The Free Press | By Tanya Lukyanova
Shortly after 5 a.m. on August 15, 2024, William Hylton stood at the foot of his son’s hospital bed, gently stroking his leg. Around him, the intensive care unit at Bridgeport Hospital Milford Campus had erupted into chaos. Nurses and doctors pumped on 26year-old Conor Hylton’s chest, shouting instructions and working frantically to resuscitate him. A breathing tube protruded from his mouth. Dark, lumpy, blood-clotted vomit stained the sheets and pooled on the floor.
“It’s just a very chaotic scene, as you can imagine,” William recalled. “You just want your child to survive. You start trying to make deals with God.”
Across the hallway, William’s wife, Betsy, sat hunched over a trash can, sick with fear. Then, at 6:11 a.m., a doctor’s voice cut through the commotion. “Is his family there?” The voice came from a large monitor mounted on the wall. There, onscreen, was the physician directing the resuscitation efforts. He was 12 miles away, working from Yale New Haven Health’s headquarters in the tele-ICU hub. Someone answered yes. A minute later, via video screen, Conor Hylton was pronounced dead.
Conor grew up in picture-perfect Milford, Connecticut, just a few houses from the shoreline, in what his father described as a “Leave It to Beaver kind of childhood.”
The oldest of three brothers, he was a gifted student and athlete. Conor played Division I hockey, earned a black belt in tae kwon do, ran a half marathon, and graduated near the top of his high school class. He planned to become a dentist, like both his parents. He studied cell biology at the University of Connecticut before entering dental school there.
But days before the fall semester was set to begin, Conor became sick. He was vomiting, complaining of abdominal pain, and unable to keep food down. His family assumed he had picked up a stomach bug. On the morning of August 14, he called his father at work and asked for a ride to the hospital. They arrived at Bridgeport Hospital’s Milford campus shortly after 11 a.m.
“I took him to Milford because it’s a little smaller than Yale New Haven, but it’s still a Yale facility,” William, 63, said. “We thought it might be quicker.”
According to subsequent state and federal investigations, Conor was triaged as an Emergency Severity Index Level 2 patient—considered high risk and in need of prompt evaluation. He had low blood pressure, elevated heart and respiratory rates, and EKG results suggesting possible heart rhythm problems. His clinical record also noted a history of alcohol abuse, including prior treatment for alcohol-withdrawal seizures.
Within hours, the doctors at Bridgeport Milford did a panel of tests and diagnosed Conor with alcohol withdrawal and related conditions, including dehydration, pancreatitis, and metabolic acidosis. He was admitted for monitoring.
When the Hyltons left around 7 p.m. that evening, no one believed Conor’s condition was life-threatening.
“The plan was, they were just going to rehydrate him and send him to the floor,” his father told me.
The family wondered whether Conor would be well enough to pick up his UConn parking pass before classes resumed the next day, or whether his father would have to do it instead. The Hyltons planned to return the following day, perhaps with Conor’s two younger brothers.
The next call came at 4:45 a.m. An ICU physician told the family Conor was undergoing CPR and that they needed to get to the hospital immediately.
Unbeknownst to his parents, Conor’s condition had deteriorated overnight. He was transferred to the ICU shortly after midnight. His parents say no one called to let them know. By the time they arrived, William said Conor “was, basically, for all intents and purposes, already dead.”
“We saw the whole thing go down,” William recalled. “We saw the guy on the TV screen running the whole thing remotely, telling the nurses and everyone else what to do. And you know, at first, it doesn’t maybe hit you, but then you start thinking, so this guy on the TV is really running the show here.”
The Hyltons are now suing Bridgeport Hospital and its parent companies, Yale New Haven Health and Northeast Medical Group, alleging that Conor’s death resulted from negligent care.
“You can’t delegate the responsibility for intensive care to somebody on a screen,” Joel Faxon, the family attorney, said. “I mean, it’s called intensive care for a reason. And this is why I say this is a fake ICU.”
Bridgeport Hospital and Yale New Haven Health did not respond to The Free Press’s multiple requests for comment, but the organization’s spokesperson previously told reporters that “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.”
A 2025 investigation into Conor Hylton’s death by the Connecticut Department of Public Health, in conjunction with the Centers for Medicare & Medicaid Services, found that hospital employees violated their own protocols, failed to follow explicit physician orders, and communicated poorly across departments.
Among its most striking findings: From the time Conor was transferred to the ICU shortly after midnight until he suffered cardiac arrest roughly four hours later, no physician ever examined him at the bedside. Each year, roughly five million Americans are admitted to intensive care units. And each year, a growing number of them receive at least part of their care from physicians who never set foot inside the hospital.
Critical care specialists monitor patients remotely from centralized hubs—scanning electronic medical records, tracking vitals in real time, and directing bedside teams through cameras and microphones. Telehealth proponents say this allows them to offer a higher standard of care to more people. But some ask whether telehealth is just really a cost saving measure that, when implemented incorrectly, can actually increase risk to patients.
