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Home > Topics > EMS Management
December 05, 2012

Medics refuse to take swine flu victim to hospital 3 times

Arriving paramedics said her symptoms did not seem life-threatening

By Martin Fricker
Daily Mirror

BIRMINGHAM, England — A young swine flu victim died of a heart attack after paramedics refused to take her to hospital three times in a night, an inquest heard.

Relatives called 999 when Niyousha Haki, 28, collapsed after feeling ill for days during the height of the outbreak in December 2010.

Full story: Medics refuse to take swine flu victim to hospital 3 times

Comments
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Pearl Pauze Irwin Pearl Pauze Irwin Wednesday, December 05, 2012 5:54:30 PM I worked in the state of michigan and we could not refuse to transport anyone.
Amanda Nicole Amanda Nicole Wednesday, December 05, 2012 5:57:50 PM I work in Indiana and we are not allowed to refuse transport either, no matter what the call is.
Dylan Reed Dylan Reed Wednesday, December 05, 2012 6:01:13 PM Medics in England recently told a family there little girl didn't need to go to the hospital and she.ended up dying a few hours later, Idk what there protocols are there but you can't deny a patients right to.go to the hospital cause you ask a few questions.
Jake Zbacnik Jake Zbacnik Wednesday, December 05, 2012 6:01:31 PM Greene County! In the NHS system Paramedics are allowed to refuse to take patients to the hospital in order to save money and resources. As you see, it doesn't allows work out.
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 6:02:11 PM I worked in Puerto Rico and we never but never refuse any transport no matter the patient's condition.
Ryan Fuhrmeister Ryan Fuhrmeister Wednesday, December 05, 2012 6:03:31 PM They pay for it anyway, that's retarded.
Timothy Tremain Timothy Tremain Wednesday, December 05, 2012 6:05:16 PM There is much less risk of liability with patients that are transported than those that are not. My rule of thumb (forgive the uncaring sound of this) is that "if you call, we haul". That does not mean I don't care, contrary. It is just the fact that if someone took the time to call feeling it is an emergency, then in their mind it is. We also are required to contact Medical Control with any no transport for physician input.
Max Mowry Max Mowry Wednesday, December 05, 2012 6:07:40 PM thats wrong know matter what im a EMT and we do everything in our power to save lifes
Craig Prager Craig Prager Wednesday, December 05, 2012 6:08:49 PM Why didn't the relatives take it upon themselves to just put her in a car and just drive her down to a hospital or a clinic of some sort? At least a clinic could have asked for medical transport. The medics should have just taken her by the third time, however, the relatives should have done something, too! Tragic tale of protocol's getting in the way of good judgement.
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 6:16:57 PM Jake Zbacnik WTF? Is that more important than a person's life? We are here to save lives, I hate seeing EMT's working only for money
Dennis Worden Dennis Worden Wednesday, December 05, 2012 6:18:39 PM In Wisconsin, we must transport if requested. In fact, we have protocols to try to talk people into going to the hospital when they don't want to.
Connie Wheeler-Buckallew Connie Wheeler-Buckallew Wednesday, December 05, 2012 6:22:35 PM that's not the point its our job to take care of patients when they call they are seeking help and the patients have the right to refuse care not the medics coming to the call... And we are trained on how to keep ourselves from contacting these viruses.. its all about insurance not about patient care..
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 6:22:35 PM Here in Puerto Rico we do the same
Connie Wheeler-Buckallew Connie Wheeler-Buckallew Wednesday, December 05, 2012 6:24:18 PM My Point exalty.. we should treat patients like we would want to be treated golden rule..
Elizabeth Kane Carter Elizabeth Kane Carter Wednesday, December 05, 2012 6:25:06 PM Don't they have socialized medicine in England? I wonder if that had something to do with it...
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 6:26:40 PM Maybe they haven't got a car, did you think of that?
Shane Jordan Shane Jordan Wednesday, December 05, 2012 6:27:34 PM In Ga, we take everyone who wants to go, but honor the ones who don't want to go the first time they call. If they continue to call, we aren't interested in refusals.
