Foul Balls, EMT's and no ambulances

[Guest guest]

Woman Struck By Ball At Missions Game Cries Foul

POSTED: 9:27 pm CDT September 14, 2006

UPDATED: 7:50 am CDT September 15, 2006

SAN ANTONIO -- A family said it waited for a San Missions game

over the Labor Day weekend to make a big announcement to their loved

ones, but a foul ball shattered the good news.

Bonnie Jimenez and her family were seated near third base at Wolff

Stadium on Sept. 3 when she was struck by a ball.

" I was talking to my mother-in-law, and I turned, " said Jimenez. " We

were taking about the baby -- me being pregnant. "

Jimenez said that's when she heard the ball being hit and her vision went black.

" I just heard ringing in my ears, and then I remember saying I

couldn't breathe, because I had blood going down my throat, " said

Jimenez.

Showing the initial signs of shock, she and her family said emergency

personnel then rushed them to a back room of the stadium.

Jimenez said she was told that all she needed were stitches and that

she would be fine. She said she and her family were then helped out to

the parking lot.

" They were like, 'Everything is going to be fine. Uh, if you need

anything call,' " said husband Joe Jimenez.

The family said they know spectators are at risk, but they believe

better medical help should be on standby.

Jimenez said she received eight stitches in her mouth that night. But

a burst blood vessel in her nose overnight caused uncontrollable

bleeding, and the next morning she was rushed to a hospital.

" The doctor came to check me and I had blood all over the wall, all

over him, all over the bed and all over me, " said Jimenez. " He even

said he had never seen a nose bleed that bad. "

Three surgeries later and nine days in the hospital, she said she is

still on the mend from that foul ball. But the Jimenez family said

what was out of line was the lack of an ambulance.

" It makes me angry, and it concerns me. Why they didn't, knowing that

we had just told them I was pregnant, that should have been an extra

precaution, " said Jimenez.

KSAT 12 News contacted management officials at Wolff Stadium, but they

declined an on-camera interview. However, stadium officials did say

that the emergency medical technician working that night felt Jimenez

was in a stable condition to get help on her own.

The officials also said they do not keep an ambulance on standby.

The Jimenez family said it feels that netting is needed along the

first- and third-base lines. The family members said that in this

incident, the ball was hit fast and they never even saw it -- just its

aftermath.

**********************************************************

Man, I'd hate to be that EMT... I hope he's got good " lawyer insurance. "

As for whether or not an ambulance would have made a difference, she

made it to the hospital, was evaluated by a doctor and had a problem

hours AFTER she was stitched up...

As for " netting, " well, if you're sitting along the baseline - it's a

BALL GAME. You either watch for foul balls or pay for box seats.

Duh?

Mike :/

[Guest guest]

Maybe they dont need lawyers at all.

Just maybe, at some point in our life, we dont have to have an ambulance on

standby at every baseball, soccor, horseshoe throwing, washer tossing, mall,

city hall, refinery, paper mill (GOD knows those paper cuts can kill), PTA

meeting, etc., etc. etc.

Just maybe, everytime someone reads this crap, they don't think " Man, he

better have a good lawyer. "

Just maybe, the victim was lucid, talkative, walking and needed stitches.

Just maybe, she did go get stitches. Just maybe the hospital didnt do a real

good job of checking her out or just maybe she didnt complain of a deep

feeling of a nosebleed as she sat in the ER in a lucid, talkative and walking

wounded manner.

Just maybe, I am tired of all this lawyer and it's your fault crap.

Andy

[Guest guest]

Just maybe, he did or just maybe, she signed a refusal (which don't mean a

thing) and just maybe, they were happy with everything and drove to the

hospital in a normal manner (which they did) and just maybe, this poor EMT did

exactly what he felt was right given the appearance of the patient, their

response

and his training.

