Anybody had to report to their state's Medical Board - advice?

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Taurus40

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Several months ago I was on a code call for an elderly man who was pulseless and apneic. Witnessed collapse, CPR in progress upon our arrival. After applying the patches, only compressions showed on my monitor screen. After I applied the electrodes nothing came on the screen but dashes in all three leads so I didn't have a clear rthymn before I decided to shock. After the shock, the patient revived and we transported. 2 months later, my supervisor reported the incident to my state's Board of Medical Examiners and the screening is scheduled for July 19th. Has anybody had to appear before their board before? Any advice you can give me? Thanks
 
What kind of advice are you looking for?
You say you successfully resuscitated a patient, yet you were turned into your medical board for ... what?

Is this a standard review? Is the company/EMS agency being sued? Have you been issued a protocol violation by your medical director? Have you been censured or reprimanded?

Got to give us a little more information.

Here's what I do know:

Should you blindly shock three lines of dashes? Not just no, but Hell No … and shocking a rhythm that may or may not be shockable may be viewed as malfeasance if you caused injury to the patient. (And by the way, the three dashes on the monitor isn't "lack of a clear rhythm," it's NO rhythm. The machine is not connected to the patient.)

If it turns out that you are being reprimanded, in danger of losing your job or your certification or if the patient's family is seeking damages, you have to ask yourself the following question…

Should I seek legal counsel? Probably not a bad idea.

Remember, we don't allow the solicitation or offering of any legal advice on the forum aside from "consult an attorney"
 
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If you use a Lifepack, you forgot to turn the lead selector from leads to paddles. However, this can **also** happen as a result of component failure- happened to me on a simple cardiac transfer, had to call and get another monitor. Do you test your monitors daily? Did you report this one for servicing?

The best thing I would say from a QI perspective is to admit readily that you made a mistake, identify corrective actions and accept all criticism well, but make it clear that you are an otherwise competent technician who simply made a mistake.

Depending on your state and the politics thereof between your agency, you might be fine or you might be SOL.
 
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If you're up before a state licensing agency, my advice is to get a lawyer. The licensing board has an attorney on staff, who may well end up being at the hearing/meeting.

Find an attorney who's a specialist in administrative law. Those folks deal with licensing issues all the time. My strong hunch is that there's someone who's known as the go-to person for practicing before your state's medical board. Hire them.

And this is another example, to me, of why more of us should carry professional liability insurance. I do and I know my policy also has a benefit to provide for an attorney for any state licensing issues.
 
DEmedic said:
What kind of advice are you looking for?
You say you successfully resuscitated a patient, yet you were turned into your medical board for ... what?

Is this a standard review? Is the company/EMS agency being sued? Have you been issued a protocol violation by your medical director? Have you been censured or reprimanded?

Got to give us a little more information.
Click to expand...

Thank you for your reply. I was just looking for any advice on how I can prepare, nothing legal, I just want to make sure all my bases are covered. If I crossed a line, I do apologize.
To answer your question I was turned in for "Unprofessional Conduct - failing to exercise technical competence in carrying out EMT care" by my Medical Director. The company is NOT being sued and the patient had a good outcome. Yes, I was reprimanded - 3 training sessions on the Lifepak with Lead Instructor, ACLS class, Rthymn Strip interpretation test, and suspension on my ALS privileges till the above was completed. I have had a clear record since I became an EMT 3 years ago. I was ultimately terminated due to ongoing interpersonal issues that I had tried to resolve and they used this incident as part of my termination.
 
Rocketmedic40 said:
If you use a Lifepack, you forgot to turn the lead selector from leads to paddles. However, this can **also** happen as a result of component failure- happened to me on a simple cardiac transfer, had to call and get another monitor. Do you test your monitors daily? Did you report this one for servicing?

The best thing I would say from a QI perspective is to admit readily that you made a mistake, identify corrective actions and accept all criticism well, but make it clear that you are an otherwise competent technician who simply made a mistake.

Depending on your state and the politics thereof between your agency, you might be fine or you might be SOL.
Click to expand...

Thank you for your response. When I turned the dial, I just still got the dashes. I later found the plug in to be loose, but also did find out that about a week later after it was giving us some abnormally high BPs, the internal batteries were low and were replaced - we don't check them daily. I made a huge mistake and I am so thankful that my patient is ok and if I had to do it all over again, there is no way I would follow through with the shock! I'm just sick to my stomach over it - I just feel like I'm SOL.
 
Wes said:
If you're up before a state licensing agency, my advice is to get a lawyer. The licensing board has an attorney on staff, who may well end up being at the hearing/meeting.

Find an attorney who's a specialist in administrative law. Those folks deal with licensing issues all the time. My strong hunch is that there's someone who's known as the go-to person for practicing before your state's medical board. Hire them.

And this is another example, to me, of why more of us should carry professional liability insurance. I do and I know my policy also has a benefit to provide for an attorney for any state licensing issues.
Click to expand...

