Two ambulance medics have been arrested for allegedly failing to treat a dying man because "he was not worth saving".
By Richard Edwards, Crime Correspondent
Last Updated: 8:08AM GMT 31 Dec 2008
Ambulance controllers overheard a private conversation between the crew members in which they supposedly made disparaging remarks about the victim's untidy home, allegedly failed to attempt to resuscitate him, and then apparently decided to claim he was already dead when they arrived.
Barry Baker, 59, dialled 999 from his home in Patcham, near Brighton in the early hours of November 29 and said that he was suffering from severe chest pains.
Controllers sent a paramedic and ambulance technician immediately, and although Mr Baker collapsed while talking on the phone, the line to the control centre was left open as he lay on the floor.
Minutes later the control staff heard the crew enter the house. A police source said: "What they heard after their ambulance crew arrived frankly astonished them. "Apparently their first reaction was to comment on the untidy and unkempt state of the house. Then they are heard to comment on seeing Mr Baker and allegedly saying that it was not worth bothering to try to carry out resuscitation to try to save him. They then are heard discussing what to tell ambulance control and allegedly decide to say that he was already dead when they arrived. "Obviously the crew did not realise that the phone was still connected and, of course, the 999 call was all recorded on tape," said the source.
The unnamed ambulance staff were arrested after the tape was handed to the Sussex Police Major Crime Team. They have been suspended from duty and a file has been passed to the Crown Prosecution Service to consider prosecuting the pair for wilfully neglecting to perform a duty in public office.
Police confirmed the two medics, both based at Brighton ambulance station, were detained on December 5, six days after Mr Baker's death. They were later freed on bail until next month, pending further inquiries.
A spokesman said: "The men, aged 35 years and 44 years and from the Brighton area, have been arrested and questioned following the death of a man in Brighton. They were detained on suspicion of wilfully neglecting to perform a duty in public office, contrary to Common Law."
A spokesman for the South East Coast Ambulance NHS Trust said that both men had been suspended from duty.
"We have suspended two male members of staff from duty as police conduct an investigation into the circumstances surrounding the sudden death of a man at his home. We are giving the police our full co-operation in this matter and are not in a position to comment further at this time due to the police investigation taking place."
Mr Baker, who walked with the aide of two sticks after undergoing hip replacement operations, was said to be a popular local figure in village.
He was described by neighbours as a smartly dressed civil servant who was picked up by taxi every morning at 8.30am to go to the job he had been working at since he was 16.
Ralph Virgo, 79 said: "He was always picked up at the same time every morning to go to his job in the benefits office and was always smartly dressed. He had had two hip operations over the years and walked with two sticks and he was quite overweight but he was a very friendly chap and always said hello." Mr Virgo who has lived in the neighbouring house for 15 years said Mr Baker's parents had died before he moved in when he had inherited the house. "I always used to offer to help him out getting the trees cut and such like but he always said no. He didn't like to let anyone in the house." Another neighbour who asked not to be named said Mr Baker was a regular in the local pub where he liked to drink real ale and was a member of the Campaign for Real Ale. The neighbour added: "He seemed to have a good social life and by all accounts he was quite outgoing. He was a decent chap and always friendly."
Mr Baker's dilapidated detached house lies in a well-to-do street not far from the centre of Brighton.
Paul Newman, landlord of the local Ladies Mile pub, said: "He used to come to the pub every Sunday morning at opening time. He arrived by bus and met friends here and together they played a few hands of cards. He did it every Sunday without fail and was a really nice chap," said Mr Newman.
His funeral has been delayed but a memorial service is due to take place next month.
Wednesday, December 31, 2008
Saturday, December 13, 2008
High level of calls for ambulance
Ambulance chiefs urged people only to call 999 in an emergencyThe ambulance service which covers Merseyside, Lancashire, Cumbria and Greater Manchester has had an "unprecedented" number of 999 calls.
The North West Ambulance Service said the number of calls received so far this winter had been higher than ever.
A spokesman said the service had increased its resource levels and staff were working extremely hard.
But it is urging people to only call 999 if absolutely necessary so as to help those most at risk.
'Healthcare choices'
The service's chief executive, John Burnside, said: "The winter period is always a busy time for the NHS and the ambulance service in particular, with a significant increase in calls over this period.
"However, this year, we are experiencing extremely high levels of 999 calls compared with the same time last year."
He added: "The service has increased its resource levels to prepare for the winter period and our staff are working extremely hard to make sure that our patients receive a speedy and safe response, throughout these months.
"There are a number of healthcare choices available to members of the public suffering from illness, which may not require the need for an ambulance."
People are being urged not to call paramedics unless someone is suspected of having a heart attack or a stroke, or is unconscious, has a serious wound or head injury or is struggling to breathe.
Story from BBC NEWS: http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/england/7781208.stm
Published: 2008/12/13 10:54:30 GMT
Thursday, December 11, 2008
Ambulance attendants molesting patients
129 paramedics accused of sex-related crimes over last 18 months
DALLAS - They answer the call 24-7, often risking their own safety to rescue the sick and injured and rush them to the hospital. But some paramedics have been more predator than hero.
Over the past 18 months, at least 129 ambulance attendants across the U.S. have been accused of sex-related crimes on duty or off, an investigation by The Associated Press found. Some of them molested patients in the back of an ambulance.
"It's a dream job for a sexual predator," said Greg Kafoury, a Portland, Ore., lawyer who represents three women who were groped by a paramedic. "Everything is there: Women who are incapacitated, so they're hugely distracted. Medical cover to put your hands in places where, in any other context, a predator would be immediately recognized as such."
Across the U.S., emergency medical technicians have been accused in recent months of such crimes as rape, soliciting minors over the Internet and possession of child porn, according to an AP survey of the state agencies that oversee those professions.
Some shocking cases
Exactly how many of these EMTs were alleged to have committed their crimes on the job is unclear. But some of more shocking cases include:
Several EMS officials said the number of complaints is troubling but does not necessarily point to an industrywide problem. They noted that the profession employs nearly 900,000 people in the U.S.
'Is even one case tolerable?'
"That number in and of itself doesn't shock me, knowing the number of providers we have in the country," said Steve Blessing, state EMS director in Delaware and president of the National Association of State EMS Officials. "Is even one case tolerable? I think most state directors would say no. But we're bound by reality here."
In Portland, paramedic Lannie Haszard was sentenced to five years in prison in August after pleading guilty to five counts of attempted sexual abuse. Haszard, 62, was charged with inappropriately touching four female patients while they were being taken by ambulance to hospitals.
Three of the women have sued Haszard and American Medical Response, his employer at the time. The lawsuits contend that the company, which operates ambulances in 40 states, failed to react to previous complaints about the paramedic's conduct.
Haszard's behavior came to light last December when a 28-year-old single mother of three, Royshekka Herring, told police that he touched her genitals while she was en route to the hospital for emergency treatment of a gastrointestinal condition.
In a recent taped deposition, Herring's voice shook with emotion as she described how a nurse tried to convince her that Haszard was probably performing an abdominal exam.
"I started yelling at her, because I didn't feel safe," Herring testified. "Somebody I never expected to touch me touched me."
A spokesman for American Medical Response had no comment on the case.
Former Dallas Fire Chief Steve Abraira suggested ambulances carry three workers. Ambulances usually have two — one in the front, one in the back.
"If there's a person predisposed to do something wrong, there's nobody there to witness or discourage that individual from doing something," said Abraira, now the fire chief in Palm Bay, Fla.
Twenty-eight states do not automatically bar known sex offenders from working as EMTs, the AP found.
Although most insist they would rarely, if ever, allow sex offenders to work those jobs, the AP found that Texas has knowingly allowed eight, Louisiana two and Maine, Virginia and North Carolina one each. There is no indication any of those people were accused of sexual misconduct after being allowed to work EMS jobs.
Twenty-two states strictly prohibit such offenders from working as EMTs.
"This is the type of person we don't want in the back of an ambulance with your mother or daughter," said March Tucker, an EMS regulator in West Virginia.
All but one of the eight registered sex offenders certified to work in Texas victimized children ranging in age from 6 to 16.
"Oh, my goodness, that's really scary," said Winfred Dean, who supervises the sex offender monitoring unit for the Harris County probation department in Houston. "I thought people like that would more than likely be eliminated."
Texas officials said state regulations call for EMS licensing decisions to be made on a case-by-case basis.
"The only thing we can do is follow the law, and the law allows this," said Maxie Bishop, state EMS director. "We have to take a look at the crime, how long it's been, the nature of it and what that person has done since."
http://www.msnbc.msn.com/id/28179848/
DALLAS - They answer the call 24-7, often risking their own safety to rescue the sick and injured and rush them to the hospital. But some paramedics have been more predator than hero.
Over the past 18 months, at least 129 ambulance attendants across the U.S. have been accused of sex-related crimes on duty or off, an investigation by The Associated Press found. Some of them molested patients in the back of an ambulance.
"It's a dream job for a sexual predator," said Greg Kafoury, a Portland, Ore., lawyer who represents three women who were groped by a paramedic. "Everything is there: Women who are incapacitated, so they're hugely distracted. Medical cover to put your hands in places where, in any other context, a predator would be immediately recognized as such."
Across the U.S., emergency medical technicians have been accused in recent months of such crimes as rape, soliciting minors over the Internet and possession of child porn, according to an AP survey of the state agencies that oversee those professions.
Some shocking cases
Exactly how many of these EMTs were alleged to have committed their crimes on the job is unclear. But some of more shocking cases include:
- A Standish, Mich., paramedic sent to prison in March for molesting a girl who was on her way to the hospital after she was injured at her 15th birthday party.
- A Pinellas County, Fla., paramedic arrested in July after he allegedly sexually assaulted a woman in an ambulance en route to a hospital.
- A Chester County, Pa., paramedic sentenced in July to up to 20 years in prison for engaging in sex and providing alcohol to teenagers he befriended through their interest in emergency medical service.
- A Copperas Cove, Texas, paramedic awaiting trial in January on charges he exposed and touched an 18-year-old accident victim's breasts while pretending to tend to her injuries.
- A Chattanooga, Tenn., EMT accused in a lawsuit of giving a 30-year-old woman an extra dose of morphine and then completely undressing her in the back of an ambulance even though her injuries were minor.
Several EMS officials said the number of complaints is troubling but does not necessarily point to an industrywide problem. They noted that the profession employs nearly 900,000 people in the U.S.
'Is even one case tolerable?'
"That number in and of itself doesn't shock me, knowing the number of providers we have in the country," said Steve Blessing, state EMS director in Delaware and president of the National Association of State EMS Officials. "Is even one case tolerable? I think most state directors would say no. But we're bound by reality here."
In Portland, paramedic Lannie Haszard was sentenced to five years in prison in August after pleading guilty to five counts of attempted sexual abuse. Haszard, 62, was charged with inappropriately touching four female patients while they were being taken by ambulance to hospitals.
Three of the women have sued Haszard and American Medical Response, his employer at the time. The lawsuits contend that the company, which operates ambulances in 40 states, failed to react to previous complaints about the paramedic's conduct.
Haszard's behavior came to light last December when a 28-year-old single mother of three, Royshekka Herring, told police that he touched her genitals while she was en route to the hospital for emergency treatment of a gastrointestinal condition.
In a recent taped deposition, Herring's voice shook with emotion as she described how a nurse tried to convince her that Haszard was probably performing an abdominal exam.
"I started yelling at her, because I didn't feel safe," Herring testified. "Somebody I never expected to touch me touched me."
A spokesman for American Medical Response had no comment on the case.
Former Dallas Fire Chief Steve Abraira suggested ambulances carry three workers. Ambulances usually have two — one in the front, one in the back.
"If there's a person predisposed to do something wrong, there's nobody there to witness or discourage that individual from doing something," said Abraira, now the fire chief in Palm Bay, Fla.
