Vent Was right - Another EMS screw up, stroke, California

[spenac]

Well sadly I guess I must apologize to Ventmedic. No odor of alcohol, Zero on breath test. Yet EMS did not decide this guy needed medical care. I mean of course unless theres more to it than the news reports. If most in EMS are as stupid as this seems I guess I see more of Vents disgust with EMS.

http://www.jems.com/news_and_articles/news...ictim_sues.html

Family of Detained Stroke Victim Sues

Steven Mayer

The Bakersfield Californian

2008 Dec 16

BAKERSFIELD, Calif. -- A Bakersfield surgeon handcuffed and forced to wait more than an hour for treatment after suffering a massive stroke last year is suing the Bakersfield Police Department, Hall Ambulance, the county of Kern and others.

The case could cost taxpayers millions in damages.

The November 2007 incident represents a series of monumental blunders by police -- who may have believed Dr. Mohamad Harb was intoxicated -- and paramedics -- who should have overruled police and immediately taken Harb to a hospital, said Steven Gibbs, the attorney representing the doctor and his family.

The stroke has left Harb unable to practice medicine. The 58-year-old neonatal intensive care specialist and sole provider for his wife and four children spent two months in a coma before waking to a life in which he had to learn how to feed himself again, Gibbs said.

City and county officials said they haven't had a chance to review the lawsuit. A spokesman for Hall ambulance did not return calls for comment.

Harb was driving home that autumn evening after finishing a 12-hour shift at Kern Medical Center when his Mercedes suddenly veered off 24th Street, according to the lawsuit.

Bakersfield police arrived minutes later to find Harb still wearing his surgical scrubs. He was disoriented, had urinated on the sidewalk and vomited on his shirt.

Harb was given two alcohol breath tests, both of which registered zero.

Medical tests later showed Harb had suffered a life-threatening stroke, yet the first Hall ambulance crew called to the scene left, according to the company's own reports, leaving Harb sitting on the curb drooling, his eyes glazed, one shoe off and lying in the gutter.

Registered Nurse Mehgan Coffey was passing in her car when she recognized Harb. She pulled over, identified herself as an RN and told police she had spent the entire day working with Harb.

At her insistence, a second ambulance was called to the scene.

An incident report by a Hall employee suggests the first crew couldn't evaluate Harb because he was in handcuffs.

But Coffey and veteran paramedic Mike Danaher said paramedics must insist on taking critically ill patients to the emergency room, even when police are reluctant to cede control.

"Police are looking to you for information," he said. "There is no way I would let a police officer take that patient."

Though not connected to the possible delay of treatment, the county was added to the lawsuit, alleging KMC personnel applied pressure to the Harb family to essentially pull the plug on Dr. Harb.

The family also believes Harb's confidential medical information was disseminated to non-treating physicians.

[crotchitymedic1986]

how about showing a little love to your arch-nemesis ? I know it hurts to say I was right, but you will survive the encounter, unlike the patients we continue to leave behind.

Again, I ask, How many deaths are too many ?

The FDA and communities are all in an outrage because 62 hospital patients have died from Heparin errors in the US during the past 24 months. Do you really believe that nationwide, EMS has not been responsible for atleast as many deaths ?

[JPINFV]

^

Well, to be fair, he's not dead yet. Apparently his last words before going into a coma was something about 'not wanting to go on the cart.' Monty Python reference.

[VentMedic]

Spenac,

In all fairness this is a California example.

how about showing a little love to your arch-nemesis ? I know it hurts to say I was right, but you will survive the encounter, unlike the patients we continue to leave behind.

Again, I ask, How many deaths are too many ?

The FDA and communities are all in an outrage because 62 hospital patients have died from Heparin errors in the US during the past 24 months. Do you really believe that nationwide, EMS has not been responsible for atleast as many deaths ?

This is something hospitals had to learn and correct. Of course they do have an incentive since Medicare no longer will pay for screw ups.

