Re: ER, EMD and 911 failure in CA

[Guest guest]

In a message dated 6/13/2007 12:52:49 P.M. Central Daylight Time,

dannykendallus@... writes:

Okay, I'm just recently an EMT-B. But, couldn't someone just help the woman

and let the bureaucracy work itself out later. Would I really have gotten

heat if I were the Medic and I helped her? I mean, I know I'm real green and

am probably speaking way out of turn. But, if you're going to let

bureaucracy get in the way of helping someone in need, you need to forfeit your

certs

and licenses and find another line of work, possibly at the DMV.

Gee what would emergency medicine become if we let the patients needs

dictate what we do?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** See what's free at http://www.aol.com.

[Guest guest]

Okay, I'm just recently an EMT-B. But, couldn't someone just help the

woman and let the bureaucracy work itself out later. Would I really

have gotten heat if I were the Medic and I helped her? I mean, I know

I'm real green and am probably speaking way out of turn. But, if

you're going to let bureaucracy get in the way of helping someone in

need, you need to forfeit your certs and licenses and find another line

of work, possibly at the DMV.

[Guest guest]

While the dispatcher should've sent paramedics to the woman's location, I

must say that I place a greater blame on the shoulders of the ER staff,

particularly the triage nurse... If the woman was indeed vomiting blood, she

shouldn't have been told to shut up and wait. That hospital needs to have a

serious look at its triage policy and see if its really being handled in the

best manner.

Joe Percer, NREMT-P

>

> Okay, I'm just recently an EMT-B. But, couldn't someone just help the

> woman and let the bureaucracy work itself out later. Would I really

> have gotten heat if I were the Medic and I helped her? I mean, I know

> I'm real green and am probably speaking way out of turn. But, if

> you're going to let bureaucracy get in the way of helping someone in

> need, you need to forfeit your certs and licenses and find another line

> of work, possibly at the DMV.

>

>

>

[Guest guest]

The triage nurse should lose her license. Period. And that's quite likely

what will happen. If there were physicians involved, they should lose

theirs also. The hospital has been one step from being closed for months

because

it is notoriously bad. Perhaps it is time that it is closed.

The public won't put up with this. And it should not. EMS cannot hide

behind the hospital on this. If a person calls for EMS, no matter where they

are, EMS should respond and sort it out on the spot. Telephone triage is a

prescription to end up in the courtroom as a defendant.

If you found out that your mother was sitting in a waiting room of a hospital

vomiting blood and nobody would see her, wouldn't you call for a truck and

take her someplace else?

People seem to think that a hospital OWNS a patient. It does not. And EMS

usually does not work for the hospital. Who does EMS owe the duty to? The

hospital or the patient? Answer that simple question and you see the folly

of the position that EMS should not have responded.

Gene Gandy, JD. LP

>

> While the dispatcher should've sent paramedics to the woman's location, I

> must say that I place a greater blame on the shoulders of the ER staff,

> particularly the triage nurse... If the woman was indeed vomiting blood, she

> shouldn't have been told to shut up and wait. That hospital needs to have a

> serious look at its triage policy and see if its really being handled in the

> best manner.

>

> Joe Percer, NREMT-P

>

>

> >

> > Okay, I'm just recently an EMT-B. But, couldn't someone just help the

> > woman and let the bureaucracy work itself out later. Would I really

> > have gotten heat if I were the Medic and I helped her? I mean, I know

> > I'm real green and am probably speaking way out of turn. But, if

> > you're going to let bureaucracy get in the way of helping someone in

> > need, you need to forfeit your certs and licenses and find another line

> > of work, possibly at the DMV.

> >

> >

> >

>

>

[Guest guest]

I don't know of any state or federal regulation that would prevent an EMS

crew from removing a patient who had called them. It's the patient's

determination, not the hospital's. The doctor and the hospital can strongly

recommend

that the patient not leave, but so long as the patient possesses the present

mental capacity to make a rational healthcare decision, the patient controls

it.

I can't imagine how DSHS would get involved with that so long as the patient

was the one who initiated the call.

COBRA is actually a part of the Internal Revenue Code and it pertains mainly

to reimbursement. There are no federal regulations for EMS that would affect

an EMS provider's actions in the situation you mention.

Gene

>

> I have a question here for the masses. If an ambulance had responded to the

> ED waiting room doesn't state regs or COBRA prohibit them from taking that

> patient from hospital property without them being seen by a physician? I

> understand that she had not been seen & that it looked like she was not

> going to be seen anytime soon, but would that not put the EMS crew in a

> potential situation with their regulatory agency? Now this is with the

> understanding that the hospital she was @ did have (even though they were

> not acting @) the appropriate level to treat her. This was a situation that

> give all of emergency medicine a black eye (911 / EMS / ED / ED RN's / ED

> MD's)!

>

>

>

> _____

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of wegandy1938@wegandy

> Sent: Wednesday, 13 June, 2007 18:20

> To: texasems-l@yahoogrotexasem

> Subject: Re: Re: ER, EMD and 911 failure in CA

>

> The triage nurse should lose her license. Period. And that's quite likely

> what will happen. If there were physicians involved, they should lose

> theirs also. The hospital has been one step from being closed for months

> because

> it is notoriously bad. Perhaps it is time that it is closed.

>

> The public won't put up with this. And it should not. EMS cannot hide

> behind the hospital on this. If a person calls for EMS, no matter where they

>

> are, EMS should respond and sort it out on the spot. Telephone triage is a

> prescription to end up in the courtroom as a defendant.