Twenty-eight states do not automatically bar known sex offenders from working as EMTs, the AP found.
Although most insist they would rarely, if ever, allow sex offenders to work those jobs, the AP found that Texas has knowingly allowed eight, Louisiana two and Maine, Virginia and North Carolina one each. There is no indication any of those people were accused of sexual misconduct after being allowed to work EMS jobs.
Twenty-two states strictly prohibit such offenders from working as EMTs.
"This is the type of person we don't want in the back of an ambulance with your mother or daughter," said March Tucker, an EMS regulator in West Virginia.
All but one of the eight registered sex offenders certified to work in Texas victimized children ranging in age from 6 to 16.
"Oh, my goodness, that's really scary," said Winfred Dean, who supervises the sex offender monitoring unit for the Harris County probation department in Houston. "I thought people like that would more than likely be eliminated."
Texas officials said state regulations call for EMS licensing decisions to be made on a case-by-case basis.
"The only thing we can do is follow the law, and the law allows this," said Maxie Bishop, state EMS director. "We have to take a look at the crime, how long it's been, the nature of it and what that person has done since."
http://www.msnbc.msn.com/id/28179848/
Wednesday, December 10, 2008
Doctors call emergency care ‘national disgrace’
msnbc.com and NBC News
By Alex Johnson and Tracie Potts
90 percent of states get poor, near-failing grades in nationwide report card
The nation’s emergency care system is “a ticking time bomb,” with demand far outstripping the capacity of hospital emergency departments already crippled by a widespread shortage of doctors and nurses, according to a national report on the state of emergency medicine.
The annual report card by the American College of Emergency Physicians gave the nation a D- grade for Americans’ access to emergency care, saying the emergency care system was “fraught with significant challenges and under more stress than ever before.”
That stress is likely to worsen as the weakening economy forces public officials and health administrators to cut back even further on costs, the report said.
The report, which was issued Tuesday, was one half of a double whammy for America’s state and local emergency officials. The same day, the Trust for America’s Health and the Robert Wood Johnson Foundation declared in a separate study that the United States was underprepared for a major disaster, such as a biological attack or a pandemic.
Access to emergency care was one of five categories the physicians’ group assessed to come up with a C- grade for the overall U.S. emergency health system.
The group found serious problems across the board, choosing to give no state an A. Massachusetts (B) and the District of Columbia and Rhode Island (both B-) — all with high concentrations of advanced medical institutions in small geographic areas — were the top three, while Arkansas came in last with a D-.
Scores were so low — 90 percent of the states earning mediocre or near-failing grades — that Nebraska’s grade, a C+, was good for fifth in the rankings.
“That is a national disgrace,” said the organization’s president, Nicholas Jouriles, an emergency physician in Moreland Hills, Ohio. “The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine.”
Too many patients; too few resources
The organization said rising costs were forcing hospitals to close emergency departments at the same time that demand for their services was skyrocketing, thanks to a rise in the number of Americans who seek treatment in the emergency room because they have no health insurance.
“The emergency care system in the United States remains in serious condition, with numerous states facing critical problems,” the report said, concluding that “the nation has too few emergency departments to meet the needs of a growing and aging population.”
The report found that emergency room visits had grown by 32 percent in the last decade as the number of emergency rooms had fallen by 7 percent. Other factors contributing to the crisis were:
Shortages of nurses, primary care physicians, emergency physicians and other specialists.
Hospital crowding leading to boarding of patients in emergency departments.
Inadequate reimbursement from public and private insurers.
“Adverse legal environments” — that is, rising medical malpractice claims and an accompanying rise in malpractice insurance costs — that are leading emergency physicians to retire early, cut high-risk services or move to states with less liability exposure.
Chronic lack of state-level programs to address preventable illnesses, resulting in “avoidable health care expenditures and additional demands on the medical system.”
The physicians’ group stressed that it was not passing judgment on the quality of emergency room doctors’ and nurses’ care; instead, it was assessing resources and availability of critical care.
Angela Gardner, an emergency room doctor in Galveston, Texas, who is president-elect of the physicians’ group, said the emergency care system was a “ticking time bomb.”
“Doctors are working in a war zone out there,” Gardner said.
“They’re being asked to do more with less every single day. They’re being asked to see more patients,” she said. “They’re being asked to do so with fewer nurses, with fewer beds in the hospital, so they have no place to put the patients that they’re seeing.”
Comprehensive reform urged
The doctors’ group called on Congress and the incoming Obama administration to enact a comprehensive health care reform program with an emphasis on boosting resources for emergency departments.
Reform of federal and state liability regulations is also critical, the report said, to lure qualified doctors and nurses back into emergency rooms.
“Emergency medical care is the most overlooked part of our health care system, and also the one everyone depends on in their hours of need,” Jouriles said. “Policy-makers must make strengthening emergency departments a national priority.”
http://www.msnbc.msn.com/id/28148474
Video: http://www.msnbc.msn.com/id/21134540/vp/28148590#28148590
By Alex Johnson and Tracie Potts
90 percent of states get poor, near-failing grades in nationwide report card
The nation’s emergency care system is “a ticking time bomb,” with demand far outstripping the capacity of hospital emergency departments already crippled by a widespread shortage of doctors and nurses, according to a national report on the state of emergency medicine.
The annual report card by the American College of Emergency Physicians gave the nation a D- grade for Americans’ access to emergency care, saying the emergency care system was “fraught with significant challenges and under more stress than ever before.”
That stress is likely to worsen as the weakening economy forces public officials and health administrators to cut back even further on costs, the report said.
The report, which was issued Tuesday, was one half of a double whammy for America’s state and local emergency officials. The same day, the Trust for America’s Health and the Robert Wood Johnson Foundation declared in a separate study that the United States was underprepared for a major disaster, such as a biological attack or a pandemic.
Access to emergency care was one of five categories the physicians’ group assessed to come up with a C- grade for the overall U.S. emergency health system.
The group found serious problems across the board, choosing to give no state an A. Massachusetts (B) and the District of Columbia and Rhode Island (both B-) — all with high concentrations of advanced medical institutions in small geographic areas — were the top three, while Arkansas came in last with a D-.
Scores were so low — 90 percent of the states earning mediocre or near-failing grades — that Nebraska’s grade, a C+, was good for fifth in the rankings.
“That is a national disgrace,” said the organization’s president, Nicholas Jouriles, an emergency physician in Moreland Hills, Ohio. “The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine.”
Too many patients; too few resources
The organization said rising costs were forcing hospitals to close emergency departments at the same time that demand for their services was skyrocketing, thanks to a rise in the number of Americans who seek treatment in the emergency room because they have no health insurance.
“The emergency care system in the United States remains in serious condition, with numerous states facing critical problems,” the report said, concluding that “the nation has too few emergency departments to meet the needs of a growing and aging population.”
The report found that emergency room visits had grown by 32 percent in the last decade as the number of emergency rooms had fallen by 7 percent. Other factors contributing to the crisis were:
Shortages of nurses, primary care physicians, emergency physicians and other specialists.
Hospital crowding leading to boarding of patients in emergency departments.
Inadequate reimbursement from public and private insurers.
“Adverse legal environments” — that is, rising medical malpractice claims and an accompanying rise in malpractice insurance costs — that are leading emergency physicians to retire early, cut high-risk services or move to states with less liability exposure.
Chronic lack of state-level programs to address preventable illnesses, resulting in “avoidable health care expenditures and additional demands on the medical system.”
The physicians’ group stressed that it was not passing judgment on the quality of emergency room doctors’ and nurses’ care; instead, it was assessing resources and availability of critical care.
Angela Gardner, an emergency room doctor in Galveston, Texas, who is president-elect of the physicians’ group, said the emergency care system was a “ticking time bomb.”
“Doctors are working in a war zone out there,” Gardner said.
“They’re being asked to do more with less every single day. They’re being asked to see more patients,” she said. “They’re being asked to do so with fewer nurses, with fewer beds in the hospital, so they have no place to put the patients that they’re seeing.”
Comprehensive reform urged
The doctors’ group called on Congress and the incoming Obama administration to enact a comprehensive health care reform program with an emphasis on boosting resources for emergency departments.
Reform of federal and state liability regulations is also critical, the report said, to lure qualified doctors and nurses back into emergency rooms.
“Emergency medical care is the most overlooked part of our health care system, and also the one everyone depends on in their hours of need,” Jouriles said. “Policy-makers must make strengthening emergency departments a national priority.”
http://www.msnbc.msn.com/id/28148474
Video: http://www.msnbc.msn.com/id/21134540/vp/28148590#28148590
Tuesday, December 9, 2008
Controversial Exam for D.C. EMT's
WASHINGTONfrom ABC 7 News -
Click here to see the related video:
http://www.wjla.com/news/stories/1208/576376_video.html?ref=newsstory
A plan to raise standards in the D.C. fire department is stirring up a controversy.
Some firefighters are losing their jobs because they can't pass a tough new exam for emergency medical technicians.
The new exam is part of an agreement with the family of murdered New York Times reporter David Rosenbaum. Now the department is agreeing to give recruits more chances to pass the test just to keep their jobs.
Graduation day was a proud moment for JaQuante' Staton. Born and raised in D.C., he always dreamed of becoming a firefighter. After six months of training, he made it.
"You have to understand, my whole family was there at graduation. They were proud of me, they were cheering for me. To have it stripped away just a couple of months later, it's not fair," said Staton.
Staton's dream was shattered when he was among the 28 percent of firefighters who failed to pass a new national registry exam for EMTs, put in place after graduation. Staton had already passed state standards.
"I'm not disgruntled. I'm sad actually. I'm sad that they would spend the money on me to graduate, shake hands with the mayor and the chief of the fire department and then fire me," said Staton.
"It was definitely a wakeup call because by no means have I ever considered myself a failure. I still don't. It was just one of those things. It was an unfortunate event and I did the best I could," said Evan Pace who was also terminated.
Both Pace and Staton say they studied extensively on their own, but that the department offered no instruction.
"There were questions about bears and what would we do if someone got attacked by one," said Pace.
You have like 30 guys sitting in one class with no instructor, said Ronnie Williams.
Even some veteran firefighters are having trouble. Williams fought fires for six years, but has now been on the bench for 11 months. He failed the test multiple times, he says because of his dyslexia. Williams is still on the city payroll.
"I haven't done nothing on a fire truck. And that's what I wanted to do to serve my city," said Williams.
When asked what he did for work everyday, Williams responded "Just go down there, sit in the classroom, get on the computer, do some test-taking online and try to find some ways to pass this national registry," he said.
"It is not true that the recruits have sat in a classroom without an instructor. There are independent study times," said Dr. James Augustine, acting medical director with D.C. Fire & EMS.
The department says there is training as well as mentoring programs for those who need extra help, both of which are disputed by six firefighters that were interviewed.
"You have to take a look at yourself in the mirror and say did I do everything that I could do to pass this test? Did I study on my own? Did I ask for help?," said Kenneth Crosswhite, deputy fire chief.
After our interview the department said it now plans to bring Staton and Pace back for three more attempts at passing the exam.
And this time, officials say they'll make sure the new recruits have every opportunity to prepare.
http://www.wjla.com/news/stories/1208/576376.html
Click here to see the related video:
http://www.wjla.com/news/stories/1208/576376_video.html?ref=newsstory
A plan to raise standards in the D.C. fire department is stirring up a controversy.
Some firefighters are losing their jobs because they can't pass a tough new exam for emergency medical technicians.
The new exam is part of an agreement with the family of murdered New York Times reporter David Rosenbaum. Now the department is agreeing to give recruits more chances to pass the test just to keep their jobs.
Graduation day was a proud moment for JaQuante' Staton. Born and raised in D.C., he always dreamed of becoming a firefighter. After six months of training, he made it.
