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Re: Legal or Not?

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Signed your AMA form? Sounds like this wasn't an AMA refusal... sounds like

your advice was that a refusal was acceptable under certain enumerated

conditions that the Sergeant agreed to. If it was AMA, that's a lot of

liability for a police officer...

Mike :)

Re: Legal or Not?

Heres the flip side to the consent for treatment issue. I had a call at

one of the local city jails. The prisoner had a severe case of " jailitis "

and wanted to go to the hospital (something about a change of

scenery).Anyway, since I could not refuse transport I did talk to the

Sgt. on duty who did refused to allow her to go seek medical treatment.

I assessed this patient very well and documented well. The sgt. then

signed my AMA form. Does anyone see a problem with this?

Lindsey EMT-P

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Wow, that's possibly a big problem, for both you and the PD. There's a

couple of reasons why.

In City of Canton, Ohio v. (1989), the city (PD) was sued and

lost when an inmate was refused medical care. The court ruled the

officers showed " deliberate indifference " by not allowing her access to

medical care. The court stated the officers had not been provided the

proper training to assess whether or not the inmate needed medical care

and therefore were liable for her mistreatment. The subsequent case law

implies that unless an officer has the training and necessary equipment

as well as medical direction he could not make the determination whether

or not a prisoner could be denied ACCESS to medical care. While an

officer cannot force someone to accept care, he can control their access

to such care.

Secondly, without knowing the entire pt. complaint/hx., etc., I don't

know if your protocols cover this incident. However, it is important to

remember that as medics we do not practice automonously. We require the

oversight and interaction of a physician, therefore, it is his/her

license in jeapordy when we engage in behavior that is ill-advisable (as

well as our own certification/licensure). I would be willing to bet

that if it came to a suit, that Sgt., the PD and the city would put it

all right on your's, your company's and your medical director's back.

Again, I'm not saying you did anything improper per your protocols, I

just believe we should be much more judicious in our " no transports " .

This very jailitis, a.k.a. abberrant jail avoidance syndrome, is the

very reason why telemedicine is working its way into detention

facilities. This is fast becoming the next arena for pre-hospital

providers.

LP

julie a lindsey wrote:

>

> Heres the flip side to the consent for treatment issue. I had a call at

> one of the local city jails. The prisoner had a severe case of " jailitis "

> and wanted to go to the hospital (something about a change of

> scenery).Anyway, since I could not refuse transport I did talk to the

> Sgt. on duty who did refused to allow her to go seek medical treatment.

> I assessed this patient very well and documented well. The sgt. then

> signed my AMA form. Does anyone see a problem with this?

>

> Lindsey EMT-P

>

> ------------------------------------------------------------------------

> Get your bargains at AndysGarage.com!

> http://click./1/2579/4/_/4981/_/955137376/

> ------------------------------------------------------------------------

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Guest guest

,

Having once been in law enforcement and with the way everyone is lawsuit

happy now days, It is my understanding that most departments either PD or SO

jails will not take a person that maybe in need of medical attention because

of the legal liability that they are assuming by taking that person. Does

this still hold true for the most past still?

Thanks,

Wayne

Re: Legal or Not?

>Wow, that's possibly a big problem, for both you and the PD. There's a

>couple of reasons why.

>

>In City of Canton, Ohio v. (1989), the city (PD) was sued and

>lost when an inmate was refused medical care. The court ruled the

>officers showed " deliberate indifference " by not allowing her access to

>medical care. The court stated the officers had not been provided the

>proper training to assess whether or not the inmate needed medical care

>and therefore were liable for her mistreatment. The subsequent case law

>implies that unless an officer has the training and necessary equipment

>as well as medical direction he could not make the determination whether

>or not a prisoner could be denied ACCESS to medical care. While an

>officer cannot force someone to accept care, he can control their access

>to such care.

>

>Secondly, without knowing the entire pt. complaint/hx., etc., I don't

>know if your protocols cover this incident. However, it is important to

>remember that as medics we do not practice automonously. We require the

>oversight and interaction of a physician, therefore, it is his/her

>license in jeapordy when we engage in behavior that is ill-advisable (as

>well as our own certification/licensure). I would be willing to bet

>that if it came to a suit, that Sgt., the PD and the city would put it

>all right on your's, your company's and your medical director's back.