>

> If you found out that your mother was sitting in a waiting room of a

> hospital

> vomiting blood and nobody would see her, wouldn't you call for a truck and

> take her someplace else?

>

> People seem to think that a hospital OWNS a patient. It does not. And EMS

> usually does not work for the hospital. Who does EMS owe the duty to? The

> hospital or the patient? Answer that simple question and you see the folly

> of the position that EMS should not have responded.

>

> Gene Gandy, JD. LP

> In a message dated 6/13/07 1:13:29 PM, jpercer (AT) gmail (DOT)

> <mailto:jpercer%mailto:jper> com writes:

>

> >

> > While the dispatcher should've sent paramedics to the woman's location, I

> > must say that I place a greater blame on the shoulders of the ER staff,

> > particularly the triage nurse... If the woman was indeed vomiting blood,

> she

> > shouldn't have been told to shut up and wait. That hospital needs to have

> a

> > serious look at its triage policy and see if its really being handled in

> the

> > best manner.

> >

> > Joe Percer, NREMT-P

> >

> >

> > >

> > > Okay, I'm just recently an EMT-B. But, couldn't someone just help the

> > > woman and let the bureaucracy work itself out later. Would I really

> > > have gotten heat if I were the Medic and I helped her? I mean, I know

> > > I'm real green and am probably speaking way out of turn. But, if

> > > you're going to let bureaucracy get in the way of helping someone in

> > > need, you need to forfeit your certs and licenses and find another line

> > > of work, possibly at the DMV.

> > >

> > >

> > >

> >

> >

[Guest guest]

In a message dated 6/13/2007 8:41:37 P.M. Central Daylight Time,

medictaz@... writes:

This was a situation that give all of emergency medicine a black eye (911 /

EMS / ED / ED RN's / ED MD's)!

On that point I think we all agree but this is also a bit of a social issue

related to ED overcrowding and al that but we all know that. I think just

about everyone knows that over all we have a dead person and that's not good

everyone seems a bit at fault here even the victim but we do al have the black

eyes and she's dead with the family looking at a jackpot, of sorts.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** See what's free at http://www.aol.com.

[Guest guest]

I have a question here for the masses. If an ambulance had responded to the

ED waiting room doesn't state regs or COBRA prohibit them from taking that

patient from hospital property without them being seen by a physician? I

understand that she had not been seen & that it looked like she was not

going to be seen anytime soon, but would that not put the EMS crew in a

potential situation with their regulatory agency? Now this is with the

understanding that the hospital she was @ did have (even though they were

not acting @) the appropriate level to treat her. This was a situation that

give all of emergency medicine a black eye (911 / EMS / ED / ED RN's / ED

MD's)!

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of wegandy1938@...

Sent: Wednesday, 13 June, 2007 18:20

To: texasems-l

Subject: Re: Re: ER, EMD and 911 failure in CA

The triage nurse should lose her license. Period. And that's quite likely

what will happen. If there were physicians involved, they should lose

theirs also. The hospital has been one step from being closed for months

because

it is notoriously bad. Perhaps it is time that it is closed.

The public won't put up with this. And it should not. EMS cannot hide

behind the hospital on this. If a person calls for EMS, no matter where they

are, EMS should respond and sort it out on the spot. Telephone triage is a

prescription to end up in the courtroom as a defendant.

If you found out that your mother was sitting in a waiting room of a

hospital

vomiting blood and nobody would see her, wouldn't you call for a truck and

take her someplace else?

People seem to think that a hospital OWNS a patient. It does not. And EMS

usually does not work for the hospital. Who does EMS owe the duty to? The

hospital or the patient? Answer that simple question and you see the folly

of the position that EMS should not have responded.

Gene Gandy, JD. LP

In a message dated 6/13/07 1:13:29 PM, jpercer (AT) gmail (DOT)

<mailto:jpercer%40gmail.com> com writes:

>

> While the dispatcher should've sent paramedics to the woman's location, I

> must say that I place a greater blame on the shoulders of the ER staff,

> particularly the triage nurse... If the woman was indeed vomiting blood,

she

> shouldn't have been told to shut up and wait. That hospital needs to have

a

> serious look at its triage policy and see if its really being handled in

the

> best manner.

>

> Joe Percer, NREMT-P

>

>

> >

> > Okay, I'm just recently an EMT-B. But, couldn't someone just help the

> > woman and let the bureaucracy work itself out later. Would I really

> > have gotten heat if I were the Medic and I helped her? I mean, I know

> > I'm real green and am probably speaking way out of turn. But, if

> > you're going to let bureaucracy get in the way of helping someone in

> > need, you need to forfeit your certs and licenses and find another line

> > of work, possibly at the DMV.

> >

> >

> >

>

>

[Guest guest]

,

In many situations that are similar this call, we are only called because

there is a long wait in the E/R. Here in Beaumont, this occurs and we try to

discourage the patient from calling another ambulance. However, we are also

triaged by the hospital pretty darn quick here. If patient persists, we would

send a field supervisor to the hospital and talk to both the ER personnel

and the patient. Not ever having one that was a critical as this, I am sure

the obersvance of the patient and talking with nurse/doctor, whatever, this

would not happen in our hospitals here. I have never been to Ben Taub in

Houston or this hospital in Chicago, so I cannot make a judgement on their

triage

or behavior. In short, you must CYA whether you want to go or not. Good

judgement would prevail and I have the utmost admiration for my field

personnel.

In a message dated 6/14/2007 9:36:16 AM Central Daylight Time,

kimberleyrc@... writes:

As a dispatcher, I have always thought that we cannot pick up a patient when

they are in the hospital, even if the pt calls 9-1-1. The idea that is being

propogated is that it is an EMTALA violation. Can any of the legal people on

the list confirm or deny this?