Thank you for your response also. This board is the state licensing agency. From what I understand, this first meeting is a screening to see if there needs to be an investigation. I have not been in this position before (thankfully) so I am not quite sure what to expect.
We aren't required to carry liability insurance but i will definitely be checking into it and if I get to keep my license, I will be getting myself a policy. Not that I ever plan on being in a situation like this, but to cover all my bases. Thank you for the info.
 
Taurus40 said:
Thank you for your response. When I turned the dial, I just still got the dashes. I later found the plug in to be loose, but also did find out that about a week later after it was giving us some abnormally high BPs, the internal batteries were low and were replaced - we don't check them daily. I made a huge mistake and I am so thankful that my patient is ok and if I had to do it all over again, there is no way I would follow through with the shock! I'm just sick to my stomach over it - I just feel like I'm SOL.
Click to expand...

Inaccurate autocuff readings are not necessarily an indication of a malfunctioning monitor, they seem to be about as common as accurate readings on any monitor I have ever used.
 
Best of luck to you Taurus. I don't think there is an EMT alive who has never made an honest mistake, and yours had a positive outcome. Keep us posted.
 
Anonymous said:
Best of luck to you Taurus. I don't think there is an EMT alive who has never made an honest mistake, and yours had a positive outcome. Keep us posted.
Click to expand...

Well in all honesty, this was not a "honest mistake". From the description, this sounds like operator error or lack of knowledge in the equipment. And the positive outcome was not the result of his mistake. The patient recovered despite his mistake

I mean let's be honest, we continue to demand higher educational standards for EMTs and paramedics, yet a paramedic shocks a cardiac arrest while the monitor is not reading a rhythm due to operator error and we say, "everybody makes a mistake"?

Do I think the guy should lose his cert? No. He mentioned that he had remediation and retraining, and I think that's probably enough. I'm sure he feels bad enough already. But it's certainly not an excusable mistake with, "oh well, things happen."
 
Lol dude, you have to switch your lead selector to the "paddles" setting on a LP.
 
DEmedic said:
Well in all honesty, this was not a "honest mistake". From the description, this sounds like operator error or lack of knowledge in the equipment. And the positive outcome was not the result of his mistake. The patient recovered despite his mistake

I mean let's be honest, we continue to demand higher educational standards for EMTs and paramedics, yet a paramedic shocks a cardiac arrest while the monitor is not reading a rhythm due to operator error and we say, "everybody makes a mistake"?

Do I think the guy should lose his cert? No. He mentioned that he had remediation and retraining, and I think that's probably enough. I'm sure he feels bad enough already. But it's certainly not an excusable mistake with, "oh well, things happen."
Click to expand...


My thoughts as well.
 
DEmedic said:
Well in all honesty, this was not a "honest mistake". From the description, this sounds like operator error or lack of knowledge in the equipment. And the positive outcome was not the result of his mistake. The patient recovered despite his mistake

I mean let's be honest, we continue to demand higher educational standards for EMTs and paramedics, yet a paramedic shocks a cardiac arrest while the monitor is not reading a rhythm due to operator error and we say, "everybody makes a mistake"?

Do I think the guy should lose his cert? No. He mentioned that he had remediation and retraining, and I think that's probably enough. I'm sure he feels bad enough already. But it's certainly not an excusable mistake with, "oh well, things happen."
Click to expand...

My thoughts as well.

I dont agree with your company reporting it to the state. They handled the remediation and I take it were comfortable with you continuing to work as a paramedic and only reported after your employment ended.

We've had a few employees do similar things, they were remediated and continued on. Nothing was reported to the state.
 
DEmedic said:
Well in all honesty, this was not a "honest mistake". From the description, this sounds like operator error or lack of knowledge in the equipment. And the positive outcome was not the result of his mistake. The patient recovered despite his mistake

I mean let's be honest, we continue to demand higher educational standards for EMTs and paramedics, yet a paramedic shocks a cardiac arrest while the monitor is not reading a rhythm due to operator error and we say, "everybody makes a mistake"?

Do I think the guy should lose his cert? No. He mentioned that he had remediation and retraining, and I think that's probably enough. I'm sure he feels bad enough already. But it's certainly not an excusable mistake with, "oh well, things happen."
Click to expand...

Fair point
 
If you seriously want a career in EMS you need to speak with a lawyer. You need someone to advocate for you.
 
Sounds like you had other issues which prompted this termination, this was just the coup de grace.
 
If you are not sure with the lifepak, switch it to semi-automatic (press analyse) and let it interpret the rhythm for you. This is better than shocking the wrong rhythm in manual mode.
 
I think this goes beyond whether or not the OP should've used the life pack in manual or automatic mode.

And I agree with Matt. It's probably time to consult an attorney and have someone on your side. I certainly would not go in front of the medical board without representation.
 
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