Vermont Medic loses license over fatal crash

[Just Plain Ruff]

A convicted murderer can be released from prison after serving his sentence and is considered rehabilitated (in most states). If he can get a second chance in society then why shouldn't this medic? Suspend him, retrain him, educate him, just because it was beyond his scope should not be a "death sentence". Even Scratrat admits to "bending the rules". If functioning beyond one's scope is a loss of licence event, then Vermont would likely lose most of its medics. This was a blatant and extreme case with plenty of witnesses, but according to some, beyond the scope is beyond the scope and the punishment should be the same...so if you give 15mg of morphine to a 300lb guy in pain when your protocols state your maximum allowed cumulative dose is 10mg, you'd better be prepared to lose your cert and never work EMS again.

I'll bet there was a second half to what the medic said. "I'm probably going to lose my licence for this," "but the love I have for my friend and her family trumps that."

Like a mentioned in my first post. For such a heavy handed reaction from the state he must have been disciplined before.

NO I disagree on the licensure thing Arctic, There were not one but two issues in this particular call. Let us not just focus on the pericardiocentesis, let us remember that there was a medication component in this as well. I believe that the medications used to control the airway were not approved medications either.

So this is two instances.

So let's say that we use your comparison of the criminal. He goes to jail for a long time. Well maybe the medic in question needs to go to jail so to speak. He needs to be re-trained but what does that require. We revoke licenses for medics and health care professionals who abuse painkillers and if they steal the meds then they likely get their licenses revoked. He broke 2 of the states rules that are punishable by the revocation of his license. If doing that skill and practicing out of scope punishment is revocation of licensure then there is no middle ground.

You can't give him remediation for a act that the states only remedy is revocation of licensure.

I don't know if that's the case but if it is then the rules are written and there should be no middle ground, no special treatment or they need to rewrite the rules. Which maybe they do? I don't know.

[DFIB]

I'll bet there was a second half to what the medic said. "I'm probably going to lose my licence for this," "but the love I have for my friend and her family trumps that."

Like a mentioned in my first post. For such a heavy handed reaction from the state he must have been disciplined before.

Love is a very powerful motivator, one of the most powerful motivators. I think one of the big questions he will have to answer is, Did he act in a manner that other medics would have acted in the same situation.

I absolutely believe in second chances in some instances. I don't know if the second chance should be immediate. There are some things we do we just cannot make repair for and should not get a second chance.

Does this case qualify for a second chance? It is not for me to decide, I simply do not know.

[Just Plain Ruff]

Anyone can have the balls to freelance, the question is, do we have the brains not to.

I have transported patients with medications drawn that I know I am not authorized to give, praying to God that I don't have to. Until now I never have. A lot of our job is about calculated restraint.

Yeah, it's the brain that should make your decision. You know you can do the skill, yet do you have the balls to do it? Do you have the skills to make sure that you do it right? Sure I have the balls to do it, I relocated a knee in the field one day, out of scope for me as a medic, sure, but lots of extenuating circumstances, 30minute hike to the ambulance with a patient on a board and just me and my partner and 3 volunteer firefighters. was guided by medical control via phone. so yes I had the balls to do it. and it worked.

Would I have done it if I was in any other circumstances other than the ones I was in, no freaking way but this procedure saved the guys leg, even the trauma surgeon said so after we got him to the trauma center. Backstory if you want it via pms.

But it was calculated, followed up by a strong willed ER doctor who trusted me and my partner and a patient who was all for it.

But my brain was working on overtime saying, holy crap holy crap. I could really get reamed for this. In the end I realized that this was in the patients best interest. I did get questioned by the state but with the trauma surgeon and local ER doc who was the one who walked me through it, the state dropped the investigation, stamped it closed - procedure warranted or something like that.

[Arctickat]

So this is two instances.

Actually, three. He disregarded the order from Medical Control to transport immediately

Well maybe the medic in question needs to go to jail so to speak.

Which would be a suspension of his licence until conditions of his sentence are met. Not a permanent revocation.

We revoke licenses for medics and health care professionals who abuse painkillers and if they steal the meds then they likely get their licenses revoked.

Not here. The precedent has been set by our College for that exact scenario. Fine, Suspension, Counselling, Mandatory drug testing, and Rehabilitation have been the decisions handed down.

