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Home > Topics > News
August 16, 2014

Responders acted appropriately, hospital takes blame for not transporting patient

The responders voiced concern about not taking a still-breathing gunshot victim to the hospital, but in the end listened to a Vanderbilt ER doctor who told them not to transport

NewsChannel5

NASHVILLE, Tenn. — Eight Metro Nashville Fire Department personnel will be back on the job next week.

Fire Chief Ricky White put them on administrative leave Wednesday, after a NewsChannel 5 investigation revealed an ambulance did not transport a gunshot victim to hospital, despite the fact he was still breathing.

Friday, Vanderbilt University Medical Center took responsibility for medical decisions made in the case.

Read full storyVanderbilt Takes Responsibility For Not Transporting Patient Who Was Still Alive

Comments
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Anthony Poole Anthony Poole Saturday, August 16, 2014 9:33:13 AM Due diligence, hell!! And no disciplinary action planned against the ER Dr?! In Idaho it does not matter-if you have a patient whom is breathing, get him to a hospital, stat!!!
Philip Shannon Philip Shannon Saturday, August 16, 2014 11:45:32 AM The EMTs and any RN can ignore and override the doctor if they think the doctor is wrong in his assessment.
Bernadette Graham Bernadette Graham Saturday, August 16, 2014 12:02:22 PM I applaud the hospital for taking responsibility for their doctor's choice and for not allowing the medics to shoulder the blame. That being said, as a medic, if I see a patient breathing, gunshot or whatever, I would work the patient as best I could while transporting and let the doctor with the family decide the final outcome. I wouldn't even call medical control for direction. BUT, I don't know Vanderbilt's particular protocols so can't judge the medics either way really. Apparently they followed their protocol since no discipline will result.
Steve Mauch Steve Mauch Saturday, August 16, 2014 2:35:29 PM What if the doctor knows better and, by overriding his order you cause the pt harm? What happens then??
Christopher Holland Morgan Christopher Holland Morgan Saturday, August 16, 2014 4:54:54 PM Agreed its quite odd...
Justin Bailey Justin Bailey Saturday, August 16, 2014 5:04:37 PM Steve Mauch The Doctor isn't the one on scene, he's not physically examining the patient...how would he know better?
Debbie Gasparo Solem Debbie Gasparo Solem Saturday, August 16, 2014 7:08:06 PM Should have been worked !Dr said what ? Could not hear bad portable/phone ..
Steve Mauch Steve Mauch Saturday, August 16, 2014 7:52:44 PM Justin, there weren't any rn's there either. That wasn't the comment. It was about overriding the doctor. I was directing my comment to Phillips statement, not the incident at hand.
Christopher Holland Morgan Christopher Holland Morgan Saturday, August 16, 2014 9:31:19 PM Debbie Solem Totally agree
Roy Werth Roy Werth Sunday, August 17, 2014 12:17:13 AM In Detroit they would burn you at the stake. #allwaysup4agoodwitchhunt
Scott Bernier Scott Bernier Sunday, August 17, 2014 1:37:07 AM I am sorry Philip, but that is why the ER doc is called Medical Control, right, wrong or indifferent, the go by Protocols because we operate under State, County or Hospital protocols. We can strenuously object but in the end they have all responsibility.
Cory R C Sheedy Cory R C Sheedy Sunday, August 17, 2014 2:20:30 AM So ... why did they need to talk to the physician in the first place?
Bobbie Gamblin Bobbie Gamblin Sunday, August 17, 2014 5:42:39 AM Sounded like the patient was already dead.., they just didn't know it yet. Thank god for recorded lines.., I'm sure the hospital didn't voluntarily accept responsibility
Justin Bailey Justin Bailey Sunday, August 17, 2014 7:26:57 AM Steve Mauch I see. Well, then the RN or Medic would be in for a world of hurt in that situation. :)
Local Guy Local Guy Sunday, August 17, 2014 12:43:00 PM So here's where I take issue with the situation: Granted, it may not have been a survivable injury, but if his heart is still beating why wouldn't they transport him to the hospital for potential organ donation? Huge waste of a resource that could have helped so many people. I always transport patients (exactly like this one - major, non-survivable head trauma that still has a pulse) to the ED if for no other reason than they may live long enough to give up their organs.
Stephanie Womack Stephanie Womack Sunday, August 17, 2014 4:29:10 PM Fire me for violating their protocol. I'm sorry but the patient is breathing he goes. I'd tell that doctor to take his orders and shove em
Brian Fendley Brian Fendley Sunday, August 17, 2014 7:43:48 PM I don't know about Nashville specifically but I have heard some services around the country still function under the "Mother may I" form of oversight.
Scott Best Scott Best Monday, August 18, 2014 7:08:11 AM When in doubt, transport. No transport should be reserved for those without VS, asystolic arrest, etc. One other caveat is to never accept an order of such finality from a resident. Residents function under a training license (RTL) and are not licensed to practice autonomously within their role as residents. Only orders from an attending should be accepted in such circumstances.
Richard Cooper Richard Cooper Monday, August 18, 2014 12:31:52 PM I'd rather defend that decision than non-transport
Brian Nolde Brian Nolde Monday, August 18, 2014 7:13:52 PM Here's a thought......Police stated the PT was still breathing, could those have been agonal?? We all know those are not compatible with life.
Nate Ebert Nate Ebert Monday, August 18, 2014 7:20:45 PM Reading this article leave alot of questions unanswered, as well as seeing it written as a "fry the doctor" point of view. Seems like a gsw to the face/head, and I can see that being "not compatible with life" but who knows for sure, and, they'll never release the pictures anyways. Who knows?
Rob Werner Rob Werner Tuesday, August 19, 2014 4:03:17 PM Right wrong or indifferent a paramedic does not have a license to practice medicine, the physician has the license to practice medicine. Going against medical control orders is called "practicing medicine without a license" and it is against the law the paramedics did exactly what they should have done by leaving but they should have reported it directly to their medical director.
Jeff Fein Jeff Fein Tuesday, August 19, 2014 10:37:44 PM The PAramedics could have transported as a BLS unit and not provide ALS protocals without and risk of practising medicine. If a doctor orders something that is incorrect and yo do it you are still responsible.for not regocnizing that thte order is incorrect.
Rob Werner Rob Werner Wednesday, August 20, 2014 5:24:23 AM Good point @ Jeff Fein
Scott Best Scott Best Wednesday, August 20, 2014 9:04:43 AM Not exactly. Neither an EMT and most especially a nurse cannot OVERRIDE anything. They may decline to carry an order out, but that can be a situation where, if they are wrong, then they are putting their license, and possibly a patient's life in jeopardy. Occasionally, nurses and other allied health personnel will have valuable input into a situation. In 18 years, I have not had anyone refuse an order from me, but I have had a couple who were uncomfortable giving a med. In such cases, I took the opportunity to educate that person while I gave the med myself, to the patient's benefit.

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