Paramedic In Mistaken Death Case Could come back

[Jon]

Paramedic In Mistaken Death Case Could Be Reinstated


POSTED: 8:36 p.m. EDT July 22, 2005
UPDATED: 8:55 p.m. EDT July 22, 2005


Story by nbc17.com

LOUISBURG, N.C. -- A paramedic who was suspended by the North Carolina Office of Emergency Medical Services for mistakenly declaring a Franklin County man dead six months ago could regain his license, officials said Friday.

Paul Kilmer had his paramedic license suspended in January, days after he and other responders zipped Larry Green into a body bag and transported him to the Franklin County morgue following a traffic accident.

A medical examiner later saw that Green was still breathing, and he was taken to the hospital. He now lives in a rehabilitation facility.

Kilmer appealed the suspension to the state Office of Administrative Hearings, but he withdrew the appeal Friday after reaching a settlement with the state.


From Firehouse.com - Rest Here Clicky

 

[TTLWHKR]

I had a bad call a few years ago, a man was ejected from the vehicle, his skull was opened completely. He had very horrific injuries, there was no way in the world he could have been alive. The patient was not breathing, and he had no heart beat. The State Police kept checking him, the cop was in some state of shock, and just wouldn't let it go. He kept checking the guy for a pulse. The car was cold, so the accident happened hours before, and he had probably bled out almost entirely. But the cop grab a hold of my partner and yells that he has a pulse. It was not possible, later we would find that the brain stem was severed, and his heart and lungs were punctured. The cop started to do CPR, the chest was crushed, we couldn't convince him that it was not possible to do anything. When we arrived I Hooked him up to the monitor, flat line, I left the leads on, hooked him up again.. still asystole. But the cop wrote up that he flet a pulse, and the coronor refused to allow him to do CPR. But at least we gave the patient a chance, doesn't hurt to hook up the monitor and make sure. In this case, the LEO was wrong, but his emotions were in the way - I don't fault him, I just hope he got over it.

If you don't properly check for vitals, I could see this happening, obviously he didn't use all of his tools to do his job properly. He should be punished.

 

[usafmedic45]

As I understood it (and then again we are all only hearing this second and third hand, so who knows what really happened), the "medic" responded as a member of a BLS rescue squad or VFD- which means (unless NC is different than any other state I have ever worked in) that he was responding as a first responder, or at most a basic EMT. Therefore the logical assumption would be that he could not assess an EKG, or do any of the ALS level skills that we would expect out of a paramedic. Even if he hooked the patient up to an AED (assuming one without a monitor screen) then the most he would have gotten out of that is "SHOCK NOT ADVISED-CHECK PATIENT", which would be of no help in a patient in regards to determining whether they have a perfusing rhythm (i.e., they could be in sinus tach or asystole and the AED will treat it the same).

Now, should he have started CPR? Maybe- it could be argued effectively either way. I hate catch-22 situations. I probably would have started CPR if for nothing else just to avoid having to stand around like a moron with my thumb up my....well, you know. I've done this a few times and the medics show up and say something to the effect of "What are you doing?" and my response is usually to effect of "Covering my ***". But I can see the logic behind not doing anything for an apparently dead person.

Honestly, there is as much fault to be spread around on this call as anyone can ask for- the "medic" should have been reprimanded, the coroner (who according to other reports I have read, came to the scene to pronounce the patient dead) should have really gotten his lower colon reamed for PRONOUNCING this guy dead (he's the one who has the legal authority to do this, not any EMS provider), and if you are going to fault one or two essentially BLS level EMS providers for not aiding an apparently dead person then any EMT or first responder on that scene should have been equally punished, not just the couple or three that were. Personally I think the ambulance crew that responded (the ones who were working as medics) were most culpable for this colossal fustercluck and for having taken someone at their word in trauma arrest case- I don't care who a responder is (and we have a local ER doc who runs as a Basic EMT), I don't take their word on someone being dead until I've examined them myself- and probably run a 3-lead on them. I'm not saying that people don't deserve to be punished for their mistakes, but I do feel that there was more to be considered in this case than has been.

It is terribly easy to sit back and play Monday morning armchair quarterback but I would bet you money that most of us have made similar judgement calls- and I wonder how many people we've thought were scene deaths that weren't quite as arrested as we might have thought.....just a little food for thought.

If you'd like to read a very heated debate on this topic: http://www.emtcity.com/phpBB2/viewtopic.ph...=north+carolina

 

[Ridryder911]

Has medics forgot, carotid pulse check.. apical pulse checks ?.. My medical director DOES NOT want us to hook patients to declare death. If the need to hook monitor then you should had worked them.. simple enough. conclussive signs of death. Obvious injuries incompatible with life..(decap).. purtrification of body, rigor or documented time of no resucitation efforts greater> than 20 minutes.

I might disagree, but thats her policy.

Be safe,
Ridryder911

 

[Jon]

Yeah.... around here most folks say to leave the lifepak in the rig.

Although had a bad MVC during my ride-time that we hooked the patine up for, just because the PSP trooper wanted it.

Jon

 

[TTLWHKR]

Originally posted by MedicStudentJon@Jul 23 2005, 06:26 PM
just because the PSP trooper wanted it

If they would do their job, and let us do ours... It would always run more smoothly. The only reason I hooked the monitor on was b/c the damn trooper was screaming that he did have a pulse, we have to be wrong.

<snaps his fingers to the waiter> an order of valium for the man in the orange tux

 

[usafmedic45]

<snaps his fingers to the waiter> an order of valium for the man in the orange tux

And a round for the house! Put it on the WHKR's tab. :lol:

 

[TTLWHKR]

Originally posted by usafmedic45@Jul 23 2005, 07:43 PM

<snaps his fingers to the waiter> an order of valium for the man in the orange tux

And a round for the house! Put it on the WHKR's tab. :lol:

long as it's on baby medic's credit card

 

[DT4EMS]

There is a ton of talk about this case but don't you remember the same thing happened in NYC (I believe) about 10 years ago.

The woman was pronounced dead, transported to the morgue only to "wake up".
In that case, I believe there were some on-scene efforts (ACLS) and they called the code.

The woman lived a couple more months and re-died. I can (barely) recall both stories being covered by the news.

Remember, we are all human. Mistakes happen.

Things aren't always exactly the way the "press" reports them.

 

[TTLWHKR]

Originally posted by DT4EMS@Jul 23 2005, 08:06 PM
There is a ton of talk about this case but don't you remember the same thing happened in NYC (I believe) about 10 years ago.

Actually, if you google the topic... It happens too often!

re-died

First time I ever heard that!

 

[DT4EMS]

I thought it fit the story...........