Andy

In a message dated 9/16/2006 8:34:41 AM Central Standard Time,

jpercer@... writes:

I do believe the best medicine for a case like this are the words:

" I'd be happy to arrange transport to the hospital for you, if you would

like me to do so... "

Joe Percer

Corpus

[Guest guest]

Just maybe, I better get off of my high horse and relax.\\

Andy

[Guest guest]

Mike wrote:

Man, I'd hate to be that EMT... I hope he's got good " lawyer insurance. "

Sounds like he made an evaluation unsupported by his training and scope of

practice. Plus, it also puts the city at risk, as well. Bet it will be a

'settled out of court' deal.

" A prudent man foresees the difficulties ahead and prepares for them; the

simpleton goes blindly on and suffers the consequences. " Proverbs 22:3

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

All-new Yahoo! Mail - Fire up a more powerful email and get things done faster.

[Guest guest]

Why do patient refusals mean nothing? Just like any other piece of paper,

they can say they were not properly informed of what they were refusing, they

were unaware of the medical lingo they heard, they were not in their right

state of mind at the time. I will say, that it is another tool we have to

cover ourselves, but any lawyer, anywhere, can sue about anything. I believe

that is a direct quote from GG.

There is malpractice and their is good intent. I only said what I did

because people these days are so legal crazy, we are having to run everything

from

blood tests to full body MRI's to cover our asses.

I can see tomorrows first headline. Woman loses control of vehicle, kills 5

children in a school zone and sues the pizza company that she was eating

their pizza, when she lost control of the steering wheel of her car because

there was too much grease on the pizza. Then her lawyer informs her they will

also sue the vehicle manufacturer because steering wheel cover was not course

enough for her to maintain control while eating greasy pizza. They will also

sue the School District for not putting a walkway overpass over the street to

avoid a collision with the children, and there was no ambulance on standby

at the school that morning. A teacher had a heart attack when she saw the

massacre and her husband sued the school district because they did not have an

AED on scene. Should I go further into the next five lawsuits because no CISD

team was ineffective in counseling all of those present at the time and

another suit because there was no Catholic preist there to give last rights to

the Catholic victims.

[Guest guest]

It stops when juries start holding idiots responsible for their own problems

rather than trying to blame someone with " deep pockets "

Kirk

EMT B

[Guest guest]

I do believe the best medicine for a case like this are the words:

" I'd be happy to arrange transport to the hospital for you, if you would

like me to do so... "

Joe Percer

Corpus

>

> Mike <paramedicop@... <paramedicop%40gmail.com>> wrote:

> Man, I'd hate to be that EMT... I hope he's got good " lawyer insurance. "

>

>

> Sounds like he made an evaluation unsupported by his training and scope of

> practice. Plus, it also puts the city at risk, as well. Bet it will be a

> 'settled out of court' deal.

>

>

> " A prudent man foresees the difficulties ahead and prepares for them; the

> simpleton goes blindly on and suffers the consequences. " Proverbs 22:3

>

>

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

> All-new Yahoo! Mail - Fire up a more powerful email and get things done

> faster.

>

>

[Guest guest]

That is why you should always ask if the patient would like to be transported to

the hospital via ambulance.

Saves alot of heartache and time visiting with attorney's.

Mike wrote:

Woman Struck By Ball At Missions Game Cries Foul

POSTED: 9:27 pm CDT September 14, 2006

UPDATED: 7:50 am CDT September 15, 2006

SAN ANTONIO -- A family said it waited for a San Missions game

over the Labor Day weekend to make a big announcement to their loved

ones, but a foul ball shattered the good news.

Bonnie Jimenez and her family were seated near third base at Wolff

Stadium on Sept. 3 when she was struck by a ball.

" I was talking to my mother-in-law, and I turned, " said Jimenez. " We

were taking about the baby -- me being pregnant. "

Jimenez said that's when she heard the ball being hit and her vision went black.

" I just heard ringing in my ears, and then I remember saying I

couldn't breathe, because I had blood going down my throat, " said

Jimenez.

Showing the initial signs of shock, she and her family said emergency

personnel then rushed them to a back room of the stadium.