>

>Again, I'm not saying you did anything improper per your protocols, I

>just believe we should be much more judicious in our " no transports " .

>This very jailitis, a.k.a. abberrant jail avoidance syndrome, is the

>very reason why telemedicine is working its way into detention

>facilities. This is fast becoming the next arena for pre-hospital

>providers.

>

> LP

>julie a lindsey wrote:

>>

>> Heres the flip side to the consent for treatment issue. I had a call at

>> one of the local city jails. The prisoner had a severe case of " jailitis "

>> and wanted to go to the hospital (something about a change of

>> scenery).Anyway, since I could not refuse transport I did talk to the

>> Sgt. on duty who did refused to allow her to go seek medical treatment.

>> I assessed this patient very well and documented well. The sgt. then

>> signed my AMA form. Does anyone see a problem with this?

>>

>> Lindsey EMT-P

>>

>> ------------------------------------------------------------------------

>> Get your bargains at AndysGarage.com!

>> http://click./1/2579/4/_/4981/_/955137376/

>> ------------------------------------------------------------------------

>

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Guest guest

I was under the impression that until a patient was unresponsive he/she had

the right to refuse treatment. If the officers still wanted the patient seen

it would be at the cost of the particular department, i.e., DPS, SO, or local

PD. This is worth checking into since we are told (through the media) that

counties and states pay for housing and all other bills incurred when they no

longer have the room for inmates.

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Wayne, I can't speak for all but you're right on the money as far as

our's goes. If they're so drunk they're unconcious, any major lacs, any

complaint of illness or injury, etc., and they get a free ride to the

ER. Again, that's where telemedicine is making progressive inroads.

This may not seem important but it keeps medics on the street, MICU's

available, taxpayer costs down. That last one translates into more money

for other endeavours, i.e. EMS perhaps. Furthermore, it may provide a

place for tired old medics to go... :-).

LP

Arlington PD

Wayne wrote:

>

> ,

>

> Having once been in law enforcement and with the way everyone is lawsuit

> happy now days, It is my understanding that most departments either PD or SO

> jails will not take a person that maybe in need of medical attention because

> of the legal liability that they are assuming by taking that person. Does

> this still hold true for the most past still?

>

> Thanks,

> Wayne

> Re: Legal or Not?

>

> >Wow, that's possibly a big problem, for both you and the PD. There's a

> >couple of reasons why.

> >

> >In City of Canton, Ohio v. (1989), the city (PD) was sued and

> >lost when an inmate was refused medical care. The court ruled the

> >officers showed " deliberate indifference " by not allowing her access to

> >medical care. The court stated the officers had not been provided the

> >proper training to assess whether or not the inmate needed medical care

> >and therefore were liable for her mistreatment. The subsequent case law

> >implies that unless an officer has the training and necessary equipment

> >as well as medical direction he could not make the determination whether

> >or not a prisoner could be denied ACCESS to medical care. While an

> >officer cannot force someone to accept care, he can control their access

> >to such care.

> >

> >Secondly, without knowing the entire pt. complaint/hx., etc., I don't

> >know if your protocols cover this incident. However, it is important to

> >remember that as medics we do not practice automonously. We require the

> >oversight and interaction of a physician, therefore, it is his/her

> >license in jeapordy when we engage in behavior that is ill-advisable (as

> >well as our own certification/licensure). I would be willing to bet

> >that if it came to a suit, that Sgt., the PD and the city would put it

> >all right on your's, your company's and your medical director's back.

> >

> >Again, I'm not saying you did anything improper per your protocols, I

> >just believe we should be much more judicious in our " no transports " .

> >This very jailitis, a.k.a. abberrant jail avoidance syndrome, is the

> >very reason why telemedicine is working its way into detention

> >facilities. This is fast becoming the next arena for pre-hospital

> >providers.

> >

> > LP

> >julie a lindsey wrote:

> >>

> >> Heres the flip side to the consent for treatment issue. I had a call at

> >> one of the local city jails. The prisoner had a severe case of " jailitis "

> >> and wanted to go to the hospital (something about a change of

> >> scenery).Anyway, since I could not refuse transport I did talk to the

> >> Sgt. on duty who did refused to allow her to go seek medical treatment.

