# Florida Firefighters To Pay $200K For Dropping Patient



## MMiz (Jun 28, 2010)

*Firefighters To Pay $200K For Dropping Patient*

ORANGE COUNTY, Fla. -- Orange County firefighters will have to pay a $200,000 legal settlement for dropping a patient. In 2006, Orange County firefighters tried to carry a man out of his second floor apartment in a wooden chair, and the chair broke.

The man broke his back in that fall and says he broke his hip, shoulders and had spinal fractures.

*Read more*


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## Aidey (Jun 28, 2010)

That is a lot of injuries for a 3 foot fall.

Note, this is just an observation, not trying to make a smart arse remark.


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## MrBrown (Jun 28, 2010)

Good colour too


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## DrParasite (Jun 28, 2010)

1) that is quite a bit of broken bones from a 3 foot fall, esp for a 52 year old.

2) if he was no longer seizing, and he was awake and talking, then he should have walked down the stairs.

3) carrying him down in a wooden chair is pretty stupid; that's what the stair chair was designed for

4) another reasons it's safer to ambulate a stable patient down the stairs

5) 200,000 for spinal fractures, both shoulders and a hip?  sounds like the FD got off lucky.

6) walk the patient under his own power, this way you don't have to worry about the chair breaking.  and if for some reason he can't walk, then use a chair that is designed for carrying people down the stairs.  and if they can't sit in a chair, carry then in a reeves, backboard, or as a last resort, a stokes basket.  not really rocket science here.


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## Aidey (Jun 28, 2010)

Here is another article on the incident, but it contradicts the first one in almost every way, which is odd, because they are both credited to the same news organization. http://emsresponder.com/online/arti...t_comment=y&submit_comment=y&submit_comment=y

I'm sorry, but there is no way they got him 6 feet off the ground on a flat surface, it just doesn't make any sense.


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## EMSLaw (Jun 28, 2010)

Brown, Brown, Brown.... Come into the 21st Century.  






Might as well use a kitchen chair if you're going to go with the old-style stair chairs.


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## jjesusfreak01 (Jun 28, 2010)

You could go really oldschool


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## medicdan (Jun 28, 2010)

Something was seriously wrong, or this guy must have hired a really good ambulance chasing lawyer... 
I will say, though, in some areas (MA), we aren't allowed to walk patients, especially on stairs...


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## 8jimi8 (Jun 28, 2010)

DrParasite said:


> 1)
> 4) another reasons it's safer to ambulate a stable patient down the stairs





didn't read the article, completely disagree with this statement.


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## Trayos (Jun 28, 2010)

> It is now mandatory to use a stair chair


Good for them, cant be more then $200,000 each


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## JPINFV (Jun 28, 2010)

emt.dan said:


> Something was seriously wrong, or this guy must have hired a really good ambulance chasing lawyer...
> I will say, though, in some areas (MA), we aren't allowed to walk patients, especially on stairs...




This is one of the many stupid policies from MA OEMS. While, in general, it's much better to carry than walk, situations are way too dynamic to make a hard and fast rule, especially with how OEMS has it written where EMS providers aren't even supposed to "allow" the patient to walk to the gurney. Sorry, the gurney is just outside this door, but we've gotta carry you out because a few a-holes ruined it for everyone else.


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## BLSBoy (Jun 28, 2010)

8jimi8 said:


> didn't read the article, completely disagree with this statement.



How many pts have you carried?

Its not a one size fits all decision, but walking, if the pt can do it, will ALWAYS happen if I have a say in it.


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## CAOX3 (Jun 28, 2010)

BLSBoy said:


> How many pts have you carried?
> 
> Its not a one size fits all decision, but walking, if the pt can do it, will ALWAYS happen if I have a say in it.



Agreed.

If it wont exacerbate the injury or illness they walk.

Remember your ABC's  

Ambulate Before Carry.


