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Rapid Response: ‘Dead’ baby hoax: Avoid finger-pointing stemming from a mistaken death

A hands-on patient assessment must be performed to declare a victim dead, even at a potential crime scene

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What happened: At about 7:30 a.m. on June 18, a 911 caller reported finding a baby lying face-down in the grass at Chocheron Park, Bayside, Queens, New York. As we might imagine, there was a significant response from law enforcement and EMS. Police initially reported that the child was “approximately three months” old and “had been pronounced dead of an undetermined cause.”

The reports available so far don’t tell us exactly who did or said what, and multiple news sources leave readers and viewers to conclude that somebody, probably EMS, had messed up. The baby turned out to be a very lifelike doll, and the few low-resolution photos available appear that somebody did a good job of moulaging injuries and lividity. The doll looked like a dead infant who had been there for a while.

Why it’s significant: Every 12 to 18 months or so, it seems that there is some sort of mistaken declaration of death event involving EMS. Some have pretty serious outcomes, like the case of Larry Green, 29, of Franklin County, North Carolina, mistakenly declared dead at the scene in 2005, but found to be alive by the medical examiner. The Office of EMS investigation found that the on-duty paramedic made the determination of death without conducting a thorough assessment of the patient, after listening to the oral report of another, off-duty, paramedic, who was also at the scene. That case resulted in a million dollar settlement with the paramedics and the county, and an additional $425,000 settlement with the medical examiner, who failed to recognize that the patient was still alive.

These cases are always tragic, emotional and sensational. Right or wrong, there is always plenty of finger pointing and Monday-morning quarterbacking by those outside the EMS community (like the print and electronic media) and inside the EMS community (usually on social media).

Death or potential death scenes present many challenges, and EMS responders face conflicting demands. Most EMS protocols include lividity, decapitation and tissue decay as clear indicators of death, whether the EMS system is a paramedic level system or not. Established lividity on a baby in a park screams crime scene, so our training includes trying not to contaminate the crime scene. But other authorities may expect, or want, EMS responders to make a judgment about the patient’s condition. It is a challenge at the best of times, worse when dealing with a child.

3 takeaways for EMS providers from the ‘dead’ baby hoax

So what can EMS responders do to avoid the spotlight in a case like this? Here are three takeaways from the “dead” baby hoax incident:

1. Don’t get involved unless you’re called to

First, avoid involvement to the extent that you can. If other authorities have already decided that the patient is dead, and they cancel the EMS response, stay cancelled. Avoid the temptation to “roll in” just to check things out.

2. Conduct a hands-on patient assessment

Second, if the death is not completely obvious (like a decapitation or something like it), conduct some sort of a hands-on assessment. Rolling a patient for a pulse check may be enough. It’s important to respect the integrity of the crime scene, but it is equally important to make sure that signs of life are absent.

Do it yourself (you and your partner) – don’t take somebody else’s word for it. This can be challenging. In another less-publicized case many years ago, a patient had experienced a significant CVA while preparing chicken in his kitchen. Over 36 hours later, responders smelled the odor of decaying chicken and concluded that the patient was deceased – delaying care again until the medical examiner moved the “body,” finding the source of the odor, and discovering that the patient still had a pulse and respirations.

3. Document everything

Third, document thoroughly. When one of these mistaken death incidents gets investigated, and it surely will, it will be important that your actions and decisions on scene be completely and professionally documented. The media, in particular, want to say that somebody “screwed up,” when that might not be the case at all. A thorough and professional report that reflects an adequate assessment will go a long way toward keeping the image of competent, hard-working EMS professionals intact.

Thankfully, these are rare occurrences, and realistic-looking patient simulators are usually too expensive to leave lying about the community. But as EMS responders often say, “You can’t make this stuff up.”

Additional resources on mistaken death

Learn more about the frequency of mistaken death incidents in EMS and how to prevent a similar occurrence from happening in your agency with these resources from EMS1:

Skip Kirkwood has been involved in EMS since 1973, as an EMT, paramedic, supervisor, educator, manager, consultant, state EMS director, and chief EMS officer. He is a past president of the National EMS Management Association, is a vigorous advocate for the advancement of the EMS profession, and a frequent speaker at regional and national EMS conferences.