# San Francisco Woman Pronounced Dead By Medics Late



## rescuecpt (Jul 11, 2004)

> *San Francisco Woman Pronounced Dead By Medics Later Found To Be Alive
> SAN FRANCISCO (AP) -- A paramedic crew pronounced a 90-year-old woman dead, leaving her body behind for the medical examiner, but had to rush back an hour later when investigators discovered she was alive.
> 
> The San Francisco Fire Department is investigating how the incident occurred and who is responsible.
> ...



OOPS!


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## ResTech (Jul 11, 2004)

You know.. whatz the deal recently. I have read so many instances over the past year or two where EMS personnel assessed a patient, confirmed death, and went in service only to find out later that the patient was still alive. This is getting sort of freaky. 

I can honestly say that I confirm death with carotid pulse check, listen apically (even when appears obvious just for formality and documentation), and observe other signs of death (rigor mortis, lividity, injuries incompatible with life etc.).

This definitely does not make EMS personnel look very good. What criteria do other provider's use to confirm death?


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## Firechic (Jul 11, 2004)

Unless it is a decapitation or a gross deformity - I usually run an ECG strip in addition to the things you mentioned. It's just one more thing to document and one more thing to cover my behind.   :huh:


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## ffemt8978 (Jul 11, 2004)

I agree about the ECG strip, since it is the only thing that you will have later to prove the patient was not alive.


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## rescuecpt (Jul 12, 2004)

Yeah, medics should have run the strip... but if you're not certified to, there still should be better ways to determine death.

In a way I almost can't blame them though, I haven't found anything grosser than brushing bugs of a dead body just so you can touch it. :blink:


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## SafetyPro2 (Jul 12, 2004)

There was an episode of CSI: Miami last season with this same scenario. Supposedly, the medics mistook the odor of the decaying blood for the odor of body decomposition.

In our protocol, if we observe decomp, we're not required to do anything else. We only have to assess vitals for lividity and rigor. Not to say its not a good idea to in other circumstances, but that's what the protocol says.


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## ffemt8978 (Jul 12, 2004)

It's not in our protocols either, but I'm going to do it anyway.

Speaking of CSI: Miami, there was also an episode on CSI with a similar situation.  The pathologist started to make the Y-incision, and observed that the deceased patient was bleeding.  Turns out he wasn't dead.


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## cbdemt (Jul 16, 2004)

We recently had a call for a murdercicle in a corn field.  I was first on scene, followed soon by two officers in my dept.  As I was walking up to the scene, the cops stoped me.  I ID'd myself as an EMT yada yada yada, and they told me the guy was "obviously DOA".  The two officers with my dept seemed to be satisfied this, so as the new guy I didnt argue.  It made me think though... are cops EMT's now?  

As it turns out the guy had been dead for several hours (somewhere around 12 I think).  But I cant help thinking it would have been all the same if he had still been alive...  I dont think I'll give in so easily next time, officers or not. 

It realy seems like there has been alot of this lately.


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## SafetyPro2 (Jul 16, 2004)

> _Originally posted by ffemt8978_@Jul 12 2004, 10:01 AM
> * Speaking of CSI: Miami, there was also an episode on CSI with a similar situation.  The pathologist started to make the Y-incision, and observed that the deceased patient was bleeding.  Turns out he wasn't dead. *


 I remember that one too, but that was as the result of a poisoning (snake venom, I believe). The Miami one was trauma, like this case.


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## ffemt8978 (Jul 16, 2004)

> _Originally posted by cbdemt_@Jul 16 2004, 08:08 PM
> * We recently had a call for a murdercicle in a corn field.  I was first on scene, followed soon by two officers in my dept.  As I was walking up to the scene, the cops stoped me.  I ID'd myself as an EMT yada yada yada, and they told me the guy was "obviously DOA".  The two officers with my dept seemed to be satisfied this, so as the new guy I didnt argue.  It made me think though... are cops EMT's now?
> 
> As it turns out the guy had been dead for several hours (somewhere around 12 I think).  But I cant help thinking it would have been all the same if he had still been alive...  I dont think I'll give in so easily next time, officers or not.
> ...


 First of all, some law enforcement officers are trained as First Responders, depending upon their agency or state requirements.

Secondly, I would have informed them that since I had been called, I was going to have to check the body to verify death or treat (as appropriate).  If this didn't work, I would have called my medical control and explained the situation to him and let him decide what was to be done.