Jimenez said she was told that all she needed were stitches and that

she would be fine. She said she and her family were then helped out to

the parking lot.

" They were like, 'Everything is going to be fine. Uh, if you need

anything call,' " said husband Joe Jimenez.

The family said they know spectators are at risk, but they believe

better medical help should be on standby.

Jimenez said she received eight stitches in her mouth that night. But

a burst blood vessel in her nose overnight caused uncontrollable

bleeding, and the next morning she was rushed to a hospital.

" The doctor came to check me and I had blood all over the wall, all

over him, all over the bed and all over me, " said Jimenez. " He even

said he had never seen a nose bleed that bad. "

Three surgeries later and nine days in the hospital, she said she is

still on the mend from that foul ball. But the Jimenez family said

what was out of line was the lack of an ambulance.

" It makes me angry, and it concerns me. Why they didn't, knowing that

we had just told them I was pregnant, that should have been an extra

precaution, " said Jimenez.

KSAT 12 News contacted management officials at Wolff Stadium, but they

declined an on-camera interview. However, stadium officials did say

that the emergency medical technician working that night felt Jimenez

was in a stable condition to get help on her own.

The officials also said they do not keep an ambulance on standby.

The Jimenez family said it feels that netting is needed along the

first- and third-base lines. The family members said that in this

incident, the ball was hit fast and they never even saw it -- just its

aftermath.

**********************************************************

Man, I'd hate to be that EMT... I hope he's got good " lawyer insurance. "

As for whether or not an ambulance would have made a difference, she

made it to the hospital, was evaluated by a doctor and had a problem

hours AFTER she was stitched up...

As for " netting, " well, if you're sitting along the baseline - it's a

BALL GAME. You either watch for foul balls or pay for box seats.

Duh?

Mike :/

Danny L.

Owner/NREMT-P

PETSAR INC.

(Panhandle Emergency Training Services And Response)

Office

Fax

[Guest guest]

Andy;

Have some coffee and a doughnut on me. : )

Why do patient refusals mean nothing?

Being in the standby field I have seen where problems occur. I train my

personnel to always ask if the patient would like an ambulance, whether we feel

that one is justified or not.

I once saw a post from a very learned individual who stated that most lawsuits

are the result of the suer not feeling they were properly taken care of.

Is this not one of those instances?

Just my thoughts. Probably not worth much, but I have little to do this

morning.

rachfoote@... wrote:

Just maybe, he did or just maybe, she signed a refusal (which don't mean a

thing) and just maybe, they were happy with everything and drove to the

hospital in a normal manner (which they did) and just maybe, this poor EMT did

exactly what he felt was right given the appearance of the patient, their

response

and his training.

Andy

In a message dated 9/16/2006 8:34:41 AM Central Standard Time,

jpercer@... writes:

I do believe the best medicine for a case like this are the words:

" I'd be happy to arrange transport to the hospital for you, if you would

like me to do so... "

Joe Percer

Corpus

[Guest guest]

I don't beleive patient refusals mean nothing. With proper

documentation a refusal could be the difference between you defending

yourself well in a lawsuit. (because you will still get sued!!!)

Does an ambulance have to be a every event, I don't believe so, but

one should be made available to the patient.

I wonder if the EMT is part of an EMS company or EMT that works for

the staduim.

>

> Why do patient refusals mean nothing? Just like any other piece

of paper,

> they can say they were not properly informed of what they were

refusing, they

> were unaware of the medical lingo they heard, they were not in

their right

> state of mind at the time. I will say, that it is another tool we

have to

> cover ourselves, but any lawyer, anywhere, can sue about anything.

I believe

> that is a direct quote from GG.

>

> There is malpractice and their is good intent. I only said what I

did

> because people these days are so legal crazy, we are having to run

everything from

> blood tests to full body MRI's to cover our asses.