> >> I assessed this patient very well and documented well. The sgt. then

> >> signed my AMA form. Does anyone see a problem with this?

> >>

> >> Lindsey EMT-P

> >>

> >> ------------------------------------------------------------------------

> >> Get your bargains at AndysGarage.com!

> >> http://click./1/2579/4/_/4981/_/955137376/

> >> ------------------------------------------------------------------------

> >

> >------------------------------------------------------------------------

> >Special Offer-Earn 300 Points from MyPoints.com for trying @Backup

> >Get automatic protection and access to your important computer files.

> >Install today:

> >http://click./1/2344/4/_/4981/_/955143499/

> >------------------------------------------------------------------------

> >

> >

>

> ------------------------------------------------------------------------

> Special Offer-Earn 300 Points from MyPoints.com for trying @Backup

> Get automatic protection and access to your important computer files.

> Install today:

> http://click./1/2344/4/_/4981/_/955151221/

> ------------------------------------------------------------------------

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Guest guest

It is the same in County, if there is any

complaint of illness/injury or if the jail Sgt. thinks

they need medical attention, they go to the ER. One

that I have trouble with is if the person's blood

alcohol is greater that .250, they go to the ER. We

got people that maintain that BAC as their normal I

think.

Moseley LP

Cleburne PD

--- wrote:

> Wayne, I can't speak for all but you're right on the

> money as far as

> our's goes. If they're so drunk they're unconcious,

> any major lacs, any

> complaint of illness or injury, etc., and they get a

> free ride to the

> ER. Again, that's where telemedicine is making

> progressive inroads.

> This may not seem important but it keeps medics on

> the street, MICU's

> available, taxpayer costs down. That last one

> translates into more money

> for other endeavours, i.e. EMS perhaps.

> Furthermore, it may provide a

> place for tired old medics to go... :-).

>

> LP

> Arlington PD

> Wayne wrote:

> >

> > ,

> >

> > Having once been in law enforcement and with the

> way everyone is lawsuit

> > happy now days, It is my understanding that most

> departments either PD or SO

> > jails will not take a person that maybe in need of

> medical attention because

> > of the legal liability that they are assuming by

> taking that person. Does

> > this still hold true for the most past still?

> >

> > Thanks,

> > Wayne

> > Re: Legal or Not?

> >

> > >Wow, that's possibly a big problem, for both you

> and the PD. There's a

> > >couple of reasons why.

> > >

> > >In City of Canton, Ohio v. (1989), the

> city (PD) was sued and

> > >lost when an inmate was refused medical care.

> The court ruled the

> > >officers showed " deliberate indifference " by not

> allowing her access to

> > >medical care. The court stated the officers had

> not been provided the

> > >proper training to assess whether or not the

> inmate needed medical care

> > >and therefore were liable for her mistreatment.

> The subsequent case law

> > >implies that unless an officer has the training

> and necessary equipment

> > >as well as medical direction he could not make

> the determination whether

> > >or not a prisoner could be denied ACCESS to

> medical care. While an

> > >officer cannot force someone to accept care, he

> can control their access

> > >to such care.

> > >

> > >Secondly, without knowing the entire pt.

> complaint/hx., etc., I don't

> > >know if your protocols cover this incident.

> However, it is important to

> > >remember that as medics we do not practice

> automonously. We require the

> > >oversight and interaction of a physician,

> therefore, it is his/her

> > >license in jeapordy when we engage in behavior

> that is ill-advisable (as

> > >well as our own certification/licensure). I

> would be willing to bet

> > >that if it came to a suit, that Sgt., the PD and

> the city would put it

> > >all right on your's, your company's and your

> medical director's back.

> > >

> > >Again, I'm not saying you did anything improper

> per your protocols, I

> > >just believe we should be much more judicious in

> our " no transports " .

> > >This very jailitis, a.k.a. abberrant jail

> avoidance syndrome, is the

> > >very reason why telemedicine is working its way

> into detention

> > >facilities. This is fast becoming the next arena

> for pre-hospital

> > >providers.

> > >

> > > LP

> > >julie a lindsey wrote:

> > >>

> > >> Heres the flip side to the consent for

> treatment issue. I had a call at

> > >> one of the local city jails. The prisoner had a

> severe case of " jailitis "

> > >> and wanted to go to the hospital (something

> about a change of

> > >> scenery).Anyway, since I could not refuse

> transport I did talk to the

> > >> Sgt. on duty who did refused to allow her to

> go seek medical treatment.

