Man Dies After Paramedics Told Him To Take Antacid for his "Reflux"

[Klutz]

Video - Breaking News Videos from CNN.com

It seriously concerns me that if these guys really did just wing it, that there are "fully-trained" paramedics that quite frankly just don't give a damn.

[Null]

I know two Paramedics, both of them are two of the dumbest people I know. Neither appear to have a medical degree either so this story is very believable.

[Klutz]

I know two Paramedics, both of them are two of the dumbest people I know. Neither appear to have a medical degree either so this story is very believable.

I live in a mediocre town, not a huge population, so this kind of thing shocks me, lol.

[Sqwunk]

I live in a mediocre town, not a huge population, so this kind of thing shocks me, lol.

From what I think I saw you say in a different post, you live in NH right? Well so do I and as far as I know all of NH is a mediocre town with not a huge population, lol. Mine especially, but I've never been to the northern cities/towns so I don't know about up there.

Definitely shocking to hear this also though.

[ByeByeTasai]

The news often refers to BLS units as Paramedics which are not. Paramedic training is not easy, unless you get it done in St Louis. But even after that you have to know your shit to pass the boards.
There is a world of difference from an EMT to a Paramedic, I assume Null knows two EMTs which yes... very easy training, but even an EMT knows better then to tell someone they have acid reflux when they have signs of it. It is pushed upon you over and over through training about how heart attacks often appear to be reflux.

[Talus]

I know two Paramedics, both of them are two of the dumbest people I know. Neither appear to have a medical degree either so this story is very believable.

You don't need a medical degree (M.D./D.O./MBChB/MBBS) to be a paramedic. The entry level to EMS is EMT-B, or EMT-Basic. Then EMT-Intermediate, and EMT-P, or paramedic. The training/scope of practice broadens with the certification from EMT-B to EMT-P.

A lot of people get experience as an EMT and THEN go to medical school, but you don't go to medical school to be an EMT. A lot of community colleges offer EMT-B courses, some as short as six months, sometimes as long as two years where you get an associate's degree.

[Kohan]

This is indeed entirely believable, and I say that because I've had a similar experience myself. Obviously, I'm still alive, but I did have severe chest pains and trouble breathing, and the first thing I was told was that "it's probably acid reflux." I'm willing to bet that the paramedics deal with so many "false alarms" that a lot of them have become jaded, and considering the demanding nature of their work, this isn't an unreasonable observation to make.

And for the curious, I had esophageal damage which led to internal bleeding.

[Mizango]

Wow...

[ByeByeTasai]

This is indeed entirely believable, and I say that because I've had a similar experience myself. Obviously, I'm still alive, but I did have severe chest pains and trouble breathing, and the first thing I was told was that "it's probably acid reflux." I'm willing to bet that the paramedics deal with so many "false alarms" that a lot of them have become jaded, and considering the demanding nature of their work, this isn't an unreasonable observation to make.

And for the curious, I had esophageal damage which led to internal bleeding.

This is very true. Many of the medics I've worked with often dismissed signs and symptoms as the obvious, but you still treat with precautions for the worst. A medic telling you that it's probably acid reflux is common, but any who completely dismisses it as such and refuses to treat you is guilty of malpractice, and criminal neglect and will serve jail time before he joins the poor house.

If it was an esophageal veracies that you had, you have no clue how lucky you are to be alive. I got to see one of these up close one time and it was the bloodiest and quickest death I've witnessed.

[Boyiee]

Medics aren't allowed to Diagnose, and by doing so, could lose their certs over it.

Most likely just EMT's, which also can't diagnose. They shouldn't get jail time or anything, it's patient neglect/abandonment, which is loss of cert/career.

And @ the above poster, you most likely know emt's, at least in NJ, the medic program is pretty grueling, lot's of semesters of anatomy/bio/etc packed into a week or 2, over a several year program and something like 1000hours of interning. I know quite a few doctors that were medics first, and most emt's I know are quite retarded, with the exception of a few.

Edit:: if they were medics, they would have put the patient on a 12lead and actually checked his rhythm for a cardiac related issue, administered drugs and transported. They aren't allowed to release any possible cardiac situation like that. In NJ, it's a requirement to put the patient on a monitor if you aren't canceled before you make patient contact.

Edit again:: not to mention, if they told him it's probably just acid reflux, and are going to leave, they have to get a refusal of medical treatment. Which is signed by the patient and a witness saying the patient doesn't want to go to the hospital at the time, and it clearly states that by not going whatever is going on could worsen and even cause death. This way by being called out there they don't bill, and it covers their asses.

