Woman left for dead by EMS, later found alive, dies of injuries

[Johnny_Blaze_47]

http://www.ksat.com/news/14876856/detail.html

[MaNuMaNiAc]

Incompetence kills

[exstatic]

I think the Welmaker law firm might just be getting a call. How the fuck does the coroner figure out she's alive and EMS totally whiffs on this one?

[ZStomp]

daaaaaaaaaaaaaamn


Boss stands by medics

Web Posted: 12/17/2007 11:00 PM CST

Brian Chasnoff
Express-News

Four paramedics who responded to a head-on collision over the weekend did not treat a critically injured victim in a car that police said was struck by a drunken driver, Fire Chief Charles Hood said Monday.

Instead, the paramedics, working to "save the most savable victims," he said, took two others who'd been in the Honda Accord to Brooke Army Medical Center, leaving Erica Smith — alive, suffering from a head injury and in critical condition — inside the car, covered with a yellow tarp.

Officials believed that she was dead. However, she clung to life until 2 p.m. Monday.

About two hours passed from the time the wreck had occurred before a second wave of paramedics returned to the scene at Loop 410 near Rigsby Road to treat her, according to a police report. A medical examiner's investigator had been called to the scene to examine the body and noticed that Smith was breathing.

Standing before news cameras Monday, Hood spoke mostly in generalities, citing confidentiality laws he said prevented him from providing details about the incident that outraged at least one of Smith's relatives. Declining to clarify how the paramedics determined Smith's condition, he said paramedics generally check for vital signs, which can be compromised in cold weather.

The low temperature Sunday — the wreck occurred just before 4 a.m. — was 29 degrees.

"The paramedics, when they were doing their job, they didn't think they were missing anything," Hood said.

But according to a police officer familiar with the incident, police told paramedics at least twice that the woman was still breathing.

"They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,'" said the officer, who requested anonymity because he is not authorized to speak about the case.

Smith, a 23-year-old senior at Texas State University, was at BAMC on Monday, where she died at about 2 p.m., according to the Bexar County medical examiner's office.

Kimberly McGuire, a cousin of Smith's, characterized the incident as a severe mistake.

"It is unfathomable to me that my little cousin sat, bleeding, under a tarp and in the cold while receiving no medical attention," McGuire wrote in an e-mail. "I can't help but wonder if her injuries would be less severe had she received the prompt medical treatment she deserved."

Emergency medical personnel often cite the "golden hour," the 60 minutes between a person's critical injury and the moment before the body begins to shut down. A nonfiction television show on Discovery Health Channel, "The Critical Hour," documents such cases, showcasing the fast-action pace of medical attention in the first hour after a severe injury and the chances of survival as the minutes tick on.

Hood, who became fire chief in April, said he visited Smith's family at BAMC for half an hour Monday to express his sympathy.

"It was difficult, man. I was in tears," Hood said. "You can't describe the amount of grief in there."

Yet Hood would not accept responsibility on behalf of Emergency Medical Services, a branch of the Fire Department, for the apparent mistake. He said the incident is under review and the paramedics involved are expected to return to work Wednesday for their regular shifts. He said the review's findings likely would remain confidential in accord with current law.

"I don't foresee any discipline for (the paramedics)," Hood said, adding, "There's nothing to apologize for. We weren't driving the vehicle that hit the car."

The driver of the other vehicle, Jenny Ann Ybarra, 28, was charged with intoxication assault in the wreck and released Sunday from Bexar County Jail after posting $5,000 bond.

Police said Ybarra's gray Pontiac GS veered into an oncoming lane on Loop 410, striking the Honda Accord. Sabrina Shaner, 22, the Accord's driver, and back-seat passenger Amber Wilson, 22, suffered serious but non-life-threatening injuries.

All three people in the Accord were taken to BAMC. Police had said Smith was in critical condition Sunday afternoon.

[email protected]


Some strong statements there...

[Johnny_Blaze_47]

You know, if the officers said that, why didn't it make the police report?

http://www.ksat.com/download/2007/1218/14877270.pdf

[Gerryatrics]

http://en.wikipedia.org/wiki/Triage

Before the first story was edited and in a previous story it says she was declared dead by EMS. Can someone be pronounced dead by Paramedics in Texas?


Erica Smith, 23, was believed to be dead by EMS officials, but was not treated because her injuries appeared to be fatal, the San Antonio Fire Chief said Monday.

That sentence still doesn't make sense to me by the way.

[ZStomp]

You know, if the officers said that, why didn't it make the police report?

http://www.ksat.com/download/2007/1218/14877270.pdf


It's not? The PD is so much under fire that I wouldn't be surprised if it isn't in there....PD don't want any part of that!