> > >> I assessed this patient very well and

> documented well. The sgt. then

> > >> signed my AMA form. Does anyone see a problem

> with this?

> > >>

> > >> Lindsey EMT-P

> > >>

> > >>

>

------------------------------------------------------------------------

> > >> Get your bargains at AndysGarage.com!

> > >>

>

http://click./1/2579/4/_/4981/_/955137376/

> > >>

>

------------------------------------------------------------------------

> > >

> >

>

>------------------------------------------------------------------------

> > >Special Offer-Earn 300 Points from MyPoints.com

> for trying @Backup

> > >Get automatic protection and access to your

> important computer files.

> > >Install today:

> >

>

>http://click./1/2344/4/_/4981/_/955143499/

> >

>

>------------------------------------------------------------------------

> > >

> > >

> >

> >

>

------------------------------------------------------------------------

> > Special Offer-Earn 300 Points from MyPoints.com

> for trying @Backup

> > Get automatic protection and access to your

> important computer files.

> > Install today:

> >

>

http://click./1/2344/4/_/4981/_/955151221/

> >

>

------------------------------------------------------------------------

>

__________________________________________________

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In a message dated 04/08/2000 07:50:16 AM Central Daylight Time,

gmoe240@... writes:

<< It is the same in County, if there is any

complaint of illness/injury or if the jail Sgt. thinks

they need medical attention, they go to the ER. One

that I have trouble with is if the person's blood

alcohol is greater that .250, they go to the ER. We

got people that maintain that BAC as their normal I

think.

Moseley LP

Cleburne PD >>

Ok guys, but you let one county lose a lawsuit for a couple of million

dollars and that little trip wont seem so bad. We all have bad calls, we all

know pts that know how to work the system, so just say to yourself, I guess

it could be worse and go on with life. If you start to let little things

like this get to you, you won't last as long in this business as you would if

you just let them roll off your back, go home, hug your kids, make love to

your wife and have a nice career in EMS. It's what you studied to be, so

don't let nonsense like this, shorten your career with ulcers and burn out.

Remember the ones you saved and how many people had a much better day because

of you and you will feel good most of the time.

Andy Foote, EMTP

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Comments inline...

RE: Legal or Not?

Mike,

Uhm, I am trained in incident command. I used to be a fire-fighter, though

only a lowly volunteer one whose department ran 600+ calls per year.

M> I don't remember making any statements with regards to firefighters,

or the volume of departments. It's my belief that this is important to

everyone... and that this is something where size (of department, of call

volume, etc.) doesn't matter. :)

My point, which I was using sarcasm and humor to make, was that when a

police officer tells you to do something, it is in your best interest to do

it. The scene is NOT the place to get into a pissing match at. If the cop

wants to be a dip-stick and insist that the patient isn't going to the

hospital, let them take the lawsuit. In this situation it is time to cover

your ass.

M> You and I disagree completely here. If the police officer is

attempting to make a decision that I feel endangers life, whether it be

mine, my crews or my patients, and he/she can't back up that decision with a

rational argument, then I'm not going to allow that decision to be made.

Now that doesn't require getting in his/her face and intoning chants to

Satan, but it may require stern refusals. Hopefully, though, this is a

very, very rare situation, and hopefully, there's someone else that can

handle the problem (EMS supervisor, PD Sergeant, etc.). As for lawsuits,

it's my patch until someone above me accepts responsibility, and most

likely, the police officer is not a higher medical authority.

As far as IC goes. I don't care what it says. Texas Code states that the

Police Department is in charge on the scene. Unless it is a fire, the the FD

is in charge. Period. End of discussion.

M> I disagree completely. If you'll show me the code you're referring

to (VTCS is pretty large to go browsing through), I'd love to discuss it.

I'm sure several others here would, too. There have been SEVERAL scenes

that weren't law-enforcement related, and several that were, where EMS

and/or Fire ran the scene, but again, it's usually because it's the right

thing to do, not some " bad cop no doughnut " king of thing.