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## LucidResq (Jun 28, 2010)

As someone who was raised by my single epileptic father in an apartment building, and had to call 911 for him a few times (bonking his head or lots of seizures in a short period of time) they never walked him out, he always got a magic chair ride, and I'm glad honestly. Not only can the postictal haze last for a while (this is especially easy to notice when you know someone very well and know their baseline very well).... my dad once took a swing at me 10 minutes after seizing, but seizing is extremely tiring and often left my dad a little weak. 

I'm not saying the wood chair was the best idea, but I don't think ambulating someone who just had a seizure down a flight of stairs is the best idea either.


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## TraprMike (Jun 28, 2010)

CAOX3 said:


> Agreed.
> 
> Remember your ABC's
> 
> Ambulate Before Carry.



beat me by an hour..


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## DrParasite (Jun 28, 2010)

Aidey said:


> Here is another article on the incident, but it contradicts the first one in almost every way, which is odd, because they are both credited to the same news organization. http://emsresponder.com/online/arti...t_comment=y&submit_comment=y&submit_comment=y
> 
> I'm sorry, but there is no way they got him 6 feet off the ground on a flat surface, it just doesn't make any sense.



this article was from back in 2007.  the OP's article was from about a week or so ago in 2010.  the 2007 job looks like a lot of opinion from the victim and victim family, to play up a lot of the situation as being worse than it really is (or rather, the paint a more sympathetic picture).

oh, and the older article says the pt's was a diabetic whose BGL fell.  once you wake them up, and they become AOx3, no reason they can't walk to the stretcher or ambulance (assuming you give them a sandwich, OJ, etc).  we have many diabetics whose sugar drops on a weekly basis, and they routinely get woken up and then they RMA, with directions to follow up with their endocrinologist.

ambulate before you carry..... your back will thank you, especially if the patient's condition doesn't warrant them being carried.

as a side note, in my system, seizure patients who seize and are no longer seizing is a BLS dispatch.  in fact, seizure patients often walk from the location to the ambulance, and/or from the ambulance into a wheel chair to the hospital. day in and day out


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## JPINFV (Jun 28, 2010)

CAOX3 said:


> If it wont exacerbate the injury or illness they walk.


Here's the problem with that *in this case*. Can you guarantee, with in a reasonable doubt, that a postictal patient can reasonable ambulate safely? I'm all for the ambulate before carry, but I'm not quite sure that I'm going to pick a patient immediately post seizure to apply that to.


Additionally, in this case, if you're going to carry someone out in a chair, you need a pretty good reason not to switch to a stair chair.


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## JPINFV (Jun 28, 2010)

DrParasite said:


> ambulate before you carry..... your back will thank you, *especially *if the patient's condition doesn't warrant them being carried.



Please explain the bolded. Would you actively try to ambulate a patient who's condition warrants being carried unless the situation dictated that the only feasible method is ambulation?


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## CAOX3 (Jun 28, 2010)

JPINFV said:


> Here's the problem with that *in this case*. Can you guarantee, with in a reasonable doubt, that a postictal patient can reasonable ambulate safely? I'm all for the ambulate before carry, but I'm not quite sure that I'm going to pick a patient immediately post seizure to apply that to.
> 
> 
> Additionally, in this case, if you're going to carry someone out in a chair, you need a pretty good reason not to switch to a stair chair.



I was speaking in general terms, addressing "everyone needs to be carried."

No your right on, he isn't a candidate to walk in my opinion either, anything where exertion may exacerbate the condition they will be carried, by the fire department hopefully   but usually it ends up being me.  I consider walking a postictal or altered patient to be potentially dangerous unless there is a difficult extrication he goes in the stair chair.

We have those fancy stair chairs now with the tracks on them.  So you never really have to lift anyone any more, they do suck going around corners and if you do have to lift them for a considerable amount of time they are F'n heavy.


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## Melclin (Jun 28, 2010)

EMSLaw said:


> Brown, Brown, Brown.... Come into the 21st Century.
> 
> 
> 
> ...



I used one of those on the barriatric ambulance the other day. They are basically the greatest things ever invented. 

I'm asking the ambulance fairy for one for the normal trucks.


