SC medics sued

[zzyzx]

http://www.islandpacket.com/news/local/story/830326.html

[spenac]

Here is an overview. Just makes you remember to do proper documentation so you can show why you decided on a treatment or destination. Honestly looks like EMS is just part of a blanket lawsuit of everyone involved by a family that has suffered a loss.

"The mother of a 17-year-old Bluffton High School student who died following a prom-night car wreck in May has filed a wrongful death lawsuit against Beaufort County, alleging county paramedics took her son to a hospital unequipped to treat him."

"The suit, filed March 12 and obtained by The Island Packet on Wednesday, alleges:

• Beaufort County paramedics failed to "accurately assess Joshua's condition at the scene of the accident and (failed) to transport him to the appropriate medical facility."

• The paramedics' decision to take George to Hilton Head Hospital instead of a rated trauma hospital, such as Savannah's Memorial University Medical Center, "is the direct and proximate cause of Joshua's death." In Savannah, the lawsuit says, he "would have been promptly treated ... by a trauma team and a neurosurgeon..." "

"Paramedics arrived at the crash scene at 3 a.m., the report said.

Ten minutes later, with George in the ambulance, they were on the way to Hilton Head Hospital. When the ambulance reached the hospital at 3:24 a.m., George "was conscious and was able to explain what had happened to him," according to the suit.

Over the next two hours, Hilton Head Hospital personnel "performed a number of diagnostic tests and procedures," according to the lawsuit.

At 5:20 a.m., less than two hours after he arrived, George was transferred to Memorial University Medical Center, a top-rated trauma hospital, according to the suit.

The reason for the transfer, according to Hilton Head Hospital records, was that "physician specialties needed are not available. ...specialty not available: neurosurgeon," the suit states."

[FireMedic65]

That is just ridiculous!

[ncmedic309]

I'm not taking sides here, but just something that does concern me about the entire case...

The teen, who was not wearing a seat belt, was thrown 30 feet from his truck and suffered serious head trauma, according to an incident report obtained from Beaufort County Emergency Medical Services earlier this year.

they were on the way to Hilton Head Hospital.

Hilton Head Hospital used to be a Level 3 center but dropped that status in July 2007.

The one thing that I find most concerning is proven in the quotes above - this patient had a major mechanism of injury that was obviously known to the EMS crew on the scene. The patient was transported to a facility that was not rated as a trauma center. There were other facilities in proximity that did have trauma services and would have been better suited to care for the patient. I could understand transporting to the closest facility if you were having airway difficulties or another immediate life threatening injury that couldn't be corrected in the field but as stated in the article:

When the ambulance reached the hospital at 3:24 a.m., George "was conscious and was able to explain what had happened to him," according to the suit.

...which makes me believe that he was likely stable enough to be managed during the longer transport to the more appropriate facility. Now that's just my take on it, we know that time is of importance with trauma and we can't say that his outcome wouldn't have been better if he had been transported to the appropriate facility initially vs. the delay in definitive care. Just something else to ponder, but that alone in my opinion gives the family good reason for the lawsuit.

I also want to make it clear that I don't know jack about the protocols of those providers and that they may have very well been working well within those established procedures and protocols when this incident occured. If that's the case, then they likely have little to worry about.

[HERBIE1]

Need more info, but unrestrained and ejection 30 feet from a vehicle- that buys someone a trip to a Trauma center in any system I know of.

Like was noted, he had a stable airway if he was awake and talking. Yes, nobody likes a Monday AM QB, but this one seems pretty obvious.

I would simply like to know WHY they did not take the guy to an appropriate facility- that's what they are for.

[spenac]

So he appeared stable so no need for immediate trauma surgery. Even the hospital he was at did not feel a need for a rush. MOI is not always indicative of severity. Treat the patient not the MOI. The medics will be OK if they did proper documentation so it is clear why they decided on this and not another hospital.

[FireMedic65]

Need more info, but unrestrained and ejection 30 feet from a vehicle- that buys someone a trip to a Trauma center in any system I know of.

Like was noted, he had a stable airway if he was awake and talking. Yes, nobody likes a Monday AM QB, but this one seems pretty obvious.

I would simply like to know WHY they did not take the guy to an appropriate facility- that's what they are for.

Takes quite a bit of force to throw someone 30ft from a car. Not a lot of info on the crash itself, but it seems to me the county just got made an example of.

I will take a critical patient to a lower level facility to get them stabilized and then transfer from there. All depending on my location and distances. I don't recall the article mentioning anything like that.

[HERBIE1]

So he appeared stable so no need for immediate trauma surgery. Even the hospital he was at did not feel a need for a rush. MOI is not always indicative of severity. Treat the patient not the MOI. The medics will be OK if they did proper documentation so it is clear why they decided on this and not another hospital.

No, MOI is not always indicative of the severity of an injury and no, we do not treat mechanism of injury, but you damn well had better at least suspect a serious injury. Intuitively, there should be a high index of suspicion with something like this. The victim was ejected 30 feet from the vehicle- that's more than enough force to cause a multitude of problems- up to and including the apparent bleed that killed him. According to the article, the patient had a significant scalp lac, thus he experienced more than enough force to cause his injury. I've seen people ejected from vehicles who didn't have a scratch on them and still died. I've also seen people who were ejected, were transported and were discharged from the ER with no injuries. Point is, in situation like this, it's up to the hospital to rule out any internal or unlikely injuries, not us.

This is an example of why most policies state this MOI- ejection from a vehicle- is a reason to transport to a trauma center.

Again, I'd be curious to see any other info not provided in the article that could explain why the crew made the decisions they did, but I do hope they documented their arses off.

Takes quite a bit of force to throw someone 30ft from a car. Not a lot of info on the crash itself, but it seems to me the county just got made an example of.

I will take a critical patient to a lower level facility to get them stabilized and then transfer from there. All depending on my location and distances. I don't recall the article mentioning anything like that.

Clearly, transport times are important, but if this guy's vitals are stable and he has a patent airway, I see no reason why he couldn't make that trip.

[FireMedic65]

Clearly, transport times are important, but if this guy's vitals are stable and he has a patent airway, I see no reason why he couldn't make that trip.

Agreed. I was just making a point. I don't think they mentioned distances in the article. Vitals stable, patient goes to the nearest facility unless MOI proves otherwise and/or their condition.

[HERBIE1]

Agreed. I was just making a point. I don't think they mentioned distances in the article. Vitals stable, patient goes to the nearest facility unless MOI proves otherwise and/or their condition.

Exactly.