>

> I can see tomorrows first headline. Woman loses control of

vehicle, kills 5

> children in a school zone and sues the pizza company that she was

eating

> their pizza, when she lost control of the steering wheel of her car

because

> there was too much grease on the pizza. Then her lawyer informs

her they will

> also sue the vehicle manufacturer because steering wheel cover was

not course

> enough for her to maintain control while eating greasy pizza.

They will also

> sue the School District for not putting a walkway overpass over

the street to

> avoid a collision with the children, and there was no ambulance on

standby

> at the school that morning. A teacher had a heart attack when she

saw the

> massacre and her husband sued the school district because they did

not have an

> AED on scene. Should I go further into the next five lawsuits

because no CISD

> team was ineffective in counseling all of those present at the

time and

> another suit because there was no Catholic preist there to give

last rights to

> the Catholic victims.

>

>

>

[Guest guest]

I believe I said that the refusal was a good tool we have, but if you are sued,

you are still in the middle of a big lawsuit. People sue for anything and

everything is my whole platform. Where does it stop?

Andy

Re: Foul Balls, EMT's and " no ambulances "

I don't beleive patient refusals mean nothing. With proper

documentation a refusal could be the difference between you defending

yourself well in a lawsuit. (because you will still get sued!!!)

Does an ambulance have to be a every event, I don't believe so, but

one should be made available to the patient.

I wonder if the EMT is part of an EMS company or EMT that works for

the staduim.

>

> Why do patient refusals mean nothing? Just like any other piece

of paper,

> they can say they were not properly informed of what they were

refusing, they

> were unaware of the medical lingo they heard, they were not in

their right

> state of mind at the time. I will say, that it is another tool we

have to

> cover ourselves, but any lawyer, anywhere, can sue about anything.

I believe

> that is a direct quote from GG.

>

> There is malpractice and their is good intent. I only said what I

did

> because people these days are so legal crazy, we are having to run

everything from

> blood tests to full body MRI's to cover our asses.

>

> I can see tomorrows first headline. Woman loses control of

vehicle, kills 5

> children in a school zone and sues the pizza company that she was

eating

> their pizza, when she lost control of the steering wheel of her car

because

> there was too much grease on the pizza. Then her lawyer informs

her they will

> also sue the vehicle manufacturer because steering wheel cover was

not course

> enough for her to maintain control while eating greasy pizza.

They will also

> sue the School District for not putting a walkway overpass over

the street to

> avoid a collision with the children, and there was no ambulance on

standby

> at the school that morning. A teacher had a heart attack when she

saw the

> massacre and her husband sued the school district because they did

not have an

> AED on scene. Should I go further into the next five lawsuits

because no CISD

> team was ineffective in counseling all of those present at the

time and

> another suit because there was no Catholic preist there to give

last rights to

> the Catholic victims.

>

>

>

[Guest guest]

Ok, so the lawsuits are all around us.

If you don't have any money for the attorney's to recover usually there will

not be a resulting suit.

If you do proper patient care, sue people may, recover they may not.

Proper documentation is paramount to CYA.

Take my money if you can. Oh, that's right I don't have any money.

rachfoote@... wrote:

Why do patient refusals mean nothing? Just like any other piece of

paper,

they can say they were not properly informed of what they were refusing, they

were unaware of the medical lingo they heard, they were not in their right

state of mind at the time. I will say, that it is another tool we have to

cover ourselves, but any lawyer, anywhere, can sue about anything. I believe

that is a direct quote from GG.

There is malpractice and their is good intent. I only said what I did

because people these days are so legal crazy, we are having to run everything

from

blood tests to full body MRI's to cover our asses.

I can see tomorrows first headline. Woman loses control of vehicle, kills 5

children in a school zone and sues the pizza company that she was eating

their pizza, when she lost control of the steering wheel of her car because

there was too much grease on the pizza. Then her lawyer informs her they will

also sue the vehicle manufacturer because steering wheel cover was not course

enough for her to maintain control while eating greasy pizza. They will also

sue the School District for not putting a walkway overpass over the street to

avoid a collision with the children, and there was no ambulance on standby

at the school that morning. A teacher had a heart attack when she saw the

massacre and her husband sued the school district because they did not have an

AED on scene. Should I go further into the next five lawsuits because no CISD

team was ineffective in counseling all of those present at the time and

another suit because there was no Catholic preist there to give last rights to

the Catholic victims.

