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The Legal Guardian
by David Givot

3 ways to protect yourself from patient lawsuits

The lawsuit may be a bunch of crapola, but you need to take precautions to make sure it goes away as fast as it comes up

By David Givot

“Medical control, this is Rescue 1.”

“Go ahead, Rescue 1.”

“We’ve been called to the home of a 76-year-old male complaining of chest pain. He describes a non-provoked, dull, sub-sternal pressure that radiates up into his jaw and down his left arm. Patient states the pain started about 30 minutes ago and rates it at a seven out of 10. He denies any shortness of breath.

His vital signs are as follows: pulse is 98, strong and regular; blood pressure is 176/60; respirations are 18. Lungs are clear bilaterally with good tidal volume…”

And your report goes on and on in fine, concise, organized detail.

Treatment orders are given, received and executed.

The patient is transported to the closest STEMI center, rather than the patient’s hospital of choice. You explained that his preferred hospital is another 15 minutes away and is not equipped to handle his [probable] acute MI as well as the closer specialty center.

He survived his first heart attack because of your good work and clear communication; another job well done. Unfortunately, after he was admitted to the CCU from the ER, he contracted a staph infection and died.

The family is now suing you — among others — for the wrongful death.

They are claiming that, had you taken him to his hospital of choice, he would not have contracted the infection that ultimately killed him. Their lawyer is arguing that any ER can handle a heart attack and you cannot diagnose an MI in the field anyway.

Before you get mad and stop reading, I know the lawsuit is a bunch of crapola. But it’s just the kind of crapola that ambulance-chasing shysters file all the time — and it’s just the kind of crapola you need to be prepared for if you want to make it go away as fast as it comes up.

Develop good documentation

The amount of concern you need to have in a situation like this is inversely proportional to the quality of your documentation and radio report. Simply put you will have very little to worry about if your documentation and radio report are organized, methodical, complete, and accurate; based on the objective findings of your thorough, systematic assessment; and reflective of proper treatment and transport based on local protocols, policies, and procedures.

On the other hand, if your documentation and radio report are choppy, incomplete, disorganized, and weak, you will have plenty of reason to be concerned, because a skilled attorney will use every means you give him or her to make you look incompetent — and incompetent providers lose lawsuits.

Not to worry, though. Your own protection and security are as easy as these three steps.

Step 1: Get your facts straight

Take a minute; take a breath.

Remember that the call you make to medical control is recorded and you have to assume that recording is going to be played back for an entire courtroom to hear.

Before you make that report, be certain you understand what is going on. Make sure you have enough relevant information to paint the appropriate picture without having to say “stand by” or “I’m not sure, let me check.”

Also be sure that the information you are relaying is correct and be clear in your own head before you start speaking; too many pauses, “ums” and “ahs” will not only frustrate the person on the other end, but it will create the appearance that you are clueless.

Step 2: Be predictable

Follow a prepared, consistent format. Deliver each report in the same organized manner, following the same systematic formula every time.

If you follow the same format on each and every call-in report, you will be far less likely to miss anything and far more likely to paint the proper picture and get the necessary orders without delay or confusion.

Step 3: Make it match

All too often, providers forget that the recorded call-in reports to medical control are a form of documentation, and the recorded report and the narrative on the written patient care report are frequently at odds.

Be sure that the content of your call-in report matches the content of your narrative documentation. Once again, a prepared and practiced formula or consistent system for documenting will help assure that nothing is missing and that the correct picture is painted.

Think about the lawsuit proposed in this hypothetical scenario, and the excerpt of the call-in report on which it is based. You will quickly see that if you are the provider, and your documentation is as clear and organized as your report, you have nothing to fear.

Even the greenest of providers knows you are describing the signs and symptoms of an acute MI and your choice of receiving facilities was medically justified and exactly right.

Another lawsuit bites the dust.

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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Brendan McStay Brendan McStay Friday, May 09, 2014 3:27:13 PM "Remember that the call you make to medical control is recorded" I wish. We use cellphones to non-recorded landlines. We haven't used radios since the 80's/early 90's.
Richard Cote Richard Cote Tuesday, May 13, 2014 8:47:43 AM Ooh. We use cellphones too. However we have a dedicated recorded line that we call from our cellphone and then type a 4 digit extension that will directly connect us to our chosen hospital. We use this for both urban and rural hospitals. Probably not too difficult to establish in your area
Tim Stone Tim Stone Tuesday, May 13, 2014 9:20:26 AM At the Medical Command Centers in West Virginia, ALL medical conversations are recorded. No matter how they are received. WV Medical Coordination Center, WESTCOM
Scot StClair Scot StClair Tuesday, May 13, 2014 8:34:04 PM Call in through your county's 911 PSAP and have them patch you through. Those lines are recorded.
Brendan McStay Brendan McStay Tuesday, May 13, 2014 8:53:21 PM Scot StClair we have one 911 answering center for the entire state. They're a little busy.
Seamus Murphy Seamus Murphy Wednesday, May 14, 2014 8:10:09 PM I might have read this article in its entirety had the author been able to resist using Jewish slurs to refer to unscrupulous lawyers.
Wes Ogilvie Wes Ogilvie Thursday, May 15, 2014 4:34:06 AM Isn't amazing how an attorney feeds in to EMS's misconceptions and myths about lawyers and the legal process? Bluntly, it's also not even "new" knowledge that he's sharing. Everyone has been hammered on good documentation practices. How about some advice on what happens if you get served with papers?
Yedidya Ben-Avie Yedidya Ben-Avie Thursday, May 15, 2014 2:36:29 PM You should note that shyster (which I assume you are referring to) is not actually a Jewish slur. I believe it is similar to how niggardly isn't actually a slur for African Americans http://en.wikipedia.org/wiki/Shyster http://en.wikipedia.org/wiki/Controversies_about_the_word_%22niggardly%22 http://www.urbandictionary.com/define.php?term=shyster http://www.rsdb.org/search?q=jews
Seamus Murphy Seamus Murphy Thursday, May 15, 2014 4:43:18 PM Wikipedia articles aside, the history of "shyster" is that of an anti-Semitic slur. In not-so-distant African history, African American lawyers were often disparaged as "eggplants" while Jewish lawyers were referred to as "shysters." ...and, no, it is nothing like the word niggardly which has never been defined as, or used as, a slur. It might get misheard because it sounds like a racial slur, but it never held a racial meaning.

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