News breaking out of Columbia, SC, where a man died from injuries secondary to a motor vehicle collision. Turns out there's a refusal of transport document, with the Officer's signature. And now there's video.Read more HERE.
From the story, the incident occurred in August but is only now gaining attention due to a small storm of "Wait, what the...?"
Firstly, witnesses stated a car ran a red light and collided with another car. Paramedics on scene had one of the drivers inside an ambulance, on the cot, when the first Officer arrived on the scene. After observing wine in the car the Officer removed the patient and performed a field sobriety test, which was failed.
Problem #1: No one comes into the ambulance and dictates where a patient goes until the care takers on scene have completed their assessment and treatment plan. Unless there is a safety issue, this man needs to stay under the care of the Paramedics and EMTs.
The patient refusal document was not signed by the patient but instead, according to the victim's attorney, by someone who then wrote "CPD" and a badge number.
Problem #2: This patient may not meet local criteria to refuse care. Depending on level of alertness, he may not have been able to express his understanding of the risks of refusal. My own policy requires that I document that the patient did "not appear to be under the influence of drugs or alcohol" and "understands the risks of refusing care." From what little we know of this situation, I'd doubt the second statement can be met. Also, Officers only sign if two benchmarks are met. First, a complete secondary assessment has been completed and the patient meets all refusal criteria and is refusing transport AND removing handcuffs for a proper signature is unsafe based on PD's recommendations. Plus, PD can only sign if the person is in custody and can NEVER refuse for a patient if they indicate a desire to be transported. I use those terms in reference to my local laws and as a good frame of reference.
Later at the PD, the patient/suspect begins to lose consciousness, based on video obtained by The State, and Paramedics are recalled to the scene. Be warned, the video is hard to watch. Not just because the victim is in obvious distress, but it takes so long for anyone to ACTUALLY ASSESS HIM.
This video needs to be shared in every EMT class during assessment taking 101. They eventually get involved with the basics. This video is bad news for these providers in my opinion.
Problem #3: A return call for a patient needs a QI flag. Anytime a refusal turns into a second call we need to see that chart and get more information while it is fresh in the minds of the providers and witnesses.
Investigators have requested body camera and dash camera footage of the August incident but the CPD claims it was lost either in a "glitch" or in routine erasing of the tapes."
Problem #4: I'll buy that excuse and the oceanfront property in Montana, please. Any call for Paramedics in the custody setting, be it jail or prison should have an immediate archiving of relevant video, recordings and observations. Convenient that these got wiped. While I as writing this the video above was released, so at least we have this.
I've been in the position where PD wants to keep someone who wants to go. That person gets to go, plain and simple. We don't know if the victim here requested transport and it was declined, but my hopes are that whoever did that assessment and wrote that chart is ready to answer questions about it.
Problem is, instead of answering questions 2 hours later, each answer will now be followed by "your honor."
What did you think of the patient's presentation and the Paramedic response? Was their assessment complete?
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