Paramedic charged in patients death

[FiremanMike]

Former paramedic facing manslaughter charge in patient death, accused of giving wrong meds

A former Sioux City Fire Rescue paramedic allegedly gave a patient the wrong medication before that patient died.

www.kktv.com

Cliff notes - accidentally gave roc instead of ketamine for an agitated patient. Didn’t tell anyone, apparently didn’t rapidly intubate, patient coded but died 2 days later from hypoxic brain death.

I’ve said it before and I’ll say it again. We have a serious job with serious responsibilities and our actions have serious consequences.

I’m not as upset with the med error, it happens, I’m upset that she didn’t tell anyone on the truck which could have facilitated emergent intubation and prevented the patients death.

 

[DesertMedic66]

Exactly, med errors can and do happen but this paramedic did not report it to the hospital and more importantly did not take the appropriate steps to correct the issue they caused. There were a cascade of failures that ended with this patient dying. A Paramedic Assisted Death if you may

 

[DrParasite]

He's the only paramedic on scene, telling others wouldn't have changed anything; he told the ER doc who was treating the patient. If anything, he should have intubated the patient, and he was the only person who could have intubated the patient.

Criminal charges? for a medication error?

is this the paramedic's fault, or a systemic fault? IE, what controls were in place that would have prevented this form happening? Was it malicious, or negligent? Civil lawsuit, sure, but if it was a systemic issue, criminal charges seem inappropriate (esp if their were no controls in place to prevent this medication error from occuring).

 

[FiremanMike]

He's the only paramedic on scene, telling others wouldn't have changed anything; he told the ER doc who was treating the patient. If anything, he should have intubated the patient, and he was the only person who could have intubated the patient.

Criminal charges? for a medication error?

is this the paramedic's fault, or a systemic fault? IE, what controls were in place that would have prevented this form happening? Was it malicious, or negligent? Civil lawsuit, sure, but if it was a systemic issue, criminal charges seem inappropriate (esp if their were no controls in place to prevent this medication error from occuring).

What’s negligent is she knew she did it before he went down and did nothing to prepare to take the airway. I don’t care if there wasn’t another paramedic doe 50 miles, everyone on scene needed to know what happened so they could work as a team to prevent the outcome which occurred.

This was a simple fix. Secure the airway, sedate the patient, breathe for them, let the hospital wake them up in a controlled manner. Instead this patient went into hypoxic cardiac arrest, which means she sat around and did nothing for several minutes until the patient decomposated.

I have zero problems with criminal charges here, just like with Vaught..

 

[FiremanMike]

People get lost in the weeds on these cases, just like with Vaught. In both cases, the med error is not the criminally negligent part, the lack of care after the fact is.

 

[DrParasite]

This was a simple fix. Secure the airway, sedate the patient, breathe for them, let the hospital wake them up in a controlled manner. Instead this patient went into hypoxic cardiac arrest, which means she sat around and did nothing for several minutes until the patient decomposated.

I'm not a roc expert by any stretch, but could a BVM have prevented any issues? I know the patient went into unconscious, then cardiac arrest; with roc being a paralytic, and not a sedative, could they have simply bagged the patient (keep em conscious? probably not a good idea) until they made it to the hospital? https://www.ncbi.nlm.nih.gov/books/NBK539888/ says it has a duration of 35 minutes, which is a lot of bagging, but doable, in theory?

I have zero problems with criminal charges here, just like with Vaught..

I respect your consistency. I think the circumstances are different here, esp if the system lacked any controls to prevent it from happening (color coded vials, separate pouches for paralytics, etc), but if she didn't do what should have been done (accidently give Roc, oops, better RSI and intubate until you get the hospital, no other options), and due to her inaction, it resulted in a death, I can see your perspective.

I might not agree with it (I'm on the fence, since you explained why you think charges are justified), but I can definitely understand why charges are warranted.

I do think that, regardless of the reason, prison isn't justified for this former paramedic, however a large civil suit is warranted, and she probably should finding a new profession.

 

[E tank]

No way the details from a news story are accurate or even useful....but....sounds like she gave the roc, left briefly for something, discovered the error and came back to find the patient in arrest.

Trying to explain to the other non ALS personnel on the scene at that point what happened is moot. The guy had arrested and the job just got very simple. Sounds like a delay in mask ventilation or the inability to mask ventilate was the second hole in the swiss cheese that lined up and that's not one person's fault.

She told someone in the ER, but the story of course doesn't say when. The problem is if she didn't say something on rolling through the ER doors, the medical staff there are chasing zebras trying to figure out what happened when a simple reversal agent would be the answer.

