Refusing to transport???

[MasterIntubator]

http://now.msn.com/now/0305-amputee-lawsuit-settlement.aspx

".......the paramedics who answered her 911 call wouldn't take her back to the ER...."

Soooo as I read this story, as well as a few others... they lead to the fact that FDNY medics did not transport her when she requested it. The city paid 8 mil in the settlement. What a sucky situation.

Anyone have any insight on this? The stories seem somewhat vague..

 

[MedicBrew]

If the story is true as reads, then I’d say she didn’t get enough.

Lab should have caught the infection.

As far as refusing to transport, that is considered criminal negligence. As a medic and public servant we have a duty to act, regardless if it’s a gomer or not.

There's always 2 sides to every story though.

Wow, what a black eye for FDNY.

 

[Shishkabob]

I don't see the culpability of the EMS system at all. Story even says her boyfriend took her. Unless the time between EMS refusal and BF transport was a lengthy time, nothing EMS could have done (transporting or otherwise) would have made a difference. And if it WAS that lengthy of a time, again... issue falls on them.

Crappy situation... but not EMS fault. Transport is not a right. This sets a bad precedent legally.




Part of negligence is proving cause and effect... I'd like to see how her lawyer 'proved' EMS not transporting had a detrimental effect above and beyond POV transport, and how if she would have been transported by EMS there would have been a different outcome.

 

[MedicBrew]

Crappy situation... but not EMS fault. Transport is not a right.

North of the Red River it is.

You call, we haul PEROID.

You don't, then your looking for a new career.

 

[Shishkabob]

North of the Red River it is.

You call, we haul PEROID.

You don't, then your looking for a new career.

Policy =/= right. Just because your agency says you 'have to', doesn't mean it's a law, federal, state, local or otherwise.

 

[Hellsbells]

Any one have other links? This story is way too brief to get all the details.

 

[Shishkabob]

After reading the expanded article, they waited 24 hours to take her.

Serious enough to call 911, but not serious enough to drive yourself?




But it's also a settlement and not a lawsuit win as the original article leads to believe.

 

[MedicBrew]

Policy =/= right. Just because your agency says you 'have to', doesn't mean it's a law, federal, state, local or otherwise.

Forgive me, I can't find the exact statute. OK State Statute title 63,ss 63-1-2502-24-a covers transporting to the facility of the patients choice.

Basically states that if a patient requests EMS for treatment and transport, then said individual has the right to medical care. Regardless if you find it medically necessary.

Your definition of an actual emergency defers greatly than that of most of the public. (Should say yours and mine)

That’s for a Board lic. Physician to decide, not us. According to OSDH.

But yes, it’s company policy as well. Not that I agree with it, just the way it is.

 

[Shishkabob]

Having read that statute, no.

To be clear, the statute says the it is up to the individual / regional agency to decide on transport protocols, but that they should include allowing the patient to choose in 'non-emergency, routine transports' (arguably non-911). However, in urgent, non-life threatening situations, is to be taken to the closest appropriate facility, unless system coverage is able to facilitate a further transport. Life threatening emergencies are to be transported to the closest apprpirate.


This A) Does not say transport is a right, and that anyone requesting it get it, and B ) says the patient gets a choice, so far as it is compliant with the local agencies guidelines.






Several agencies across the US, mine included, do have situations where transport can, and is, refused to those that request it. To my knowledge, most require physician approval. Clearly, so far as these agencies and their lawyers are concerned, it's legal.

 

[MedicBrew]

Forgive me, I can't find the exact statute. OK State Statute title 63,ss 63-1-2502-24-a covers transporting to the facility of the patients choice. Basically states that if a patient requests EMS for treatment and transport, then said individual has the right to medical care. Regardless if you find it medically necessary.

Your definition of an actual emergency defers greatly than that of most of the public. (Should say yours and mine)

That’s for a Board lic. Physician to decide, not us. According to OSDH.

But yes, it’s company policy as well. Not that I agree with it, just the way it is.

Give me a bit, I'll keep digging. Just left shift.

 

[Aidey]

I'm having a hard time finding any news coverage older than the articles about this settlement, so there is a lot of missing information.