"You have to understand, my whole family was there at graduation. They were proud of me, they were cheering for me. To have it stripped away just a couple of months later, it's not fair," said Staton.
Staton's dream was shattered when he was among the 28 percent of firefighters who failed to pass a new national registry exam for EMTs, put in place after graduation. Staton had already passed state standards.
"I'm not disgruntled. I'm sad actually. I'm sad that they would spend the money on me to graduate, shake hands with the mayor and the chief of the fire department and then fire me," said Staton.
"It was definitely a wakeup call because by no means have I ever considered myself a failure. I still don't. It was just one of those things. It was an unfortunate event and I did the best I could," said Evan Pace who was also terminated.
Both Pace and Staton say they studied extensively on their own, but that the department offered no instruction.
"There were questions about bears and what would we do if someone got attacked by one," said Pace.
You have like 30 guys sitting in one class with no instructor, said Ronnie Williams.
Even some veteran firefighters are having trouble. Williams fought fires for six years, but has now been on the bench for 11 months. He failed the test multiple times, he says because of his dyslexia. Williams is still on the city payroll.
"I haven't done nothing on a fire truck. And that's what I wanted to do to serve my city," said Williams.
When asked what he did for work everyday, Williams responded "Just go down there, sit in the classroom, get on the computer, do some test-taking online and try to find some ways to pass this national registry," he said.
"It is not true that the recruits have sat in a classroom without an instructor. There are independent study times," said Dr. James Augustine, acting medical director with D.C. Fire & EMS.
The department says there is training as well as mentoring programs for those who need extra help, both of which are disputed by six firefighters that were interviewed.
"You have to take a look at yourself in the mirror and say did I do everything that I could do to pass this test? Did I study on my own? Did I ask for help?," said Kenneth Crosswhite, deputy fire chief.
After our interview the department said it now plans to bring Staton and Pace back for three more attempts at passing the exam.
And this time, officials say they'll make sure the new recruits have every opportunity to prepare.
http://www.wjla.com/news/stories/1208/576376.html
Monday, December 8, 2008
Ambulance crash baby 'critical'
A four-week-old baby boy who was on board an ambulance which overturned on a motorway remains in a critical condition in hospital. The "seriously ill" child was being moved from Preston to Leeds for treatment when the crash happened on Sunday morning. The ambulance is thought to have hit a patch of ice at the junction of the M62 and M621 at Gildersome. Police said two other crashes were reported in the same area. A doctor and nurse were travelling in the ambulance along with a paramedic crew when the vehicle turned onto its side and skidded along the motorway. The crew were said to be shocked but there were no other injuries. The parents of the child, who was described as being in a serious condition prior to the accident, were travelling separately. Another ambulance took the baby to Leeds General Infirmary where police described his condition as "critical but stable". A West Yorkshire Police spokesman added: "It is believed ice on the roadway was a primary contributory factor." He confirmed that when the ambulance crashed police were already driving to the scene to attend other accidents which had occurred around the same stretch of road. A Toyota Corrolla and VW Passat collided nearby and shortly afterwards a Nissan Micra hit the central barrier. | |
Thursday, December 4, 2008
City Pushes Cooling Therapy for Cardiac Arrest
By ANEMONA HARTOCOLLISStarting on Jan. 1, New York City ambulances will take many cardiac arrest patients only to hospitals that use a delicate cooling therapy believed to reduce the chances of brain damage and increase the chances of survival, even if it means bypassing closer emergency rooms.
The move by the city’s Fire Department and Emergency Medical Service, after a year of preparation, indicates a shift away from the prevailing view among emergency workers and the public that how fast critically ill patients reach the hospital is more important than which hospital treats them.
It amounts to an endorsement by the Bloomberg administration of a labor-intensive, often expensive and still-developing therapy that smaller community hospitals say they lack the staffing and financial wherewithal to provide.
Some hospital officials fear that the policy could be unfair to these smaller hospitals, depriving them of income from emergency-room patients and hurting their reputations with the public.
Since the Fire Department sent letters to hospital chief executives this week informing them of the impending change, about 20 of the 59 hospitals with emergency rooms have said they will have cooling operations ready by the Jan. 1 deadline.
Dr. David J. Prezant, chief medical officer of the New York Fire Department, acknowledged the culture change and the possibility that some hospitals would feel slighted. But he argued that scientific data shows the survival rate of cardiac arrest patients treated with therapeutic hypothermia, as the cooling process is called, is so much better than with conventional treatment that it would be irresponsible not to provide it.
“Theoretically every closest 911-receiving hospital will be able to provide this service,” he noted. “Whether that will be a reality or not is not for me to say.”
New York joins a handful of other American cities, including Seattle, Boston and Miami, as well as Vienna and London, in requiring transport to hospitals with cooling systems. But given New York’s large population and concentration of hospitals, the policy may provide the largest test to date of therapeutic hypothermia.
Most patients who suffer total cardiac arrest outside hospitals die because their brains have been starved of oxygen. But studies show that if the pulse of patients can be restarted and the body temperature cooled to about 8 degrees Fahrenheit below normal, brain damage can be reduced or minimized.
Only those cardiac arrest patients revived enough to show a pulse and whose heart problems are not associated with some other trauma are eligible for the cooling treatment, Dr. Prezant said. In New York City, that represents 1,500 to 2,000 of the about 7,500 out-of-hospital cardiac arrest cases reported each year.
Dr. Prezant said that in deference to hospital finances, the city has set no requirements for the kind of cooling techniques hospitals must use — some may start with inexpensive saline solutions and plastic bags filled with ice, while others employ sophisticated equipment manufactured and aggressively promoted by companies like Alsius, Innercool Therapies and Medivance.
The American Heart Association endorsed cooling for some types of cardiac arrest patients after two studies on its effectiveness were published in The New England Journal of Medicine in 2002. One study found that 55 percent of the patients who received the cooling treatment ended up with moderate or no brain damage, compared with 39 percent who received standard treatment. About 41 percent of the cooled patients died within six months, compared with 55 percent of the others.
But hospitals have been slow to adopt the treatment because it requires a precision of temperature regulation that is difficult to achieve, constant vigilance and cooperation among nursing, emergency, cardiac and neurological units.
The research has shown that cooling is effective for cardiac arrest from ventricular fibrillation, in which the heart muscle wriggles ineffectively.
If a pulse can be restarted quickly enough — within a matter of minutes — with a defibrillator, such patients can walk away relatively unscathed. But if not, they become comatose and suffer a cascading series of cellular-level injuries to the brain, which frequently lead to permanent brain damage or death.
Inducing moderate cooling of the body within 6 hours, for 24 hours, followed by gradual warming, slows cerebral metabolism and seems to reduce such injuries, studies have shown. (The technique’s effectiveness on other medical problems, including traumatic brain injury, is more controversial.)
Dr. Stephan Mayer, chief of the neurological intensive care unit at NewYork-Presbyterian/Columbia hospital in Manhattan, spearheaded New York’s effort by bringing the idea to a critical-care committee of the Greater New York Hospital Association and United Hospital Fund a year ago. Soon after, the committee held a symposium on hypothermia, where Dr. Mayer continued to advocate for the therapy, and the ambulance protocol developed from there.
“It was a very slow process in terms of really getting it to take hold,” Dr. Mayer said of the cooling treatment. “One reason is that cardiac arrest patients have just been surrounded by this shroud of therapeutic nihilism. They come in after cardiac arrest, they’re intubated, in a coma, everybody’s reflex thought process in terms of caregivers is ‘Oh God, there’s nothing you can do for these people.’ ”
Dr. Mayer has served as a consultant for Medivance, and holds stock options in the company, which stands to benefit from the shift. He said in an interview that he has “worked directly or indirectly with cooling technology startup companies since 1998” and helped design “the next generation of equipment” for Medivance, earning about $10,000 from the company.
He said that his main motivation was not financial but experiential, and that he had been converted by seeing patients who were comatose and given up for dead recover full or near-full function after hypothermia.
Under the New York protocol, patients would be eligible for cooling if they suffered cardiac arrest and regained a pulse within 30 minutes of the start of resuscitation but remained neurologically compromised. Hospitals without the ability to cool patients would be bypassed if one that did was within a 20-minute drive. Dr. Prezant said his goal is, within six months, to begin the cooling process in the ambulance, accelerating treatment.
NewYork-Presbyterian has been a leader in hypothermia in New York, but a number of other major hospitals in the city — including Mount Sinai, Bellevue Hospital Center and St. Vincent’s Hospital Manhattan, Elmhurst Hospital Center in Queens, Maimonides Medical Center in Brooklyn and Staten Island University Hospital — also practice cooling, and others are developing plans to start. Dr. Prezant said enough hospitals in each borough had indicated interest in cooling to keep transport time to an average of 10 minutes. “If people knew about it, of course they’d want it,” Dr. Mayer said.
One recent success story is Dr. Syed Hasan Naqvi, 56, who had just finished jogging on the treadmill in his Long Island home on Oct. 18 when his daughter heard a thud and found him on the floor in cardiac arrest. An ambulance took him to Nassau University Medical Center, where he was revived, but he remained comatose and breathing on a ventilator.
Unable to accept that there was nothing else to be done, Dr. Naqvi’s wife, Nina, contacted a neurologist at the hospital who knew Dr. Naqvi, a consulting neurologist at North Shore University Hospital. The neurologist at Nassau had recently heard Dr. Mayer describe the cooling treatment, unavailable at Nassau, and so he called him and then urged Mrs. Naqvi to get her husband to NewYork-Presbyterian.
Since more than five hours had elapsed since the cardiac arrest — the optimal time for cooling was running out — Dr. Mayer suggested putting ice packs on Dr. Naqvi during the hourlong trip to Manhattan. When he got there, Dr. Mayer said, Dr. Naqvi’s score on the Glasgow coma scale was a 4, near bottom on a scale of 3 to 15, and he had a high chance of remaining in a vegetative coma permanently.
“The brain waves were very flat,” Dr. Mayer said. “But we decided to give it a try.”
Dr. Naqvi was cooled for 24 hours, and woke up five days later, though he was confused and had memory lapses. Now, six weeks later, he is back to seeing patients two days a week, and said in an interview that he remains physically weak but has regained all of his mental function.
“The hospital does make a difference,” Nina Naqvi said. “The knowledge of the doctors does make a difference.”
Man Dies at Home After Paramedics Diagnose Acid Reflux
By Elissa Silverman - Washington Post Staff Writer
A 39-year-old Northeast Washington man died yesterday, a few hours after paramedics responding to his complaints of chest pains and trouble breathing told him he had acid reflux and did not take him to a hospital, family members said.
D.C. fire officials are investigating the circumstances surrounding the death of Edward L. Givens, who was found by family members just before 6 a.m. in his home in the 700 block of Division Avenue. Paramedics told Givens late Tuesday that he had acid reflux, instructed him to take Pepto-Bismol and left, family members said.
"I don't understand the paramedics, why, when he said he was in chest discomfort, he wasn't taken to the hospital," said Lolitha Givens, the man's mother, who lives in the home and was there when 911 was called Tuesday night. "I'm just baffled by that."
Paramedics are required by department protocol to transport by ambulance a patient who asks to go to a hospital, said Alan Etter, a spokesman for D.C. Fire and Emergency Medical Services.
Officials said the D.C. medical examiner will conduct an autopsy to determine a cause of death.
The department has launched an investigation into the call, Etter said. He said that the department will interview all personnel who responded and that top officials are involved in the review, including Fire Chief Dennis L. Rubin and Assistant Fire Chief Lawrence Schultz.
"As per protocol, we are conducting a thorough quality assurance case review, and we will determine whether proper care was provided and if the two medical events are related," Rubin said in a written statement.
Lolitha Givens said her son was in the living room Tuesday night when he yelled out to family members to call 911. He was on his back on the floor and said he had chest pains and was having trouble breathing.
