# AMR returns expired patient to home.



## JPINFV (Apr 23, 2008)

*Springfield Man's Body Returned To Family's Door*

http://www.cbs3springfield.com/news/local/17986579.html




> ...
> 
> "They took him into the ambulance and they told us he passed away," said Colon.
> 
> ...



While EMS isn't necessarily about customer service in the traditional sense, it looks like a little bit of tact could have gone a long way in a situation like this. Based on the article, it seems that the family doesn't have any concerns over treatment or the return, but how the EMTs (B or P) handled the situation.


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## Jon (Apr 23, 2008)

It gets better:

http://www.cbs3springfield.com/news/local/18022649.html


> The state is now looking into what happened when an ambulance returned a man to his home shortly after he died. His family says he left home alive, and wanted him to go to the hospital.
> 
> The Massachusetts Office of Emergency Medical Services says they are now looking into an incident that culminated with a deceased man declined transportation to the morgue, and was instead returned to his family at his Fort Pleasant Street home.


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## mikie (Apr 23, 2008)

I would have no clue how to handle it and if my partner didn't, probably calling Med Control is what I would do.  

But what they did makes me kind of speechless that something like that in EMS happens, gives us a bad image (private or public services!)


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## santaclaraco (Apr 23, 2008)

In reading the full article, it looks like the Medical Director told them what to do.  It's _how_ they did it that was tactless.

I think the legal action against AMR would be pain and suffering....?

I would have walked to the families door first, explain to them what had just happened and the direction they were given, and then let them know they had an opportunity to be with their grandfather for a while to pay their last respects...and to make some decisions for his final care.

If they balked at him being returned to the home, I would have then called the Supervisor for HEELLLPPPP!  Good Lord, why didn't they do that??


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## ffemt8978 (Apr 23, 2008)

Didn't people learn from the last one?

http://www.emtlife.com/showthread.php?t=5625


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## Jon (Apr 23, 2008)

If I had this situation, I'd consult with the hospital and my supervisor... that way, it wouldn't be MY fault. In some cases, there is no "good" option... just the one that management wants you to do.


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## Kimmy Schaub (Apr 23, 2008)

OMG thats horrible!! I bet they have a lawsuit coming!!


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## paramedix (Apr 23, 2008)

Weird! Sometimes I think people don't think before they act.


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## Airwaygoddess (Apr 23, 2008)

*You Have Got To Be Kidding!!*

Some things STILL never cease to amaze me......... YIKES!:wacko:


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## medic258 (Apr 23, 2008)

The crew definitely handled this situation incorrectly in regards to the interaction with the family. However, the same thing happened at a service that I work for almost a year ago. I am attempting to locate the specific section but our service and the BLS service were investigated by OEMS and it was ruled that the body should have been returned to the home. In our case the BLS crew transported the dead body to the hospital. Again I am trying to locate the specific ruling and I will post it as soon as I find it.

Let the onslaught begin!!!

For the record I do not agree with this case.


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## triemal04 (Apr 23, 2008)

So, other than lacking some compassion and tact (maybe, I wasn't there and the article doesn't give many details) the AMR employees really didn't do a whole lot wrong. This wasn't a pt that had a chance at resucitation; hell, it wasn't even going to be tried, so why take him to a hospital? Mass laws prohibits carrying dead bodies around, so why take him to a hospital? 

I can get behind leaving him in the ambulance and waiting for a funeral home to arrive, but that may not have been possible or event thought of. Really, that would have been the best course of events; allow the family to see the body, say goodbye and do what they need to. And there would have been nothing wrong with explaining to the family what had happened and asking if they wanted their loved one brought back into the house to wait. 

This has happened before and it seems to get a bit overblown each time. While I'm happy to help someone start the arrangements when a family member dies, I'm not (and I doubt any paramedic is) required to get ahold of the funeral home. I damn sure am not required to take the person there, or to the morgue at the hospital. Like I said, the employees may need to work on their compassion and how they interact with the family of the newly dead, but other than that, don't think they did much of anything wrong. 

Why is everybody so shocked by this?  Maybe the people involved didn't act as nice as they could have but come on...when did it become mandatory for DEAD PEOPLE WHO WILL NOT BE COMING BACK to go to the hospital?  What is the point of transporting them?  Leave the body in the ambulance while you explain the situation to the family.  Offer to help them with the intial arrangements and ask if they want the body to stay outside or be brought back into the persons home.  

I think way to many people out there, and here, watch way to much TV; seeing ambulances arrive to take the person in the bodybag away is not how it really happens.


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## Jango (Apr 23, 2008)

Either way....very touchy case and it's hard to make a decision that going to make EVERYONE happy......tact is definitely one of our most important skills in any situation.


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## BossyCow (Apr 23, 2008)

Sounds to me like the family was less concerned with the fact that the body was returned to the home as they were with the way it was done. But hey, at least it was better than that case in my state a few years back where they had the guy loaded into the rig for delivery to the funeral home, got a call for a cardiac event at another address and left the guy in a body bag, in the driveway for the morgue-mobile. That man's widow is a wealthy woman today! 

I don't know how many of you have had the opportunity to hear Gordon Graham speak. He gives lectures on risk management. He swears that the polite, smiling, well mannered medics don't get sued. You get sued for that call where your patience is at an end, your stomach is growling and you're working on your third 24 hour shift in a rotation. Courtesy counts! 

The how it was done often becomes more of an issue than what was done.