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## DrParasite (Jun 28, 2010)

as a comment on the stairchairs: the stryker ones are lighter to carry than the ferno models.  also, the older style handle narrow hallways and are lighter than the treaded model.  

every ambulance should have a treaded strairchair on it, as well as an older model for the more urban areas (in addition to, not as a replacement).   your backs will thank you for it.


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## EMSLaw (Jun 29, 2010)

Melclin said:


> I used one of those on the barriatric ambulance the other day. They are basically the greatest things ever invented.
> 
> I'm asking the ambulance fairy for one for the normal trucks.



We have them on all our rigs now.  Agreed that this might be one EMS innovation that's actually worth the money.  I'm so spoiled now that I wouldn't want to use anything else.


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## Simusid (Jun 29, 2010)

Melclin said:


> I used one of those on the barriatric ambulance the other day. They are basically the greatest things ever invented.
> 
> I'm asking the ambulance fairy for one for the normal trucks.



We've got these exact models on both of our regular trucks.  I've been told that we get a break on our insurance rates as a result beause of the lowered risk of injury to the staff.  That might be a selling point to management.  B)


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## 8jimi8 (Jun 29, 2010)

BLSBoy said:


> How many pts have you carried?
> 
> Its not a one size fits all decision, but walking, if the pt can do it, will ALWAYS happen if I have a say in it.






I have ambulated patients TO the stretcher no more than 10 feet.  Anyone sick enough to call the ambulance and NEED it, is not walking down stairs on my shift.

Think about it. You are taking someone to the hospital who is too sick to take themselves... and you make them walk a flight of steps?   Don't you think they'd have walked downstairs already if they could have?

And keep on making that decision buddy, but let me ask you this:  who is going to feel worse the first time you make the wrong call,  You or the patient?


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## DrParasite (Jun 29, 2010)

8jimi8 said:


> I have ambulated patients TO the stretcher no more than 10 feet.  Anyone sick enough to call the ambulance and NEED it, is not walking down stairs on my shift.


and you think everyone who calls the ambulance actually needs it? many I have seen just  need a ride to the hospital.  they don't NEED an ambulance, they need a taxi (and usually to a doctor, not even an ER, but they have no PMD or their PMD is closed)


8jimi8 said:


> Think about it. You are taking someone to the hospital who is too sick to take themselves... and you make them walk a flight of steps?   Don't you think they'd have walked downstairs already if they could have?


 apparently you have never had a patient greet you at the curb, with an umbrella and suitcase in hand.  a patient did that to my crew when a new ER nurse was doing a ride a long... her jaw dropped when she saw that.  


8jimi8 said:


> And keep on making that decision buddy, but let me ask you this:  who is going to feel worse the first time you make the wrong call,  You or the patient?


I'm pretty sure AJ sleeps pretty well actually.  He probably has a girl or two with him many nights, and I don't think he agonizes over his decisions.

and if you are asking me this, after you have carried down the 5th 300lb patient with an ear ache in a 12 hour shift, and you hurt your back, or you carry down the patient with a wrist injury and she insist of grabbing the banister throwing you off balanace and you all go tumbling down the stairs, or the 6 month old who has had a fever for 2 days and mom didn't want to call a cab, then you will know why you shouldn't carry everyone.

and sorry BLSboy for answering in your place, but I have a hunch I'm pretty close to what you would be saying.


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## 8jimi8 (Jun 29, 2010)

Dr Parasite,

read my statement more closely.

You are talking about the population of people who do not NEED the ambulance.

I've had my share of refusals, or people who are abusing the 911 system.  The hospital i work at was the one posted about, that had 5 patients costing so many many millions for "ER visits."

And yes, i've pulled my share of weight on the 400lb patients, but tell me this, are you trying to do that with you and your partner, 5 times per night? or are you appropriately calling for additional resources when you have someone too large for two people to carry.


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## usafmedic45 (Jun 29, 2010)

> That is a lot of injuries for a 3 foot fall.
> 
> Note, this is just an observation, not trying to make a smart arse remark.