A SMART cop or Fire Chief is going to allocate his/her resources

appropriatly. Unfortunately, those little trumpets/buggles on many a chiefs

collar seem to indicate how fast his/her brains drain out. Then there is the

problem that too many cops have the badge and gun attitude (I have a badge

and a gun, so I am god). DON'T start the fight with them at the scene. That

is what your supervisor and medical director are for. Let THEM fight the

battle in the correct place, the Police Officers Bosses office. You will

accomplish more that way.

M> All depends on the chief and the department. But you should fight

if anyone is creating a danger for you, your crew or your patient.

Webb, EMT-P

FLW EMS, MO

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Where can the copy of the federal mandate be seen.

Henry Barber

Greg Higgins wrote:

> >

> >ICS is something that should be considered ESSENTIAL training for ANYONE in

> >EMS. Any more, EMS isn't just the paramedics playing with neat toys, it's

> >everyone and their dog showing up on scene, all wanting to help. ICS let's

> >everyone play in the sandbox together without fighting over toys or throwing

> >sand.

> >

> >Mike :)

> >

>

> There is a Federal mandate that REQUIRES ALL emergency response agencies to

> train AND use the Incident Command System. The fire service has been using

> some form of ICS for 30 years so it is second nature for us. It's too bad

> that some agencies (industry, police and EMS, etc.) don't think it applies

> to them.

>

> Greg Higgins

> Fort Worth Fire Department

>

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HEY Explain what you mean maybe I can help.

Legal or Not?

Can a licensed peace officer in the State of Texas legally refuse:

a. medical assessment by EMS personnel

b. medical treatment by same or;

c. medically supervised transportation

I honestly thought that I knew the answer but have been told

differently and could use some help.....thanks!

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Parsley wrote:

Can a licensed peace officer in the State of Texas legally refuse:

a. medical assessment by EMS personnel

b. medical treatment by same or;

c. medically supervised transportation

I honestly thought that I knew the answer but have been told

differently and could use some help.....thanks!

Gene Gandy answers:

The answer is quite simple: Yes, they CAN because they're wearing the gun.

But they do so at their EXTREME legal peril. EMS people would document in

detail the interference of the law enforcement people and this should trigger

a whole series of events: official complaints to the Chief of Police, City

Manager, Mayor, and so forth. EMS Management cannot ignore this. To fail to

respond subjects it to liability.

Somebody would immediately call up a friendly newsperson, and the media loves

NOTHING so much as police misconduct given the recent problems in NYC and LA.

Plaintiffs' attorneys would emerge from the woodwork to make sure the

afflicted prisoner was made aware of his rights to sue, the FBI would be

notified and would investigate, the Department of Justice Civil Rights

Division would get the case and decide whether to prosecute the police

persons for criminal civil rights violations, the Police Chief would, if s/he

is smart would ask the Texas Rangers to investigate, and a civil suit would

most surely be filed if there were any significant injuries and damages.

The cops would find themselves in a heap of trouble. The ACLU would bleat

bloody murder and if the prisoner belonged to a racial or ethnic minority all

the organizations involved in promoting the rights of those people would be

on Larry King Live not to mention Today, Good Morning America, and Bill

O'Reilly.

My advice to cops: Just don't do it! Go the other way and DEMAND EMS

Assessment, treatment and transport. Then you're covered.

Incidents like this in a police officer's personnel file will retard

advancement even if they ultimately win. Who needs this?

Gene Gandy, JD, LP

My opinions are my own.

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Guest guest

I believe my question has been asnwered but the perspective I was

looking for was from that of a peace officer's ability to

consent/refuse for a prisoner.

If you have additional information I would be more than happy to take

a look at it, thanks!

> Can a licensed peace officer in the State of Texas legally refuse:

>

> a. medical assessment by EMS personnel

>

> b. medical treatment by same or;

>

> c. medically supervised transportation

>

> I honestly thought that I knew the answer but have been told

> differently and could use some help.....thanks!

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Guest guest

My best judgment is that the police officer stands in loco parentis of the

prisoner and can consent; however, the perils of failure to consent probably

wipe that out as an alternative.

I'm sure somebody can think up a scenario or has experienced one where it

would have been OK for the police officer to refuse treatment on behalf of

the prisoner, but I can't. Police can't perform medical assessments unless

they're cross certified/licensed as EMS personnel.

Gene Gandy, JD, LP

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