A firetruck and ambulance from Engine 30 were dispatched to the house at 11:40 p.m., Etter said. The truck, staffed by three firefighters trained in emergency medicine and a firefighter-paramedic, arrived first.
Lolitha Givens said the firefighters asked her son what was wrong, and the emergency medical technicians who arrived by ambulance checked his vital signs and performed an electrocardiogram, the results of which they said were normal.
The EMTs asked Givens whether he had eaten or had anything to drink that evening, and he said he had eaten a burger, Givens said. They told him and his mother that he probably was suffering from acid reflux and suggested he take antacid.
"Six hours later, my son was on the floor, dead," Lolitha Givens said.
After the family member found Edward Givens, who was not breathing, yesterday morning, another 911 call was made.
Improving the city's emergency medical services has been a stated priority for Mayor Adrian M. Fenty (D) and Rubin since the death of David Rosenbaum in January 2006. Rosenbaum, a former New York Times journalist who lived in upper Northwest, was beaten in a street robbery, but emergency workers assessed him as a drunk and considered him a low-priority patient. He died two days later at Howard University Hospital.
A task force chaired by Rubin suggested numerous reforms, which Rubin said are being implemented.
Givens was a father of two teenagers and worked as a counselor at a group home for youths who had been victims of domestic violence, his mother said.
He was a graduate of Eastern High School and Wilberforce University in Ohio, where he majored in business administration.
He coached Little League baseball and youth football and worked with a basketball team in the Barry Farm neighborhood.
"Sports was his love," Lolitha Givens said.
A 39-year-old Northeast Washington man died yesterday, a few hours after paramedics responding to his complaints of chest pains and trouble breathing told him he had acid reflux and did not take him to a hospital, family members said.
D.C. fire officials are investigating the circumstances surrounding the death of Edward L. Givens, who was found by family members just before 6 a.m. in his home in the 700 block of Division Avenue. Paramedics told Givens late Tuesday that he had acid reflux, instructed him to take Pepto-Bismol and left, family members said.
"I don't understand the paramedics, why, when he said he was in chest discomfort, he wasn't taken to the hospital," said Lolitha Givens, the man's mother, who lives in the home and was there when 911 was called Tuesday night. "I'm just baffled by that."
Paramedics are required by department protocol to transport by ambulance a patient who asks to go to a hospital, said Alan Etter, a spokesman for D.C. Fire and Emergency Medical Services.
Officials said the D.C. medical examiner will conduct an autopsy to determine a cause of death.
The department has launched an investigation into the call, Etter said. He said that the department will interview all personnel who responded and that top officials are involved in the review, including Fire Chief Dennis L. Rubin and Assistant Fire Chief Lawrence Schultz.
"As per protocol, we are conducting a thorough quality assurance case review, and we will determine whether proper care was provided and if the two medical events are related," Rubin said in a written statement.
Lolitha Givens said her son was in the living room Tuesday night when he yelled out to family members to call 911. He was on his back on the floor and said he had chest pains and was having trouble breathing.
A firetruck and ambulance from Engine 30 were dispatched to the house at 11:40 p.m., Etter said. The truck, staffed by three firefighters trained in emergency medicine and a firefighter-paramedic, arrived first.
Lolitha Givens said the firefighters asked her son what was wrong, and the emergency medical technicians who arrived by ambulance checked his vital signs and performed an electrocardiogram, the results of which they said were normal.
The EMTs asked Givens whether he had eaten or had anything to drink that evening, and he said he had eaten a burger, Givens said. They told him and his mother that he probably was suffering from acid reflux and suggested he take antacid.
"Six hours later, my son was on the floor, dead," Lolitha Givens said.
After the family member found Edward Givens, who was not breathing, yesterday morning, another 911 call was made.
Improving the city's emergency medical services has been a stated priority for Mayor Adrian M. Fenty (D) and Rubin since the death of David Rosenbaum in January 2006. Rosenbaum, a former New York Times journalist who lived in upper Northwest, was beaten in a street robbery, but emergency workers assessed him as a drunk and considered him a low-priority patient. He died two days later at Howard University Hospital.
A task force chaired by Rubin suggested numerous reforms, which Rubin said are being implemented.
Givens was a father of two teenagers and worked as a counselor at a group home for youths who had been victims of domestic violence, his mother said.
He was a graduate of Eastern High School and Wilberforce University in Ohio, where he majored in business administration.
He coached Little League baseball and youth football and worked with a basketball team in the Barry Farm neighborhood.
"Sports was his love," Lolitha Givens said.
Firehouse brawl case ends quietly with $3.75M settlement
By JEFF HARRELL - STATEN ISLAND ADVANCE
Assault with chair 5 years ago sparked lawsuit, FDNY shakeup
STATEN ISLAND, N.Y. -- The firefighter had demanded $100 million from the
city as the price for what he branded a toxic firehouse culture that led to
his being slammed in the face with a metal chair.
Yesterday, Robert Walsh, formerly of Annadale, settled for $3.75 million.
Walsh had testified that the New Year's Eve 2003 assault by Firefighter
Michael Silvestri was the culmination of nearly two years of anti-gay slurs.
"We are pleased that the matter has been resolved amicably," said city
spokeswoman Kate Ahlers, who declined further comment "out of respect for
the parties."
Walsh, 45, could not be reached for comment.
His attorney, Jonathan C. Reiter, did not return phone messages left at his Manhattan office last night. Co-counsel Glenn Herman confirmed the settlement but declined to discuss specifics of the agreement.
After Silvestri pleaded guilty to criminal charges and ent to prison for a year, Walsh sued the city and Silvestri for $100 million over the "permanent injuries" he said he suffered when his colleague assaulted him at Tottenville's Engine Co. 151/Ladder Co. 76 firehouse on Dec. 31, 2003.
The suit proceeded in Manhattan federal court in front of U.S. District Judge Robert W. Sweet. Attorneys had been scheduled to begin summations this morning following the two-week-long civil trial, in which a jury heard doctors testify through videotaped depositions that Walsh suffered eye, jaw and skull fractures and severe back injuries, which ended his FDNY career of seven years. Neurologist Dr. Melanie B. Shulman also said Walsh sustained "post-concussive syndrome" that resulted in "moderate to sev epression" and "moderate anxiety," as well as post-traumatic migraine headaches and memory loss as a result of the attack.
The hulking Walsh -- who stands 6 feet, 7 inches tall and now weighs close to 350 pounds -- took the stand last week with the aid of a cane and told jurors that firehouse supervisors, including former Caeeney, laughed off the verbal abuse he suffered. Walsh admitted on the stand he took Silvestri's slurs part of the day-to-day banter among firefighters. Sweeney and others tried to cover up the incident by telling doctors at Staten Island University Hospital, Ocean Breeze, that Walsh was hurt in a fall on the stairs. The lie cost Sweeney his FDNY career.
Reiter maintained the city was responsible for the injuries that cut Walsh's FDNY career short of a fully vested pension, since Silecity were locked in an "employer-employee relationship" at the time. City assistant corporation counsel Sosimo Fabian argued that the city had "no notice of Silvestri's propensity for violence," since Silvestri had no prior disciplinary record.
The attack was triggered by a bet between Walsh and another firefighter over Elvis Presley's birth date. When Walsh lost the bet, Silvestri chided Walsh with a string of slurs that were met with a biting comeback. Silvestri first threatened to hit Walsh with a metal chair, then he slammed the firefighter in the head from behind.
In March, Sweet ruled against the city, saying Sweeney failed to exercise reasonable care to control a subordinate. But the federal judge dismissed Walsh's other claims of negligence and
violations of the General Municipal Law against the city.
Assault with chair 5 years ago sparked lawsuit, FDNY shakeup
STATEN ISLAND, N.Y. -- The firefighter had demanded $100 million from the
city as the price for what he branded a toxic firehouse culture that led to
his being slammed in the face with a metal chair.
Yesterday, Robert Walsh, formerly of Annadale, settled for $3.75 million.
Walsh had testified that the New Year's Eve 2003 assault by Firefighter
Michael Silvestri was the culmination of nearly two years of anti-gay slurs.
"We are pleased that the matter has been resolved amicably," said city
spokeswoman Kate Ahlers, who declined further comment "out of respect for
the parties."
Walsh, 45, could not be reached for comment.
His attorney, Jonathan C. Reiter, did not return phone messages left at his Manhattan office last night. Co-counsel Glenn Herman confirmed the settlement but declined to discuss specifics of the agreement.
After Silvestri pleaded guilty to criminal charges and ent to prison for a year, Walsh sued the city and Silvestri for $100 million over the "permanent injuries" he said he suffered when his colleague assaulted him at Tottenville's Engine Co. 151/Ladder Co. 76 firehouse on Dec. 31, 2003.
The suit proceeded in Manhattan federal court in front of U.S. District Judge Robert W. Sweet. Attorneys had been scheduled to begin summations this morning following the two-week-long civil trial, in which a jury heard doctors testify through videotaped depositions that Walsh suffered eye, jaw and skull fractures and severe back injuries, which ended his FDNY career of seven years. Neurologist Dr. Melanie B. Shulman also said Walsh sustained "post-concussive syndrome" that resulted in "moderate to sev epression" and "moderate anxiety," as well as post-traumatic migraine headaches and memory loss as a result of the attack.
The hulking Walsh -- who stands 6 feet, 7 inches tall and now weighs close to 350 pounds -- took the stand last week with the aid of a cane and told jurors that firehouse supervisors, including former Caeeney, laughed off the verbal abuse he suffered. Walsh admitted on the stand he took Silvestri's slurs part of the day-to-day banter among firefighters. Sweeney and others tried to cover up the incident by telling doctors at Staten Island University Hospital, Ocean Breeze, that Walsh was hurt in a fall on the stairs. The lie cost Sweeney his FDNY career.
Reiter maintained the city was responsible for the injuries that cut Walsh's FDNY career short of a fully vested pension, since Silecity were locked in an "employer-employee relationship" at the time. City assistant corporation counsel Sosimo Fabian argued that the city had "no notice of Silvestri's propensity for violence," since Silvestri had no prior disciplinary record.
The attack was triggered by a bet between Walsh and another firefighter over Elvis Presley's birth date. When Walsh lost the bet, Silvestri chided Walsh with a string of slurs that were met with a biting comeback. Silvestri first threatened to hit Walsh with a metal chair, then he slammed the firefighter in the head from behind.
In March, Sweet ruled against the city, saying Sweeney failed to exercise reasonable care to control a subordinate. But the federal judge dismissed Walsh's other claims of negligence and
violations of the General Municipal Law against the city.
Wednesday, November 26, 2008
The city is raising the cost of an ambulance ride
By SALLY GOLDENBERG
First gas, then milk, now ambulances.
The city is raising the cost of an ambulance ride - with transports for the most critical patients going up to $850 per ride - as part of Mayor Bloomberg's orders to slash costs to raise revenue and plug future budget holes.
Basic Life Support rides will increase to $515 from $475; Advanced Life Support will jump to $750 from $600 and Advanced Life Support for the most critical patients will go up to $850 from $700,
FDNY Commissioner Nicholas
Scoppetta told a City Council Public Safety Committee hearing Monday.
First gas, then milk, now ambulances.
The city is raising the cost of an ambulance ride - with transports for the most critical patients going up to $850 per ride - as part of Mayor Bloomberg's orders to slash costs to raise revenue and plug future budget holes.
Basic Life Support rides will increase to $515 from $475; Advanced Life Support will jump to $750 from $600 and Advanced Life Support for the most critical patients will go up to $850 from $700,
FDNY Commissioner Nicholas
Scoppetta told a City Council Public Safety Committee hearing Monday.
