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The hospital staffers who watch heart rhythms are usually “telemetry” technicians, not nurses. At HCA Healthcare facilities, they may monitor as many as 80 patients at a time.

After three harrowing weeks in the hospital, Terry Downs, 68, was on a path to recovery. A former Boeing engineer who helped design the stealth bomber, Downs was admitted to HCA Healthcare's Wesley Medical Center in Wichita, Kansas, in July 2022 with what was found to be a brain bleed. By month’s end, he was scheduled for discharge from the 760-bed facility and headed for rehabilitation.

He never made it. In the wee hours of Aug. 1, a nurse walking by his room heard him choking and found his heart barely beating. A half hour earlier, his pulse had been strong, Downs’ 2,200-page hospital record shows, but when his heart rhythm changed, no one assigned to monitor it had alerted nurses.

In Wesley Medical Center, and in most hospitals today, the people monitoring patients’ heart rhythms, blood pressure or respiratory functions are not nurses who interact with them. They are “telemetry” technicians who are supposed to alert those nurses to meaningful changes in the vital signs transmitted by electronic devices hooked up to the patients.