[Moridam]

From what I think I saw you say in a different post, you live in NH right? Well so do I and as far as I know all of NH is a mediocre town with not a huge population, lol. Mine especially, but I've never been to the northern cities/towns so I don't know about up there.

My brother lived in West Lebanon for a number of years, going by his account of the area, there's a lot of hicks and also a tremendous amount of nothing to do. Sounds about right by my estimation, although my only experiences with NH have been in Nashua, Hampton (lol), Portsmouth and those fantastic state liquor stores.

[Kohan]

This is very true. Many of the medics I've worked with often dismissed signs and symptoms as the obvious, but you still treat with precautions for the worst. A medic telling you that it's probably acid reflux is common, but any who completely dismisses it as such and refuses to treat you is guilty of malpractice, and criminal neglect and will serve jail time before he joins the poor house.

If it was an esophageal veracies that you had, you have no clue how lucky you are to be alive. I got to see one of these up close one time and it was the bloodiest and quickest death I've witnessed.

It wouldn't be the first time I've been told something like that. I have had some pretty spectacular experiences, and have lived to tell all the tales. Honestly, it's strange, as I've been in car accidents, fallen from a two storey height, slid on my neck for over twenty feet and slammed into a concrete wall -- and I've never broken a bone. I was briefly "dead" during childhood due to severe pneumonia and I was resuscitated.

I AM INVINCIBLE BITCHES

I'm probably going to die in the most pathetic way someday, like choking on a marble or some such.

[ByeByeTasai]

Actually, I've been through Paramedic training, my EMS licenses just lapsed last month though. Looking forward to a better career. But criminal neglect can warrant a conviction with jail time. Just depends on the case, judge and DA.

[Boyiee]

It's not criminal neglect if they in fact hooked him up to a monitor, let them know possible consequences of not going, and had an RMA signed. The RMA will state right on it consequences.

The worst is they lose certs for neglect/abandonment, I can't see them getting charged with anything other than that since they would need a refusal in order to leave without transport. If they didn't get a refusal, which is retarded cause it's requirement by law, then they can be royally fucked.

[thestalkmore]

It wouldn't be the first time I've been told something like that. I have had some pretty spectacular experiences, and have lived to tell all the tales. Honestly, it's strange, as I've been in car accidents, fallen from a two storey height, slid on my neck for over twenty feet and slammed into a concrete wall -- and I've never broken a bone. I was briefly "dead" during childhood due to severe pneumonia and I was resuscitated.

I AM INVINCIBLE BITCHES

I'm probably going to die in the most pathetic way someday, like choking on a marble or some such.

Pretzel

[ByeByeTasai]

It's not criminal neglect if they in fact hooked him up to a monitor, let them know possible consequences of not going, and had an RMA signed. The RMA will state right on it consequences.

The worst is they lose certs for neglect/abandonment, I can't see them getting charged with anything other than that since they would need a refusal in order to leave without transport. If they didn't get a refusal, which is retarded cause it's requirement by law, then they can be royally fucked.

AMA's almost never hold up in court unless witnessed and signed by a family member of the patient, the reason being is that it can be influenced by the medical staff. Fire, Police, and other EMS witnessing is very risky in situations like this.

And neglect/abandonment is a felony, you don't just lose your certs/license for it. Hence the legal title for it: Criminal Neglect.

edit: Laws for EMS are a little bit different from nursing. Nurses are either under direct supervision of a physician, or always near communications with a physician. If an AMA is signed in a hospital, then doctors are informed before the patient leaves laying the responsibility on him/her.

EMS works under the license of a physician, but is not required to be in direct contact with him 24/7 because of communication ranges. This is why an EMT-Basic is permitted to pronounce death, while a nurse is not. EMS is targeted with criminal negligence or malpractice much more often then nursing, therefore the legalities of it are more strict.

The medic in question failed to act to the common signs and symptoms of a heart attack(refusals can be worked around since patient might not be 100% orientated, if patient still refuses after you make them aware of this, police will take them into protective custody and ride in the ambulance to the hospital)
Diagnosing a problem as reflux is a breach of protocol
Injury was caused by failure to act: Death
And proof exists that the medic was in fact responsible

He is guilty of malpractice by those 4 conditions, and therefor is also guilty of criminal negligence since death/life threatening injury was a result.

[Boyiee]

Must be state based, cause a large portion of your post is wrong in my state.

