Is it murder? More EMS1 readers react to EMTs charged in patient's death
"We must never, ever forego the safety of our patients because we are angry, tired, hungry, cold or irritated," one commenter wrote
In January 2023, two EMTs were charged with first-degree murder after a patient they were transporting died in their care. Read EMS1's ongoing coverage:
- Malpractice or murder: When do EMS providers cross the line from negligence to a crime?
- Video: Is deeply disturbing patient care murder?
- Listen: 'How does this happen?' – Wolfberg and Wirth weigh in on EMT murder charges
- You've seen the video; now what? 14 action steps for EMS leaders to root out bad behavior
- Prone positioning: Therapy or apathy?
First degree murder charges were filed against two Illinois EMTs after a patient died in their care. Police bodycam footage of the incident sparked outrage among providers and throughout the industry.
The providers, Peggy Finley and Peter Cadigan, were arrested on Jan. 10 and are being held on $1 million bond each.
In a recent EMS1 poll, we asked readers if they agreed with the charge of first-degree murder and received more than 1,300 responses. Respondents were split, with 28% agreeing with the charge of first-degree murder, and 46% believing a lesser charge is in order. Just 10% of respondents feel the providers shouldn't be charged at all.
As more information about the case comes to light, EMS1 readers are offering their thoughts on the providers' actions and whether there is enough evidence for a first-degree murder conviction – or if that's the right charge at all.
Where do you stand? Let us know your thoughts in the comments below, or send an email to firstname.lastname@example.org.
Responding to the article’s question. While the EMT’s actions are indefensible in terms of patient care the body cam video did not appear to me to show evidence of intentional murder. Yes, the EMT’s showed a distressing level of disregard for the Pt’s wellbeing, callousness and flagrant omissions of standards of care but everything they did was aligned with getting the Pt to the hospital. How they [a]ffected this was completely inappropriate but nonetheless they did effectuate the Pt’s movement to the hospital. They never stated any intent to kill explicitly or implicitly, nor did they take any willful proximate action that unquestionably would result in the Pt’s death. The degree of disregard for both the Pt and Pt care standards suggests a level of disregard for the consequences their own actions may have had on the Pt. meaning the Pt’s death was not intentional and possibly wasn’t even considered.” – B. Klarman
Were the man's hands handcuffed behind his back? THAT is the difference between risky and dangerous. If not, it's the recovery position. If they violated company policies, then there is that. But otherwise, this isn't anything more than an unfortunate, unavoidable death. It happens every day.” – J. Self, retired paramedic
This EMS crew should be charged with murder. I am not familiar with Illinois law pertaining to the different classifications (First and Second degree, etc.) of murder charges. This crew had a duty to act which they failed to provide. I believe their actions show ‘willful malice’ defined as a ‘total disregard to another’s well-being.’
If the EMS providers actions are negligent while they are providing care to the patient, they should be charged criminally. The law would have to be very clear and written by someone much smarter than me.
I found the actions of these EMS providers disgusting. I’m curious as to the amount of complaints prior to this call made on these two providers.” – K. Hall, paramedic
The statement ‘should have known from their training and experience that positioning a patient in such a way would create a substantial probability of great bodily harm or death’ is definitely correct. Although it does not appear to be the classic excited delirium picture, hallucinations were mentioned, and the patient was clearly not alert or oriented. [It’s] unclear whether his lack of cooperation in walking was deliberate or because his condition made him unable to ambulate. [N]ot being a lawyer, I am not clear about what defines a ‘murder’ but the pre-hospital actions by the EMS providers demonstrate gross negligence … the patient care attitude of the female EMS worker was atrocious and a shame to EMS. [W]hy was the patient placed face down on the cot? [H]e had an obvious altered level of consciousness and prone is definitely not the position of choice for that symptom. I was just horrified at the pre-hospital care that was given to this patient!!! And I would think that the attitude of the female EMS worker towards patient was known by her employers who should have fired her; they deserve equal blame for this tragedy. [R]eviewing their CQI records would probably reveal that.” – B. Harrington, RN, EMT-P (retired)
Yes, these two providers should be criminally charged for the death of their patient, why?They are medically trained professionals which means they are held to a higher standard than a lay person or even a police officer, and they are required to monitor their patient during transport. They should have discovered there were perfusion issues if they were monitoring the patient appropriately. Laying a patient prone during transport has not been acceptable medical practice in EMS for more than a DECADE.
There could be mitigating circumstances for these two providers – why? Were there signs/symptoms of burnout/mental hygiene issues with this crew? Were they seeking assistance? Did Leadership know? Were their requests ignored? Was the crew in fear of physical harm during transport from this patient? Were there threats of physical violence from this patient? Was there actual physical or verbal abuse from this patient? This does not excuse what happened; could be a reason for the prone positioning.
I am not without sympathy for the crew, given the duress most crews are under, being understaffed, overworked, underpaid and being treated poorly each and every shift, HOWEVER, mistreatment of a patient is never acceptable.
When the facts of the case come to light, we can better evaluate whether charges are appropriate. I was not on the call, so my comments are strictly from my narrow perspective as an armchair quarterback. However, we must never, ever forego the safety of our patients because we are angry, tired, hungry, cold or irritated. First, we do no harm, and we do KNOW harm. It is the oath we take, and our patients deserve our best, all day every single day, every single call.” – A. Perry, BSN, RN, CLNC, CEN, NRP, CP-C, DICO-C
I feel they should definitely face some charges, first degree... maybe. But I also feel that the service and management should be held accountable also. Because I'm sure looking at the way these two acted on this call that they have probably almost definitely had complaints on them before that was probably never addressed. But ultimately, it's still on the crew. You just don't place a patient prone, wrap them in a blanket and cinch the straps tight like you're strapping down a 40,000 lb. load on a semi.” – C. Watts
I teach EMTs and paramedics at a college in MI. We not only teach proper patient management procedures but also appropriate affective behavior when dealing with patients, family, bystanders, and other emergency workers and healthcare professionals. What I witnessed in the video was totally inappropriate affect of the female EMT – no empathy or compassion, no actual assessment of a patient in obvious distress, plus (now also involving her partner) improper positioning of the patient on the stretcher and clear inappropriate strapping of a patient (clearly the straps were too tight over the back inhibiting the patient’s ability to breathe). The police officers displayed totally appropriate behavior in that situation and though they were the ones placing the patient on the stretcher (this should have been the responsibility of the EMTs), they are not responsible for the medical care of a patient.” – D. Martin
The responding crew should have been fired years ago!