Hospitals say tele-ICU emerged in response to several converging forces: an aging population that requires more intensive care, a shortage of intensivists—the physicians specially trained to care for the sickest patients—and the growing financial pressures facing community hospitals, many of which joined larger health systems to share the costs of expensive technology, specialty staffing, and other overhead. By 2023, roughly 70 percent of American hospitals belonged to larger health systems. Milford Hospital was no exception.
By 2019, the nearly century-old community hospital had lost more than $41 million over the previous five years, according to documents Yale submitted to Connecticut health regulators in support of its proposed acquisition. With inpatient volume dwindling to roughly two dozen patients a day, the hospital could no longer remain financially viable on its own.
Yale New Haven Health stepped in with a plan to preserve the Milford location, invest at least $50 million, and fold the hospital into its growing regional network. Improving critical care at Milford Hospital was one of Yale’s top priorities. At a public hearing before state regulators, Yale’s chief medical officer, Dr. Keith Churchwell, described Milford’s 10-bed ICU as “a wonderful space” that nevertheless struggled to maintain the physician staffing needed to care for critically ill patients. Yale’s plan, he said, was to strengthen the unit with “appropriate critical care,” pulmonology, and “intensive TeleICU capability.”
Within months of acquiring Milford in June 2019, Yale had installed Epic—the electronic medical records system used across much of American healthcare—upgraded bedside monitoring systems, and expanded telehealth services, including tele-ICU, tele-neurology, and tele-stroke.
Yale’s health system had launched its InSight tele-ICU program years earlier, in 2015, but Covid rapidly accelerated its expansion—from 56 monitored ICU beds in 2019 to more than 200 across Yale’s five hospital system in early 2020.
“There weren’t enough doctors in the world to care for as many critical patients as we got,” said Chris Gutmann, Yale’s former system director of IT and clinical engineering, who helped build the health system’s teleICU program. Telecritical care, he said, allowed health systems to extend scarce specialist expertise.
Independent monitors and annual compliance reports later credited the broader modernization effort at Milford with helping to stabilize the hospital. Yale reported that telehealth allowed Milford to retain more patients who previously might have been transferred elsewhere, and to care for increasingly complex cases.
Yale’s vision for tele-ICU was never to replace bedside care. It was to allow the best of the best—who are concentrated at the flagship location—to help monitor patients at smaller community hospitals from afar.
“Why put that doctor in a car and drive them down to Greenwich?” he asked. “Why can’t we just do these like any other consult?”
“We’re not here to cure the patient, diagnose the patient, or even prescribe therapy for the patient,” Gutmann added. “We’re just here to make sure that patient doesn’t fall through the cracks.”
Most tele-ICU proponents, including its earliest architects, share that vision. In a 2019 lecture, Dr. Craig Lilly, vice chair of critical care at UMass Memorial Medical Center and one of the pioneers of modern telecritical care, argued that much like Amazon had transformed retail through a combination of technology, logistics, and scale, telehealth could simultaneously expand access to specialists, improve quality, and lower costs.
But critics say that telecritical care has evolved into something different from what its architects envisioned.
Dr. Keith Corl, an emergency physician and intensivist who has worked both at the bedside and as a tele-ICU physician, believes telecritical care has an important role in rural hospitals, where the alternative may be (and often is) no intensivist at all. However, in large health systems, he argues, tele-ICU has increasingly become a cost-cutting measure dressed up as innovation.
“You just pick a system across the country, and chances are they’ve got a telecritical care program,” Corl said. “And what they’ve decided is instead of staffing our hospitals at night with a nurse practitioner or a physician or a physician assistant, they’re going to use telecritical care.” In many tele-ICU settings, including at Bridgeport Milford, the physician responsible for ICU patients overnight is a hospitalist—a doctor trained in general internal medicine, not critical care. In theory, that hospitalist works with tele-ICU doctors and bedside nurses to care for ICU patients overnight. In practice, Corl said, that arrangement often breaks down.
“In a lot of places, what ends up happening is, the internal medicine doc, the hospitalist, is busy,” Corl said. “And so quickly it devolves to the tele-ICU doctor just working with the nurses. And that’s it.” That, investigators concluded, was essentially what happened at Bridgeport Milford.
The hospitalist covering the night of August 14 to 15, identified in the lawsuit as Dr. Frances Denu, told investigators that she did not see patients in the ICU because tele-ICU physicians were in charge from 5 p.m. to 7 a.m.; she only responded to emergencies in the ICU. Although she was informed that Conor’s condition had worsened and that he had been transferred to intensive care, she said she neither examined him nor issued orders because she did not know it was her responsibility. (Dr. Denu’s physician profile, maintained by the Connecticut Department of Public Health, shows she has no reported medical malpractice judgments, settlements, or arbitration awards, and no reported hospital disciplinary actions in Connecticut, Pennsylvania, or Florida, where she’s licensed to operate.)
According to the investigation, from the time Conor was transferred to the ICU at 12:38 a.m. until he went into cardiac arrest at 4:33 a.m., the only person present at his bedside was a nurse. His airway was never assessed by a physician, even as his condition required closer monitoring.