Refusal of medical attention require 2 signatures, 1 of the patient, 1 of a witness which can not be a care giver. EMS can't leave after making patient contact without both signatures.

Paramedics work under a medical director... and EMT-B's can not pronounce here. Only Paramedics after confirming with director. I'll agree with Medics possibly getting charged with malpractice over nurses, since they can push drugs without orders, but for basics there aren't many things they could do that would be considered malpractice.

If patient is aox3, patient can refuse whatever he wants. He has the choice to die in his own home rather then in a hospital. If they aren't x3, then yeah they can be taken as it is in the best interest of their health.

Diagnosing isn't protocol, but saying "well it might just be heartburn, do you get that often?" might be taken by a hysterical family as "diagnosed" which in turn becomes hesaid/shesaid, which is what paperwork is for.

#1 rule of EMS, CYA(cover your ass). Whatever happens, make sure it's worded right in the report so that it doesn't come back to bite you. With enough EMS/Police witnesses, and a well written narrative on a run sheet, it could boil down to pretty much nothing but them following protocol, advising transport, and having an RMA signed with the cautions of doing so stated.

#1 rule of paramedics in particular which follows the above: Documentation.

It's sad this shit happens, as it could be avoided in so many ways from many different angles. It does at least interest me in how that states ems system is set up, especially paramedic training. It seems to have gotten worse over the years here(or maybe people are just getting stupider with the years), wonder if thats the same everywhere. If they were Medics and not EMT's, it's too bad they released with symptoms like that, but it also could have to do with how it was presented to them, and the guy being sinus on the monitor. lol@diagnosing though, when did they learn how to do that in prehospital care without an md/do at the end of their name... really hope for their sake that it's just mistranslated in the commotion. If not, then that sucks for them. If they really did neglect that guy and did all these bogus steps in one call, let alone one but so many wrongs, then they need to serve as much time as possible for it.

edit:: also wonder how their fire-ems system works in regaurds to dispatching. Here, BLS and medics are separate and called separately, due to more BLS then there are medics. So it is very very often that bls arrives on scene first, makes the initial assessment to brief medics on when they arrive, and/or decide if the medics are actually needed. I see it very often where BLS will cancel medics because it's most likely a bullshit call, so depending on how their system works, I guess BLS could have arrived and said "it's probably reflux" canceled medics and had the pt refuse cause they probably convinced everyone that he was ok. Lot's of possible story variations, outcomes, and occurences, not enough information in the news story really. Probably won't even get to see more on this, but I'd like to.

[ByeByeTasai]

In Missouri: EMT-B can pronounce dead, I've done this more then once when I worked on a BLS unit. Which is a good thing considering CPR is completely worthless and ineffective without medications and cardio-version, usually worthless with.

All EMS works under Medical Direction, but protocols are in place to take over medical direction when contact can't be established. This is where more responsibility falls into EMS, and minor diagnostic practices. (Don't tell anyone I called it diagnosing)

A patient can be taken into protective custody and forced to go to a hospital if patient is a danger to themselves or others rather then not AOX3. Now in this particular case, no you couldn't just force them into protective custody. But if patient states something like "I don't care if I die" then that can be considered a suicidal patient, and police can take them into custody and force transport. The responsibility then falls on the police.

12-lead EKG interpretation is now part of Paramedic curriculem and has been for the last 5 years or so, as is blood gas interpretation although medics can't take blood gases in the field. This and physiology were my favorite parts of Paramedic training.

The ambulance was from a fire department (which is a personal dislike of mine anyway... Fuck fire fighters and their government branch!!!) and a paramedic was on board with 2 basics.

Apparently the Medic charged with the offense told the patient that they just had acid reflux, and didn't necessarily need to go to the ER, and the documentation was very questionable. But here in Missouri EMT-B/P can pronounce dead and Co-workers can sign as a witness, although it is discouraged.

Reports from EMS blogs:
Patient complained of difficulty breathing + chest pain.
Patient said he wanted to go to the hospital (word of mouth by mother), and apparently A.M.A. was signed as patient refused signature, by both employees.

Paramedic said 12 lead - EKG reading was normal. He either never looked below the machine diagnosis, or only looked for the presence of a Q wave, either case were talking about a dumb-ass.
Apparently the EKG strip was reviewed by the medical examiner and showed:
slight Sinus Bradycardia 58, Sever Acid Reflux causes increase in pulse rate
2mm ST elevation in I, V5, V6 - possible Lateral Infarction.
and 1mm ST elevation in V4 - possible Right Ventricular Infarction.