[ZStomp]

http://en.wikipedia.org/wiki/Triage

Before the first story was edited and in a previous story it says she was declared dead by EMS. Can someone be pronounced dead by Paramedics in Texas?


I believe so. I've handled incidents before where the paramedics time is used as the time of death (or pronounced time).....

[Johnny_Blaze_47]

It's not? The PD is so much under fire that I wouldn't be surprised if it isn't in there....PD don't want any part of that!

The report makes no mention of the ME having to call back EMS. It simply says all three were transported to BAMC.

[Johnny_Blaze_47]

http://en.wikipedia.org/wiki/Triage

Before the first story was edited and in a previous story it says she was declared dead by EMS. Can someone be pronounced dead by Paramedics in Texas?



That sentence still doesn't make sense to me by the way.

Yeah, that probably should read "...and was not treated... "

[ZStomp]

Damn, I'm glad that wasn't my call.

[RashoFan]

http://en.wikipedia.org/wiki/Triage

Before the first story was edited and in a previous story it says she was declared dead by EMS. Can someone be pronounced dead by Paramedics in Texas?



That sentence still doesn't make sense to me by the way.
Triage is used on mass casualty incidents. As "First on scene medics" , usually 2 of them, they go through the injured rapidly to classify them in to 4 catagories. Green: "walking wounded" Yellow: can delay transport due to injuries are manageable for the time being, Red: critical, needing rapid transport and Black: dead or will be in just a matter of mins.
It sounds like 4 Paramedics should have been able to manage 4 patients with the assistance of SAFD which those guys have minimun EMT Basic certs.

Pronouncing onscene...
Paramedics can contact their online medical direction to pronounce a person onscene which contact info(Dr name, orders, TOD, etc) is documented on pt report. In all cases that I have been onscene of a DOA. the online medical direction asked if a cardiac monitor confrimed asystloe in all the leads(wires).

[RashoFan]

It's not? The PD is so much under fire that I wouldn't be surprised if it isn't in there....PD don't want any part of that!
Can't blame them for not wanting to be brought down in this matter.

[Johnny_Blaze_47]

Yeah, that probably should read "...and was not treated... "

Fixed it. Thanks, Gerry.

[ZStomp]

What you guys think of this quote?


"I don't foresee any discipline for (the paramedics)," Hood said, adding, "There's nothing to apologize for. We weren't driving the vehicle that hit the car."

[RashoFan]

There are some good Paramedics in SAFD EMS...but it is the bad ones that really throw a shadow on the department.

[ZStomp]

Can't blame them for not wanting to be brought down in this matter.

Rasho, when you guys make emergency calls do you have to wait for the police department to let you know that its safe to enter the scene?


There are some good Paramedics in SAFD EMS...but it is the bad ones that really throw a shadow on the department.

It's like any job....there always bad employees.....

[RashoFan]

What you guys think of this quote?


"I don't foresee any discipline for (the paramedics)," Hood said, adding, "There's nothing to apologize for. We weren't driving the vehicle that hit the car."
Negligence...abandonment could be argued, it depends who has the better lawyers in the case if there will be one....(settling out of court anyone?)

[Johnny_Blaze_47]

Page six of the report says "Items" 6 & 8 (driver and one passenger) were notified at 0350, while Item 7 has a time arrived time of 0555. I don't know what that other writing is, though.

[RashoFan]

Rasho, when you guys make emergency calls do you have to wait for the police department to let you know that its safe to enter the scene?
If it is a crime scene...shootings, beatings,violence in the nature of the call...for the most part ...yes we wait till the LEO's clear the scene.
Traffic accidents...not unless a gun was involved/road rage....

[Johnny_Blaze_47]

BTW, Z, good to know you weren't the cop who got the broken arm in the traffic accident tonight.

[RashoFan]

Would love to stick around and discuss THIS topic, but I have to be up early for work.

[ZStomp]

If it is a crime scene...shootings, beatings,violence in the nature of the call...for the most part ...yes we wait till the LEO's clear the scene.
Traffic accidents...not unless a gun was involved/road rage....

Well, that became part of their procedures this year and it's irritating sometimes. I understand that for major violence calls (shootings/cuttings..etc), you guys should wait for LEO's... but we (I) have handled calls simple assaults where we get there- and after a few minutes ask our dispatcher to get EMS.

She does so- and we end up waiting another 10 mins- so we ask our dispatcher again. After a few moments, she comes back and says, "they were waiting for you to clear the scene..."

Are they serious!!!! I had a call for a guy hit with a bat on the head twice- and I asked for EMS 3 times and had to wait 15 mins for them. After I asked for EMS the 3rd time my dispatcher tells me- "They were waiting for you to clear the scene.." Oh my god! I asked you for 3 times- what do you think!

