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The Legal Guardian
by David Givot

5 ways to manage conflicts with cops in a medical emergency

He's not drunk, he's having a stoke; use these tips to make sure the patient, not the suspect, receives proper care

By David Givot

My new client sat across from me in my office. He was more frustrated than nervous. He clearly understood the situation and why he was in it, but he was still kicking himself for letting it happen.

“It was a weekend night, like any other weekend night. There was really nothing unusual about the call,” he said calmly, and then went on to tell the rest of the story.

He and his EMT partner had been called out to the scene of a DUI stop by a police agency. When they arrived, one officer told them that they called because the guy seemed altered and they wanted the paramedic to “clear him for booking.” RED FLAG!

Knowing that “clearing for booking” was not even a legal activity, he continued with his regular assessment. Based on his objective findings, the paramedic believed the patient was not under the influence; rather, he was likely having a CVA or some other neurological problem and he directed that the patient be prepared for transport.

“You’re not transporting him. He’s just drunk!” one of the officers told him.

My client was surprised at that response. He made every effort to explain the potential seriousness of the medical situation, but the officers on scene were not having any of it.

Despite the absence of any odor of ETOH and despite the 0.00% reading on the Preliminary Alcohol Screening device, it was the officer’s untrained medical opinion that the patient’s altered mental status was the result of intoxicants and not a stroke.

To make a long story short, the argument ended when the officer told my client that the argument was over and the suspect, not patient, was going to jail, not the hospital.

He didn’t know better

Now, I know what you are thinking: why didn’t the paramedic get his supervisor involved or call the base hospital to speak with the officer or something?

The answer is as simple as it is sad. He was six months out of paramedic school and the only paramedic on scene and he just didn’t know better.

Like many others, he was trained that the most senior medic is the highest medical authority on scene, but the one with the gun is ultimately in charge. So, believing that was true, he did what he was told.

Of course, ten minutes later, when the patient lost consciousness altogether, another paramedic unit was called out and the patient was transported to the hospital, where it was confirmed that he was indeed having a stroke.

Six years later 

After a long and complicated trial, the jury agreed that my client was not at fault. Unfortunately, the State EMS Authority sees it differently and they have now launched an investigation. We are still dealing with that.

Strangely, as silly as it seems from the sidelines, this conflict is not uncommon. From coast to coast, there are stories of police interfering with medical care and even with scene safety.

Everyone has seen the video of the officer assaulting the provider in Oklahoma.

Five ways to resolve a conflict before it gets out of hand

To make a difficult situation as simple as possible, here are five things to remember if you ever find yourself in a similar predicament:

1. Don’t waste your breath

Police officers are trained to be aggressive, assertive, controlling, and correct in all situations. Going head-to-head is not a winning strategy and going toe-to-toe is not going to end well, either for the patient or for you.

Don’t waste your breath telling them how much they don’t know or why they are wrong. Instead, calmly remind them of the liability they are inviting and accepting by not allowing you to do your job. Make letting you do your job their idea.

2. Get the patient on the gurney

If you sense that a problem may arise, move the patient to the gurney as quickly as possible. Even police officers know that taking someone off of an ambulance gurney and placing them in a police car creates a bad visual.

3. Call your supervisor

This is a big one. Not only will that help relieve you of much, if not all, of the liability, it is one of the occasions for which supervisors exist.

4. Call a doctor

Contact your base hospital and have the officer speak with the nurse or doctor. While law enforcement officers are trained and practiced in taking control in their natural habitat, the street, they can be far less comfortable when an outsider steps in — particularly when that outsider is a recognized medical professional.

Furthermore, both the base hospital and you can remind them that the conversation is being recorded and that the officer’s disregard for a known or suspected medical condition is now a matter of record.

5. Stay calm

Do not let your frustration or fear spin you out of control. Your interaction should remain cool, calm, and professional. If the officer escalates or attempts to escalate, don’t fall for it. You are a professional patient care advocate and nothing shakes you.

Behind the conflict

In my experience dealing with law enforcement officers, both as a paramedic and a defense attorney, I have found that certain characteristics run like common threads through many well-intentioned cops.

Tunnel-vision may be the most common trait. That is, what they think they see is what they are sure they are seeing and any other explanation can be worked out in court.

Likewise, in my experience, many law enforcement officers tend to be more conclusory than analytical. That is, what they are trained to see, combined with have seen in the past and what they expect to see, is what they are seeing now. In this case, the officer disregarded the 0.00% alcohol reading,  overlooked the fact there were no other objective signs of intoxication and concluded that the disoriented driver was DUI and had to go to jail.