Craig Prager Craig Prager Wednesday, December 05, 2012 6:29:10 PM Yup, sure did. I am going on the premise that they felt that she needed immediate medical attention and that their first thought was EMS. All I am suggesting is that they should have taken more initiative in her care.
Timothy Tremain Timothy Tremain Wednesday, December 05, 2012 6:29:27 PM In consultation with medical control we certainly can. However, refer to my post above. Refusals / AMA are the calls that will get you in trouble. It is not generally what you do but what you don't do that creates the liability.
Aimee Thomas Aimee Thomas Wednesday, December 05, 2012 6:34:01 PM Delaware also has the same protocols
Vikki L Ward Vikki L Ward Wednesday, December 05, 2012 6:36:10 PM We do the same...they can refuse transport but we can NOT tell them sorry your condition don't look life threatning we cant take you....let the ER be the judge of that because I have found 9 times out of 10 it is best to err on the side of caution....
Jake Zbacnik Jake Zbacnik Wednesday, December 05, 2012 6:36:58 PM I guess it depends. NHS is a single payer system and that is how they have chosen to keep costs down. I'm sure the vast majority of times people who don't need to go to hospital aren't taken as opposed to the converse. I personally think anytime someone presents with "verifiable" clinical symptoms they should be taken to the ER. Of course, some non-verifiable symptoms should necessitate transport as well; like chest pain.
Mikaela Anne Cohen Mikaela Anne Cohen Wednesday, December 05, 2012 6:44:59 PM This article is written oddly... MI or pneumonia?
Cathy Pankey Dixon Cathy Pankey Dixon Wednesday, December 05, 2012 6:45:34 PM I was going to say I know in Texas they transport no matter what cause you never know. With my illness I may look okay on the outside but the inside my sodium drops quickly and well it isn't good.
Matthew Whitt Matthew Whitt Wednesday, December 05, 2012 6:47:25 PM This was in England and the medics on this particular case are trained to the level of a PA or NP here in the states. It is a totally different system across the pond. Mistakes happen as they do with PA's and doctors here in the states.
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 6:48:16 PM I understand that, that happened to me too, when we got to a house because a baby has a respiratory stress there was 3 cars at the house, I was so upset that I ended cursing those people, they said that they wait for the ambulance because in that way they doesn't have to wait in the waiting room. The patient was a 2 year old girl, after that I called a cops and made a report
Matthew Whitt Matthew Whitt Wednesday, December 05, 2012 6:51:03 PM They are also trained to a much higher level than we are here in the states. The medical error rate is no higher than it is here in the states. Think about it, there are over 62 million people in the UK and this is only the second case in which a patient has died within a year because a paramedic refused transport. That's actually better than here in the states.
Darren Eubanks Darren Eubanks Wednesday, December 05, 2012 7:05:40 PM Yes it is. It also states she was taken the next day to a medical center then taken to hospital. It was in the hospital where she died, but there no time line from arrival to death. Was it same day or 2 -3 days later. Is EMS really to blame, You know what I mean?
Kan Chan Kan Chan Wednesday, December 05, 2012 7:10:54 PM I think that is pretty much the case anywhere in the US.
Jake Zbacnik Jake Zbacnik Wednesday, December 05, 2012 7:13:29 PM I completely forgot that only Master's Level trained paramedics can refuse transport to patients. Thanks for input!
Jeff Jones Jeff Jones Wednesday, December 05, 2012 7:15:47 PM how can you refuse to take anyone? that is plain abandonmemnt and neglect and a tort, which you will end up in court then jail. we are public servants and we have a duty to help. granted we get abused with frequent fliers and people who abuse the system, but it comes with the job. this girl would be alive today if they hadn't refused to transport her. don't know all the facts but from what is stated, they should be in jail and lose their license. it is better to take them than to miss something (which 3 crews did) and now their lives and careers are in jepardy, plus this girl died. sad.
Mikaela Anne Cohen Mikaela Anne Cohen Wednesday, December 05, 2012 7:19:09 PM Maybe it's just ignorance of someone confusing cardiac arrest with an MI... who the heck knows.