I don't mind hanging it out there sometimes, if I can control the situation.  I do not like for someone else to put my license on the line because of their view of the situation.


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## MMiz (Jul 17, 2004)

In our area a cop can't call a death, no matter what.  An EMT of any level can call a death on scene with certain conditions, and after contacting med control.

We can't be cancelled by PD after we've seen the patient.  Just seeing the patient counts as an evaluation, and that would be abandonment.  I've arrived on scene and to a small 2 car MVC and the cop stated "I cancelled you guys, you guys can go."  We had to explain to him that we saw the patients approaching the scene, and we couldn't go without pt. refusals.  We went on to share his rank etc, but we didn't budge.  It took us all of two minutes to get the refusals for no injuries.

I'm anal about abandoning patients at this point, I'm just not going to do it.  Most cops are MFRs in my county, but that doesn't mean a thing to me.


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## ffemt8978 (Jul 17, 2004)

> _Originally posted by MMiz_@Jul 16 2004, 09:27 PM
> * Most cops are MFRs in my county, but that doesn't mean a thing to me. *


Me either, but sometimes they think it does mean something


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## MMiz (Jul 17, 2004)

Okay, now I realize that we have a lot of MFRs on our board, and I think I came off sounding a bit harsh.  I'm all for MFRs, in fact the know many of the skills we do.  It's really the police/MFRs that I lack confidence in.

It's just that there are three levels of EMS, EMT-B, EMT-I, and EMT-P.  Polie/MFRs are critical to our system, they are often the first responders.  It's just that for the most part they don't use their skills as often as we do, and they don't have to face the same legal actions we do. 

I'm not an elitist or a paragod, it's just that I'm a bit jealous of the Police/MFR in a way.  They have the knowledge to provide medical assistance, but aren't legally responsible to do so.  I've found that many love to jump in and do the CPR, resipirations, but are never there when the sh*t hits the fan.

Now for those using the MFR as a stepping-stone to EMS, and truly enjoy the medical portion of it, more power to you, we need more people like you.  It's just those few police officers who are required to be MFRs by their department, and could care less about being helpful, that annoys me in a way.

Enough venting, I have to work the midnight shift tonight  :unsure:


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## Chimpie (Jul 17, 2004)

And don't forget about the security officers and the fire birgade officers that work at some of the industrial plants.  Many of those are MFR as well (that's where I got my training).  Our Emergency Response Team (Department) were all certified MFR and FF I and II.  I left to move to Florida before I took the training.

You will never see a more professional, hard working team than those at the Toyota plant in Princeton, Indiana.  Cheers to the guys back home.

Chimp


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## SafetyPro2 (Jul 17, 2004)

On a DOA, even if the cops are on-scene, they'll let us check the patient/body, assuming we're called. Now if they come on-scene to a patient in obvious decomp, they probably wouldn't have us dispatched, but they would probably with a suicide or similar situation.

Now, if PD has a patient in custody when we arrive, they _can_ refuse to allow us to treat the patient. Technically, they become the patient's guardian as soon as they arrest them and can make decisions on medical treatment (and assume the liability for doing so). We had a situation a few months back where we were dispatched for an ALOC. Got on-scene to find a female who was likely under the influence of something and had been arrested. The cop on-scene refused to allow our crew to evaluate her, even though one of our guys raised the concern that she might have been sexually assaulted (her underwear was in her blouse pocket). The crew brought it up with our Chief later, and he said that was the arresting officer's right, that we weren't responsible for not providing care in that situation and that PD assumed the liability.


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## rescuecpt (Jul 18, 2004)

I had a call recently where I rolled up and started pulling out my gear and two firefighters told me "don't bother, he's dead"...  So I put on a pair of gloves, got my stethoscope, and I said "I have to see for myself".  Not that I really wanted to see, but the firefighters were not EMTs and we had been banged out for a Sig 16 (medical).  He was, indeed, dead, but I'm not really sure how I would have written up the PCR without actually looking at the patient.

Around here, PD loves us, and would rather have us think the person was alive and take them away than for the officer to have to sit and babysit a body for half the night.  The new rule in my county is that all officers receive EMT training in the Academy.  Once the three years is up, they do not have to renew it, but can if they wish.  At least if they're not current EMTs, they once were, and that helps a lot.  Currently each squad car has oxygen, gloves, and a defibrillator.  Most of the cops are very good about getting the pt on O2 before we get there.  We change out setups and give them a new non-rebreather and they're on their way.


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