Around 2:50 a.m., Conor was given two powerful sedating medications—phenobarbital and Precedex—that altered his consciousness and required close observation. The ICU nurse told investigators she was told to increase his Precedex doses by the tele-ICU physician assistant she was texting with. Investigators later found that the doses administered exceeded the range in that written order, despite no additional physician authorization.
Around 4:30 a.m., Conor slid down in bed. His eyes rolled back. He became unresponsive, showed seizure-like activity, and began vomiting coffee-ground secretions. He needed to be intubated.
But Dr. Denu was not trained to provide that lifesaving airway care. The only physician in the hospital qualified to perform that procedure was the emergency department attending physician. According to investigators, the hospital’s overnight emergency plan explicitly put him in charge of providing these critical care procedures—leaving the ER, in the meantime, unattended.
The ER physician later told investigators he was informed Conor needed “assistance with an airway.” But he didn’t know how to reach the ICU and had to find a nurse to guide him there, delaying his arrival by roughly 10 minutes.
Between the time Conor went into cardiac arrest and the time he was successfully intubated, 21 minutes passed. The ER doctor told investigators intubation typically takes five to 10 minutes from setup.
According to the written testimony of the family’s expert medical witness, the failure to properly protect and monitor Conor’s airway was a substantial factor in his death.
Dr. Chris Gallagher, a cardiologist and the founder of Access TeleCare, one of the country’s largest providers of acute specialty telemedicine, doesn’t dispute that tele-ICU can be poorly implemented. But he argues that too often, critics mistake bad implementation for a bad model.
Before founding Access TeleCare, Gallagher worked at a small Texas hospital with a 10-bed ICU that struggled to recruit intensivists. Critically ill patients were routinely flown by helicopter to larger hospitals because the expertise simply wasn’t available on-site. The challenges were strikingly similar to those Yale later confronted at Bridgeport Milford.
Today, he said, critical care has fallen from that hospital’s leading reason for transfer to its 16th, while the ICU—which once averaged only about two occupied beds—now consistently cares for roughly eight or nine patients.
To portray telecritical care as “the modern face of medical neglect,” Gallagher argued in a recent article at MedPage Today’s KevinMD blog, ignores two decades of research and the workforce realities confronting American hospitals.
“Our healthcare system is not working,” he told me. “It’s going to break this country if we don’t figure out how to deliver care differently.”
The evidence from the academic literature is mixed. Some studies have found tele-ICU programs reduce mortality and shorten ICU stays, while others have found little or no measurable benefit. Gallagher said telecritical care succeeds or fails less because of the technology itself than because of how hospitals implement it.
“There’s a process to it. There’s a method to it. There are best practices that you have to implement. And if you don’t do those things, then you won’t see these outcomes.”
Corl agrees with that point. He just doesn’t think the care referenced in the studies mirrors that in the real world. He said that one of the “landmark” positive studies about telehealth that Gallagher references in his article didn’t reduce the in-person care team at the hospital.
“In the real world this almost always happens,” Corl said.
But Gallagher said his company has repeatedly found that patients report high satisfaction with virtual physicians when the programs are thoughtfully designed. “Patients recognize good care,” he said, “whether that good care is in person or that good care is virtual.”
But the care may not be good enough for the medical professionals themselves.
For several years, Corl said, the most common comment nurses wrote in annual surveys at one hospital where he worked was that they would not want to be patients in their own tele-ICU. When Corl asked why, the answer was always the same: They felt abandoned.
“Everybody knows that it’s substandard care,” he told me. “And everybody says they would never want to be cared for in a tele-ICU. They’d never let their husband or wife or child be taken care of in a tele-ICU.”
Corl says tele-ICU should be rolled back, though he acknowledges the incentives for hospital systems make that difficult. He wants the American Medical Association and the Society of Critical Care Medicine to issue formal guidance restricting tele-ICU to critical access hospitals that have genuinely been unable to hire or retain in-person intensivists. Everywhere else, he said, the standard should be a living, present provider at the bedside.
“Reserve tele-ICUs for remote hospitals,” Corl said. “And every place else? You should get a real person because you’re the sickest patient in the hospital. And you deserve in person care 24/7. It’s really that simple.”
William Hylton said the whole ordeal has made him reevaluate what used to be a blind trust in hospital systems.
“Looking back and realizing what happened to my son I think people really have to ask questions when they go to the hospital—what level of care they’re going to get, who’s going to be there, who is actually going to be treating them,” he said.
William’s lawsuit is still in its early stages. Years of litigation likely lie ahead. But on March 13, the day the original complaint was filed, William did something uncharacteristic. He got a tattoo.
On his right arm now sits a cartoon outline of Conor in a baseball cap, holding his dog, Howie. “That was his boy,” William said.
William told me he’s “not really a tattoo person.” But this felt necessary.
“Because it’s an important date for me,” he said. “That’s the day my son starts getting justice.”