- Kimberley

************************************** See what's free at http://www.aol.com.

[Guest guest]

As a dispatcher, I have always thought that we cannot pick up a patient when

they are in the hospital, even if the pt calls 9-1-1. The idea that is being

propogated is that it is an EMTALA violation. Can any of the legal people on

the list confirm or deny this?

- Kimberley

>

> I don't know of any state or federal regulation that would prevent an

> EMS

> crew from removing a patient who had called them. It's the patient's

> determination, not the hospital's. The doctor and the hospital can

> strongly recommend

> that the patient not leave, but so long as the patient possesses the

> present

> mental capacity to make a rational healthcare decision, the patient

> controls

> it.

>

> I can't imagine how DSHS would get involved with that so long as the

> patient

> was the one who initiated the call.

>

> COBRA is actually a part of the Internal Revenue Code and it pertains

> mainly

> to reimbursement. There are no federal regulations for EMS that would

> affect

> an EMS provider's actions in the situation you mention.

>

> Gene

> In a message dated 6/13/07 8:42:38 PM,

medictaz@...<medictaz%40saunders-family.org>writes:

>

> >

> > I have a question here for the masses. If an ambulance had responded to

> the

> > ED waiting room doesn't state regs or COBRA prohibit them from taking

> that

> > patient from hospital property without them being seen by a physician? I

> > understand that she had not been seen & that it looked like she was not

> > going to be seen anytime soon, but would that not put the EMS crew in a

> > potential situation with their regulatory agency? Now this is with the

> > understanding that the hospital she was @ did have (even though they

> were

> > not acting @) the appropriate level to treat her. This was a situation

> that

> > give all of emergency medicine a black eye (911 / EMS / ED / ED RN's /

> ED

> > MD's)!

> >

> >

> >

> > _____

> >

> > From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> > Behalf Of wegandy1938@wegandy

> > Sent: Wednesday, 13 June, 2007 18:20

> > To: texasems-l@yahoogrotexasem

> > Subject: Re: Re: ER, EMD and 911 failure in CA

> >

> > The triage nurse should lose her license. Period. And that's quite

> likely

> > what will happen. If there were physicians involved, they should lose

> > theirs also. The hospital has been one step from being closed for months

> > because

> > it is notoriously bad. Perhaps it is time that it is closed.

> >

> > The public won't put up with this. And it should not. EMS cannot hide

> > behind the hospital on this. If a person calls for EMS, no matter where

> they

> >

> > are, EMS should respond and sort it out on the spot. Telephone triage is

> a

> > prescription to end up in the courtroom as a defendant.

> >

> > If you found out that your mother was sitting in a waiting room of a

> > hospital

> > vomiting blood and nobody would see her, wouldn't you call for a truck

> and

> > take her someplace else?

> >

> > People seem to think that a hospital OWNS a patient. It does not. And

> EMS

> > usually does not work for the hospital. Who does EMS owe the duty to?

> The

> > hospital or the patient? Answer that simple question and you see the

> folly

> > of the position that EMS should not have responded.

> >

> > Gene Gandy, JD. LP

> > In a message dated 6/13/07 1:13:29 PM, jpercer (AT) gmail (DOT)

> > <mailto:jpercer% <jpercer%25>mailto:jper> com writes:

> >

> > >

> > > While the dispatcher should've sent paramedics to the woman's

> location, I

> > > must say that I place a greater blame on the shoulders of the ER

> staff,

> > > particularly the triage nurse... If the woman was indeed vomiting

> blood,

> > she

> > > shouldn't have been told to shut up and wait. That hospital needs to

> have

> > a

> > > serious look at its triage policy and see if its really being handled

> in

> > the

> > > best manner.

> > >

> > > Joe Percer, NREMT-P

> > >

> > >

> > > >

> > > > Okay, I'm just recently an EMT-B. But, couldn't someone just help

> the

> > > > woman and let the bureaucracy work itself out later. Would I really

> > > > have gotten heat if I were the Medic and I helped her? I mean, I

> know

> > > > I'm real green and am probably speaking way out of turn. But, if

> > > > you're going to let bureaucracy get in the way of helping someone in

> > > > need, you need to forfeit your certs and licenses and find another

> line

> > > > of work, possibly at the DMV.

> > > >

> > > >

> > > >

> > >

> > >

[Guest guest]

Not sure how EMS being called to a hospital and taking a patient from

the facility (at the patients request), regardless of where that patient

is, could be construed as an EMTALA violation.

I was about to get parked in an ER with a cardiac patient, the patient

didn’t want to get parked, nor did he NEED to be parked for any length

of time. The patient asked if I could take him to a different facility,

and I was prepared to accommodate his request, and was told that I would

be violating EMTALA….not so I explained, it would be such if the

facility requested that I turn around and take him somewhere else

without following proper procedures, but it would be no different than a

patient walking into an ER, seeing how busy triage is, and walking out.

The only difference is the mode of transportation.

They still don’t like me

Re: Re: ER, EMD and 911 failure in CA

> >

> > The triage nurse should lose her license. Period. And that's quite

> likely

> > what will happen. If there were physicians involved, they should

lose

> > theirs also. The hospital has been one step from being closed for

months

> > because

> > it is notoriously bad. Perhaps it is time that it is closed.

> >

> > The public won't put up with this. And it should not. EMS cannot

hide

> > behind the hospital on this. If a person calls for EMS, no matter

where

> they

> >

> > are, EMS should respond and sort it out on the spot. Telephone

triage is

> a

> > prescription to end up in the courtroom as a defendant.