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## JPINFV (Apr 23, 2008)

BossyCow said:


> I don't know how many of you have had the opportunity to hear Gordon Graham speak. He gives lectures on risk management. He swears that the polite, smiling, well mannered medics don't get sued. You get sued for that call where your patience is at an end, your stomach is growling and you're working on your third 24 hour shift in a rotation. Courtesy counts!




That was the message of one of the lectures in the Intro to Clinical Med class I took last year. "Doctors [insert "paramedics" here] who patients like don't get sued."


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## Arkymedic (Apr 23, 2008)

JPINFV said:


> *Springfield Man's Body Returned To Family's Door*
> 
> http://www.cbs3springfield.com/news/local/17986579.html
> 
> ...


 
In my state we have to call the ME for every single death. Our policy is if we are going to a probable DOA we have law enforcement enroute. Once medical control is contacted, the decision to pronounce can be made. The body is then left in law enforcements custody and we return to service. If my pt was a known DNR pt that arrested enroute, I would have my partner shut it down to C-1 if we were going C-3 and notify medical control of situation while continuing to the facility unless directed otherwise. Our policy is very clear that we do not transport dead bodies and we are there to assist the living. Interesting scenario.


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## Ops Paramedic (Apr 24, 2008)

Ditto on Triemal04's reply.  The article is one sided, as only the testimony of the family is represented (Not saying that that is not the way it happened).  Unless you suspect something sinister, there is no need for you transport the body.  As said, explain to the family what happened and help them with initial arrangements if they don't know the procedure, and your circumstances (You need to become available for the next call once you have sorted them out).  Bearing in mind the they just lost a family member, so being tactfull is at the order of the day.

We often have a problem at many of the hospitals that they refuse to take patients who are dead on arrival (DOA).  More so on the interfacility tranfsers where they than force us to take the body back to the initial facility.  Or you would have to take the body to the government morgue, as the patient was a vagrant.  It sounds ruthless, but we can only give in to their demands, otherwise that vehicle will still be driving around with the body...


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## firemedic7982 (May 5, 2008)

*Media twist?*

I find it hard to believe that this story is showing the entire course of events. 
I'm led to believe that the media has undoubtedly put there twist on, and intentinally deleted events to make the crew out to be the bad guy. 

That being said, My sympathy's to the family. I belive in this case that the most appropriate action would have been to continue transport to the closest appropriate facility. Both of the services I work for are 911. And both protocol sets are setup so that online control is almost never nessessary. They also both state that in a case such as this, the arrest was witnessed, and that transport to the closest appropriate facility would have been dictated, even though the pt. had an active OOH DNR. 

I don't belive that "We have another call" was an approprite, or ethical excuse for dumping a pt back at the house, I find that to be negligable, and derelict. It's also immoral, and unethical. I am a medic, not a funeral home, transport the morgue / funeral home as someone suggested in the thread, is not my job. I feel that the crew is at fault in this case. Placing the blame on the M.D. is not acceptable. We are all adults, and MOST of us are capable of making sound descisions. If the M.D. had told someone to do this, they should have used a little common sense, and a little compassion, and suggested an alternative to "dumping" the pt. on the front porch. 

If I was involved in this, I would feel someone needs to lose their job over this, possibly their patch. It's pretty much innexcusable.


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## JPINFV (May 5, 2008)

firemedic7982 said:


> I am a medic, not a funeral home, transport the morgue / funeral home as someone suggested in the thread, is not my job.



So you have no problem transporting a corpse to a hospital, but object to taking it to the morgue? I fail to see the difference since regardless of where you transport the body, the end fact is that you are transporting a body. At least if you take the body to the funeral home, you save work for the hospital at no real expense to you (since you're transporting anyways).


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## firemedic7982 (May 5, 2008)

JPINFV said:


> So you have no problem transporting a corpse to a hospital, but object to taking it to the morgue? I fail to see the difference since regardless of where you transport the body, the end fact is that you are transporting a body. At least if you take the body to the funeral home, you save work for the hospital at no real expense to you (since you're transporting anyways).



Im not entirely clear on the policy's in other states. I am aware that other services in the north do transport to funeral homes. 

If I am to rely totaly on the liberal spin the media put on this article, and take it as gospel, the pt. died in the back of the ambulance. Which would note that the pt. was now under medical care. The ONLY appropriate step as I see it in this case is to continue that care. The crew should have continued the chain of care, and transported to the closest facility. The attending in the ER would have then signed the death certificate. This would have shown significant proof that the crew effectively mitigated the situation, and did their job effectively. If this particular service has provisions for transportation of the deceased to the funeral home / morgue, then why did they call the physician and ask him/her what to do in the first place. Why didn't the simply transport the pt. to the final destination?

The argument I make is not over why the pt. wasnt taken to the funer home, its why the pt was dumped on the front porch. 

The fact that they unloaded the pt, and put him back on the front porch is absolutely inexcusable. There are other ambulance to take other calls. And if this particular service didnt have any units in service, well ... that's what mutual aide agreements are for.


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## Flight-LP (May 5, 2008)

FM7982 actually has a valid point though. We do not transport dead people. The expense is saved by going back in service (thus enabling us to be available to patients who need us) and allowing the other appropriate agencies take care of the deceased. Now this patient presents an interesting scenerio by dying in the truck. Then, yes transport would be necessary. But I would transport to the ER, not a funeral home. Its not my place to sort out these details, these need to be handled by the family.

My only other question would be why a family that has a terminally ill pt with a DNR called 911. Especially a hospice environment patient. Completely defeats the purpose of staying home and resting in peace. Call a private ambulance, have home health come out, but don't call 911 and issues like these could possibly be avoided.


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