[Guest guest]

Soo much pain my Jedi friend.

The Dark Side this will lead to.

rachfoote@... wrote:

I believe I said that the refusal was a good tool we have, but if you

are sued, you are still in the middle of a big lawsuit. People sue for anything

and everything is my whole platform. Where does it stop?

Andy

Re: Foul Balls, EMT's and " no ambulances "

I don't beleive patient refusals mean nothing. With proper

documentation a refusal could be the difference between you defending

yourself well in a lawsuit. (because you will still get sued!!!)

Does an ambulance have to be a every event, I don't believe so, but

one should be made available to the patient.

I wonder if the EMT is part of an EMS company or EMT that works for

the staduim.

>

> Why do patient refusals mean nothing? Just like any other piece

of paper,

> they can say they were not properly informed of what they were

refusing, they

> were unaware of the medical lingo they heard, they were not in

their right

> state of mind at the time. I will say, that it is another tool we

have to

> cover ourselves, but any lawyer, anywhere, can sue about anything.

I believe

> that is a direct quote from GG.

>

> There is malpractice and their is good intent. I only said what I

did

> because people these days are so legal crazy, we are having to run

everything from

> blood tests to full body MRI's to cover our asses.

>

> I can see tomorrows first headline. Woman loses control of

vehicle, kills 5

> children in a school zone and sues the pizza company that she was

eating

> their pizza, when she lost control of the steering wheel of her car

because

> there was too much grease on the pizza. Then her lawyer informs

her they will

> also sue the vehicle manufacturer because steering wheel cover was

not course

> enough for her to maintain control while eating greasy pizza.

They will also

> sue the School District for not putting a walkway overpass over

the street to

> avoid a collision with the children, and there was no ambulance on

standby

> at the school that morning. A teacher had a heart attack when she

saw the

> massacre and her husband sued the school district because they did

not have an

> AED on scene. Should I go further into the next five lawsuits

because no CISD

> team was ineffective in counseling all of those present at the

time and

> another suit because there was no Catholic preist there to give

last rights to

> the Catholic victims.

>

>

>

[Guest guest]

You know, I had forgotten why I don't send messages, but you keep reminding me.

My rant agains't lawsuits turns into something we can't even remember what

started it, but the title will still come up tomorrow and if you are not

following up with this, you will wonder what Theme Parks had to do with

anything.

Re: Foul Balls, EMT's and " no ambulances "

Just maybe, I better get off of my high horse and relax.\\

Andy

[Guest guest]

I always use the statement: " I don't have x-ray vision, so I can only

evaluate what I can see, what I can locate, or what YOU tell me about. I

will NOT say you are absolutely fine. I believe it is in your best interest

to allow us to transport you to an appropriate hospital to have further

evaluation of your condition. I cannot force you to go, but you may be at

risk of complications if you do not allow us to treat you according to our

training and transport you to the hospital. If you refuse treatment and

transport, it will be against medical advice. "

I know, I know, it's long-winded. But let me tell you, it is the rare

patient who truly needs care who refuses to go after hearing it. You know

the old saying:

" If you can't dazzle them with diamonds, baffle them with buffalo chips. "

<wink>

Barry McClung, EMT-P

[Guest guest]

Or for that matter the price of tea in China.

rachfoote@... wrote: You know, I had forgotten why I don't send

messages, but you keep reminding me. My rant agains't lawsuits turns into

something we can't even remember what started it, but the title will still come

up tomorrow and if you are not following up with this, you will wonder what

Theme Parks had to do with anything.

Re: Foul Balls, EMT's and " no ambulances "

Just maybe, I better get off of my high horse and relax.\\

Andy

[Guest guest]

Lawsuits have their place just like any other predator.