[ZStomp]

BTW, Z, good to know you weren't the cop who got the broken arm in the traffic accident tonight.


Thanks man. Do you know his name? It's scary at times when you're on the way to an emergency call and in a split second...well, you know.

[Johnny_Blaze_47]

Thanks man. Do you know his name? It's scary at times when you're on the way to an emergency call and in a split second...well, you know.

Nope. I didn't get any identifying info from the scripts.

[Sapphire]

This is a really sad case, but at least they knew of her existence, unlike in this story, where the victim wasn't found until the car was taken to the towing company's yard:
http://www.foxnews.com/story/0,2933,317195,00.html

[Gerryatrics]

Triage is used on mass casualty incidents. As "First on scene medics" , usually 2 of them, they go through the injured rapidly to classify them in to 4 catagories. Green: "walking wounded" Yellow: can delay transport due to injuries are manageable for the time being, Red: critical, needing rapid transport and Black: dead or will be in just a matter of mins.

Triaged in the sense of separating and focusing treatment on the victims based on their conditions and the ability of the responders to to enact aid. It would make sense to concentrate treatment on those who would respond to it instead of someone beyond medical treatment. However, that doesn't quite explain why they covered the victim with a sheet when she wasn't yet deceased, why she wasn't transported when she wasn't asystolic, why nobody reevaluated her condition even though - as you pointed out - there were four paramedics and probably a few EMTs milling around; and finally, why it took her nearly 36 hours to succumb to her injuries after having medical care withheld for two hours when the paramedic's allegedly believed she was dead or would be dead within minutes.


Pronouncing onscene...
Paramedics can contact their online medical direction to pronounce a person onscene which contact info(Dr name, orders, TOD, etc) is documented on pt report. In all cases that I have been onscene of a DOA. the online medical direction asked if a cardiac monitor confrimed asystloe in all the leads(wires).

Thank you.


Fixed it. Thanks, Gerry.

Whoops, sorry, didn't realize that was your story. Had I known I would have been a little more tactful in pointing out the contradiction.


She does so- and we end up waiting another 10 mins- so we ask our dispatcher again. After a few moments, she comes back and says, "they were waiting for you to clear the scene..."

Are they serious!!!! I had a call for a guy hit with a bat on the head twice- and I asked for EMS 3 times and had to wait 15 mins for them. After I asked for EMS the 3rd time my dispatcher tells me- "They were waiting for you to clear the scene.." Oh my god! I asked you for 3 times- what do you think!

We'll stage for law enforcement i.e. park down the street and around the corner. Once the dispatcher says the scene is secure it should only take a minute or so to actually reach the scene, not 10 or 15. Sounds like there's either a breakdown in communication between the dispatcher and EMS or they aren't actually leaving the station until they get the all clear signal.

[ShoogarBear]

What you guys think of this quote?


"I don't foresee any discipline for (the paramedics)," Hood said, adding, "There's nothing to apologize for. We weren't driving the vehicle that hit the car."What I think is that Mr. Hood is going to get various forms of reaming out over the next few days. If his intention was to deflect attention from the paramedics, he's probably temporarily succeeded.

[to21]

What you guys think of this quote?


"I don't foresee any discipline for (the paramedics)," Hood said, adding, "There's nothing to apologize for. We weren't driving the vehicle that hit the car."

That's f'd up. You don't say some insensitive shit like that. It might be true, but that's someone's little girl.

Bottom line is some body made a mistake and someone needs to apologize. EMS falls under the Fire Chief right?

[BacktoBasics]

I guess I was wrong to assume that no matter how bad my injuries may be I would be given every opportunity to survive.

[MannyIsGod]

TRIAGE?

FUCKING TRIAGE?

IN SAN ANTONIO?


Dude, what the fuck? Does anyone not seriously have a problem with that word being brought up in San Antonio as though we're in the middle of a fucking war zone and we can't gather enough paramedics to treat everyone that needs it in a FUCKING CAR ACCIDENT?

That fire chief is waaaaaaaaaaaaaaaaaaaaaaaay out of line. It IS their fault. They may not have caused an accident, but they have a responsibility to respond to those accidents correctly. You know, thats your fucking job. Oh I can't believe he had the nerve to say that. If this was my family I'd have his nuts in a fucking vice.

Triage in Iraq? OK I UNDERSTAND.

Triage in San Antonio at a small car accident? No, fix the fucking problem and make sure that NEVER happens.

[BacktoBasics]

TRIAGE?

FUCKING TRIAGE?

IN SAN ANTONIO?


Dude, what the fuck? Does anyone not seriously have a problem with that word being brought up in San Antonio as though we're in the middle of a fucking war zone and we can't gather enough paramedics to treat everyone that needs it in a FUCKING CAR ACCIDENT?