He broke 2 of the states rules that are punishable by the revocation of his license. If doing that skill and practicing out of scope punishment is revocation of licensure then there is no middle ground.

Is there a written policy from the state that identifies this? Something worded like "Any contravention of these protocols will result in revocation of a practitioner's licence." If there is then everyone in Vermont had better watch out.

I relocated a knee in the field one day, out of scope for me as a medic, sure, but lots of extenuating circumstances, 30minute hike to the ambulance with a patient on a board and just me and my partner and 3 volunteer firefighters. was guided by medical control via phone. so yes I had the balls to do it. and it worked.

So, by your own logic, because you functioned beyond your scope you should have your licence permanently revoked.

Edited October 3, 2012 by Arctickat

[DFIB]

Would a action guided by online medical direction be considered a breach. Wouldn't they in essence be authorizing you as an extension of their practice and taking ultimate responsibility for the action?

If they are not taking responsibility I would like to know the difference of one exsists.

[Arctickat]

Would a action guided by online medical direction be considered a breach.

Absolutely

Wouldn't they in essence be authorizing you as an extension of their practice and taking ultimate responsibility for the action?

If they are not taking responsibility I would like to know the difference of one exsists.

Our protocols are approved by the Saskatchewan College of Physicians and Surgeons and the Saskatchewan Medical Association. In 2009 we obtained self regulation and licensure, which means that we act under our own licence, not as an extension of a Medical Director. No one, absolutely no one, can give us provisional permission to exceed our scope of practice or protocols. Anyone accused of exceeding their Scope is investigated byt the college and if warranted summoned before the professional conduct committee. The sentences to date have included fines and suspensions, never revocation. Their decisions are published online:

http://www.collegeofparamedics.sk.ca/conduct/index.php

[DFIB]

Absolutely

Our protocols are approved by the Saskatchewan College of Physicians and Surgeons and the Saskatchewan Medical Association. In 2009 we obtained self regulation and licensure, which means that we act under our own licence, not as an extension of a Medical Director. No one, absolutely no one, can give us provisional permission to exceed our scope of practice or protocols. Anyone accused of exceeding their Scope is investigated byt the college and if warranted summoned before the professional conduct committee. The sentences to date have included fines and suspensions, never revocation. Their decisions are published online:

http://www.collegeof...nduct/index.php

I like that, operating under your own license that is.

[Arctickat]

It makes us more accountable for our actions, some have had difficulty with the adjustment. Prior to this the Province was our regulatory and registration body. In that time the protocols were considered more of a "guideline" and breaches with and without medical authorisation were a pretty common event. Once the College took over, the change in policy resulted in the Protocols being an absolute black and white with punishments being handed down for breaches.

Some have adjusted well, others, including me, have had some difficulties.

[Just Plain Ruff]

So, by your own logic, because you functioned beyond your scope you should have your licence permanently revoked.

Actually yes ArcticCat, by my own logic yes, and if that was the decision of the state bureau, then so be it but it wasn't.

But my relocating a knee is not a license revocatable action, at least it wasn't 17 years ago.

I'm not sure if it is now or not.

But if the state had wanted to pull my license, sure, they could have. But I'd have really been pissed but I'd have appealed and if unsuccessful, then I'd be doing something else workwise.

I don't know the statutes I was merely guessing but I would not be surprised if there is some sort of language that does say that revocation is the only penalty.

Am I advocating for this medic to lose his license, I don't think I've said it either way, If I have I don't remember, but I'm saying that if there is remediation, it better be significant. Maybe his license suspended for 6 months or a year but isn't that taking away his livelihood anyway? Suspending someone from working in their field of choice is taking away their livelihood don't you agree? It might not be a permanent thing but for that period of time, he can't work in EMS so he's effectively out of work. So whats the difference between a suspension and a revocation when the medic can't work as a medic, it's still a career death sentence, just one is longer than the other.

I'm not arguing any of your point's Cat, just seeing it from a different perspective.

[fab]

Captain, I see your point and it's your decision. It's fairly easy over here, everything invasive means breaking the law so I've done it quite often.

Then again, (as Kat pointed) you breached your scope too... would you do that again? What if your procedure had gone wrong? What if that paramedic had succeeded with his?

How many doctors fuck up massively and don't have their license to practise revoked?