> >

> > If you found out that your mother was sitting in a waiting room of a

> > hospital

> > vomiting blood and nobody would see her, wouldn't you call for a

truck

> and

> > take her someplace else?

> >

> > People seem to think that a hospital OWNS a patient. It does not.

And

> EMS

> > usually does not work for the hospital. Who does EMS owe the duty

to?

> The

> > hospital or the patient? Answer that simple question and you see the

> folly

> > of the position that EMS should not have responded.

> >

> > Gene Gandy, JD. LP

> > In a message dated 6/13/07 1:13:29 PM, jpercer (AT) gmail (DOT)

> > <mailto:jpercer% <jpercer%25>-mailto:jper> com writes:

> >

> > >

> > > While the dispatcher should've sent paramedics to the woman's

> location, I

> > > must say that I place a greater blame on the shoulders of the ER

> staff,

> > > particularly the triage nurse... If the woman was indeed vomiting

> blood,

> > she

> > > shouldn't have been told to shut up and wait. That hospital needs

to

> have

> > a

> > > serious look at its triage policy and see if its really being

handled

> in

> > the

> > > best manner.

> > >

> > > Joe Percer, NREMT-P

> > >

> > >

> > > >

> > > > Okay, I'm just recently an EMT-B. But, couldn't someone just

help

> the

> > > > woman and let the bureaucracy work itself out later. Would I

really

> > > > have gotten heat if I were the Medic and I helped her? I mean, I

> know

> > > > I'm real green and am probably speaking way out of turn. But, if

> > > > you're going to let bureaucracy get in the way of helping

someone in

> > > > need, you need to forfeit your certs and licenses and find

another

> line

> > > > of work, possibly at the DMV.

> > > >

> > > >

> > > >

> > >

> > >

[Guest guest]

It's been a while since I've looked at EMTALA, but if I remember correctly,

EMTALA applies to hospitals, not EMS providers.  (Of course, a hospital-based

EMS system might be a whole different beast!)

-Wes

Re: Re: ER, EMD and 911 failure in CA

>

> The triage nurse should lose her license. Period. And that's quite

likely

> what will happen. If there were physicians involved, they should

ose

> theirs also. The hospital has been one step from being closed for

onths

> because

> it is notoriously bad. Perhaps it is time that it is closed.

>

> The public won't put up with this. And it should not. EMS cannot

ide

> behind the hospital on this. If a person calls for EMS, no matter

here

they

>

> are, EMS should respond and sort it out on the spot. Telephone

riage is

a

> prescription to end up in the courtroom as a defendant.

>

> If you found out that your mother was sitting in a waiting room of a

> hospital

> vomiting blood and nobody would see her, wouldn't you call for a

ruck

and

> take her someplace else?

>

> People seem to think that a hospital OWNS a patient. It does not.

nd

EMS

> usually does not work for the hospital. Who does EMS owe the duty

o?

The

> hospital or the patient? Answer that simple question and you see the

folly

> of the position that EMS should not have responded.

>

> Gene Gandy, JD. LP

> In a message dated 6/13/07 1:13:29 PM, jpercer (AT) gmail (DOT)

> <mailto:jpercer% <jpercer%25>-mailto:jper> com writes:

>

> >

> > While the dispatcher should've sent paramedics to the woman's

location, I

> > must say that I place a greater blame on the shoulders of the ER

staff,

> > particularly the triage nurse... If the woman was indeed vomiting

blood,

> she

> > shouldn't have been told to shut up and wait. That hospital needs

o

have

> a

> > serious look at its triage policy and see if its really being

andled

in

> the

> > best manner.

> >

> > Joe Percer, NREMT-P

> >

> >

> > >

> > > Okay, I'm just recently an EMT-B. But, couldn't someone just

elp

the

> > > woman and let the bureaucracy work itself out later. Would I

eally

> > > have gotten heat if I were the Medic and I helped her? I mean, I

know

> > > I'm real green and am probably speaking way out of turn. But, if

> > > you're going to let bureaucracy get in the way of helping

omeone in

> > > need, you need to forfeit your certs and licenses and find

nother

line

> > > of work, possibly at the DMV.

> > >

> > >

> > >

> >

> >

[Guest guest]

Kimberley,

EMTALA does not apply to EMS. Only hospitals and physicians are covered by

it. Whether or not the pickup would constitute an EMTALA violation by the

hospital is of no consequence to EMS, although EMS should report the hospital to

CMS if it thinks there was an EMTALA violation.

Always think in these terms: Who do you owe your duty to? The hospital or

the patient? The legal answer is that your duty as an EMS provider is to

the patient, not the hospital.

In my judgment, the CA situation could have been averted had EMS responded a

unit and a supervisor and sorted out the problem with the ER. It may be that

they had tunnel vision about the patient and would have been shaken out of

that if EMS had arrived.

There is no rule whatsoever in law that prevents an ambulance service, 911 or

otherwise, from responding to a patient who is already in a hospital.

Policies are another matter. However, policies should be carefully

considered with legal counsel to make sure that they do not violate the duty to

the

patient. A policy that contravenes the law will not offer any protection in a

lawsuit.

The whole question comes down to what was the reasonable thing to do under

the circumstances. That's the question the jury will answer.

Many EMS managers seem to believe that EMTALA somehow affects EMS. It does

not except that no EMS service should accept a transfer that it cannot

reasonably make with the personnel it has available. So if you're asked to

transfer

an unstable patient and you don't feel that your staffing can handle it, then

you can refuse. But that's based in tort law, not EMTALA.

I hope this helps.