Not really, especially if they dropped him down the stairs.  The initial fall may have been three feet but if he went further down the stairs, that would produce the injuries we see in this setting.  Even if it was just a simple fall, if he landed wrong, you can easily produce spinal fractures (I'm guessing it was most likely his sacrum in that scenario). 

That's not even keeping mind that the guy may have been osteoporotic, etc. It's not uncommon at all in inactive 50 year olds.


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## LucidResq (Jun 29, 2010)

DrParasite said:


> or the 6 month old who has had a fever for 2 days and mom didn't want to call a cab, then you will know why you shouldn't carry everyone.



Is childhood obesity THAT bad in New Jersey?


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## DrParasite (Jun 29, 2010)

8jimi8 said:


> You are talking about the population of people who do not NEED the ambulance.


which is many many people who call 911, not the occasional call that you are describing.  and if you will note, BLSBoy's statement included the line "if the patient can do it."  maybe you need to reread that part?


8jimi8 said:


> And yes, i've pulled my share of weight on the 400lb patients, but tell me this, are you trying to do that with you and your partner, 5 times per night? or are you appropriately calling for additional resources when you have someone too large for two people to carry.


because if there isn't anything wrong with their legs, they can walk.  no need to carry 400 lb pts down the stairs with non-life threatening complaints, they can walk

No one says EVERYONE WALKS.  What is being said is that if their condition will allow, they walk.  if their condition won't get worse, they walk.  if they are sick, they get carried.  but certain people (both on here on in EMS in general) have this idiot notion that if you call 911, you will ALWAYS BE CARRIED,  from wherever they find you to the waiting ambulance.  You got a broken finger?  sit in the chair.  fever for 3 days? sit in the chair.  your toe hurts?  lie in the reeves, we are carrying you down three fights of stairs.  you are 14 years old, crazy and want to go speak to someone?  have a seat in the chair, we will carry you to the ambulance.  it shouldn't happen, but people have this convoluted notion about what they expect.

ambulate before you carry.  but if they are sick, and need to be carried, make sure you have a device with you to carry them out to the truck.


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## medic417 (Jun 29, 2010)

http://www.watercrest-ind.com/six_pak.php

 "the Six-Pak can provide a smooth and steady transition in confined areas. The speed in which a patient can be moved in restricted areas is minimal. The Six-Pak can provide a smooth transition while ascending or descending stairs. The Six-Pak was designed to never lose contact with the stair or stair riser thus eliminating patient jostling."


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## BLSBoy (Jun 29, 2010)

Based upon the pts _clinical condition_, and other pertinant findings is what I use to determine if they will walk or ride. 

Dan, you answered dead on. I already have back issues (at 23!!), and I do not intend on carrying anymore then I hafta. 

And its been a little slow since I made it down to Tampa....:glare::angry:


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## Aidey (Jun 29, 2010)

usafmedic45 said:


> Not really, especially if they dropped him down the stairs.  The initial fall may have been three feet but if he went further down the stairs, that would produce the injuries we see in this setting.  Even if it was just a simple fall, if he landed wrong, you can easily produce spinal fractures (I'm guessing it was most likely his sacrum in that scenario).
> 
> That's not even keeping mind that the guy may have been osteoporotic, etc. It's not uncommon at all in inactive 50 year olds.




It did say in the article that it was onto the floor, not the stairs. I could understand spinal fractures if he fell straight down, landing on his butt (compression fractures). My confusion lies in the number of injuries; the pt is claiming the fall caused spinal fractures, a broken hip and broke his shoulders (yes, plural).


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## usafmedic45 (Jun 29, 2010)

I wonder if the shoulder injuries were actually dislocations from someone grabbing him.  The "spinal fracture" and hip fracture make sense in a fall.  Of course then again, we are relying on a newspaper article and you know how accurate reporters are with this sort of thing.


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## Aidey (Jun 29, 2010)

That would make more sense than them being from the fall. In this case it's especially hard to judge what is accurate and what isn't since there are a grand total of 2 sources of information, 3 years apart, that completely contradict each other as to what the medical problem was.


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## zzyzx (Jul 9, 2010)

All that trauma due to a fall from a chair? Ha ha! I love the dark glasses too.


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