Saturday, November 8, 2008
Paramedic accused of stealing from patient
Cops arrested a Pasco County paramedic accused of stealing money from a patient's wallet while transporting the man to a hospital, reports the St. Petersburg Times.
Joshua Vitori, 26, was arrested on a charge of grand theft.
The Pasco County personnel director says he plans to resign from his job today.
Here's the story: Vitori went by ambulance to a home in Zephyrhills, where a man was having chest pains. The man's wife handed his wallet to a paramedic to retrieve his insurance card.
A few minutes later, the man was asked for a list of medications and was handed his wallet back, the report says.
That's when he discovered the money — $300 — missing.
Poor patient got taken for a ride.
Tuesday, November 4, 2008
When a heart attack goes undiagnosed
By Robert Davis, USA TODAY
Editor's Note: On October 25, 2006, USA TODAY published an article entitled "When a Heart Attack Goes Undiagnosed" regarding the emergency medical care received by James Pettry of Lafayette, Indiana, prior to his death in April 2006. The article may have conveyed the impression that Edward Seall, an emergency room physician who treated Pettry, failed to detect or diagnose a heart attack (myocardial infarction) during Pettry's emergency room visit the day before his death. That is not the case. Seall ran several tests for myocardial infarction and other acute heart problems, and all of the tests were negative. Pettry was later discharged and died suddenly the next day. An autopsy requested by the Pettry family concluded that the cause of death was severe occlusive coronary atherosclerosis, or severely blocked arteries in the heart, and that there was "no evidence" of myocardial infarction or necrosis (cell and tissue death). The story could have used more precise medical terminology in defining the cause of death.
When chest pain woke James Pettry early one morning this spring, his wife, Mary, found him sitting on their bed, short of breath and sweating profusely. She dialed 911.
In the five minutes it took for an ambulance to reach their home in Lafayette, Ind., on April 28, the seriousness of her husband's condition hit Mary. "I thought he was having a heart attack," she says.
The paramedic, who gave Pettry oxygen and aspirin and then used an electrocardiogram machine to examine the heart's electrical function, agreed. The ambulance crew whisked Pettry 3 miles to St. Elizabeth Medical Center.
The doctor in the emergency room, Edward Seall, disagreed with the paramedic. After running more tests, he sent Pettry home nearly five hours later, saying Pettry just had anxiety. The patient was advised to follow up with his doctors but to return if his chest pain became worse.
Pettry, 74, was dead the next day, one of thousands who perish each year when their heart attacks are undetected by doctors.
The retired salesman, a father and grandfather, died from severely clogged arteries while sitting in his easy chair within 24 hours of being discharged, according to an autopsy report.
In part because there is no foolproof test, one in 50 heart attack victims are mistakenly sent home by emergency room doctors, researchers from New England Medical Center in Boston reported in the New England Journal of Medicine in April 2000. Other studies have documented higher rates of missed heart attack diagnosis.
Through his attorney, Jon Pinnick of Indianapolis, Seall stands by his diagnosis and says his patient died from chronic heart disease that had no connection to the symptoms that landed him in the ER.
"It's unfortunate about Mr. Pettry's death, and all concerned wish it hadn't happened," Pinnick says. "Obviously (Seall) feels sympathetic toward the family. But he does not view this as a missed myocardial infarction (heart attack). "We don't believe the care he was provided was below the standard of care and is what led to his unfortunate demise." Mary Pettry says, "It seems like I lost somebody unnecessarily, like there could have been something done."
Going the extra step
Experts say she is right, that often more can be done. Nobody knows exactly how many people die from missed heart attacks every year, but doctors say the number is high despite advances in diagnostics and refinement of medical protocols. "It's tens of thousands of potential cases across the United States each year," says Joseph Ornato, professor and chairman of the Department of Emergency Medicine at Virginia Commonwealth University Medical Center in Richmond, who has researched the emergency care of heart attacks. "Even in the best of hands, you can easily miss cases. This is a very perilous area."
And costly. The monetary risks are huge for physicians. A missed heart attack diagnosis, research has shown, brings the highest malpractice payout of all conditions. The overwhelming majority of malpractice settlements for heart attacks come from errors in diagnosis, according to data from Jury Verdict Research, which tracks and analyzes nationwide trends in personal-injury litigation.
Over the past decade, the median jury verdict for heart attack malpractice lawsuits has been $941,000. The lowest was an Oklahoma judgment for $81,000 in 1996, and the highest, $9 million, came in an Illinois case in 1997.
The Pettry family is considering a lawsuit, but his adult children say what they want most is for other lives to be saved.
The story of Pettry's final hours — and how his death spurred a friend to fight to survive a similar situation — illustrates both the difficulties that doctors face and the actions that can be taken by patients and their advocates.
Stricken before dawn
When medics rolled Pettry into the medical center just after 5 a.m. on April 28, according to medical records, Seall, the doctor on duty in the emergency room, was told the patient with a history of heart problems had suffered "chest pain on and off for the past 24 hours."
Seall ordered the standard tests. The following is from hospital records provided by the Pettry family:
According to the medical records, after seeing all of the test results, Seall ordered Pettry to take an anti-anxiety drug, Ativan, which had made him feel better in the emergency room, as needed at home. He told Pettry to follow up with his primary physician or cardiologist within two to three days. And he advised him to come back to the emergency department if his symptoms became worse.
As he was getting dressed to leave the hospital just before 10 a.m., Pettry had more chest tightness. Notes in the medical record say: Doctor notified, no further orders and patient instructed to return for any problems. "I know what the record says," Pinnick says. "There was a shift change, and at the time that was recorded, (Seall) was not the emergency room physician. Seall was off at 7 a.m., so I don't know if it's a reference to a resident or what, but it wasn't Seall."
In an e-mail response to questions, the hospital said the nurse could have notified "any doctor on staff in the emergency room at that time." The hospital would not comment further on the case, referring all other questions to Seall.
Seall wrote in his "patient instructions for follow-up care," which Pettry signed at 9:55 a.m., "return to the ED (emergency department) if your symptoms get worse." "They dismissed him and told him to rest, and that is what he did," Mary Pettry says. But the next morning she awoke to find him in his favorite chair with the pains he had had for two days. "He said he had these tight chest pains again, but having spent time down at the hospital, we had no place to go but the same place," she says. "He said: 'I think they're going away. They're going to get better."
She went to feed the cat, Pebbles, but because her husband always brewed the coffee, she returned to ask him how many scoops to use. "I touched his arm the way you do when a person is asleep," she says. "His arm was cold, and he didn't have a pulse. I called 911, but when they came, they said it was too late. I knew that."
During the memorial service the following week at Bethany Presbyterian Church, Jim Pettry was remembered as an astute and deeply religious man who developed a love for fishing while growing up in West Virginia.
"Jim was concerned for our world's future and the future of this congregation and thoughtfully sought out a vision and discernment of God's will for our future and worked faithfully toward that future," the Rev. Kevin Bowers told Pettry's friends and family. "He never quit caring about others and will have a positive impact on people's lives even beyond his years."
Two weeks after she attended Pettry's funeral, Connie Gustafson, a longtime friend of Pettry's daughter Deborah, found herself at Methodist Hospital in Indianapolis with her husband, Rick. On a quiet Tuesday afternoon, he had suddenly felt weak, nearly fainted and broke out in a sweat. The pressure in his upper right chest felt like a previous heart problem that had required bypass surgery 11 years ago.
Despite the similarities and Gustafson's strong feeling that he was having another life-threatening problem with his heart, a cardiologist in the hospital, Irmina Gradus-Pizlo, came to a different conclusion.
'Nothing obvious'
After Gustafson had the same battery of tests Pettry had taken and doctors found no evidence of a heart attack, they went a step further. They admitted him to the hospital and performed more tests, including a stress test, putting Gustafson on a treadmill and monitoring his heart as the 59-year-old social worker was pushed to his physical limits.
"They could find nothing obvious," Connie says. "The cardiologist on call was dismissive. She said there was nothing to support the diagnosis that he had any kind of heart event."
But Connie says her husband "could feel that something was not right."
When no problems were found, doctors determined the uneasy feelings Gustafson had experienced were an "anxiety/panic attack," according to medical records electronically signed by Gradus-Pizlo. Gustafson, like Pettry, was given Ativan and "told he has anxiety attacks and to take a deep breath," the records state. Upon discharge, he was told "to return to the ER if any chest pain recurs."
The records show Gustafson was advised to follow up with his own doctor within four weeks, eat a heart-healthy diet, and take his cholesterol medicines and aspirin, among other medications.
Connie thought of Pettry. "It was heavy on my mind that this was exactly what Jim had gone through: not getting somebody to listen to him."
As the staff prepared to discharge Gustafson, he saw Barry Crevey, a cardiologist he had met through his social work, in the hallway. Crevey listened to Gustafson's story and explained that 25% of heart attacks may be "silent."
Considering Gustafson's history and the fact that both his parents had cardiovascular disease, the doctor suggested his arteries should be checked by threading a heart catheter into them, injecting dye and measuring the openings.
"When he told me his story, I'm thinking, 'This person needs a heart catheterization,' " Crevey says. "This is Cardiology 101. I would not have even bothered to do a non-invasive stress test."
A doctor intervenes
After he was discharged from the hospital, Gustafson became Crevey's patient and two days later had a cardiac catheterization, which, according to his medical records, found "severe, multivessel coronary disease."
Gustafson's medical record detailing the findings of the coronary angiography reads much like Pettry's autopsy report. Both major heart vessels and some of the 11-year-old bypass vessels were 90% to 100% blocked.
The arteries were cleared with stents and a drilling procedure, and Gustafson is now back at work with "a clean bill of health," Connie says.
"They were big arteries," she says, noting one of the arteries that was almost completely blocked — the left anterior descending artery — is sometimes called "the widowmaker" because of the deadly result when it gets clogged.
Gradus-Pizlo says, "In a patient with known disease, there is no question there are blockages there," but none of the blockages were putting Gustafson's life at immediate risk.
His heart was working fine with the reduced blood flow, which was confirmed by the fact that he passed the stress test, she says. "Even with those blockages, he had adequate blood supply. I'm not saying he doesn't have disease. He has severe disease. I didn't recommend therapy. I recommended aggressive medical management based on guidelines."
Though she agrees the blockages should have been opened once they were seen, she does not believe she misdiagnosed Gustafson. "I believe it is a difference of approach," Gradus-Pizlo says.
"This is a matter of clinical judgment."
Crevey's medical record of Gustafson's condition shows frustration with the initial diagnosis.
"He gave a vivid classic description of a major cardiac ischemic event," the report says, meaning an artery in his heart was blocked. In addition to his parents' heart disease, Gustafson's
"personal history began with a false-negative cardiac stress test" before his initial bypass surgery. "All of that was far too much to overlook, despite the 'normal' stress test," the report says.
Crevey says a doctor relying too much on tests instead of the patient's own story "is a classic dilemma in medicine."
"The tests are not perfect," he says. "I think the clinician must be super wary of worshiping at the altar of the tests. Unfortunately, that is often the case. They say the test here is negative and therefore you are OK, and that is the end of the story. It certainly happened with Mr. Gustafson."
In Crevey's opinion, based on his review of the record, Gradus-Pizlo's decision was a "serious misdiagnosis."
Many similar stories
Ornato, an expert on emergency room cardiac care, says stories such as Pettry's and Gustafson's represent the difficulties doctors face in diagnosing heart problems.
Over the past six years, studies in the New England Journal of Medicine and other journals have found a heart attack diagnosis is missed in 2% of heart attack patients seeking help in the USA's emergency rooms, 3% in Canada and 6% in the United Kingdom.
"It is the horns of the dilemma. On one hand, there are limitations to the diagnostic tools, and they are very real limitations," Ornato says. "The electrocardiogram is the first screening tool, and it's only going to pick up, on a good day, 70% to 75% of heart attacks."
