Rosenbaum EMT Reinstated

[DwayneEMTP]

Rosenbaum EMT Reinstated

"WUSA has the scoop that Selena Walker, the EMT who drove New York Times reporter David Rosenbaum to the hospital, is going to be retrained and subsequently reinstated to the D.C. Fire & EMS Department. Walker was fired after she and her partner mistook Rosenbaum's symptoms for drunkeness instead of head trauma, and then decided to take him to Howard University Hospital instead of the closer Sibley Hospital so that Walker could make a stop at her own home. An inspector general's report also concluded Walker got lost driving the ambulance to Howard. Walker won an appeal of her termination on the grounds that the department waited longer than 90 days to fire her after the incident. Rosenbaum eventually died of his head injuries."

http://dcist.com/2008/11/21/rosenbaum_emt_reinstated.php

Thoughts?

[Asysin2leads]

Absolute control over who gets to work on the ambulance should rely on the medical director, period. He should refuse to allow her to work on an ambulance due to gross incompetence and then DC Fire should take it from there.

[VentMedic]

EMT? Is this the highest level of EMS in Washington D.C.?

Asysin2leads

should rely on the medical director

We've already seen examples of how little the word of an M.D. means to Fire Depts.

[Doczilla]

Hopefully this case didn't play out in reality as badly as they make it sound in the newspaper.

The MD has say over whether or not a clinical employee can practice, and should have say over those in the agency that oversee training, con-ed, QA, etc. I don't think it is up to the MD to fire employees for reasons other than medical practice. It really shouldn't be up to the MD to "fire" someone at all. It's not uncommon for the agency to use the MD as the "hammer" to get rid of problem employees, largely because the MD's authorization to practice falls outside the usual work contract, union rules, and human resources rules. When the MD says, "this employee is not safe to practice," then there is very little the employee can do to get privileges reinstated. It is therefore easier to do this than to document the monster paper trail required to make a watertight case to get rid of someone. I think this puts the MD in a very difficult position, and unfairly so. Bottom line, the MD should only be looking over the clinical issues.

With this case, there are plenty of medical issues that warrant the revocation of clinical privileges, but firing the employee is ultimately up to the agency.

'zilla

[VentMedic]

http://dcist.com/2008/11/23/nickles_on_emt...ment_not_so.php

November 23, 2008

Nickles on EMT Reinstatement: Not So Fast

News broke on Friday that Selena Walker, driver of the ambulance carrying late New York Times reporter David Rosenbaum in 2006, would be brought back into the fold at the D.C. Fire and EMS Department. But the Post reports today that AG Peter Nickles is considering appealing the D.C. Superior Court decision to reinstate Walker to her post. Nickles should be feeling pressure to maintain the city's end of its civil settlement with the Rosenbaum family, which agreed to drop a $20 million suit in exchange for a continued commitment to improvement of the emergency response system. Second chances are great; but the reinstatement of one of the people that mistook Rosenbaum for a drunk, purposefully meandered in route to a different hospital than he requested, and even ran a personal errand while he was in the ambulance is probably not the best way to keep up with said agreement. Nickles should make a decision early next week.

[WolfmanHarris]

If on any call either en route or with a Patient on board, if dispatch showed me to have stopped somewhere along the way they're going to be on my ass on the radio and unless there's a good reason (stumbled upon another call, stopped to run an arrest) I'm going to get a complaint from CACC to the service and get hauled in. And that's without assuming ETOH, taking a pt to the wrong hospital, having them die and then having the service sued. Great, get back in on a technicality, good luck finding a partner who wants to work with you, a medical director who wants to certify you and anyone who thinks you're a diligent provider.

[CBEMT]

I do not believe that the errand was done with the patient onboard- but they did make the transport destination decision based on how close it was to the EMT's house. They stopped there after dropping the patient off.

Both bad, but one is just plain not true.

[WolfmanHarris]

Thanks for clearing that up.

[firedoc5]

How many of us "Old Guard" been on MVA's or other traumas where the pt. is combative, uncooperative, belligerent, etc. and you almost immediately think ETOH? I learned VERY early in my career, do NOT assume ETOH or other substance abuse over the possibility of closed head injury. Since learning this early in my career I guess I thought that was in EMS - Basic 101 or something.

I've had to calm down partners who were getting angry and aggitated at these accidents from the way they were behaving. And they learned that lesson.

And with or without a pt., and no matter how close to home you are, you always get permission on the radio to stop there.

[crotchitymedic1986]

First let me say that I do not know all the facts of this case, but it could be a dangerous precidence for all of us (and yes, some of this is tongue in cheek):

1. If in fact she took the patient to a hospital different than that requested, would you want a medic fired who flew a "trauma mechanism" patient to a trauma center who latered turned out to have no significant injury (patient sues because they encountered unnecessary medical bills) ? We educate or overrule our patients decisions lots of times.

2. Is everyone in this room saying they have never made a transport decision or suggested a transport decision that did not benefit them personally. Have you ever suggested that:

a. A patient not go to their facility of choice that is 5 hospitals away, when a closer facility could handle their non-emergent need.

b. A patient not go to the urban teaching hospital on a friday night, because you know they will have to wait 16 hours for treatment, and you will have to wait an hour to find a bed.

c. the pateint go to the closest hospital so you could get back to the station to eat or sleep.

d. refused to take a drug seeker to the hospital that is an hour away (because that hospital hands out drugs like candy).

e. that the patient who called you at 30 minutes before shift change should go to the closest facility versus the one that is an hour away (putting you off work and late to your part time job by 2 hours).

f. agreed to take a patient to a more distant hospital, sacrificing coverage in your county because that hospital feeds you for free, or is close to that great 1/2 price restaurant.

I am not trying to justify this EMTs actions, as they are deplorable, just realize that legal precidence can have some unforseen consequences. And before you jump on your soapbox, read the above again, and make sure you have never, not even once, been guilty of one of the things I have posted.