restraints and lawsuits

[nick72]

I recently treated a patient who was suicidal and told us that he took an overdose of his meds. It involved police assistance, since he refused to be transported to a hospital. The police, me, and my partner got the patient strapped down to the gurney and loaded him into the ambulance. Once the patient was restrained, he began to scream and pull violently at his restraints. He babbled about being "claustrophobic" and screamed at us to release him. But in my book, once a patient is restrained, they stay restrained till we get them to the hospital.

Now me and my partner are being threatened with a lawsuit. That patient and his lawyer are claiming that me and my partner gave him "emotional trauma" and "PTSD" because we "shackled" him to the gurney and performed "appallingly invasive" procedures on him.

Can ems and hospitals even treat people anymore without lawyers getting involved? I'm getting discouraged.

[island emt]

What do your State protocols say about restraint use?

Did you follow them?

Was the pt in protective custody by law enforcement?

You can be sued for every single call you go on.

All a matter of whether you follow the rules and your protocols as set by the state you practice in.

The majority of suits filed against EMS providers are for negligence or stepping outside the levels of your license and exceeding scope of practice.

[ERDoc]

Welcome to America, where people have lawyers on speed dial. Anyone can sue anyone else for anything. It doesn't mean that they have a valid case but all cases have their costs as you are finding out. Even if your company provides you with a lawyer and you have no financial costs, there are the costs of your time for depositions, testimony if it gets to court, etc. There are also the emotional costs, as you are finding out now. These may be some of the biggest cost as they can sometimes be career ending. Don't let it get you down. Island has a lot of valid points so I won't repeat them. You need to be able to show that he was restrained for either his or others safety.

[island emt]

One more thought::

Did you cover all the bases on why you restrained the Pt with police assistance and is is documented clearly in your run report?

Outstanding documentation is your best friend when faced with a case like this.

[paramedicmike]

Agreed with the above. Good documentation is your friend.

I will also suggest you do not go back and add to your documentation if your chart doesn't have the points my two colleagues mentioned. Adding the info in later will only damage your credibility should this go anywhere. Just take it as a learning point for the future because you will experience this again at some point.

[island emt]

The law enforcement officer should have filed a written report also that could verify Pt's actions and yours.

Lawyers know this and will have copies of ALL documentation pertaining to the call including dispatch logs, your EMS Pt care report and the police agencies report, along with the receiving hospital's reports.

Just had a supeona last month for documentation from an auto accident pt we treated & transported 18 months ago. It is usually a fishing expedition for the injured parties laywers to go after the other party involved in the accident, but you never know what they are looking for.

[Just Plain Ruff]

One thing I will add, one service (not naming any but it was one I worked for) required me ( I did not fulfill that request) to update my run ticket after a particularly bad and nasty call. They said it was to clear up some inconsistencies but they were requesting that I write an addendum some 11 months after the call happened.

I refused and was threatened with suspension if I did not and I told them I would not write an addendum as I thought it would be fraudulent and stuck to my guns. NOthing came of it, and no suspension was forthcoming but it did make me wonder it they were trying to get me to add to a call they were getting sued on???

Do not go back and update your run ticket after the fact, that is just asking for trouble.

Edited January 13, 2014 by Ruffmeister Paramedic

[ERDoc]

It is okay to do an addendum after the fact as long as you are clear that it is an addendum and that it is being written on X date but the call was on Y date. NEVER alter the original record. The addendum needs to make sense though. It should not state the exact opposite of your original report. It is used to clarify something in the original report or to add something that was forgotten. We do it all the time in the hospital. It will look suspicious if it is done after a lawyer has made contact or if it has been too long such as in Ruff's case where it would have been 11 months later.

[Just Plain Ruff]

Doc, I truly believe that the intent of having me make the addendum was to make changes to the document in order to cover a lawsuit. I was given writing points on what to write and how to write them. I told them that I was very uncomfortable doing it but was threatened with suspension. I refused and requested a meeting with the service's attorneys in order to see what the legality of all of it was and I heard nothing more about it. That only reinforced my suspicion that they were trying to get me to change some items in a report that was in front of a plaintiff's attorney at the time.

[ERDoc]

I agree Ruff, it is very suspect. 11 months seems about the right amount of time to contact a lawyer and have the slow cogs of justice put in motion. If they were telling you what to write, they had an agenda.