Gene Gandy, JD, LP

>

> As a dispatcher, I have always thought that we cannot pick up a patient when

> they are in the hospital, even if the pt calls 9-1-1. The idea that is being

> propogated is that it is an EMTALA violation. Can any of the legal people on

> the list confirm or deny this?

> - Kimberley

>

>

> >

> > I don't know of any state or federal regulation that would prevent an

> > EMS

> > crew from removing a patient who had called them. It's the patient's

> > determination, not the hospital's. The doctor and the hospital can

> > strongly recommend

> > that the patient not leave, but so long as the patient possesses the

> > present

> > mental capacity to make a rational healthcare decision, the patient

> > controls

> > it.

> >

> > I can't imagine how DSHS would get involved with that so long as the

> > patient

> > was the one who initiated the call.

> >

> > COBRA is actually a part of the Internal Revenue Code and it pertains

> > mainly

> > to reimbursement. There are no federal regulations for EMS that would

> > affect

> > an EMS provider's actions in the situation you mention.

> >

> > Gene

> > In a message dated 6/13/07 8:42:38 PM, medictaz@saunders-medictaz@s<

> medictaz%40saundermedictaz%med>writes:

> >

> > >

> > > I have a question here for the masses. If an ambulance had responded to

> > the

> > > ED waiting room doesn't state regs or COBRA prohibit them from taking

> > that

> > > patient from hospital property without them being seen by a physician? I

> > > understand that she had not been seen & that it looked like she was not

> > > going to be seen anytime soon, but would that not put the EMS crew in a

> > > potential situation with their regulatory agency? Now this is with the

> > > understanding that the hospital she was @ did have (even though they

> > were

> > > not acting @) the appropriate level to treat her. This was a situation

> > that

> > > give all of emergency medicine a black eye (911 / EMS / ED / ED RN's /

> > ED

> > > MD's)!

> > >

> > >

> > >

> > > _____

> > >

> > > From: texasems-l@yahoogro From: texasems-l@yahoogr From: texasems- From

> > > Behalf Of wegandy1938@ Behalf

> > > Sent: Wednesday, 13 June, 2007 18:20

> > > To: texasems-l@yahoogro To: te

> > > Subject: Re: Re: ER, EMD and 911 failure in CA

> > >

> > > The triage nurse should lose her license. Period. And that's quite

> > likely

> > > what will happen. If there were physicians involved, they should lose

> > > theirs also. The hospital has been one step from being closed for months

> > > because

> > > it is notoriously bad. Perhaps it is time that it is closed.

> > >

> > > The public won't put up with this. And it should not. EMS cannot hide

> > > behind the hospital on this. If a person calls for EMS, no matter where

> > they

> > >

> > > are, EMS should respond and sort it out on the spot. Telephone triage is

> > a

> > > prescription to end up in the courtroom as a defendant.

> > >

> > > If you found out that your mother was sitting in a waiting room of a

> > > hospital

> > > vomiting blood and nobody would see her, wouldn't you call for a truck

> > and

> > > take her someplace else?

> > >

> > > People seem to think that a hospital OWNS a patient. It does not. And

> > EMS

> > > usually does not work for the hospital. Who does EMS owe the duty to?

> > The

> > > hospital or the patient? Answer that simple question and you see the

> > folly

> > > of the position that EMS should not have responded.

> > >

> > > Gene Gandy, JD. LP

> > > In a message dated 6/13/07 1:13:29 PM, jpercer (AT) gmail (DOT)

> > > <mailto:jpercer% <jpercer%25><wbr>mailto> com writes:

> > >

> > > >

> > > > While the dispatcher should've sent paramedics to the woman's

> > location, I

> > > > must say that I place a greater blame on the shoulders of the ER

> > staff,

> > > > particularly the triage nurse... If the woman was indeed vomiting

> > blood,

> > > she

> > > > shouldn't have been told to shut up and wait. That hospital needs to

> > have

> > > a

> > > > serious look at its triage policy and see if its really being handled

> > in

> > > the

> > > > best manner.

> > > >

> > > > Joe Percer, NREMT-P

> > > >

> > > >

> > > > >

> > > > > Okay, I'm just recently an EMT-B. But, couldn't someone just help

> > the

> > > > > woman and let the bureaucracy work itself out later. Would I really

> > > > > have gotten heat if I were the Medic and I helped her? I mean, I

> > know

> > > > > I'm real green and am probably speaking way out of turn. But, if

> > > > > you're going to let bureaucracy get in the way of helping someone in

> > > > > need, you need to forfeit your certs and licenses and find another

> > line

> > > > > of work, possibly at the DMV.

> > > > >

> > > > >

> > > > >

> > > >

> > > >

[Guest guest]

Gene,

You’re so smart, when I grow up I want to be just like you, except I

want more hair…J

On another list, I made the comment, that there are countless hospitals,

EMS and transfer services, as well as dispatch systems already changing

their policy in light of what happened in CA.

I am curious to see how it all pans out.

Re: Re: ER, EMD and 911 failure in CA

Policies are another matter. However, policies should be carefully

considered with legal counsel to make sure that they do not violate the

duty to the

patient. A policy that contravenes the law will not offer any protection

in a

lawsuit.

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[Guest guest]

So let's try this. You get the call per dispatch and

respond to the hospital. You find the patient in

emergent distress and your protocol is to transport to

the closest hospital (you are already there). You roll

the patient into the trauma room and the patient is

seen quicker because they are received by EMS. This

remains and sad situation, but the root is that many

hospitals are abused by patients and the media. As

always, there is more to this story than the media is

willing to find and disclose because it is not ratings

worthy. In closing, I hope that people don't figure

out that when they are not seen quick enough, they

just abuse (call) EMS instead and call the media .....

