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Home > Topics > EMS Management

Medics suspended after pregnant woman dies in ambulance

After a two and a half month investigation, family members wonder if incompetence and problems with the city's 911 system played a role in the woman's death

By Marisa Brahney, Lauren DiSanto, Harry Hairston and David Chang
NBC 10

PHILADELPHIA — Two Philadelphia paramedics have been suspended for two days following a 2 1/2-month investigation into an incident in which a pregnant woman in their care died. Now family members are wondering if incompetence and problems with the city’s 911 system played a role in her death.

On Oct. 1, 2012, the paramedics responded to a 911 emergency in Philadelphia. Joanne Rodriguez, 24, was 9 months pregnant and having trouble breathing when she fell down the stairs at her home. The family says she was asthmatic and on medication for a blood clot.

"I told her (dispatcher) she fell down the steps, she's 37 weeks pregnant, she's hurt, and she's lying down,” said Joanne’s aunt, Carmen Morales. “I told her she was responsive but couldn’t breathe.”

Full story: Paramedics Suspended After Pregnant Woman Dies in Ambulance


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Joshua Vincent Joshua Vincent Thursday, January 10, 2013 6:09:27 PM Well I dont like to do Monday morning quarterbacking. First no C-Spine. I probably wouldn't have either. Two reasons 1) Supine Hypotensive Syndrome 2) Ever tried to put a C-collar on a patient with asthma? Makes them worse. I would gave put her on left lateral treated with Difficulty Breathing protocol. She already being treated for clots so possibility for PE is great. But again I wasn't there nor was any others that will comment.
Joshua Vincent Joshua Vincent Thursday, January 10, 2013 6:13:26 PM Are you a paramedic?
Chris Connor Chris Connor Thursday, January 10, 2013 6:18:29 PM I agree Joshua, maybe a KED would of been the approite tool.
Chris Connor Chris Connor Thursday, January 10, 2013 6:24:31 PM did you learn about why you would not back board someone who is 9months pregnant? That is usually included in a BLS class.
Chris Connor Chris Connor Thursday, January 10, 2013 6:25:22 PM I dont think that is why she died, so its probably a pointless argument.
Joshua Vincent Joshua Vincent Thursday, January 10, 2013 6:27:02 PM "Dude" I'm not getting cocky. Ever heard the saying "Life over limb" When you lay a term or close to term pregnant female on her back the fetus can and will depress the inferior vena cava surpress blood flow. When she shifts it joltz blood flow. She already has clots this will multiply the possibility of PE. I've had patients with difficulty breathing that would beat you to death if you come near them with a C-collar.
Tyler Collins Tyler Collins Thursday, January 10, 2013 6:28:11 PM oh ok, i didnt realize that with the pregnancy. im not a primary provider, but what your saying makes sense. thanks for clarifying
Amy Rohmiller Amy Rohmiller Thursday, January 10, 2013 6:29:39 PM I know I have only been in EMS for 12 years and 6 as a medic, but I would think that c-spine is secondary to the breathing problems... to the EMT monday morning quartbacking a medic. I hope you never make a BLS mistake that someone could rip you appart for. they were suspended for conduct not becoming... that sounds like we need to repremand someone, and don't want to let the public know that they treated the patient to the best of their ability give the equipment and help on hand. Maybe you ought to stop thinking of things you are not trained to deal with and let the grown folks do their job.
Monta Jean Farrell Monta Jean Farrell Thursday, January 10, 2013 7:10:50 PM Did the resp distress originate before or after the fall? Possible C2 fx is concerning. Lastly, if you cannot be brilliant then you most certainly must be courteous and professional.
Joshua Vincent Joshua Vincent Thursday, January 10, 2013 7:19:31 PM That's info we want know till reports are released. My comments for a young gun that was insisting they be fired. So much can or could be said. But we wasn't there.
Steve Hough Steve Hough Thursday, January 10, 2013 8:10:12 PM Fell down the steps on blood thinners, L1 trauma and she didnt apear combative.
Chuck Sorrow Chuck Sorrow Thursday, January 10, 2013 8:28:00 PM You can board and place the board on it's side. The correct procedure is actually to tip the board about 15 degrees to the left side, which takes pressure off of the vena cava on the right. Falling down steps would warrant a board, IMHO.
Dawn Narry Dawn Narry Thursday, January 10, 2013 8:51:29 PM Tough call for any of us to manage. We were not there...
Jay Greenblatt Jay Greenblatt Friday, January 11, 2013 5:19:46 AM Agreed, just saw that as as a question on part of my NYS EMT-B refresh testing last evening.
Steve Jacobi Steve Jacobi Friday, January 11, 2013 6:47:24 AM It seems some are forgetting to read and watch the first video which captured their total lack of concern before they even got to the patient. It goes way beyond just the C-Spine. Anybody remember watching the woman struggle for 8 minutes to breathe and being walked to the ambulance for oxygen while being scolded for "not doing her part". Alot of their actions or lack of action were captured on a surveilance cam.
Joshua Vincent Joshua Vincent Friday, January 11, 2013 7:29:04 AM Fact is this. You can put 500 paramedics in a room give them this little information that we know about this case and come out with 200 different treatments. None of us were there nor know all the details.
Chuck Sorrow Chuck Sorrow Friday, January 11, 2013 1:21:28 PM Is this a rhetorical question? Are you addressing this to a specific response or person? If it's to me, then the answer is yes, since January 1986.