He says new devices, including an experimental ECG that maps the heart and CT scanners that can look inside of clogged heart arteries, offer new hope for the future.
But he says patients and their advocates must sometimes push doctors who are not listening.
"If something doesn't feel right to them, they have the responsibility to express that," Ornato says. "It's the responsibility of the nurses and physicians to listen."
Prediman Shah, director of cardiology at Cedars-Sinai Medical Center in Los Angeles, says better listening might have saved Pettry.
"A 74-year-old is already a high-risk candidate," he says. "Then, having symptoms, that patient deserves a full evaluation in the hospital. No question. If he is admitted and treated, the risk of sudden death is dramatically reduced."
Mary Pettry wishes she had fought for more aggressive treatment of her husband's symptoms.
"You look back, and you know what you should have done," she says. "It was a great loss. He was such a good person to talk to."
Connie Gustafson, who won her own battle with breast cancer, says her husband's fight to survive reminded her "how vigilant you have to be in taking care of yourself in hospitals. The system is very precarious, and it is easy for mistakes to be made."
Editor's Note: On October 25, 2006, USA TODAY published an article entitled "When a Heart Attack Goes Undiagnosed" regarding the emergency medical care received by James Pettry of Lafayette, Indiana, prior to his death in April 2006. The article may have conveyed the impression that Edward Seall, an emergency room physician who treated Pettry, failed to detect or diagnose a heart attack (myocardial infarction) during Pettry's emergency room visit the day before his death. That is not the case. Seall ran several tests for myocardial infarction and other acute heart problems, and all of the tests were negative. Pettry was later discharged and died suddenly the next day. An autopsy requested by the Pettry family concluded that the cause of death was severe occlusive coronary atherosclerosis, or severely blocked arteries in the heart, and that there was "no evidence" of myocardial infarction or necrosis (cell and tissue death). The story could have used more precise medical terminology in defining the cause of death.
When chest pain woke James Pettry early one morning this spring, his wife, Mary, found him sitting on their bed, short of breath and sweating profusely. She dialed 911.
In the five minutes it took for an ambulance to reach their home in Lafayette, Ind., on April 28, the seriousness of her husband's condition hit Mary. "I thought he was having a heart attack," she says.
The paramedic, who gave Pettry oxygen and aspirin and then used an electrocardiogram machine to examine the heart's electrical function, agreed. The ambulance crew whisked Pettry 3 miles to St. Elizabeth Medical Center.
The doctor in the emergency room, Edward Seall, disagreed with the paramedic. After running more tests, he sent Pettry home nearly five hours later, saying Pettry just had anxiety. The patient was advised to follow up with his doctors but to return if his chest pain became worse.
Pettry, 74, was dead the next day, one of thousands who perish each year when their heart attacks are undetected by doctors.
The retired salesman, a father and grandfather, died from severely clogged arteries while sitting in his easy chair within 24 hours of being discharged, according to an autopsy report.
In part because there is no foolproof test, one in 50 heart attack victims are mistakenly sent home by emergency room doctors, researchers from New England Medical Center in Boston reported in the New England Journal of Medicine in April 2000. Other studies have documented higher rates of missed heart attack diagnosis.
Through his attorney, Jon Pinnick of Indianapolis, Seall stands by his diagnosis and says his patient died from chronic heart disease that had no connection to the symptoms that landed him in the ER.
"It's unfortunate about Mr. Pettry's death, and all concerned wish it hadn't happened," Pinnick says. "Obviously (Seall) feels sympathetic toward the family. But he does not view this as a missed myocardial infarction (heart attack). "We don't believe the care he was provided was below the standard of care and is what led to his unfortunate demise." Mary Pettry says, "It seems like I lost somebody unnecessarily, like there could have been something done."
Going the extra step
Experts say she is right, that often more can be done. Nobody knows exactly how many people die from missed heart attacks every year, but doctors say the number is high despite advances in diagnostics and refinement of medical protocols. "It's tens of thousands of potential cases across the United States each year," says Joseph Ornato, professor and chairman of the Department of Emergency Medicine at Virginia Commonwealth University Medical Center in Richmond, who has researched the emergency care of heart attacks. "Even in the best of hands, you can easily miss cases. This is a very perilous area."
And costly. The monetary risks are huge for physicians. A missed heart attack diagnosis, research has shown, brings the highest malpractice payout of all conditions. The overwhelming majority of malpractice settlements for heart attacks come from errors in diagnosis, according to data from Jury Verdict Research, which tracks and analyzes nationwide trends in personal-injury litigation.
Over the past decade, the median jury verdict for heart attack malpractice lawsuits has been $941,000. The lowest was an Oklahoma judgment for $81,000 in 1996, and the highest, $9 million, came in an Illinois case in 1997.
The Pettry family is considering a lawsuit, but his adult children say what they want most is for other lives to be saved.
The story of Pettry's final hours — and how his death spurred a friend to fight to survive a similar situation — illustrates both the difficulties that doctors face and the actions that can be taken by patients and their advocates.
Stricken before dawn
When medics rolled Pettry into the medical center just after 5 a.m. on April 28, according to medical records, Seall, the doctor on duty in the emergency room, was told the patient with a history of heart problems had suffered "chest pain on and off for the past 24 hours."
Seall ordered the standard tests. The following is from hospital records provided by the Pettry family:
- An electrocardiogram. The first ECG done just minutes after Pettry arrived in the emergency room was "abnormal." When the test was repeated two hours later, the computerized device said "cannot rule out anterior infarct," a type of heart attack. Pinnick says such computerized findings "are not absolute, and when there are circumstances and clinical findings that kind of trump that, you can't make a diagnosis simply based on a computerized reading."
- A chest X-ray and a CT (computed tomography) scan. Both pictures gave doctors a virtual peek inside and showed Pettry did not have any life-threatening problems that sometimes mimic a heart attack, such as large blood clots in his lungs, bulging blood vessels or problems with organs in his chest.
- •Blood tests, called "cardiac markers" because they can indicate a heart attack, were normal.
According to the medical records, after seeing all of the test results, Seall ordered Pettry to take an anti-anxiety drug, Ativan, which had made him feel better in the emergency room, as needed at home. He told Pettry to follow up with his primary physician or cardiologist within two to three days. And he advised him to come back to the emergency department if his symptoms became worse.
As he was getting dressed to leave the hospital just before 10 a.m., Pettry had more chest tightness. Notes in the medical record say: Doctor notified, no further orders and patient instructed to return for any problems. "I know what the record says," Pinnick says. "There was a shift change, and at the time that was recorded, (Seall) was not the emergency room physician. Seall was off at 7 a.m., so I don't know if it's a reference to a resident or what, but it wasn't Seall."
In an e-mail response to questions, the hospital said the nurse could have notified "any doctor on staff in the emergency room at that time." The hospital would not comment further on the case, referring all other questions to Seall.
Seall wrote in his "patient instructions for follow-up care," which Pettry signed at 9:55 a.m., "return to the ED (emergency department) if your symptoms get worse." "They dismissed him and told him to rest, and that is what he did," Mary Pettry says. But the next morning she awoke to find him in his favorite chair with the pains he had had for two days. "He said he had these tight chest pains again, but having spent time down at the hospital, we had no place to go but the same place," she says. "He said: 'I think they're going away. They're going to get better."
She went to feed the cat, Pebbles, but because her husband always brewed the coffee, she returned to ask him how many scoops to use. "I touched his arm the way you do when a person is asleep," she says. "His arm was cold, and he didn't have a pulse. I called 911, but when they came, they said it was too late. I knew that."
During the memorial service the following week at Bethany Presbyterian Church, Jim Pettry was remembered as an astute and deeply religious man who developed a love for fishing while growing up in West Virginia.
"Jim was concerned for our world's future and the future of this congregation and thoughtfully sought out a vision and discernment of God's will for our future and worked faithfully toward that future," the Rev. Kevin Bowers told Pettry's friends and family. "He never quit caring about others and will have a positive impact on people's lives even beyond his years."
Two weeks after she attended Pettry's funeral, Connie Gustafson, a longtime friend of Pettry's daughter Deborah, found herself at Methodist Hospital in Indianapolis with her husband, Rick. On a quiet Tuesday afternoon, he had suddenly felt weak, nearly fainted and broke out in a sweat. The pressure in his upper right chest felt like a previous heart problem that had required bypass surgery 11 years ago.
Despite the similarities and Gustafson's strong feeling that he was having another life-threatening problem with his heart, a cardiologist in the hospital, Irmina Gradus-Pizlo, came to a different conclusion.
'Nothing obvious'
After Gustafson had the same battery of tests Pettry had taken and doctors found no evidence of a heart attack, they went a step further. They admitted him to the hospital and performed more tests, including a stress test, putting Gustafson on a treadmill and monitoring his heart as the 59-year-old social worker was pushed to his physical limits.
"They could find nothing obvious," Connie says. "The cardiologist on call was dismissive. She said there was nothing to support the diagnosis that he had any kind of heart event."
But Connie says her husband "could feel that something was not right."
When no problems were found, doctors determined the uneasy feelings Gustafson had experienced were an "anxiety/panic attack," according to medical records electronically signed by Gradus-Pizlo. Gustafson, like Pettry, was given Ativan and "told he has anxiety attacks and to take a deep breath," the records state. Upon discharge, he was told "to return to the ER if any chest pain recurs."
The records show Gustafson was advised to follow up with his own doctor within four weeks, eat a heart-healthy diet, and take his cholesterol medicines and aspirin, among other medications.
Connie thought of Pettry. "It was heavy on my mind that this was exactly what Jim had gone through: not getting somebody to listen to him."
As the staff prepared to discharge Gustafson, he saw Barry Crevey, a cardiologist he had met through his social work, in the hallway. Crevey listened to Gustafson's story and explained that 25% of heart attacks may be "silent."
Considering Gustafson's history and the fact that both his parents had cardiovascular disease, the doctor suggested his arteries should be checked by threading a heart catheter into them, injecting dye and measuring the openings.
"When he told me his story, I'm thinking, 'This person needs a heart catheterization,' " Crevey says. "This is Cardiology 101. I would not have even bothered to do a non-invasive stress test."
A doctor intervenes
After he was discharged from the hospital, Gustafson became Crevey's patient and two days later had a cardiac catheterization, which, according to his medical records, found "severe, multivessel coronary disease."
Gustafson's medical record detailing the findings of the coronary angiography reads much like Pettry's autopsy report. Both major heart vessels and some of the 11-year-old bypass vessels were 90% to 100% blocked.
The arteries were cleared with stents and a drilling procedure, and Gustafson is now back at work with "a clean bill of health," Connie says.
"They were big arteries," she says, noting one of the arteries that was almost completely blocked — the left anterior descending artery — is sometimes called "the widowmaker" because of the deadly result when it gets clogged.
Gradus-Pizlo says, "In a patient with known disease, there is no question there are blockages there," but none of the blockages were putting Gustafson's life at immediate risk.
His heart was working fine with the reduced blood flow, which was confirmed by the fact that he passed the stress test, she says. "Even with those blockages, he had adequate blood supply. I'm not saying he doesn't have disease. He has severe disease. I didn't recommend therapy. I recommended aggressive medical management based on guidelines."
Though she agrees the blockages should have been opened once they were seen, she does not believe she misdiagnosed Gustafson. "I believe it is a difference of approach," Gradus-Pizlo says.
"This is a matter of clinical judgment."
Crevey's medical record of Gustafson's condition shows frustration with the initial diagnosis.
"He gave a vivid classic description of a major cardiac ischemic event," the report says, meaning an artery in his heart was blocked. In addition to his parents' heart disease, Gustafson's
"personal history began with a false-negative cardiac stress test" before his initial bypass surgery. "All of that was far too much to overlook, despite the 'normal' stress test," the report says.