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 7:21:43 PM It doesn't matter if is a Master level, if the patient wants to go you has to transport him/her to an E.R
Cassie Bordeaux Cassie Bordeaux Wednesday, December 05, 2012 7:23:47 PM Do people forget how to drive themselves to the hospital?!?
Codie Terry Codie Terry Wednesday, December 05, 2012 7:24:23 PM I would have transported based on the fact that she had abnormal symptoms.
Wanda Cajigas LA Flaca Wanda Cajigas LA Flaca Wednesday, December 05, 2012 7:26:36 PM Matthew Whitt It doesn't matter if is a Master level, if the patient wants to go you has to transport him/her to an E.R no matter what
Connie Wheeler-Buckallew Connie Wheeler-Buckallew Wednesday, December 05, 2012 7:33:16 PM As you well know Craig sometimes the family isn't educated like we are and don't have a clue about health care thats our speciality
Matthew Whitt Matthew Whitt Wednesday, December 05, 2012 7:34:16 PM They have to have preauthorization in England to be seen in an ER. So, yeah it does matter.
Micah Valentine Micah Valentine Wednesday, December 05, 2012 7:36:42 PM no excuse for this.
Nancy Cox Nancy Cox Wednesday, December 05, 2012 7:40:52 PM Yes, but I recall getting Norwalk Virus while working down there for MF and I could not drive to the ER. I had thrown up so badly that something popped in my ear drum and screwed my equilibrium up. With no family down there, I was at the mercy of asking my fellow coworkers for help.
Scott Brown Scott Brown Wednesday, December 05, 2012 7:41:41 PM They lack cabs in the UK?
Jake Zbacnik Jake Zbacnik Wednesday, December 05, 2012 7:45:51 PM No. That isn't the law in the United Kingdom. It's the same thing if a patient says they want pain medication but doesn't need it. A physician is under no obligation to give it to them.
Kristi B Dahl Kristi B Dahl Wednesday, December 05, 2012 7:48:56 PM ya, we get called, we have to transport if they want us to... I don't understand how a medic can refuse to transport a pt. they should be getting into trouble for this!
Connie Wheeler-Buckallew Connie Wheeler-Buckallew Wednesday, December 05, 2012 7:50:18 PM Well I am glad I live in the United States and I would not want to get sick in England sad situation
Judith Valencia Judith Valencia Wednesday, December 05, 2012 8:06:29 PM Cabs cost money. Some people don't have any. At all.
Robin Daghlian-Curasco Robin Daghlian-Curasco Wednesday, December 05, 2012 8:09:00 PM 3 times? A**holes need their licences revoked and never be allowed to work in Health Services again! Why not transport the first time..its obvious they would be back there again and not a thorough workup anyway...don't want them coming to my house!
Robin Daghlian-Curasco Robin Daghlian-Curasco Wednesday, December 05, 2012 8:09:57 PM I forgot...ummmm can you say lung sounds? Idiots!
Robin Daghlian-Curasco Robin Daghlian-Curasco Wednesday, December 05, 2012 8:11:46 PM Your correct and its frustrating when people dont have basic sence but thats why we have jobs!
Dana Campbell Dana Campbell Wednesday, December 05, 2012 8:56:54 PM Guess they forgot to assess the pt? touch pt(hot)? breathing rate? breath sounds? She and family look concerned?: put the the puzzle together. Please folks don't be cookbook medics We all know there are least 3 stories the pt is going to tell. parts of them are all true, now match the parts with what you see. Its not your gas. It is your job. It is your Honor. YOU CHOOSE TO SERVE YOUR COMMUNITY IN THIS PROFESSION. ITS A HONOUR TO BE INVITED INTO SOMEONE'S DURING THEIR TIME OF NEED, TO HELP THEIR LOVED ONE THEY CAN NO LONGER CARE FOR. Folks what I'm saying is really look, listen and feel the pt.
Doug Buchan Doug Buchan Thursday, December 06, 2012 12:25:27 AM She died of pneumonia. That could have been something that developed a week, 3 weeks, or three months after her initial admit. At the time the EMS crews evaluated the patient, there may not have been any signs of an acute emergency. It's not fair to judge.
Denny Bordeaux Denny Bordeaux Thursday, December 06, 2012 12:26:50 AM And people wonder why healthcare is expensive...
