classifies as pediatric and refuses to treat. What happened on Oct. 20 was not an aberration. It was the predictable outcome of a structure long signaling distress.
Though the doctors’ strike has ended and trainees have returned, the "emergency room loop" in which crews call up hospital after hospital seeking an open door has only solidified. Last year, more than 1,300 patients required over 20 calls before finding a hospital. Most were critically ill. In Busan, the country’s second-largest city, even basic pediatric emergency care has become scarce.
The death of the high school student last month illustrates the human cost. Triaged as Level 2, a category demanding immediate care, the patient was rejected by 14 hospitals across Busan and nearby Changwon, South Gyeongsang Province. Each declined. Some cited the absence of a pediatric neurologist; others claimed they could not manage pediatric cardiac arrest.
The rigidity of the system is alarming. An 18-year-old in seizures is hardly a niche case. Yet adult specialists declined to intervene, and no mechanism existed to compel flexibility or coordinate backup measures. By the time the 15th hospital accepted him, 80 minutes had passed. He arrived in cardiac arrest and could not be revived.
This tragedy exposes deeper structural failures. Hospitals often refuse patients not because the emergency room is full, but because they lack specialists for surgery or follow-up care. Several major hospitals report shortages in core fields such as thoracic surgery and pediatrics, effectively dismantling the safety net for complex cases. Resident return rates reflect this weakness; while training hospitals nationwide have recovered roughly three-quarters of their residents, Busan’s main university hospital sits far lower.
The triage system itself slows the response. Paramedics must call hospitals one by one, relying on information that is often outdated. This phone-based process is slow, easily congested and shaped by defensive calculation as hospitals hesitate to accept complex cases that expose them to legal and staffing risks.
The government has tried to intervene, though its approach has stirred resistance. In late October, the National Assembly passed the revision to the Emergency Medical Service Act, known as the "ER loop prevention law." It mandates a dedicated hotline between emergency rooms and 119, the national emergency dispatch service, along with real-time disclosure of bed and staff availability. A further proposal would let 119 designate hospitals directly, requiring acceptance unless a facility has already formally notified the central emergency network of its inability to treat specific cases.
Medical groups have reacted with fierce opposition. They argue that mandatory acceptance without added resources will overcrowd emergency rooms and disrupt the triage of other critical patients. Their concerns merit examination, but blanket resistance does not. A system already stretched thin cannot rely solely on voluntary cooperation. Nor can legislation solve a staffing crisis without addressing why specialists avoid essential fields or refuse to practice in underserved regions.
A pragmatic compromise exists. In the short term, the priority is improving the accuracy of real-time data so paramedics do not need to call at all. In the long term, incentives matter. If the government expects doctors to handle these critical gaps, it must make those roles viable.
The Busan teenager’s death was the result of insufficient staffing, rigid protocols and a breakdown of trust between the state and the medical profession. Legislation may help, but only if the details are shaped with care before the law takes effect in May 2026.
The ambulance that circled Busan should never have been forced to search for mercy. In moments of life and death, departmental boundaries must not stand in the way.
khnews@heraldcorp.com