How difficult is it to bring in a stair chair or a scoop inside and take the patient to the cot? The female crew member had the worst attitude I have ever seen – and I have worked in a small city environment in EMS for more than 20 years. It was also evident that the partner pulled the straps very tight when securing the patient to the cot – after slamming the patient’s face onto the head of the stretcher. Prone on the cot has never been a safe or acceptable option! Not to mention that transporting across the sidewalk with the cot in the full up/load position would be grounds for termination in almost any system in the country.
Before watching the video, I was going with laziness and burn-out. I now am more inclined to believe in malicious intent. Taking them off the street for 30 years will be a win for EMS!” – D. Owen, CCEMT-P
Should they be protected? No, hell no, not when there is CLEAR evidence of a wrongdoing. The police there should also be charged as well. They clearly saw wrongdoing and did nothing. They could have called someone else in. There needs to be some protocol in place to prevent this from happening again. They did nothing. They are just as much at fault as the EMT.” – L. Williams
EMS must be trained in how to overcome the anger that surfaced in this EMS worker and when it is time to call in for leave time before this happens. The hour was 2 a.m., which probably impaired judgment further but there were 3 people there. The officers need instruction on how to confront an obviously hostile angry EMS worker – they were in a position to rebuke this lack of empathy but need more training in medical conditions to understand the hostility of the EMS worker is not consistent with the medical oath to first do no harm. Empathy training is mandatory to prevent a repeat of this which is increasingly common in providers. The failure to abide by a medical standard combined with an angry & hostile attitude to the patient unfortunately led to death and as there was more intent to harm by words & actions than to help, an intent to kill conclusion is warranted.
Let this be a lesson to those choosing the medical field – this is not a profession to be taken lightly. [Y]ou are not embarking on a 9-5 desk job shuffling papers. People's lives are in your hands – treat it as such and don't blame the disease & it's effects on the inflicted, they have no control over it – that is why we step in: to help, not judge or hurt. A change in mental status is a serious life-threatening condition. I am a licensed healthcare provider and I approve of this comment.” – P. Jacobs
I am a retired Medic, with over 35 years in EMS. I was an Instructor/Educator, and a Training Officer for both private and FD-based EMS. I just watched the body cam footage. OMG...
I am in tears and OUTRAGED! Some days the supply of available curse words is insufficient to my needs – but I will try to edit my words for the sake of your ears.
An investigation of the service that employed them should be undertaken to root out source(s) of the culture within that allowed this to happen in the first place. Please don't tell me no one knew about this person masquerading as an EMS professional! The Mgmt and their Training person (IF there is one...) should be brought up on charges, as well, if they were aware of this kind of patient treatment and did nothing about it.
And where is their Medical Control Doc in all this? Does he/she/it not have a CLUE about how this crew apparently works the street?
I don't give a flying damn what the crews' excuses are or will be. I am totally ASHAMED and DISGUSTED by their behavior. If this crappy excuse for a human being/woman has a NR patch, it needs to be stripped NOW. Both their licenses should be voided and they should NEVER be allowed near another patient again. I don't care HOW tired you are, how burnt out you feel, there is NO EXCUSE for treating ANY patient in this manner.
The DEPRAVED INDIFFERENCE demonstrated in that video definitively convinces me that murder charges are NOT enough for her or her partner. It is obvious he was complicit in her behavior. I shudder to imagine what happened in the back of that rig.” – K. Rickey, NRP, EMS I/C, TO, retired
As a retired EMT of 31 years, the woman EMT was lacking empathy to this patient. Maybe she has delt with him before or had a previous patient that did the same thing. Who knows. Assisting the patient to walk out to the stretcher needs to be prudent just in case they can't walk. Placing the patient in supine position will allow the patient, if vomits, to have a patent airway. Overall, there was no need to just slam the patient onto the stretcher. There was some sort of distress or psychosis and should have been treated as such. Altered mental status protocols/difficult breathing should be a sign. Possibly an autopsy will actually find out what did contribute to his death if it will be done. What should be done to the 2 EMT's? At minimum, some sort of remediation as to patient handling and attitude adjustment accordingly. Medical control issues abound. Did the patient get to the hospital alive? If he died in transit, was the ED notified? Overall, these EMTs need a lot of remediation and QA/QC as to how to handle a call like this. When all the facts are brought out, was the crew liable for their actions? Yes! – Stiktech
I have always emphasized that you need to treat each patient as you would if they were your loved one. If you can't do that, it is time to get out of this business. I notice that this EMS practitioner was 44 years old. I've been in EMS longer than she was born so I don't care about the burnout excuse. It is idiots like these that make us that care about our patients look bad. I'm sure they won't be convicted of 1st degree murder; this is just a plea technique by the prosecution to get an easy manslaughter or negligent homicide conviction. They will be convicted, and they most certainly deserve it. – Firebeezer
Video: Is deeply disturbing patient care murder?
When lots of red flags are waving, assess the patient, provide compassionate care and always take “I can’t breathe” seriously