We just need to keep in mind they are there and try to stay at the TOP of the

food chain.

Just for information we stay at the top by never letting our education lapse,

or our compassion.

My input just to make the day go by.

rachfoote@... wrote:

You know, I had forgotten why I don't send messages, but you keep

reminding me. My rant agains't lawsuits turns into something we can't even

remember what started it, but the title will still come up tomorrow and if you

are not following up with this, you will wonder what Theme Parks had to do with

anything.

Re: Foul Balls, EMT's and " no ambulances "

Just maybe, I better get off of my high horse and relax.\\

Andy

[Guest guest]

I'm wondering just what about 911 this woman and her family didn't

understand. Last I heard, you call 911 and a Bamlance comes. Of course, it's

asking

too much for people to take any responsibility for themselves.

Now, for the bad part. If one induces another to rely upon one's advice,

and one does so to his detriment, and the reliance is reasonable, the " inducer "

may be liable.

So I'm wondering where the " informed refusal " was here? Any EMT working an

event needs to be aware of these things and always get the proper refusal if

EMS is refused.

Gene G.

>

> Maybe they dont need lawyers at all.

>

> Just maybe, at some point in our life, we dont have to have an ambulance on

> standby at every baseball, soccor, horseshoe throwing, washer tossing, mall,

> city hall, refinery, paper mill (GOD knows those paper cuts can kill), PTA

> meeting, etc., etc. etc.

>

> Just maybe, everytime someone reads this crap, they don't think " Man, he

> better have a good lawyer. "

>

> Just maybe, the victim was lucid, talkative, walking and needed stitches.

> Just maybe, she did go get stitches. Just maybe the hospital didnt do a real

> good job of checking her out or just maybe she didnt complain of a deep

> feeling of a nosebleed as she sat in the ER in a lucid, talkative and

> walking

> wounded manner.

>

> Just maybe, I am tired of all this lawyer and it's your fault crap.

>

> Andy

>

>

[Guest guest]

Hey, Andy, you've qualified for the HONORARY PLAINTIFF'S LAWYER HALL OF

FAME! You've also written a pretty good lawschool torts exam.

Gene G.

>

> Why do patient refusals mean nothing? Just like any other piece of paper,

> they can say they were not properly informed of what they were refusing,

> they

> were unaware of the medical lingo they heard, they were not in their right

> state of mind at the time. I will say, that it is another tool we have to

> cover ourselves, but any lawyer, anywhere, can sue about anything. I believe

> that is a direct quote from GG.

>

> There is malpractice and their is good intent. I only said what I did

> because people these days are so legal crazy, we are having to run

> everything from

> blood tests to full body MRI's to cover our asses.

>

> I can see tomorrows first headline. Woman loses control of vehicle, kills 5

> children in a school zone and sues the pizza company that she was eating

> their pizza, when she lost control of the steering wheel of her car because

> there was too much grease on the pizza. Then her lawyer informs her they

> will

> also sue the vehicle manufacturer because steering wheel cover was not

> course

> enough for her to maintain control while eating greasy pizza. They will also

> sue the School District for not putting a walkway overpass over the street

> to

> avoid a collision with the children, and there was no ambulance on standby

> at the school that morning. A teacher had a heart attack when she saw the

> massacre and her husband sued the school district because they did not have

> an

> AED on scene. Should I go further into the next five lawsuits because no

> CISD

> team was ineffective in counseling all of those present at the time and

> another suit because there was no Catholic preist there to give last rights

> to

> the Catholic victims.

>

>

[Guest guest]

You may not have any money, but you do have a certificate/license. And the

lawyers, if they're really vindictive, can go after that. Your employer's

mallpractice policy will not provide any protection for you there, and you'll

either represent yourself or pay a lawyer out of your own pocket.

Or, you and your employer may have a difference of opinion over who's to

blame in the lawsuit and you get thrown to the wolves. You suddenly find the

lawsuit is settled, and your medic patch is on the line.