Crevey says a doctor relying too much on tests instead of the patient's own story "is a classic dilemma in medicine."
"The tests are not perfect," he says. "I think the clinician must be super wary of worshiping at the altar of the tests. Unfortunately, that is often the case. They say the test here is negative and therefore you are OK, and that is the end of the story. It certainly happened with Mr. Gustafson."
In Crevey's opinion, based on his review of the record, Gradus-Pizlo's decision was a "serious misdiagnosis."
Many similar stories
Ornato, an expert on emergency room cardiac care, says stories such as Pettry's and Gustafson's represent the difficulties doctors face in diagnosing heart problems.
Over the past six years, studies in the New England Journal of Medicine and other journals have found a heart attack diagnosis is missed in 2% of heart attack patients seeking help in the USA's emergency rooms, 3% in Canada and 6% in the United Kingdom.
"It is the horns of the dilemma. On one hand, there are limitations to the diagnostic tools, and they are very real limitations," Ornato says. "The electrocardiogram is the first screening tool, and it's only going to pick up, on a good day, 70% to 75% of heart attacks."
He says new devices, including an experimental ECG that maps the heart and CT scanners that can look inside of clogged heart arteries, offer new hope for the future.
But he says patients and their advocates must sometimes push doctors who are not listening.
"If something doesn't feel right to them, they have the responsibility to express that," Ornato says. "It's the responsibility of the nurses and physicians to listen."
Prediman Shah, director of cardiology at Cedars-Sinai Medical Center in Los Angeles, says better listening might have saved Pettry.
"A 74-year-old is already a high-risk candidate," he says. "Then, having symptoms, that patient deserves a full evaluation in the hospital. No question. If he is admitted and treated, the risk of sudden death is dramatically reduced."
Mary Pettry wishes she had fought for more aggressive treatment of her husband's symptoms.
"You look back, and you know what you should have done," she says. "It was a great loss. He was such a good person to talk to."
Connie Gustafson, who won her own battle with breast cancer, says her husband's fight to survive reminded her "how vigilant you have to be in taking care of yourself in hospitals. The system is very precarious, and it is easy for mistakes to be made."
Wednesday, October 15, 2008
West Wirral family and paramedics overcome by toxic gas fumes
Sue McCann, Birkenhead News
PARAMEDICS rescuing a couple who had been overcome by carbon monoxide gas were themselves hit by the toxic fumes.
Two of the couple’s relatives were also treated at hospital following the incident at the West Wirral home.
Now the family - and their rescuers - are calling on householders to install carbon monoxide alarms in their homes and to have gas and other fossil fuel-burning appliances tested before winter sets in.
Irene Bishton had been feeling unwell for several days and had arranged for her sister, Sheila Ross, to take her to the doctor.
Her husband, Stan Bishton, said: “Irene felt odd when she got up. She was unsteady on her feet, started to stagger and then collapsed. “Fortunately, she had unlocked the front door in readiness for her sister’s arrival before collapsing. “I was still in bed and thought I was all right but when I tried to dial 999 I couldn’t do it. I had been overcome by fumes without realising it.”
Sheila called the ambulance and also phoned for her husband Brian to come and help.
Stan continued: “They initially thought Irene had suffered a stroke and took her to Arrowe Park Hospital.
“But when some of the paramedics began to feel ill, they realised there was a strong possibility of carbon monoxide in the house.”
All four members of the family along with six ambulance crew were treated in hospital.
Brandon Newman, one of the first ambulance paramedics on the scene, said: “We assessed the condition of Mr and Mrs Bishton but quickly realised something was not right when we began to feel ill ourselves.
“I had a gut feeling it could be carbon monoxide poisoning, so we opened all the windows and doors to ventilate the house and called for a second ambulance.
“This was potentially a very serious situation that could have caused the loss of the whole family.”
Paul Ferguson, area director for the North West Ambulance Service, added: “I am proud of the way our operational staff dealt with this incident. Their actions may well have saved the lives of those involved.”
The build-up of carbon monoxide was caused by a blocked flu from the gas central heating boiler.
Stan said: “I hadn’t had the boiler serviced for two years and it didn’t occur to me there might have been a problem.
“Now we’re having the entire system replaced and we’ve bought audible CO alarms. In fact, everyone we’ve told about this has gone out and bought an alarm.
“It has been a very frightening experience.”
http://www.wirralnews.co.uk/wirral-news/local-wirral-news/2008/10/15/west-wirral-family-and-paramedics-overcome-by-toxic-gas-fumes-80491-22029684/
Sunday, October 5, 2008
Woman, 92 Pulls Gun On Paramedics
POSTED: 9:14 am EDT October 5, 2008
UPDATED: 9:16 am EDT October 5, 2008
MELBOURNE, Fla. -- A 92-year-old woman surprised some Central Florida paramedics performing a well-being check when she pulled a gun and threatened them.
A friend called emergency services to a home located near the 2700 Block of Wickham Road on Saturday. When the emergency workers arrived, the woman pulled the gun, authorities said.
Melbourne police were called to disarm the woman.
No charges will be filed because of the woman's age and medical condition.
Woman, 92 Pulls Gun On Paramedics
MELBOURNE, Fla. -- A 92-year-old woman surprised some Central Florida paramedics performing a well-being check when she pulled a gun and threatened them.
A friend called emergency services to a home located near the 2700 Block of Wickham Road on Saturday.
When the emergency workers arrived, the woman pulled the gun, authorities said.
Melbourne police were called to disarm the woman.
No charges will be filed because of the woman's age and medical condition.
A friend called emergency services to a home located near the 2700 Block of Wickham Road on Saturday.
When the emergency workers arrived, the woman pulled the gun, authorities said.
Melbourne police were called to disarm the woman.
No charges will be filed because of the woman's age and medical condition.
Thursday, October 2, 2008
Firefighter Steals Severed Foot From Crash Scene
ST. LUCIE COUNTY — Cindy Economou, last years county firefighter of the year who runs a nonprofit horse therapy program for emotionally and mentally challenged people, is the St. Lucie County firefighter accused of taking a Melbourne mans severed foot from an Interstate 95 crash scene a week ago.
Fire District officials on Thursday called a hasty news conference to disclose a firefighter was under investigation for taking Karl Lamberts foot, but refused to identify the person, saying it was a veteran paramedic who trains cadaver dogs, which are used to follow the scent of decomposing human flesh.
On Friday, Fire District officials released a letter dated Thursday to Economou placing her on administrative leave with pay due to an internal investigation of a call to I-95 mile marker No. 118 on September 19, 2008, which you responded, and allegations of inappropriate actions have been raised against you.
Repeated attempts to reach Economou, a firefighter and paramedic since the early 1990s, were unsuccessful.
Lambert, 46, hired attorney Ray Christian, who said it was his understanding Economou wanted the foot to help in dog training. Christian said Lambert is missing a portion of his left leg from six to eight inches below the knee and that the missing portion was returned to St. Marys Medical Center in West Palm Beach five days after the crash, on Sept. 24. Lambert still is in the hospital.
The 19th through the 24th, he was not aware that somebody had absconded with his leg, Christian said.
Christian suspects law enforcement officials started asking questions because body parts typically accompany patients to the hospital.
So when they got to the hospital and he didnt have his leg, I think they started to backtrack and started looking to see what had happened, Christian said. Thats when they realized that someone had taken it.
Christian said when the Florida Highway Patrol returned the leg, it was frozen and apparently couldnt be re-attached. He said only a doctor could determine whether it could have been re-attached if it arrived with Lambert, who was traveling to Fort Lauderdale to pick up flooring material for his brother-in-law at the time.
My understanding, to be fair, is that (Economou) has not really hidden the fact that she has it, Christian said.
Fire District spokeswoman Catherine Chaney said about 17 fire district personnel, including Battalion Chief Jim Hall and Deputy Chief Michael Bailey, responded to the crash near the Tradition exit. Neither Hall nor Bailey could be reached Friday.
Chaney couldnt say whether any of these people knew Economou took the foot, citing the fire districts ongoing investigation. None of the other fire district members at the scene have been placed on administrative leave, she said.
Andy Rebmann, whos been involved in search work and K-9 police dog training since 1972 and wrote Cadaver Dog Handbook, said that in training, cadaver dogs are introduced to the scent of decomposition.
In some parts of the country, Rebmann said, the coroner can release bodily fluids or parts to qualified individuals. Some people want to donate their bodies for use in training dogs for human recovery. Donated placentas also can be used, he said.
A firefighter taking a body part for cadaver dog training or other purposes, Rebmann said, would be unusual and also unethical ... unless it was released by the proper authorities.
Economou runs Fully Involved Farms, which provides physically, emotionally and mentally challenged people an opportunity to experience horse riding at no cost to them.
Fire District officials on Thursday called a hasty news conference to disclose a firefighter was under investigation for taking Karl Lamberts foot, but refused to identify the person, saying it was a veteran paramedic who trains cadaver dogs, which are used to follow the scent of decomposing human flesh.
On Friday, Fire District officials released a letter dated Thursday to Economou placing her on administrative leave with pay due to an internal investigation of a call to I-95 mile marker No. 118 on September 19, 2008, which you responded, and allegations of inappropriate actions have been raised against you.
Repeated attempts to reach Economou, a firefighter and paramedic since the early 1990s, were unsuccessful.
Lambert, 46, hired attorney Ray Christian, who said it was his understanding Economou wanted the foot to help in dog training. Christian said Lambert is missing a portion of his left leg from six to eight inches below the knee and that the missing portion was returned to St. Marys Medical Center in West Palm Beach five days after the crash, on Sept. 24. Lambert still is in the hospital.
The 19th through the 24th, he was not aware that somebody had absconded with his leg, Christian said.
Christian suspects law enforcement officials started asking questions because body parts typically accompany patients to the hospital.
So when they got to the hospital and he didnt have his leg, I think they started to backtrack and started looking to see what had happened, Christian said. Thats when they realized that someone had taken it.
Christian said when the Florida Highway Patrol returned the leg, it was frozen and apparently couldnt be re-attached. He said only a doctor could determine whether it could have been re-attached if it arrived with Lambert, who was traveling to Fort Lauderdale to pick up flooring material for his brother-in-law at the time.
My understanding, to be fair, is that (Economou) has not really hidden the fact that she has it, Christian said.
Fire District spokeswoman Catherine Chaney said about 17 fire district personnel, including Battalion Chief Jim Hall and Deputy Chief Michael Bailey, responded to the crash near the Tradition exit. Neither Hall nor Bailey could be reached Friday.
Chaney couldnt say whether any of these people knew Economou took the foot, citing the fire districts ongoing investigation. None of the other fire district members at the scene have been placed on administrative leave, she said.
Andy Rebmann, whos been involved in search work and K-9 police dog training since 1972 and wrote Cadaver Dog Handbook, said that in training, cadaver dogs are introduced to the scent of decomposition.
In some parts of the country, Rebmann said, the coroner can release bodily fluids or parts to qualified individuals. Some people want to donate their bodies for use in training dogs for human recovery. Donated placentas also can be used, he said.
A firefighter taking a body part for cadaver dog training or other purposes, Rebmann said, would be unusual and also unethical ... unless it was released by the proper authorities.
Economou runs Fully Involved Farms, which provides physically, emotionally and mentally challenged people an opportunity to experience horse riding at no cost to them.
Tuesday, July 8, 2008
Maine Paramedic Killed in Ambulance Crash
Sun Journal
TURNER, Maine-- A Wilton paramedic was killed early this morning when an ambulance he was riding in collided with a pickup truck at the intersection of Route 4 and Potato Road, police say.
Allan Parsons, 46, was tending to a patient in the back of the Med-Care ambulance, en route from the Rumford area to Central Maine Medical Center in Lewiston. Parsons died at the scene, according to the Andrsoscoggin County Sheriff's Department.