That fire chief is waaaaaaaaaaaaaaaaaaaaaaaay out of line. It IS their fault. They may not have caused an accident, but they have a responsibility to respond to those accidents correctly. You know, thats your fucking job. Oh I can't believe he had the nerve to say that. If this was my family I'd have his nuts in a fucking vice.

Triage in Iraq? OK I UNDERSTAND.

Triage in San Antonio at a small car accident? No, fix the fucking problem and make sure that NEVER happens.::fistpump::

[Johnny_Blaze_47]

Gerry, don't be. It's just one of those things that make sense because you wrote it and I was making edits on the fly once the word came down of Smith's death. Seriously, though... thanks.

[Gerryatrics]

TRIAGE?

FUCKING TRIAGE?

IN SAN ANTONIO?


Dude, what the fuck? Does anyone not seriously have a problem with that word being brought up in San Antonio as though we're in the middle of a fucking war zone and we can't gather enough paramedics to treat everyone that needs it in a FUCKING CAR ACCIDENT?

That fire chief is waaaaaaaaaaaaaaaaaaaaaaaay out of line. It IS their fault. They may not have caused an accident, but they have a responsibility to respond to those accidents correctly. You know, thats your fucking job. Oh I can't believe he had the nerve to say that. If this was my family I'd have his nuts in a fucking vice.

Triage in Iraq? OK I UNDERSTAND.

Triage in San Antonio at a small car accident? No, fix the fucking problem and make sure that NEVER happens.

I was the only one that brought up the idea of triage and I am in no way affiliated with the San Antonio Fire Department or have any special knowledge of this incident. Do I think they were following advanced triage rules at the scene? Not at all. I doubt they were tagging people or felt they had insufficient resources available to them to fully treat all the victims. I was merely using the concept of triage as it's most basic form (the word means "to sort") to offer a possible explanation as to why medics would concentrate treatment on victims in immediate need of advanced medical care and not someone who they believed would not be able to recover and would die within minutes no matter what level of treatment they received. I pointed out earlier that among other things, they probably should have had enough people to at least have someone with her. Withholding care entirely on someone still alive in my opinion isn't excusable on an incident of this kind, no matter how close to death they believe the victim to be.

[King]

Eesh...I know her cousin. The Kim mentioned in the story.

[RashoFan]

Journal of Emergency Medical Service(Jems) has a website and has the link to Ksat.comabout the story. I get an eNewsleter in my email and it is in the headline....

http://www.jems.com/news_and_articles/news/EMS_Mistakenly_Declares_Woman_Dead.html

[SequSpur]

TRIAGE?

FUCKING TRIAGE?

IN SAN ANTONIO?


Dude, what the fuck? Does anyone not seriously have a problem with that word being brought up in San Antonio as though we're in the middle of a fucking war zone and we can't gather enough paramedics to treat everyone that needs it in a FUCKING CAR ACCIDENT?

That fire chief is waaaaaaaaaaaaaaaaaaaaaaaay out of line. It IS their fault. They may not have caused an accident, but they have a responsibility to respond to those accidents correctly. You know, thats your fucking job. Oh I can't believe he had the nerve to say that. If this was my family I'd have his nuts in a fucking vice.

Triage in Iraq? OK I UNDERSTAND.

Triage in San Antonio at a small car accident? No, fix the fucking problem and make sure that NEVER happens.

I totally agree with this. It's their fucking job to do whatever is necessary to transport someone to the hospital to get advanced critical care.

This guy who said this needs to fucking wake up and publicly apologize.

Aren't parademics supposed to scoop up victims as quickly as possible and get them to the hospital and provide some type of intermediate care? I mean What the FUCK? How in the fuck does anyone in healthcare who has taking a Basic Lifesaver Course not know that someone doesn't have a pulse???

First off, where did these dipshits take the course? Problem #1. Did their company make sure they were probably trained to assess A B Cs?????????????

Airway Breathing Circulation........

What the fuck?

Why are paramedics pronouncing anyone? hook up the bag, hook up the iv, hook up the defib and start fucking saving someone. This was a child, a strong heart, good lungs, everything... and they fucked it up.

The paramedics fucked it up.

What a fuck up of all proportions.

:pctoss

[SequSpur]

You know sometimes repetition, years on the job, etc. etc. makes healthcare providers of sorts to lack compassion. These techs should've been busting their asses and getting those victims to the hospital.

I spent 8 years in the Army as a Medic and we would never leave someone to die. We would at least try to save their life. Who gave these techs the right to fucking choose? What.. were you in a hurry to get back to your TV set at the fucking station? Were you to tired? Were you fucking stupid?

Sorry but this is a sorry ass excuse for a fucked up incompetent system.

[RashoFan]

Word!