By Matthew Cella
The Washington Times
The Importance of EMS Documentation By David GivotThe best part of EMS is also one of the most dangerous: people. The people of EMS demonstrate qualities like compassion and respect and hope on a daily basis for all the world to see and hopefully emulate. Likewise, even the best people are prone to mistakes and emotions and, in a flickering instant of fatigue or poor judgment, can bear responsibility for the loss of human life. For EMS providers, it is that constant specter of death that should keep judgment clear and focus sharp. Such was not the case for the DC paramedic who made the mistake of playing doctor. Having lectured on EMS/Legal topics to thousands of providers from coast to coast and even in Canada, my summation is always the same: Protocols and procedures, training and documentation are the cage that protects providers from the bevy of hungry and ruthless sharks that swim around them on every call. Inside the protections of the cage, the provider is as safe as a provider can be. Outside, however, is where patients die and careers end. Perhaps the most significant protection for providers is EMS documentation. Fundamentally, documentation cannot be complete unless the care is appropriate and appropriate care can only be achieved when the assessment is thorough. Would a better assessment, more comprehensive care, or more thorough documentation saved Mr. Givens’ life? We will never know. But as the providers in DC have learned the hard way, providers who step out of the cage get eaten. David is a practicing Defense Attorney in Los Angeles and a former paramedic. Read his columns at The Legal Guardian. |
WASHINGTON — The family of a Northeast Washington man who died of a heart attack hours after being told by a D.C. paramedic that he suffered from acid reflux filed a wrongful-death lawsuit against the District on Tuesday.
Lolitha Givens, mother of Edward Givens, is seeking $17 million from the District and Dr. James J. Augustine, medical director for the District’s Fire and Emergency Medical Services (FEMS).
The lawsuit charges that the city and Dr. Augustine are responsible for Mr. Givens’ December 2008 death because the paramedic who responded to a medical call at Mr. Givens’ house on the evening of Dec. 2, 2008, incorrectly interpreted medical data, mishandled documentation of the case and told Mr. Givens “that he only needed to take Pepto Bismol.”
Mr. Givens, who was 39, was found dead in his bedroom about six hours later.
“The FEMS report of the incident indicates that it does not appear that an extensive discussion of risks and possible consequences of not seeking medical care and treatment took place,” the lawsuit said.
The Washington Times in April reported that scores of the District’s paramedics either failed to meet the minimum national standard on written exams that tested their medical knowledge or they mishandled basic lifesaving procedures during videotaped assessments, according to videos, documents and interviews with industry professionals.
The videos and written tests were obtained by The Times from tests conducted at the Maryland Fire and Rescue Institute from March to June of 2008 - months before Mr. Givens’ death.
One professional who viewed the videotapes for The Times expressed concerns specifically about the assessment of the firefighter-paramedic who treated Mr. Givens.
“Based upon viewing the videotape, I would have serious concerns about him performing any medical practice,” Graydon Lord, a licensed paramedic and former fire and EMS chief in Cherokee County, Ga., said in April.
“I would recommend that the medical director make his determination as to whether this provider can safely practice medicine in the pre-hospital-care environment,” said Mr. Lord, who was unaware of the identity of the paramedic when he viewed the video.
The lawsuit charges that, during his testing, the paramedic who treated Mr. Givens “failed to demonstrate knowledge of the national standards of care as it applies to paramedic responding to cardiac complaints and conditions.”
It said Dr. Augustine, who is responsible for quality control within the city’s emergency medical services, should have been aware that the paramedic had deficient skills.
“The test results were available prior to Mr. Givens’ death, and the District and Dr. Augustine had an opportunity to take actions to protect persons such as Mr. Givens,” the lawsuit said.
Dr. Augustine on Dec. 1 announced his resignation from the fire department, citing health issues.
Deputy Fire Chief Kenneth Crosswhite, a department spokesman, said he could not comment on the lawsuit and referred questions to D.C. Attorney General Peter J. Nickles. Mr. Nickles could not be reached for comment Tuesday night.
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