________________________________________________________________________________\

____

Sick sense of humor? Visit Yahoo! TV's

Comedy with an Edge to see what's on, when.

http://tv.yahoo.com/collections/222

[Guest guest]

From: texasems-l [mailto:texasems-l ] On

Behalf Of Joe B

Subject: RE: Re: ER, EMD and 911 failure in CA

So let's try this. You get the call per dispatch and

respond to the hospital. You find the patient in

emergent distress and your protocol is to transport to

the closest hospital (you are already there). You roll

the patient into the trauma room and the patient is

seen quicker because they are received by EMS.

If your patient was found in emergent distress, then it worked out for

the best and everyone goes home with a warm fuzzy feeling. In some areas

I can see where transport to the nearest facility is required, but there

are plenty of hospitals in LA county, and sometimes the closest one is

not necessarily the appropriate one.

This

remains and sad situation, but the root is that many

hospitals are abused by patients and the media.

I agree, so lets make this a hypothetical case, lets say the facts as

presented are exactly how they happened. What do you do then? You are

called to the waiting room of an ER (a busy one) and find your patient

as presented in the media. What now? The abuse of hospitals is without

question, but that does not mean that anyone should die because of it.

This is not a local problem, this is a nationwide issue affecting

facilities, and ultimately patient care.

As

always, there is more to this story than the media is

willing to find and disclose because it is not ratings

worthy. In closing, I hope that people don't figure

out that when they are not seen quick enough, they

just abuse (call) EMS instead and call the media .....

Correct, there are many things left out, was she a frequent flyer?

Maybe, but they get sick and die too.

Food for thought, again, I am curious how this will all pan out.

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[Guest guest]

Mike,

You are right that if this patient was a system abusers, they could use this

as an end run to get seen in the ED faster. The fact that we can assess the

patient and decide if they need to be moved into the ED for immediate

treatment or seen by triage first to be classified is our best plan of

action. If the patient is a true emergency then you load and roll into the

ED and find a room. If not I would check with the triage area and see if the

patient has been classified and advise them of the 911 call by this patient.

By communicating with the hospital triage you would make it much harder for

the abuser or frequent flyers who just want to be seen quicker for a minor

problem from successfully beating the system.

This situation also brings up another interesting question. How do you bill

for your services? You transported the patient from where to where? The same

address to the same address? Would any insurance company pay for this call?

I foresee this becoming a more prevalent problem as overcrowding in most

ED's will only increase in the next few years. Is socialized medicine the

answer as suggested by Dr Bledsoe? I am not sure but the medical community

must start to address this situation soon or these problems will only

increase with every passing day.

Just my .002 worth, inflation you know

Bernie EMTP

From: texasems-l [mailto:texasems-l ] On

Behalf Of Hatfield

Sent: Friday, June 15, 2007 11:53 AM

To: texasems-l

Subject: RE: Re: ER, EMD and 911 failure in CA

From: texasems-l <mailto:texasems-l%40yahoogroups.com>

[mailto:texasems-l <mailto:texasems-l%40yahoogroups.com> ]

On

Behalf Of Joe B

Subject: RE: Re: ER, EMD and 911 failure in CA

So let's try this. You get the call per dispatch and

respond to the hospital. You find the patient in

emergent distress and your protocol is to transport to

the closest hospital (you are already there). You roll

the patient into the trauma room and the patient is

seen quicker because they are received by EMS.

If your patient was found in emergent distress, then it worked out for

the best and everyone goes home with a warm fuzzy feeling. In some areas

I can see where transport to the nearest facility is required, but there

are plenty of hospitals in LA county, and sometimes the closest one is

not necessarily the appropriate one.

This

remains and sad situation, but the root is that many

hospitals are abused by patients and the media.

I agree, so lets make this a hypothetical case, lets say the facts as

presented are exactly how they happened. What do you do then? You are

called to the waiting room of an ER (a busy one) and find your patient

as presented in the media. What now? The abuse of hospitals is without

question, but that does not mean that anyone should die because of it.

This is not a local problem, this is a nationwide issue affecting

facilities, and ultimately patient care.

As

always, there is more to this story than the media is

willing to find and disclose because it is not ratings

worthy. In closing, I hope that people don't figure

out that when they are not seen quick enough, they

just abuse (call) EMS instead and call the media .....

Correct, there are many things left out, was she a frequent flyer?

Maybe, but they get sick and die too.

Food for thought, again, I am curious how this will all pan out.

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6/15/2007 11:31 AM

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Checked by AVG Free Edition.

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6/15/2007 11:31 AM

[Guest guest]

Tonight this is the subject of CNN Headline News' Grace's show. The

anchor sitting in for Grace devoted the entire hour to it. Lots of

inflammatory stuff was said, with Gloria Allred, of course, the lawyer for the

Stars,

and other lawyers weighing in.

It turns out that the cops had actually arrested this woman before she died,

so she died in custody. That opens up another route for liability.

Apparently this hospital is a snake pit and has had many, many bad incidents

in the past and has had much trouble before this.

An interesting aspect that came out during the program is that there is

apparently a security video tape showing the whole thing, including the death of

the woman. According to the lawyers it is now being reviewed by the LA County

DA to see who is going to be charged with what criminal acts in connection

with this.

One of the things that was said is that the hospital people thought the stuff

coming out of the patient's mouth was " chocolate " rather than blood.

Stay out of LA if you intend to become sick or injured. The hospitals

stink, EMS stinks, the cops stink, and the air stinks.