Criminal? Nope. Civilly liable? Yep. And I don't think this is even in the same galaxy as the Vanderbilt assasination.

 

[FiremanMike]

I'm not a roc expert by any stretch, but could a BVM have prevented any issues? I know the patient went into unconscious, then cardiac arrest; with roc being a paralytic, and not a sedative, could they have simply bagged the patient (keep em conscious? probably not a good idea) until they made it to the hospital? https://www.ncbi.nlm.nih.gov/books/NBK539888/ says it has a duration of 35 minutes, which is a lot of bagging, but doable, in theory?

I respect your consistency. I think the circumstances are different here, esp if the system lacked any controls to prevent it from happening (color coded vials, separate pouches for paralytics, etc), but if she didn't do what should have been done (accidently give Roc, oops, better RSI and intubate until you get the hospital, no other options), and due to her inaction, it resulted in a death, I can see your perspective.

I might not agree with it (I'm on the fence, since you explained why you think charges are justified), but I can definitely understand why charges are warranted.

I do think that, regardless of the reason, prison isn't justified for this former paramedic, however a large civil suit is warranted, and she probably should finding a new profession.

Theoretically yes, quality BVM would work, but just drop the tube.

I vehemently reject this “the system didn’t do enough to prevent me from ****ing this up”. The system typed ROCURONIUM on the front of the vial. They tried to play the “system failed me” defense with Vaught as well and it was equally ridiculous.

But again, the med error itself isn’t the criminal level of stupidity, it’s the failure to do anything about it once she recognized it. In Vaughts case, it was that she dropped the vec and then peaced out without evaluating her patient..

 

[FiremanMike]

No way the details from a news story are accurate or even useful....but....sounds like she gave the roc, left briefly for something, discovered the error and came back to find the patient in arrest.

Trying to explain to the other non ALS personnel on the scene at that point what happened is moot. The guy had arrested and the job just got very simple. Sounds like a delay in mask ventilation or the inability to mask ventilate was the second hole in the swiss cheese that lined up and that's not one person's fault.

She told someone in the ER, but the story of course doesn't say when. The problem is if she didn't say something on rolling through the ER doors, the medical staff there are chasing zebras trying to figure out what happened when a simple reversal agent would be the answer.

Criminal? Nope. Civilly liable? Yep. And I don't think this is even in the same galaxy as the Vanderbilt assasination.

The way the article reads, she arrived back to the patient as he was starting to lose control of his muscles, which was after she had realized she had given rocuronium. The criminal level of negligence comes because she knew she gave roc and knew the patient was beginning to become paralyzed yet did nothing to aggressively manage the airway to prevent cardiac arrest.

While she may not have needed to go into the details of what occurred if she only had BLS providers with her, she still should have led the team and said, “guys we have a situation and we need to prep for emergent airway management.”

Civil liability would be if she had a med error, immediately took steps to rectify, and the patient was still harmed. Criminal liability applied here because she recognized her error very early on and did nothing to prevent the cardiac arrest.

 

[E tank]

Civil liability would be if she had a med error, immediately took steps to rectify, and the patient was still harmed. Criminal liability applied here because she recognized her error very early on and did nothing to prevent the cardiac arrest.

So she froze...what specific crime would she be charged with? Recognizing an error is not a crime, failure to rescue is not a crime and the two are completely unrelated. I suppose someone could make the case for involuntary manslaughter, but then you could argue that the rest of the team's incompetence lead to the death as much as the initial error. Mask ventilating with 100% oxygen is not rocket science.

 

[FiremanMike]

So she froze...what specific crime would she be charged with? Recognizing an error is not a crime, failure to rescue is not a crime and the two are completely unrelated. I suppose someone could make the case for involuntary manslaughter, but then you could argue that the rest of the team's incompetence lead to the death as much as the initial error. Mask ventilating with 100% oxygen is not rocket science.

Negligence can be a crime under the right circumstances. Similar to Vaught, the medical negligence in this case was so egregious that it met the threshold to be considered criminal.

I would agree with you on your second point, but that kinda reiterates my point that she should have communicated with the team. From their perspective, not knowing she gave roc instead of ketamine, they probably assumed they were just witnessing the ketamine kicking in. Had she found some way to communicate to the crew that emergent airway management was necessary immediately, I would assume they would have kicked in.

 

[ffemt8978]

Interesting to watch this thread since I'm originally from that city and am familiar with it.

Depending in what hundred block of Third Street they were in, the transport to Mercy Medical could have been as little as two blocks, since it is a multi block campus on Sixth St.