Patient Abandonment

[AZFF/EMT]

So I want to tell a story about what happened on shift yesterday. Here's the background, I work for a Rural/Urban interfaced Fire district, We cover about 200sq miles for fire coverage and 600+ sq miles for ems transport coverage with our rescues. We respond at the same time and are special called by the medium sized nieghboring munincipal department and 2 other nearby fire districts for ems/transport.

So around 1200 in downtown E701 gets dispatched to a 19y/o female cc of dif breathing/vomiting/constipation. E701 arrives on scene approx 1204 at 1207 they call for a rescue code 3. At that time we were busy and our nearest rescue/ambo R327 was 10-12 min out. at 1212 a 3-1 apartment fire gets dispatched about 2 miles from E701. But they are on a call so they didnt get dispatched obviously.................But they pack up and leave an tel the patient that the rescue/ambo is on the WAY!!!! 7 minutes later the rescue arrives on scene!!!!!!

If I am not mistaken this is ILLEGAL and obviously morally unethical and just flat out unacceptable.

What would you guys do as far as reporting this?
What could possibly happen to the medics on the truck?
Obviously the Capt. may be in some trouble.

I do believe the medic on that rescue did or is gonna call Department of Health Services and report it.

We let our Battalion Chief know and not sure what he is gonna do.

 

[Flight-LP]

What would you guys do as far as reporting this?
What could possibly happen to the medics on the truck?
Obviously the Capt. may be in some trouble.

I do believe the medic on that rescue did or is gonna call Department of Health Services and report it.

We let our Battalion Chief know and not sure what he is gonna do.

Are the Firefighters operating in a medical capacity? Do they have protocols and operate under a medical director? Are they a MEDICAL first responder agency? If the answer to any of these is "no" then the issue will likely not be pursued. If they are operating as medics, then yes it could be deemed a possible abandonment. However, their FD SOP's may have a contingency policy coveing situations like this when other emergencies exist. What was the issue with the girl? Did this departure and delay in care cause a deterioration in her condition?

If the medic on the truck reported it and the chief is aware of it, then no further action is needed on your part. It will only cause more aggrevation. Honestly, I would think that trying to work this issue out internally would be beneficial. A grudge is a hard thing to work around, so you really need to ask yourself if this is truly worth going to the state over. Are you willing to potentially sacrifice your working relationship with these departments. Furthermore, do these departments have any say in you EMS contract? If so, any betting man would tell you that may be a potential issue come contract renewal time. Just things to think about..................

I am confused about one aspect though. You said the engine was dispatched first and then requested a rescue (which a am going to assume is an ambulance). Why wasn't the ambulance dispatched from the start?

 

[seanm028]

If he's from the Phoenix, AZ area (which I'm assuming he is since his screen name is AZFF/EMT and because he calls ambulances "rescues"), then the SOPs say not to dispatch a rescue to calls that typically do not result in transport. Besides, every engine is BLS, and most cities' engines are actually ALS with 2 EMT-Bs and 2 medics. As for reassigning themselves from the medical call to the fire call, I have no idea what the SOPs are on that one.

 

[mdtaylor]

If the patient gave consent for the certified caregivers to leave then there was no abandonment. Not getting that consent in writing would be....stupid. It probably was not, if it was even by consent.

If no harm came to the patient there will likely be nothing come of this, from the patient.

If a member of the crew rats them out to the state then there will be an investigation, and it will be patient consent that will be at the center of that investigation, IMHO.

 

[medic001918]

If they're acting as first responders, they have an obligation to wait until they can transfer care to the transporting providers.

As far as a patient giving "consent" for them to leave, that's a fine line. It's not one that I'd want to justify if the patient took the issue to a legal battle. The thing that works in the crew's advantage though is that most patient's don't know the laws and what is required of their responding crews.

This is clearly an issue that needs to be addressed and spelled out in SOP's and SOG's.

Shane
NREMT-P

 

[AZFF/EMT]

Yes they are an ALS engine company working under a medical director, they run around 92% medical and 8% fire, service calls. I personally am not gonna call anyone over it or get involved personally, I was mainly asking to see what everyone else thought about it. I am not sure what the medic from the rescue is gonna do or at the command level.

We operate on the automatic aid system from Phoenix computer aided dispatched, other resources were approapriately dispatched to the fire and the crew had no business leaving the call they were on in my opinion. The only way we can break patient contact is with a signed refusal or by the transporting unit taking over care of the patient.

In our system dispatch sends out units based on the information given to them by the caller.

In our area all engine and ladder company's are ALS. In phoenix, and a few other bigger cities they have BLS Ladders, ALS Ladders, ALS and BLS eninges, BLS and ALS Rescues.

Generally calls that will be dispatched Engines/Ladders and a rescue will be Unconscious person, Drowning, Code, 962 extrication, 962-ALS, 962-BLS,962 pedestrian, water rescues, and at times chest pains.

In this situation it was a 19y/o F dif breathing/vomiting and constipation call and whenthe engine got on scene and determined they needed a rescue CODE 3. Not code 2 they must have thought that the patient needed immediate transport without delay and then they proceeded to leave the patient 7 minutes before the rescue arrived on scene of the apt. complex, not sure when they made patient contact. Second hand info says they told the patient, there is a fire we need to go the ambo is almost here. Upon arrival the rescue found the patient in obvious pain and discomfort.

 

[ffemt8978]

What would you guys do as far as reporting this?
What could possibly happen to the medics on the truck?
Obviously the Capt. may be in some trouble.

I do believe the medic on that rescue did or is gonna call Department of Health Services and report it.

We let our Battalion Chief know and not sure what he is gonna do.

Seeing as the medic and the Battalion Chief are aware of it, I would let them handle it. This is one of those situations where you are better off staying as far away from it as possible, unless you want a reputation as a trouble maker.

 

[AZFF/EMT]

I for sure am staying away from it. I was just looking for others opinion on the situation.