GG

So more bodies are going to hit the ground before it's over.

The hospital sees around 49,000 patients a year in its ER. That's about 134

patients per day which is not that much for a big city hospital. Apparently

it has suffered from understaffing for a long time and since it's the " ghetto

hospital " not a lot of folks want to work there.

>

>

> So let's try this. You get the call per dispatch and

> respond to the hospital. You find the patient in

> emergent distress and your protocol is to transport to

> the closest hospital (you are already there). You roll

> the patient into the trauma room and the patient is

> seen quicker because they are received by EMS. This

> remains and sad situation, but the root is that many

> hospitals are abused by patients and the media. As

> always, there is more to this story than the media is

> willing to find and disclose because it is not ratings

> worthy. In closing, I hope that people don't figure

> out that when they are not seen quick enough, they

> just abuse (call) EMS instead and call the media .....

>

> ____________ ________ ________ ________ ________ ________

> Sick sense of humor? Visit Yahoo! TV's

> Comedy with an Edge to see what's on, when.

> http://tv.yahoo.http://tv.yahoo.htt

>

>

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

See what's free at http://www.aol.com.

[Guest guest]

In a message dated 6/15/2007 9:39:06 P.M. Central Daylight Time,

wegandy1938@... writes:

It turns out that the cops had actually arrested this woman before she died,

so she died in custody.

Oh and the list of defendants just gets longer and longer, cops usually are

smarter then this.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** See what's free at http://www.aol.com.

[Guest guest]

In a message dated 6/15/2007 9:39:06 P.M. Central Daylight Time,

wegandy1938@... writes:

An interesting aspect that came out during the program is that there is

apparently a security video tape showing the whole thing, including the

death of

the woman.

It will likely be black and white, grainy as a dust storm in the panhandle

(gee, I have been here too long) and will be basically worthless.

Has anyone ever seen a decent " security " tape?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** See what's free at http://www.aol.com.

[Guest guest]

They had a LA County Supervisor on who said that he has seen it and that it's

shocking. It will be released by the family after the DA's through with it.

That will keep the pot boiling since it may be weeks before it's released.

gene

>

>

> In a message dated 6/15/2007 9:39:06 P.M. Central Daylight Time,

> wegandy1938@wegandy writes:

>

> An interesting aspect that came out during the program is that there is

> apparently a security video tape showing the whole thing, including the

> death of

> the woman.

>

> It will likely be black and white, grainy as a dust storm in the panhandle

> (gee, I have been here too long) and will be basically worthless.

>

> Has anyone ever seen a decent " security " tape?

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/ FF/

> Freelance Consultant/Trainer/ Freelance Cons Freelance Consultant/Traine

> LNMolino@...

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

>

> " A Texan with a Jersey Attitude "

>

> " Great minds discuss ideas; Average minds discuss events; Small minds

> discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

>

> The comments contained in this E-mail are the opinions of the author and the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain by

> the

> original author.

>

> ************ ******** ******** ************<wbr>*********http://www.aol.http

>

>

[Guest guest]

I don't know California law, but I'd say negligent homicide or something like

that. Contributing to death through neglect may be criminal.

Once before a California DA charged an ER physician with homicide following a

patient death. The case didn't get anywhere, but as you say, this IS

Col-ee-for-knee-ah.

GG

>

> Inquiring minds want to know... On what charges? That sounds too bizarre,

> even for LaLa land...

>

> lnmolino@... wrote:

>

> In a message dated 6/15/2007 9:39:06 P.M. Central Daylight Time,

> wegandy1938@wegandy writes:

>

> It turns out that the cops had actually arrested this woman before she died,

> so she died in custody.

>

> Oh and the list of defendants just gets longer and longer, cops usually are

> smarter then this.

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/ FF/

> Freelance Consultant/Trainer/ Freelance Consu Freelance Consultant/Traine

> LNMolino@...

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

>

> " A Texan with a Jersey Attitude "

>

> " Great minds discuss ideas; Average minds discuss events; Small minds

> discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

>

> The comments contained in this E-mail are the opinions of the author and the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain by

> the

> original author.

>

> ************ ******** ******** ************<wbr>*********http://www.aol.http

>

>

[Guest guest]

In a message dated 6/16/2007 12:05:47 A.M. Central Daylight Time,

larn572001@... writes:

How was she disturbing the peace? Throwing up blood and dying too noisily?

How rude of her!

Ya gotta admit that's harsh even for CA

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** See what's free at http://www.aol.com.

[Guest guest]

In a message dated 6/16/2007 12:54:50 A.M. Central Daylight Time,

ewedgin@... writes:

You have to remember ,Those folks are the ones whom

found O.J. not guilty.

Jury nullification won't likely happen here.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** See what's free at http://www.aol.com.

[Guest guest]

I worked in L.A. and have been to this hospital

several times. It is a pit. The place is grossly

understaffed and very in adaquate. They shut their

trauma center a couple of years back. As the County

Health Department stated in 2004[ KING-DREW{ as it was

known] IS A BLEEDING SORE ON THE HEART OF LOS ANGELES

HEALTH CARE}There are more lawsuits pending against

this facility, than any other hospital in all of

California. This place needs to be bulldozed and al

paitents in that area should be transported to St.

Francis,which is a CHW

--- wegandy1938@... wrote:

> Tonight this is the subject of CNN Headline News'

> Grace's show. The

> anchor sitting in for Grace devoted the entire hour

> to it. Lots of

> inflammatory stuff was said, with Gloria Allred, of

> course, the lawyer for the Stars,

> and other lawyers weighing in.