So, please, people, buy insurance. A 1 million policy that also provides

$10,000 for defense of your certificate/license is just $160 a year, not even

the cost of one hour of a lawyer's time.

Gene G.

>

> Ok, so the lawsuits are all around us.

>

> If you don't have any money for the attorney's to recover usually there will

> not be a resulting suit.

>

> If you do proper patient care, sue people may, recover they may not.

>

> Proper documentation is paramount to CYA.

>

> Take my money if you can. Oh, that's right I don't have any money.

>

> rachfoote@... wrote:

> Why do patient refusals mean nothing? Just like any other piece of paper,

> they can say they were not properly informed of what they were refusing,

> they

> were unaware of the medical lingo they heard, they were not in their right

> state of mind at the time. I will say, that it is another tool we have to

> cover ourselves, but any lawyer, anywhere, can sue about anything. I believe

> that is a direct quote from GG.

>

> There is malpractice and their is good intent. I only said what I did

> because people these days are so legal crazy, we are having to run

> everything from

> blood tests to full body MRI's to cover our asses.

>

> I can see tomorrows first headline. Woman loses control of vehicle, kills 5

> children in a school zone and sues the pizza company that she was eating

> their pizza, when she lost control of the steering wheel of her car because

> there was too much grease on the pizza. Then her lawyer informs her they

> will

> also sue the vehicle manufacturer because steering wheel cover was not

> course

> enough for her to maintain control while eating greasy pizza. They will also

> sue the School District for not putting a walkway overpass over the street

> to

> avoid a collision with the children, and there was no ambulance on standby

> at the school that morning. A teacher had a heart attack when she saw the

> massacre and her husband sued the school district because they did not have

> an

> AED on scene. Should I go further into the next five lawsuits because no

> CISD

> team was ineffective in counseling all of those present at the time and

> another suit because there was no Catholic preist there to give last rights

> to

> the Catholic victims.

>

>

[Guest guest]

Haaaaaaaaaaaaahahahahahahahahahahah. Oh that's RICH! You're a stitch,

Kirk. You need to be on comedy central. [Rim shot!] But seriously,

folks............

GG

>

> It stops when juries start holding idiots responsible for their own problems

> rather than trying to blame someone with " deep pockets "

>

> Kirk

> EMT B

>

>

[Guest guest]

On the subject of signed refusals. Most of them are not worth the paper

they're written on. Why?

Because they do not show " informed refusal, " present mental capacity to form

a judgment about one's medical condition and care, and that the patient

understood his condition and the risks of refusal.

At least these things must be documented:

1. That the patient was informed of the possible medical consequences of

refusal and what specific things were told the patient.

2. That the patient had the present mental capacity to make an informed

decision about her medical status and to formulate the decision to refuse and

the

facts upon which those statements are based.

3. That the patient heard and understood the information given and the

facts supporting that.

4. That the patient refused treatment and transport after being so

informed.

The problem with most refusal forms is that they contain only conclusions or

statements not supported by fact.

For example, " the patient was informed of the possible consequences of

refusal. " That's fine, but it doesn't show what specifically the patient was

informed of. To see what an informed consent or refusal should contain, refer

to

the ones used in the hospital. There are a specific set of things that the

patient needs to be told. If you don't give them specifics, they can always

say " they didn't tell me that I could be bleeding from the back of my nose and

bleed enough to go into shock. " So real information must be given and what

was told the patient must be documented.

The usual form does nothing to show that the patient had present mental

capacity to understand and refuse. The documentation on the patient care form

that the patient was " A & A & OX$ " is pure conclusion. What facts support the

conclusion that the patient was awake, alert and oriented? It may be as

obvious

as that the patient responded as follows when asked his name, where he is, what

day, month, and year, it is, and what happened: " My name is Julius Caesar,

I'm in my palace in Rome, it's Dies saturni, xvi September MMVI, and I

tripped on my way to the vomitorium and broke my pinkie finger. " That's

verifiable information and, if true, supports the conclusions.