The resultant conflict, I believe, arises when their “training and experience” is challenged by a doc-in-a-box who knows nothing about law enforcement.

The very best way to avoid the conflict is to communicate.

Take the time, in advance, to build up relationships between EMS providers and law enforcement. Take the time and make the effort to work with one another to understand and plan how similar situations will be handled in the future.

Develop policies, procedures, and mechanisms that can prevent conflicts and allow everyone to manage the real task at hand: providing a better, safer community.

Finally, always remember that no single part of the system can function in a vacuum. EMS, fire, and police must work together for the community and for each other, because at some point in every career, one will need the other.

About the author

David Givot, Esq., graduated from the UCLA Center for Prehospital Care (formerly DFH) in June 1989 and spent most of the next decade working as a Paramedic responding to 911 in Glendale, CA, with the (then BLS only) fire department. By the end of 1998, he was traveling around the country working with distressed EMS agencies teaching improved field provider performance through better communication and leadership practices. David then moved into the position of director of operations for the largest ambulance provider in the Maryland. Now, back in Los Angeles, he has earned his law degree and is a practicing Defense Attorney still looking to the future of EMS. In addition to defending EMS Providers, both on the job and off, he has created TheLegalGuardian.com as a vital step toward improving the state of EMS through information and education designed to protect EMS professionals - and agencies - nationwide. David can be contacted via e-mail at david.givot@ems1.com.
Comments
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David Newton David Newton Friday, October 10, 2014 10:50:01 PM Very good read. Well done.
Margaret Helene O'Connor Margaret Helene O'Connor Saturday, October 11, 2014 12:53:45 AM Great advice that I will use in the ER, many police officers that I've dealt with get very aggressive when we look at the person in custody from a ER nurses point of view. Some even seem to regard giving basic (or other ordered) medical care as not ''being on the same team'' as the officer, which can make for a very distracting and stressful situation.
Harry A Struppa Harry A Struppa Saturday, October 11, 2014 1:50:06 AM great topic and great article and even as a new medic if I suspected a CVA I would have definitely 1 document the officers name and badge number and have my partner right up a similar report an incident report and also if he would not allow transport after they had called for the red flags I would have got on radio and notified dispatch knowing that it is taped and state my findings and state that transport is not being allowed and the go AOR also have the officer sign the AMA paperwork and patient. My biggest thing has been diabetic issues or even when there is a chase and they have excited delerium and lets say that the suspect causes an MVA and then you know that there is significant damage to the vehicle yet four or five officers are yanking him out then throwing him to the ground with know regard to c-spine issues those I make sure and document or even get video same with CVA patient. Police wear video and audio so I have the same for me and my employees. Also your right put the patient on your stretcher evaluate him if he is good let them take him if not let them try and take him.
Bryan Goodridge Bryan Goodridge Saturday, October 11, 2014 10:27:26 AM I've had a few conflicts with police officers over the years. The officer said "Clearing for booking". Sorry officer I can't clear him for booking, he's having a stroke. If the officer insists, have him sign your PCR as the responsible party, that way, if the Patient goes bad, it's on him. I worked at an airport as a medic. We had trouble with TSA. If someone went down on the other side of the check point, they would not let us pass through even though our ID passes basically outranked them. One day, a man went down at the check point and TSA moron would not let me go through. I told him to sign my PCR which he did. Then asked "what for?". "So if that patient dies, you can be charged with interfering with EMS and tried for murder". He jumped up from his seat "I'll get a supervisor he rushed" "yea, you do that, I'll be with the patient". After that we had a sit down with TSA and clarified things. In this state, since human life is still important,, when medical arrives on the scene, they are in charge of medical and all that encompasses. Don't get into a pissing match with an officer just make him or her responsible.
Dawry Irizarry Dawry Irizarry Saturday, October 11, 2014 10:56:37 AM The fact that this is actually a valid concern proves that policing system in this country is a failure. And there needs to be a firing, retraining and/or rehiring of officers in most/all PDs in this country. Or make androids. I am perfectly okay with android cops. Hell have you seen officers directing traffic? Thank Baby Jesus for that black man who invented the stoplight. At least androids actions are to the letter and don't show bias in any which way. (Bias, especially in this case, can be both favorable or unfavorable.) This also will probably fix the civil forfeitures problem we have in this country.