>

> It turns out that the cops had actually arrested

> this woman before she died,

> so she died in custody. That opens up another

> route for liability.

>

> Apparently this hospital is a snake pit and has had

> many, many bad incidents

> in the past and has had much trouble before this.

>

> An interesting aspect that came out during the

> program is that there is

> apparently a security video tape showing the whole

> thing, including the death of

> the woman. According to the lawyers it is now

> being reviewed by the LA County

> DA to see who is going to be charged with what

> criminal acts in connection

> with this.

>

> One of the things that was said is that the hospital

> people thought the stuff

> coming out of the patient's mouth was " chocolate "

> rather than blood.

>

> Stay out of LA if you intend to become sick or

> injured. The hospitals

> stink, EMS stinks, the cops stink, and the air

> stinks.

>

> GG

>

>

>

>

>

> So more bodies are going to hit the ground before

> it's over.

>

> The hospital sees around 49,000 patients a year in

> its ER. That's about 134

> patients per day which is not that much for a big

> city hospital. Apparently

> it has suffered from understaffing for a long time

> and since it's the " ghetto

> hospital " not a lot of folks want to work there.

>

>

>

> In a message dated 6/15/07 10:36:23 AM,

> bigjberry@... writes:

>

>

> >

> >

> > So let's try this. You get the call per dispatch

> and

> > respond to the hospital. You find the patient in

> > emergent distress and your protocol is to

> transport to

> > the closest hospital (you are already there). You

> roll

> > the patient into the trauma room and the patient

> is

> > seen quicker because they are received by EMS.

> This

> > remains and sad situation, but the root is that

> many

> > hospitals are abused by patients and the media. As

> > always, there is more to this story than the media

> is

> > willing to find and disclose because it is not

> ratings

> > worthy. In closing, I hope that people don't

> figure

> > out that when they are not seen quick enough, they

> > just abuse (call) EMS instead and call the media

> .....

> >

> > ____________ ________ ________ ________ ________

> ________

> > Sick sense of humor? Visit Yahoo! TV's

> > Comedy with an Edge to see what's on, when.

> > http://tv.yahoo.http://tv.yahoo.htt

> >

> >

>

>

>

>

> **************************************

> See what's free at http://www.aol.com.

>

>

> [Non-text portions of this message have been

> removed]

>

>

________________________________________________________________________________\

____

Building a website is a piece of cake. Yahoo! Small Business gives you all the

tools to get online.

http://smallbusiness.yahoo.com/webhosting

[Guest guest]

I worked in L.A. and have been to this hospital

several times. It is a pit. The place is grossly

understaffed and very in adaquate. They shut their

trauma center a couple of years back. As the County

Health Department stated in 2004[ KING-DREW{ as it was

known] IS A BLEEDING SORE ON THE HEART OF LOS ANGELES

HEALTH CARE}There are more lawsuits pending against

this facility, than any other hospital in all of

California. This place needs to be bulldozed and al

paitents in that area should be transported to St.

Francis,which is a CHW

--- wegandy1938@... wrote:

> Tonight this is the subject of CNN Headline News'

> Grace's show. The

> anchor sitting in for Grace devoted the entire hour

> to it. Lots of

> inflammatory stuff was said, with Gloria Allred, of

> course, the lawyer for the Stars,

> and other lawyers weighing in.

>

> It turns out that the cops had actually arrested

> this woman before she died,

> so she died in custody. That opens up another

> route for liability.

>

> Apparently this hospital is a snake pit and has had

> many, many bad incidents

> in the past and has had much trouble before this.

>

> An interesting aspect that came out during the

> program is that there is

> apparently a security video tape showing the whole

> thing, including the death of

> the woman. According to the lawyers it is now

> being reviewed by the LA County

> DA to see who is going to be charged with what

> criminal acts in connection

> with this.

>

> One of the things that was said is that the hospital

> people thought the stuff

> coming out of the patient's mouth was " chocolate "

> rather than blood.

>

> Stay out of LA if you intend to become sick or

> injured. The hospitals

> stink, EMS stinks, the cops stink, and the air

> stinks.

>

> GG

>

>

>

>

>

> So more bodies are going to hit the ground before

> it's over.

>

> The hospital sees around 49,000 patients a year in

> its ER. That's about 134

> patients per day which is not that much for a big

> city hospital. Apparently

> it has suffered from understaffing for a long time

> and since it's the " ghetto

> hospital " not a lot of folks want to work there.

>

>

>

> In a message dated 6/15/07 10:36:23 AM,

> bigjberry@... writes:

>

>

> >

> >

> > So let's try this. You get the call per dispatch

> and

> > respond to the hospital. You find the patient in

> > emergent distress and your protocol is to

> transport to

> > the closest hospital (you are already there). You

> roll

> > the patient into the trauma room and the patient

> is

> > seen quicker because they are received by EMS.

> This

> > remains and sad situation, but the root is that

> many

> > hospitals are abused by patients and the media. As

> > always, there is more to this story than the media

> is

> > willing to find and disclose because it is not

> ratings

> > worthy. In closing, I hope that people don't

> figure

> > out that when they are not seen quick enough, they

> > just abuse (call) EMS instead and call the media

> .....

> >

> > ____________ ________ ________ ________ ________

> ________

> > Sick sense of humor? Visit Yahoo! TV's

> > Comedy with an Edge to see what's on, when.

> > http://tv.yahoo.http://tv.yahoo.htt

> >

> >

>

>

>

>

> **************************************

> See what's free at http://www.aol.com.

>

>

> [Non-text portions of this message have been

> removed]

>

>

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