Vermont Medic loses license over fatal crash

[Arctickat]

http://www.benningtonbanner.com/news/ci_21648505/medic-loses-license-over-fatal-crash

BENNINGTON -- A Bennington Rescue Squad paramedic has had his license renewal rejected by the state for actions he took during a fatal motorcycle crash.

Gillvray Hall, a paramedic who serves as operations manager for the squad, knowingly performed a procedure prohibited by the state and was slow in transporting the motorcyclist to the local hospital, according to Vermont Emergency Medical Services, part of the Vermont Department of Health.

This seems a bit excessive to me. There must have been additional unmentioned historical issues with this medic for the State to act in such a heavy handed manner. Up here for a first offence like this he'd likely end up with a fine and a requirement for remedial education.

Then again, it is rather unique because the story makes it sound like the medic's ego was the cause of death.

[eb1040]

By a map of this location, this crash occured almost right in front of the hospital.

It was not like this occured in some very distant place where there might have been no other options.

The part about sending a Paramedic into the hospital to get the doctor is just weird.

The Paramedic acknowledged what he was doing to others and they disagreed with his actions as did the doctor. There seems to be enough here to make a good case for relieving him of his license. Each offense separately is pretty serious. Collectively they are a disaster.

Edited October 1, 2012 by eb1040

[BillKaneEMT]

I'm not really surprised by the penalty he's facing. One of our field supervisors who's an EMT-B in this state started an IV in a patient during a 911 call and had his cert permanently revoked in this state. He's still certified as an EMT-I in another state though. In that case there were no adverse affects for the patient but he still got nailed. Part of that may have been political though. Still, reading the article I'm a little surprised he got off as lightly as he did.

[Just Plain Ruff]

*1. Keeping a "multi-systems trauma victim," who was within sight of the hospital, on scene for a prolonged time.

* 2. Allowing the patient’s sister, an EMT on the scene, to remain on duty and become directly involved in patient care.

*3. Allowing two medications to manage the patient’s airway that are not listed or approved for use as an induction agent during intubation attempts.

* 4. Sending another paramedic to the emergency department at Southwestern Vermont Medical Center to request that a physician come to the scene to perform a pericardiocentisis. The physician requested "multiple times" that the patient be transported to the hospital.

*5. Performing two unsuccessful attempts at pericardiocentisis, a procedure not allowable under the Vermont EMS paramedic scope of practice.

Ok, which of those wouldn't have possibly lost him his license. 3 and 5 if he actually did them and it sounds like he did would be cause to lose his license. Why is that so hard to understand that he shouldn't lose his license for doing number 3 and 5.

Anyone want to give me a reason why he should not lose his license? Pros and cons for and against him losing his license on numbers 3 and 5 alone.

[Arctickat]

Admittedly, our registration body here has never been faced with something as dramatic as this, however, in the past it has handed down suspensions, but never a revocation. Which I admit surprises me. He many have been functioning outside of the Vermont Scope, but he was not functioning beyond his training.

Sending a medic to get the physician when you're that close to the hospital is kinda stupid though. I see many years of a wrongful death suit ahead for this poor fella.

[eb1040]

I doubt if pericardiocentesis was in his Paramedic training if it was not in his state's scope of practice.

Where he got the training for this procedure was not mentioned. It was also not mentioned if he had done one before, how long ago and if he actively kept current in this skill. He did make two unsuccessful attempts. That also leads to a path of considering what other injuries and what other interventions had been done. It would be interesting to see the autopsy report.

I also doubt if this lawsuit will drag out many years. The ambulance's insurance and lawyers may already have an offer on the table especially with so many witnesses who advised him against doing this to the patient with a doctor/hospital in view of the scene.

[Just Plain Ruff]

I doubt if pericardiocentesis was in his Paramedic training if it was not in his state's scope of practice.

Where he got the training for this procedure was not mentioned. It was also not mentioned if he had done one before, how long ago and if he actively kept current in this skill. He did make two unsuccessful attempts. That also leads to a path of considering what other injuries and what other interventions had been done. It would be interesting to see the autopsy report.

I also doubt if this lawsuit will drag out many years. The ambulance's insurance and lawyers may already have an offer on the table especially with so many witnesses who advised him against doing this to the patient with a doctor/hospital in view of the scene.

did you read the same article I had. I believe it specifically said he had performed the procedure in a different state and that he had been trained in the procedure.

And I would bet that the lawsuit will not be a short and simple because there were others on scene, another medic especially who should have stopped him so that medic is closely responsible as well. The lawyers will be working on this for a while. They will find any and everybody who was there and all will be invited to the party. They will have to give their sides of the story and that will not be quick. I expect this to last for at least a year if not longer.

Plus the family will probably not accept the ambulance services first, second or third offer.

To me this sounds like a medic who was unable to separate the skills of one state over the other. The only thing that blows that out of the water is that he said "I might lose my license over this" and thus we are at this juncture.

Unfortunately, a guy died.

[eb1040]

I guess the thing is how long ago was the training and what had he done to review the procedue.

The settling part right away and quietly may prevent the others from telling their version of what happened. It could be even more damning especially if this guy was the type to brag about what he had done in his previous state. There is also witness testimony on record which can be used. Some of this is probably public record. Between the scope of practice, the very short distance to the hospital, sending a Paramedic to the hospital, the doctor telling him to come into the ED and whatever else was on that list, this is not something an ambulance company would want to linger for the zeros to add on.

[scratrat]

Plain and simple: He was practicing medicine without a license. I don't think they were heavy handed at all. He got what he deserved. Everyone has probably bent the rules slightly to conform to the patient's condition but this was blatantly outside his scope of practice.

And Arctickat, it's irrelevant whether he received the training and is permitted to practice said skill in another state. All states can be different. It's up to the practitioner to understand and abide by that particular State's laws and guidelines. He clearly knew he was overstepping his bounds when he made the "I may lose my license" comment. If you have to say it, then that probably means you shouldn't be proceeding.

Edited October 1, 2012 by scratrat

[Arctickat]

Having the training and experience is highly relevant and also makes a substantial difference in what laws, if any, were actually broken. Practising beyond your scope when you have the educational background to know what you're doing compared to seeing it on TV once. It's the difference between stupidity and incompetence.

I don't disagree that he lost his licence, nor do I agree that he should have. I don't know all the facts surrounding this case or the history of this medic. All I can say is that up here, given the historical decisions by our Professional Conduct Committee, for a first offence such as this he would likely have received a fine, suspension, and remedial education for exceeding his scope. That said, our PCC has never had to determine if the provider caused the death of a patient yet either.

I also agree with you, if he had to say it then he should have known better....it sounds like a statement that someone with a hero complex would make. "Screw my career!!! It's not worth letting this man die for!!!" Then beg for forgiveness once you heroically save his life....unfortunately he didn't and now he's slinging burgers.

Edited October 1, 2012 by Arctickat