Overview of the 5 Million Lives Campaign

quote:

Do No Harm. It is a fundamental principle for health care providers: primum non nocere – first, do no harm. It is our duty, our responsibility. Patients ask and assume that the health care that intends to help them should, at the very least, not injure them.

http://www.ihi.org/IHI/Programs/Campaign/C...ign.htm?TabId=1

From the July 2007 Issue of Emergency Medical Services

We Don't Mean to Hurt Patients

Incidents of harm resulting from medical care are all too common. How can EMS reduce its share?

http://www.emsresponder.com/print/Emergenc...Patients/1$5774

Isolated incidents that make the news are usually a major F#*&up and can some times be attributed to just those individuals and not necessarily an indication a whole system is broken. However, if nobody is holding them accountable for any other blunders they may have made along the way, then that system not only let the public and this patient down but also the providers.

Too often the attitude of "what happens in the truck, stays in the truck" hinders effective QI/QA. There are those that do abuse that sense of autonomy when making decisions.

Hospitals have at least had the balls to step up and say some of the things they are doing could be better. EMS still operates as if nothing is broken. Some run with the attitude that the education is great and medical oversight is adequate with a few believing they operate above any medical oversight.

This CA example is one that just stands out. There are many other things that happen during transport which will adversely affect the patient. I have spent countless hours just lecturing infection control to EMTs and Paramedics. It is something very few are taught and very few realize the effect their actions or inaction have on patients. Some may even read this and still think "what's the big deal?". Failing to see any consequences for their actions is part of the problem. Maybe it is also attributed to not realizing EMS is part of the bigger picture in health care. Too many say "we're different" or "what's that got to do with us?" and choose to remain isolated AND insulated from the world of medicine. Again, we can go back to argue the education issues.

^

Well, to be fair, he's not dead yet. Apparently his last words before going into a coma was something about 'not wanting to go on the cart.' Monty Python reference.

And he could have mumbled something that they took for a refusal. After all it sounds like he was a smelly mess that one would not want to take care of in their truck.

[crotchitymedic1986]

Damn vent, I dont think anyone could have said it better. I bow before you.

[crotchitymedic1986]

For those who love statistics:

11 Years of Research

Paramedics cannot safely determine which patients do not need ambulance transport or ED care.

This was a prospective survey and linked with medical record review. There were 183 patient charts that were reviewed. Of those, paramedics recommended alternative transport for 97 patients. 23 of those actually needed ambulance transport (thats 23.7% - love crotchity). Paramedics also recommended non-ED care for 71 patients. 32 of those needed emergency department care ( Thats 45% - love crotchity) . This study was done in Albuquerque, New Mexico. This is quoted from this site: http://www.loyolaems.com/ce_mar07.html

But if you want to get really mad, read the nursing comments on this forum, about what EMS should and should not do. I warned you to take a HBP pill:

http://allnurses.com/forums/f8/furious-amb...ent-353520.html

[crotchitymedic1986]

For all of those who refuse to look at a problem until they have statistics or scientific proof, scroll down this page:

http://www.bmj.com/cgi/content/full/325/7359/330/DC1

[VentMedic]

Let's put a face to the patient in spenac's article. And, there is a little more to the story.

Statistics are great but sometimes we forget there are real people involved in those numbers.

http://www.bakersfield.com/102/story/639064.html

http://www.bakersfield.com/opinion/editori...ory/484200.html

[ERDoc]

This person should join some of our conversations:

Just as a post script, it is not uncommon to encounter this kind of cowboy attitude in the rural setting. I work professionally as a transport RN, but also volunteer on a rural ambulance in the community that I live in. One of the most aggravating things I face is the cowboy attitude of a few of the volunteer EMT's. Some become EMT's for the t-shirt and the privilege of strutting around the community with their inflated ego's. On the other hand, we also have some very dedicated volunteers that take their job seriously and have excellent skills. Sadly, it only takes a few cowboy's to ruin the reputation of the good EMT's. Hopefully, this one paramedic in your situation hasn't ruined the other's on his service.

To play devil's advocate here, did any damage occur due to the way this poor guy was treated? If he had an ischemic stroke, thrombolytics may have helped. If this guy had a hemorhagic stroke, there might have been no difference if he had gone to the ER right away. Without all of the medical information it is hard to say for sure. That being said, both the cops and EMS screwed up either way and appropriate actions should be taken.

[Dustdevil]

Epic FAIL!