Let's take the term " awake. " We're fond of writing that the patient was

awake. What does that mean? How many of you can give the dictionary

definition of awake? According to my Merriam Webster's the adjective " awake "

means

" fully conscious, alert, and aware. "

How do we know that the patient is " fully conscious? " That his eyes are

open? The lawyer will say, " Mr. Paramedic, have you ever seen a dead person

whose eyes were open? " " Then, you would have to agree, would you not, that the

mere fact that a person's eyes are open doesn't mean that they're necessarily

awake? "

You say, " patient was fully conscious. Define for the judge and the jury

what you mean by the word 'conscious. " Taber's Medical Dictionary defines

" conscious " as " Being aware and having perception; awake. "

Since there can be altered states of consciousness, there should be a list

of questions related to LOC for the medic to answer such as, " Is there any

evidence that the patient is under the influence of alcohol or drugs? " Is

there

any evidence of a mental disorder? " " Is there any evidence of shock? " " Is

there evidence of any kind of undue influence on the patient to refuse? " " Is

the patient an adult. " " If patient is a minor, is he legally emancipated,

married, or in the military service? " " Can the patient remember three objects,

a pair of glasses, a cup, and a book, for three minutes? " And so forth.

Patients with certain injuries and medical conditions typically have a loss of

short term memory. You don't want a patient coming back and saying that he

didn't remember even signing the refusal, much less saying all the things he was

quoted as saying. So a patient with impaired lacks capacity to refuse.

Just read the definition of " consciousness " in Taber's and you'll see what I

mean. Consider this passage: " Clouding of consciousness may simulate the

dullness but usually not the other characteristics of stupor. On the

contrary, such patients may seem alert. "

So the answer is to document what the patient says, so that the jury, if it

comes to that, can see for themselves the same information that you were acting

upon when you said the patient was " awake and alert. "

The statement that " patient stated that he understands the risks " won't stand

up either. How do we know he understands it? I can say that I understand

the theory of relativity, but it doesn't mean that I do. Most patient, when

asked, " Do you understand the possible consequences? " will say yes, because

it's natural to not want to be thought to be a fool. So they'll say they

understand when they don't. The way to do it is to ask them to repeat to you

what

they believe their present condition is and what they understand the risks of

refusal to be. And you write down what they say in quotes.

And finally you must document that they said, after the aforesaid, " I

understand what I have just told you and I still refuse treatment and transport.

I

will call EMS if I change my mind or if I get worse, " or words to that effect.

This information cannot be written on the forms that are provided by most

services. People always whine about having to fill in lots of forms, but

believe me, an extra three minutes spent doing proper documentation is far

better

than a 6 hour deposition.

It is possible to make up refusal forms that contain lots of this information

so that there is a minimum of writing. For example, it can contain the

questions to be asked, and all you have to do is record the patient's answers.

Unfortunately, most services have not given this much thought and it never

comes up until a lawsuit happens.

I recently worked on a case where the medics did very careful and correct

documentation, and that resulted in the case being dismissed at the pretrial

stage. So good documentation does pay off.

Gene G.

[Guest guest]

It remains easy to blame EMS for any care not rendered. If the family was not

happy with the on site care, they could have called for an ambulance transport

in the parking lot. I have seen this happen and I have responded to several

instances. Onsite EMS can only do so much and is usually called FIRST AID and is

nothing more, it is not a hospital..jb

__________________________________________________

[Guest guest]

Nah, don't you just get tired of everyone suing everyone

else for accidents. Thats why they are called accidents. I

heard of a case where a child fell off the slide at a park

with his parents present, I believe one was actually on

the ladder behind the child when it fell. Now they are

suing the city. Go figure!!!

On Sat, 16 Sep 2006 09:49:55 EDT

rachfoote@... wrote:

> Just maybe, I better get off of my high horse and

>relax.\\

>

> Andy

>

>

>