Ryan Beck Ryan Beck Saturday, October 11, 2014 2:19:05 PM David....seriously! I dont know what your deal is brother! You are the only defense attorney that I have ever met that so openly hates the police! Id like to be a spectator in a courtroom while you are in action to see if your unprofessionalism bleeds there too! When we arrest people....its for probable cause.....when they get convicted its that they were guilty beyond a doubt. You create that doubt (the easy part). It is what it is....as a cop I dont take in personal when a drunk, or a gangster, or an addict, or a wife beater, or even a murderer walks free because you the defense attorney got them off. Its business. Youre not a snake or pos with immoral intentions....you are the defense attorney and you are simply doing your job by fulfilling a vital role in the criminal judicial system. Now on to your beef with all law enforcement and how we seem to all have a complex where we are always right and even when were wrong, we can still explain it away in court.....seriously David! For soneone who graduated and now teaches from as prestigious of a paramedic school as you do, you sure carry yourself very unprofessionally. Your client in this situation screwed up big time....but the officer screwed up even more. Doesn't CA Title 22 state that the person with overall scene control is tge law enforcement officer? Pretty sure that State EMS owes your client an apology and perhaps a check to cover your services. Should they have stood their ground? Yes. Should they have contacted base to at least document the incident? Yes. Why didnt they? You tell me....any 6th month paramedic should have known to do that (standard of care). Now as for the BAC reading .000.....so what? We dont book BACs into evidence....actually the only time I've ever seen a breath sample retained is when they tested me for h. Pylori (developed during my 14 years in EMS as an EMT and Paramedic.) What else could have been on board Professor Givot? Heroin? Narcotic pain meds? It could really have been just about anything huh? As for the officer hes an idiot...tell u that! Even as a paramedic, id never deny an EMS brother or sister wanting to take my deuce in...truth is I want blood to book and if and when this guy pukes, id rather it be in their rig anyway. Since most providers wont draw blood for me in the field, a trip to the hospital is going to a part of this lil caper anyway. 11550 H.S. (under the influence) and 23152 CVC (driving whike intoxicated)are both misdemeanors anyway. Why would any cop risk his neck over such stupidity especially when its in his/her best interest to have the guy transported by ems..... The readon this whole thing went south is because the police officer suffers from the samething that you so clearly suffer from....UNPROFESSIONALISM.....and to be perfectly honest you both really need to pull up your big boy pants and do something about it...WE ARE ALL ONE BIG FREEKING TEAM.....heck we should even be calling ourselves family right? Enough with the bs....we need each other more than we ever have before and this kind of fluffed bull crap that you are slinging is not helping anything! Personally I don't buy your story. I think u left a lot out but thats just me. When I was on the bus I used to draw blood on the scene for my le brothers then they'd cite the drunk out and Id take the patient to the hospital.....never had a beef with my guys in the black and white or the big red lumber wagon......communication and respect is why. Not saying it doesn't happen but its rare where two grown adult professionals cant handle a scene as easy as this one.......if necessary have your dispatch send a supervisor......yours or theirs....contact base......document document document! Easy! David in the future please use you position as a paramedic, an attorney, an educator, and a journalist a little more responsibly. New brothers and sisters are watching you and your words abd opinions hold a lot of weight....Take care my friend.......Ryan Beck
Arvid Engström Arvid Engström Saturday, October 11, 2014 2:36:14 PM Substitute traumatic brain injury from a fight with subsequent death in the jail cell and that sums up my first professional call. The inquest was brief. I also now have an over developed OCD issue with documentation. For the most part many LEOs that I now encounter are great team players and are very cooperative and accommodating with paramedics as well as concerned for Medic Safety.
David Fisher David Fisher Saturday, October 11, 2014 5:28:43 PM A simple statement to the officer would have been: "Look at it this way officer. We take him to the hospital where you can order a blood test to be performed. If it comes back as intoxicated, you have the evidence for a DUI. If not then the man will get the treatment he needs."
Chris Mancuso Chris Mancuso Saturday, October 11, 2014 6:21:35 PM I don't really understand how this is Occuring. Police call us to tell them iF pt. needs transport.
Chris Mancuso Chris Mancuso Saturday, October 11, 2014 6:23:32 PM If we say he needs to go, he goes. They with not take responsibility for refusing.
Sunday, October 12, 2014 10:57:11 AM My son was in serious car accident and the policeman on scene stalled the medical care and my son was in so much pain, he was completely sober but the officer followed us to the hospital threatening my son with tickets and fines. He actually went into the emergency care roomy (my son was naked and bleeding on a gurney) but the officer was so sure he was guilty of something. He finally got his blood work and left. I felt it broke every HIPPA law there was. My son was a victim not a criminal - blood work proved his innocence thank god, he was allowed to get the surgery and proper care he needed, after the officer was through antagonizing him.

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