I'm with Linuss. Transport is not a right. Unfortunately because of a variety of reasons EMS systems are still held liable if they don't transport, even if there is zero treatment that would be done en route and the patient would end up in triage anyway*. I do acknowledge though that there is a difference between refusing to transport someone who has the means gain medical care another way and giving bad/wrong advice.

*At the local hospitals if you come in by ambulance for the same problem you were seen at the hospital for yesterday you buy an automatic seat in triage unless all the ED beds are open, or you are very obviously sick.

 

[MedicBrew]

I'm with Linuss. Transport is not a right. Unfortunately because of a variety of reasons EMS systems are still held liable if they don't transport, even if there is zero treatment that would be done en route and the patient would end up in triage anyway*. I do acknowledge though that there is a difference between refusing to transport someone who has the means gain medical care another way and giving bad/wrong advice.

*At the local hospitals if you come in by ambulance for the same problem you were seen at the hospital for yesterday you buy an automatic seat in triage unless all the ED beds are open, or you are very obviously sick.

Too slippery a slope….

By the time you’re done talking with the patient and finishing paperwork, you could’ve been to the hospital. That’s even out here in the sticks.

Losing only a bit of diesel in the process, and side stepping the liability (and media coverage) completely.

Just how I see it. Seems that philosophy would be like opening Pandora’s box.

 

[ffemt8978]

Too slippery a slope….

By the time you’re done talking with the patient and finishing paperwork, you could’ve been to the hospital. That’s even out here in the sticks.

Losing only a bit of diesel in the process, and side stepping the liability (and media coverage) completely.

Just how I see it. Seems that philosophy would be like opening Pandora’s box.

You're walking a pinnacle there, with a slippery slope on both sides.

Don't transport = liability, bad media for not transporting
Do transport = system abuse, crews not available when needed, increased costs for patient, bad media for not being immediately available, etc...

 

[Shishkabob]

Too slippery a slope….

By the time you’re done talking with the patient and finishing paperwork, you could’ve been to the hospital. That’s even out here in the sticks.

Losing only a bit of diesel in the process, and side stepping the liability (and media coverage) completely.

Just how I see it. Seems that philosophy would be like opening Pandora’s box.

And that's how many of the dinosaurs see it, but that doesn't make it right. You then cost the ER a bed, hospital wasted personnel time, insurance companies wasted money, Medicare and Medicaid wasted reimbursement, and the average person higher taxes and insurance premiums.


Hence why some of the most progressive agencies are doing at home care and/or provider initiated refusals... and actually getting good publicity from it and its savings for the general public, both in money and available resources for more legit concerns.

 

[Handsome Robb]

Haven't a few members on here worked at agencies that have refusal of transport protocols for their providers?

 

[ffemt8978]

Haven't a few members on here worked at agencies that have refusal of transport protocols for their providers?

We got one, and we're a volly agency.

 

[Aidey]

Exactly. Not everyone needs an ED. Most people have 3 levels of care to chose from. Personal GP, urgent care center, and ER. Tons of the people we see are more appropriate for the personal GP or urgent care. Cold/flu symptoms, simple wound care/stitches, and x-rays of non-deformed injuries are 3 very common reasons we get called that can be treated more quickly and cheaply at an urgent care center.

 

[Shishkabob]

By the time you’re done talking with the patient and finishing paperwork, you could’ve been to the hospital. That’s even out here in the sticks.

Plus, you know what can be done while talking to the patient? EDUCATION! Educate them on their concern. Then you probably save yourself repeated calls in the future, and actually HELP your patient.

Haven't a few members on here worked at agencies that have refusal of transport protocols for their providers?

Currently do.

 

[Handsome Robb]

Currently do.

You should write my MD a letter talking advocating it. Pretty please.

We've been trying to get something going but I don't think it's going to happen unless we get a new, more aggressive/progressive MD.

 

[ffemt8978]

You should write my MD a letter talking advocating it. Pretty please.

We've been trying to get something going but I don't think it's going to happen unless we get a new, more aggressive/progressive MD.

Are you sure you want Linuss writing your MD?