Jyri Viinamäki Jyri Viinamäki Thursday, December 06, 2012 12:33:55 AM Come on people! Are you driving Ambulances or taxis? If the patient DOES NOT demonstrate symptoms that are life threatning OR your professional medical opinion is that the patient is in well enough condition to stay at home or go to the ER on some other means, you SHOULD refuse to transport. Refusing to transport doesn´t mean you can´t go to the hospital. At least this is the case in Finland. You can refuse to transport and the hospital can refuse to admit you IF you have no reason be there or ride and ambulance.
Skip Kirkwood Skip Kirkwood Thursday, December 06, 2012 2:59:14 AM I'm not sure where THAT rule is written in stone. However - if you make a decision, it needs to be the RIGHT decision!
Laura Berry Laura Berry Thursday, December 06, 2012 3:49:37 AM No they don't it has changed 18 mo. Ago I. Was in icu a wk waiting on bed in Baylor I was in bad shape instead of trying 2 get pre authorization from my ins they told me needed 1500 or they would refuse so all left was car doc
Laura Berry Laura Berry Thursday, December 06, 2012 3:52:07 AM Said I wouldn't make it more than 30 min on rd I'd code an die we had 2 call anyone we could it was a really crappy move on their part
Michael D Colgrove Michael D Colgrove Thursday, December 06, 2012 8:35:11 AM I hope those medics get what's coming to them, sound to me they were to lazy to take her to the hospital. they all need to lose there license and jobs plus have to pay for their mistake.hope they got lot of money.
Dan Douglas Dan Douglas Thursday, December 06, 2012 9:35:14 AM Jake Zbacnik I've no idea where you're getting your information from. There's no "law" that says paramedics can or can't refuse to take patients. Paramedics aren't the doorkeepers of the NHS, most services (including my own) have a policy where if a patient wants to attend then that are conveyed. This is a press article and the "facts" in it should be treated as such - where they have written "refused" I'd suggest what they should have said was the patient didn't want to travel or was referred to another care pathway. During the 2009/10 swine flu pandemic patients who called for an ambulance for flu-like symptoms were referred to a telephone service who prescribed Tamiflu and given advice on what to do if their condition changed.
Curt Aukerman Curt Aukerman Thursday, December 06, 2012 9:46:49 AM first-this is England so laws will vary-second when I had the swine flu my wife and I were advised DO NOT COME TO THER HOSPITAL UNLESS YOU ARE TOTALLY UNRESPONSIVE.
Dan Douglas Dan Douglas Thursday, December 06, 2012 9:51:03 AM I'm surprised you feel you can judge the actions of your colleagues based on only a press report - I'm sure you've all been to incidents and then read the report in the paper and thought "what a load of bull!" For the record, the policy of the ambulance service in question states "Patients should never routinely be advised that hospital treatment is not required and ambulance crews should not give patients the impression that they are reluctant to convey them." http://www.wmas.nhs.uk/pdf/PO-008%20Policy%20for%20the%20Non%20Conveyance%20of%20Patients%20to%20a%20Treatment%20Centre%20v1.pdf - the same policy also recommends alternative care should be put in place if the patient does not attend hospital. There were clinical protocols in place to support referral (with agreement with the patient) of swine flu patients to alternative care due to the obvious clinical risk of taking every caller who presented with flu-like symptoms to the ED - and let's not forget that this epidemic increased service demand by 9% on the previous year.
Curt Aukerman Curt Aukerman Thursday, December 06, 2012 9:53:33 AM DIDN'T FINISH...this csame from the ED doc and the health dept. the doc called in scripts and followed up with me and thanked me for not bringing the flu to the hospital. They sited National Health System guidelines in the decision making process. Obviously there were discussions and possibly protocols in place. I have found that news stories usually only report one side of the story. It is sad that she died, but flu epidemics are always deadly.
Dan Douglas Dan Douglas Thursday, December 06, 2012 9:58:29 AM Although it's worth saying that if a patient presents three times with the same acute illness it's a red flag - but the crews may not have been aware that the patient had been seen before or what was agreed, especially if there's a language barrier.
