The doctor was paged to the emergency room to examine a woman in pain, but she forgot to go.
It was 4 a.m., and the resident — a doctor in training — had already been at the hospital for almost 24 hours. It took a second page to remind her the patient needed help.
After another overnight shift, the doctor was so tired she accidentally stuck herself with a needle while drawing blood.
Her work week? A mind-numbing 120 hours.
"It's tough to function. I try to have people who have been working less hours double-check my medicine orders, other things. You start to get to a point where it's hard to focus," said the St. Vincent's Medical Center resident, who refused to be named because she feared retribution for exposing labor practices.
Residents and experts who talked to The Post said the punishing hours, often a violation of work rules, are commonplace among residents at New York City hospitals — and a practice that puts patients at extreme risk.
A medical student who followed residents doing 28-hour shifts at St. Vincent's said she saw one unable to calculate a medication dose.
"He was so exhausted, he couldn't think straight," she said.
Uptown at Mount Sinai Hospital, a former resident in the rehabilitation unit said she was once asked to work 13 days in a row, a violation of state rules that require residents to have 24 hours off every week. After she complained, she said her supervisor threatened her with disciplinary action.
The unit had already gotten in trouble with the state after the 2007 death of Yonkers firefighter Kevin Deane. The state found that he was not seen by a doctor the day before he died and that a resident never read an X-ray of the injured man.
A judge in the Deane family's lawsuit against Mount Sinai, which was later settled, said the hospital "cannot simply have an attending physician not show up for an entire weekend and have inexperienced, and overworked, resident physicians be solely responsible for the handling of the care of these patients."
Harvard Medical School sleep expert Dr. Charles Czeisler called resident work schedules "barbaric" and said they need to be changed to save lives.
"One out of five interns admits to making a fatigue-related mistake that has injured a patient. One out of 20 admits to making a fatigue-related mistake that has resulted in the death of a patient," Czeisler said.
A year ago, the Institute of Medicine recognized the toll taken on sleep-deprived doctors and called for residents to work no more than 16 hours without rest.
Relief for residents could finally come after the national organization that accredits residency programs next month begins considering changes to its work-hour rules.
Hospitals in New York would have to follow new guidelines from the group, the Accreditation Council for Graduate Medical Education, or ACGME, if those rules are more stringent than current New York ones.
New York has regulated resident work hours for two decades. The work week is supposed to be a maximum of 80 hours, but those hours are calculated as an average over four weeks.