Joshua Parsons Joshua Parsons Friday, January 11, 2013 3:39:10 PM I've been a subscriber of the EMS 1 newsletter for a while but I've never taken the time to comment on an article. Some of the things that I saw both in the article and in the comments posted have bothered me enough to finally elicit a posting. First is that the crew walked in without any equipment. This is PURE laziness and incompetence. I can't tell you how many times I've had this argument with other providers. No you don't need to bring in everything but the kitchen sink but you should ABSOLUTELY have everything that you might need for immediate treatment of a critical pt, at the very least for your BLS interventions (i:e OXYGEN and administration devices). Second is the possibility of abruption placentae in conjunction with the patient being on blood thinners. Hemodynamic instability from significant blood loss could be another reason that the pt was tachypneic (or "having trouble breathing"). While I wouldn't argue that given the time of symptom onset in relation to the incident this isn't as likely unless the pt was hemmorhaging significantly just the possibility should have been in indication to be moving a little quicker towards the hospital. In regards to back boarding. Scenarios like this more than anything is why EMS needs to have a unified approach to spinal clearance protocols. There have been a lot of studies that suggest that back boarding is over utilized and my actually be doing some subset of patients more harm than good. If this patient passed the NEXUS criteria an assessment that can be done rapidly during your initial assessment than that's less time spent on scene providing an intervention they don't need. And I agree with the suggestions that have been made regarding the KED especially in consideration of Vena Cava syndrome and the pt's respiratory difficulty. "The Fire Department investigation found that Rodriguez was stuck for about three and a half minutes, during which a doctor was able to get inside the ambulance through a side door and start working on her." I'd be curious to know what exactly this doctor did in those three minutes that a well trained paramedic wouldn't be capable of. He certainly didn't do the emergency cesarian back there. There seems to be a mis conception among a lot of providers that the best treatment for ALL our patients is to get them to the emergency department as quickly as possible. I take serious issue with this argument after having worked in a very busy ER for over 5 years. First physicians are far from infallible and there is nothing to stop a paramedic (or any level of EMS provider) from achieving the same level of understanding about disease processes even if they can't perform the same interventions. Just look at some of the quality educations articles you can find on this site. I guarantee some of these guys can run mental laps around a lot of doctors I've met. A doctor that barely makes it through med school is still a doctor. Second assuming that your patient is going to immediately get the care that they need as soon as they walk through the door is lunacy. You're CHF patient may be REALLY sick but our 3 codes that we're running simultaneously have a higher priority and there isn't anyone available to pull the nitro and lasix that you should have given them out of our pyxis. Some patient's needs are better met taking the extra couple minutes on scene performing the EXACT same interventions that they would receive when they get to the ER. Get that medication on board and CPAP going and get you patient feeling better faster. This is where it would be useful to see the PCR. If abruptio placentae or other serious traumatic injury had been ruled out than taking an extra minute or two to ready a BVM with an inline albuterol treatment would not have been innapropriate for this patient. Sorry for the long post and abrubt end but I lost track of time and now I have to get to work. Stay safe everyone. Joshua Parsons EMT-P.
Joshua Vincent Joshua Vincent Friday, January 11, 2013 4:11:28 PM Outstanding.... Agree 100%...
April Gettys Crocker April Gettys Crocker Friday, January 11, 2013 6:59:54 PM She was on meds for blood clots probably P.E not asthma, but who knows could of even been both. it says cause of death came back as natural causes... Back board depends on the situation, she may have not of let them board her even if they placed her on her left side, if you cant breath your not going to lay supine or on your side! I feel bad for this pt and also the medics. It doesn't say what treatments were given while onscene for 8 minutes or enroute. Sometimes your just damned if you do, damned if you don't...Would I have treated her differently? Yes and so would the next 200 medics if you took a poll. I never comment on this stuff, but I'm so tired of the constant blaming.
Sharon Springer Sharon Springer Saturday, January 12, 2013 6:24:49 PM KED's on a 37 week pregnant woman?
Lynique Johnson Gillman Lynique Johnson Gillman Saturday, January 12, 2013 7:13:08 PM I think this is a sad post because life was lost no one knows what went on or what was dispatched except those involved its hard enough working in this field without ppl always second guessing and judging emts without all the info we emts put our life on the line everytime we go to work and no one blinks an eye but when something goes wrong we are judged first and listened to last smh and ppl wonder why there's a shortage in the ems field least cops n firemen have a union to back them up
Grant Johnson Grant Johnson Saturday, January 12, 2013 8:23:40 PM In the original article it says she died of "natural causes". Did I miss something?
Linda Burke-Galloway Linda Burke-Galloway Sunday, January 13, 2013 10:11:09 PM I'm a board certified obgyn physician and my question is: if she's 37 weeks and on medicine for a "blood clot" why the heck wasn't she in the hospital as an antepartum patient for high risk treatment? She probably died from the blood clot because she wasn't anticoagulated properly. OMG, what a tragedy.
Lars Olsen Lars Olsen Wednesday, January 16, 2013 6:32:32 AM "Overworked" is no excuse. They shouldn't be suspended, they should have their cards revoked.
Jeremy Salow Jeremy Salow Wednesday, January 16, 2013 9:52:03 PM She was having a life threatening illness, so the KED would not have been appropriate. It would have been a waste if time to KED someone with respiratory difficulties and delay needed treatment. There's a reason life threatening issues are a contraindication to KED usage.

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