In a written release, Sheriff Guy Desjardins reported that the ambulance -- emergency lights reportedly flashing -- collided with a black pickup crossing Route 4 from Potato Road to Lone Pine Road at about 3 a.m.
The driver of the ambulance was identified as Arlene Greenleaf, 68, of Bethel. She had to be extricated from the ambulance.
The driver of the truck was identified as Christopher Boutin, 29, of Turner. He was ejected from his vehicle.
Greenleaf and Boutin, along with the patient in the ambulance, were taken to CMMC.
Thursday, July 3, 2008
Paramedic Sexually Assaulted Woman In Ambulance
CLEARWATER, FLA–SunStar paramedic Patrick Livingston was arrested by Pinellas County
Posted on Thursday, 3 of July , 2008
Sheriff’s detectives Wednesday afternoon for sexual battery after allegedly assaulting a woman in an ambulance that was taking her to the hospital.
Police said Livingston, 38, of Clearwater allegedly sexually battered a female patient in her mid-20s by touching the victim in a manner which was inappropriate and not medically necessary for her condition. The female was being transported in the ambulance from her home to a local hospital. The incident occurred Thursday night, June 26 and was reported by the victim the following day.
The victim’s name, and any information that could identify the victim is not being released due to the nature of the crime.
Detectives say Livingston was arrested after making certain statements during interviews with them.
Paramedic Sexually Assaulted Woman In Ambulance
CLEARWATER, FLA–SunStar paramedic Patrick Livingston was arrested by Pinellas County Sheriff’s detectives Wednesday afternoon for sexual battery after allegedly assaulting a woman in an ambulance that was taking her to the hospital.
Police said Livingston, 38, of Clearwater allegedly sexually battered a female patient in her mid-20s by touching the victim in a manner which was inappropriate and not medically necessary for her condition. The female was being transported in the ambulance from her home to a local hospital. The incident occurred Thursday night, June 26 and was reported by the victim the following day.
The victim’s name, and any information that could identify the victim is not being released due to the nature of the crime.
Detectives say Livingston was arrested after making certain statements during interviews with them.
Police said Livingston, 38, of Clearwater allegedly sexually battered a female patient in her mid-20s by touching the victim in a manner which was inappropriate and not medically necessary for her condition. The female was being transported in the ambulance from her home to a local hospital. The incident occurred Thursday night, June 26 and was reported by the victim the following day.
The victim’s name, and any information that could identify the victim is not being released due to the nature of the crime.
Detectives say Livingston was arrested after making certain statements during interviews with them.
Monday, June 30, 2008
Medical helicopter crash deaths on record pace
By Alan Levin, USA TODAY
The fiery midair collision between two helicopters in Flagstaff, Ariz., on Sunday put this year on pace to be the deadliest ever for air ambulance crashes.
So far in 2008, 16 people have died in emergency medical helicopter crashes, including six people in Sunday's crash. That's two shy of the record 18 deaths in 2004, according to the National Transportation Safety Board.
"Unfortunately we are moving toward a record-breaking year here," NTSB Chairman Mark Rosenker said in a phone interview after traveling to the accident scene Monday. "We are hoping that this accident will sensitize the industry and the regulators to immediately begin a recognition of what is necessary to prevent these accidents."
The NTSB issued a special report in 2006 highlighting issues that had caused an upsurge in emergency helicopter crashes, particularly during nighttime and in poor visibility.
The number of crashes and fatalities fell briefly after the report was issued and the Federal Aviation Administration increased oversight of the industry, but they have risen this year.
An Air Methods helicopter collided with a Classic Helicopters flight about one-quarter mile from the Flagstaff Medical Center at about 3:45 p.m. Sunday. The Air Methods craft was heading north while the other helicopter was going in the opposite direction, Rosenker said. Both were following normal paths to the hospital. The collision occurred in clear weather, Rosenker said.
The victims included firefighter Michael McDonald, 26, who was being taken to the hospital on the Classic flight after being injured near the Grand Canyon. Also dead were pilot Tom Caldwell, 54, and paramedic Tom Clausing, 36. Flight nurse James Taylor, 36, was in critical condition.
All three aboard the other helicopter died: pilot Pat Graham, 50, flight nurse Shawn Shreeve, 36, and patient Raymond Zest, 54.
The collision between two air ambulance helicopters was the first in history, according to NTSB records. Previously, most fatal accidents occurred in poor visibility, often late at night, and NTSB's suggested safety improvements focused on those factors.
Investigators do not know why the pilots apparently failed in one of the most basic concepts of flight safety: to "see and avoid" other aircraft, Rosenker said.
Gary Sizemore, president of the National EMS Pilots Association, said that crews typically have several layers of protection against midair collisions. They often report by radio when approaching a hospital and frequently will announce their presence on a special radio frequency reserved for other helicopters, he said. The two helicopters were not under the supervision of air traffic controllers, Rosenker said.
The collision was recorded on a hospital surveillance camera and the recording will be sent to the NTSB's Washington, D.C., lab for analysis, Rosenker said.
Industry officials defended the safety record of air ambulance flights, saying 500,000 patients are transported safety each year.
"There is a lesson in every accident that needs to be communicated to increase safety," said Christopher Eastlee, government relations manager for the Association of Air Medical Services.
Air-ambulance crews among most likely to die
By Alan Levin, USA TODAY
WASHINGTON — Air-ambulance helicopters have the worst fatal crash record in aviation, and their crews are among the most likely to die on the job, an expert told a panel of federal investigators Tuesday.
The rate of fatalities per 100,000 air-ambulance employees over the past 10 years exceeds other dangerous professions such as logging or deep-sea fishing, said Ira Blumen, program director of the University of Chicago Aeromedical Network.
DEADLY YEAR: Medical helicopter crash deaths on record pace
Blumen's comments came during the first day of a hearing by the National Transportation Safety Board (NTSB), which is examining the industry's burgeoning accidents.
"It's a high-risk occupation. It's alarming," Blumen said.
Relatively few patients have died: 34 out of about 4.3 million transported since 1972, Blumen said. It's unclear why; one possible explanation is that air-ambulance flights spend more time flying without a patient than while carrying one. A typical emergency run involves three trips: one to pick up the patient; another to transport the victim; and a third to return to the helicopter base after the patient is dropped off.
Another reason is that crewmembers outnumber patients three or four to one on flights.
Tearful relatives of recent crash victims demanded that the Federal Aviation Administration (FAA) take action to stem the death toll.
Steve Ogletree, 44, an airport manager whose 14-month-old granddaughter, Kirstin Blockinger, died in a crash Oct. 15, said he was stunned by how lightly the government regulates the industry compared with airlines. "I say to the FAA, shame on you," Ogletree said.
The FAA has pushed the industry to adopt stricter safety standards but has emphasized voluntary change because it can be accomplished faster than writing new regulations, FAA spokesman Les Dorr said.
Since 1972, 264 people have died in air-ambulance crashes, according to Blumen. Nine fatal crashes since December 2007 have killed 35 people. That's the highest death toll in the industry's history.
The accident statistics for the USA stand in stark contrast to Canada, which has not had a fatality since 1977. Unlike most companies in the United States, Canada requires two pilots on each helicopter, and flights are conducted under more rigorous standards for weather, said Sylvain Séguin, a vice president of Canadian Helicopters.
The NTSB hearing is trying to pinpoint what could be driving the recent increase in fatal crashes. Several witnesses raised concerns about whether competition to make the helicopter flights — which can pay as much as $10,000 — could be driving up the accident rates.
"The safety board is concerned that these types of accidents will continue if a concerted effort is not made to improve," NTSB member Robert Sumwalt said.
Tuesday, June 10, 2008
999 boss hits out at knife threat
Reporter: Beatriz Ayala
A SENIOR ambulance official has hit out after emergency crews received knife threats
Delwyn Wray, North-West Ambulance Service area director, said: “This was an unacceptable act of violence on defenceless ambulance workers carrying out a valuable service.”
Police were called to an address in Vale Drive, Coldhurst, last Tuesday following reports that an ambulance crew were being threatened.
Officers arrived at the scene to discover that the ambulance crew — a 43-year-old man and a 41-year-old woman — had locked themselves in a downstairs room and were being threatened after responding to an emergency call at the address.
Mr Wray said: “Our ambulance staff save lives on a daily basis and it is saddening that some individuals are subjecting them to violence and abuse.
“This not only places the crews at risk, but also prevents them from doing their jobs.
“Patients’ lives can also be put at risk.”
Last year in the Greater Manchester area alone there were 364 reports of verbal and physical assaults on ambulance staff. Many incidents are still not being reported.
Mr Wray said: “There is an unacceptable level of violence and abuse directed towards staff that we simply will not tolerate and we want to send out a very clear message to anyone who assaults our crews, either verbally or physically, that they face the very real possibility of prosecution.
“On this occasion the crew had a very lucky escape and were not harmed but were left shaken and upset by the incident.
“The police acted swiftly to make an arrest and we will co-operate fully with them in their investigations.”
A 44-year-old man has been charged with false imprisonment, threats to kill and affray.
He will appear before Minshull Street Crown Court, Manchester, on Thursday.
http://www.oldham-chronicle.co.uk/news-features/8/news/14893/999-boss-hits-out-at-knife-threat
A SENIOR ambulance official has hit out after emergency crews received knife threats
Delwyn Wray, North-West Ambulance Service area director, said: “This was an unacceptable act of violence on defenceless ambulance workers carrying out a valuable service.”
Police were called to an address in Vale Drive, Coldhurst, last Tuesday following reports that an ambulance crew were being threatened.
Officers arrived at the scene to discover that the ambulance crew — a 43-year-old man and a 41-year-old woman — had locked themselves in a downstairs room and were being threatened after responding to an emergency call at the address.
Mr Wray said: “Our ambulance staff save lives on a daily basis and it is saddening that some individuals are subjecting them to violence and abuse.
“This not only places the crews at risk, but also prevents them from doing their jobs.
“Patients’ lives can also be put at risk.”
Last year in the Greater Manchester area alone there were 364 reports of verbal and physical assaults on ambulance staff. Many incidents are still not being reported.
Mr Wray said: “There is an unacceptable level of violence and abuse directed towards staff that we simply will not tolerate and we want to send out a very clear message to anyone who assaults our crews, either verbally or physically, that they face the very real possibility of prosecution.
“On this occasion the crew had a very lucky escape and were not harmed but were left shaken and upset by the incident.
“The police acted swiftly to make an arrest and we will co-operate fully with them in their investigations.”
A 44-year-old man has been charged with false imprisonment, threats to kill and affray.
He will appear before Minshull Street Crown Court, Manchester, on Thursday.
http://www.oldham-chronicle.co.uk/news-features/8/news/14893/999-boss-hits-out-at-knife-threat
Wednesday, May 28, 2008
paramedic's bike from church
DailyRecord.co.uk May 28 2008
A PARAMEDIC'S bike with two baskets of life-saving drugs was stolen from inside a church.
The haul included liquid diazepam and an electric shock box used to treat heart attacks.
The theft took place on Monday at St George's West church in Shandwick Place, Edinburgh.
The paramedic was based in the church while roadworks were being carried out in the city.
A police spokesman said: "These drugs should not be taken without prescription."
Friday, January 4, 2008
Woman upset over sirens chases paramedics with rolling pin
SARASOTA - A Sarasota County woman is back home today charged with aggravated assault on EMS personnel.Authorities say 50-year-old Marjorie Kelley was put behind bars after chasing paramedics with a rolling pin at her home on Bahia Vista Street.
Officials say the ambulance showed up to Kelley's house on Wednesday after she called reporting chest pains.
Deputies say Kelley told the fire department not to use their lights and sirens. When they did, she went after three paramedics yelling with a rolling pin.
She is out on bond and charged with three counts of aggravated assault.
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