Anthony Buck Anthony Buck Thursday, December 06, 2012 10:02:32 AM And until the inquest is complete it's total speculation as to the causes - the article even starts off saying death was due to an MI and later contradicts itself by citing pneumonia!
Matthew Whitt Matthew Whitt Thursday, December 06, 2012 10:05:07 AM Fact of the matter is we are doing it here. When you go to a level 1 or 2 ER most often the triage nurse will refer you to the PA (To which these medics are equivalent to in England) and he or she will determine whether you need to see a doctor or not. They will write you a prescription (just like a paramedic can in England) and tell you to follow up with your PCP. So in essence the English paramedics are like PA's that make house calls. In the US we are headed for a single payer system like the UK. (There is a difference in the UK, Great Britain and England but the UK is the administrator of the healthcare system.) The new healthcare law is actually set up to fail and will result in a single payer system.
Dan Douglas Dan Douglas Thursday, December 06, 2012 10:35:53 AM Matthew Whitt - "They have to have preauthorization in England to be seen in an ER. So, yeah it does matter." - thiis is not true, ambulances just rock up to the ED, no authorisation is required. "They will write you a prescription (just like a paramedic can in England" - this is not true - no paramedic can prescribe, but some advanced practitioners do have delegated authority to provide a certain number of medications under the "patient group directive" system. This is restricted to a limited number of paramedics.
Sean Fiske Sean Fiske Thursday, December 06, 2012 11:12:29 AM The patient can refuse to go. You can't refuse to take them to the hospital medical control or not.
Matthew Whitt Matthew Whitt Thursday, December 06, 2012 11:41:13 AM Then I apologize for some misinformation and ignorance. However, I did know that a certain number of paramedics could provide medication. Perhaps I should have used a term different to "prescribe" but essentially that is what a PA is in the States. He or she is an advanced practitioner that can dole out certain medications under a physician license. In my defense of a flawed argument, I went on the assumption that these were advanced practitioner paramedics. I was wrong about having a preauthorization from a non-credidable source. Perhaps I rushed to judgement on behalf of the paramedics since I read so many comments from our own wishing to throw them to the wolves. It is a poorly written article and I am still not wishing to cast judgement. Thank you for the clarification Mr. Douglas.
James Dallas Williams James Dallas Williams Thursday, December 06, 2012 8:24:03 PM In San Bernardino County, we make the patient sign an "AMA" if they refuse to be transported. Without a signed AMA we will always transport every single patient, regardless of any opinions the EMT's and paramedics have about "frivilous calls"
Dan Douglas Dan Douglas Friday, December 07, 2012 10:12:51 AM And lo and behold: "A woman with swine flu who paramedics would not take to hospital died from natural causes, a coroner has ruled. Niyousha Haki, 28, and her family called an ambulance to Hall Green, Birmingham, three times on the night of 14 December 2010, an inquest was told. Paramedics found she had a temperature of 39.6C and high heart rate but NHS policy meant only high-risk swine flu patients were taken to hospital. *Coroner Aidan Cotter said no gross failure or neglect was involved.*. The coroner told the hearing at Sutton Coldfield Town Hall it was not a case of ambulance crews or other medical staff having failed in their duty of care. "None of them were guilty of gross failure by failing to provide medical attention," he said." http://www.bbc.co.uk/news/uk-england-birmingham-20639588.
West Workman West Workman Monday, December 10, 2012 11:36:15 AM Ditto Il
Steve Jacobi Steve Jacobi Thursday, December 13, 2012 8:15:54 AM It seems most here are just yakking about things you don't understand in the UK system. This is not the "you call we haul" or "just sign here so we can get back to sleep" crap we have here. The Paramedics in the UK have the equivalent of Bachelors and Masters degrees much like the US PAs. They can do a certain amount of home treatment without transport.
Steve Jacobi Steve Jacobi Thursday, December 13, 2012 8:18:04 AM James Dallas Williams So you think the death of a young person due to Swine flu and PNA is frivilous? This is exactly why US Paramedics and EMTs must transport all patients. They do not have the education to know what is serious and have a very limited view of what sick actually is unless it is a cool trauma.

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