Man Dies at Home After Paramedics Diagnose Acid Reflux

[Liberal_in_LA]

Man Dies at Home After Paramedics Diagnose Acid Reflux

http://www.washingtonpost.com/wp-dyn/content/article/2008/12/03/AR2008120303696.html

By Elissa Silverman
Washington Post Staff Writer
Thursday, December 4, 2008; Page B04

A 39-year-old Northeast Washington man died yesterday, a few hours after paramedics responding to his complaints of chest pains and trouble breathing told him he had acid reflux and did not take him to a hospital, family members said.

D.C. fire officials are investigating the circumstances surrounding the death of Edward L. Givens, who was found by family members just before 6 a.m. in his home in the 700 block of Division Avenue. Paramedics told Givens late Tuesday that he had acid reflux, instructed him to take Pepto-Bismol and left, family members said

-------------

Lolitha Givens said her son was in the living room Tuesday night when he yelled out to family members to call 911. He was on his back on the floor and said he had chest pains and was having trouble breathing.

A firetruck and ambulance from Engine 30 were dispatched to the house at 11:40 p.m., Etter said. The truck, staffed by three firefighters trained in emergency medicine and a firefighter-paramedic, arrived first.

Lolitha Givens said the firefighters asked her son what was wrong, and the emergency medical technicians who arrived by ambulance checked his vital signs and performed an electrocardiogram, the results of which they said were normal.

The EMTs asked Givens whether he had eaten or had anything to drink that evening, and he said he had eaten a burger, Givens said. They told him and his mother that he probably was suffering from acid reflux and suggested he take antacid.

"Six hours later, my son was on the floor, dead," Lolitha Givens said.

[MountainLaurel]

1. Par for the course in DC

Emergency services in DC had a bad reputation prior to the Rosenbaum death (e.g., the paramedics who stood around laughing as a transvestite died), and it looks like things haven't changed much in the interim.

[ikojo]

2. They should lose their jobs

They are not doctors so how can they make a diagnosis? He should have been taken to the nearest hospital.

Unless there is more to this story, such as did they get a lot of calls from this address that were not emergencies?

[atreides1]

4. Don't count on it

The EMT in the Rosenbaum case was just recently given her job back, it seems that the city has a problem with not following procedures when they fire police, fire fighters, and EMT's.

One would think that it was done intentionally, so that those fired could get their jobs back once the furor dies down, but we all know that the bureaucrats would never pad the books for city workers in D.C.?

[Liberal_in_LA]

11. I'd hadn't heard about this story until you mentioned it. Here's a link

http://www.ems1.com/careers/articles/439623-D-C-EMT-fired-in-Rosenbaum-case-back-to-work/

[atreides1]

3. Now they wait

An autopsy will help to determine the COD, and will also determine whether a civil suit will be filed against the city.

[sandnsea]

5. I've known ERs to do this

A friend was sent home twice from the ER, on two separate occasions, before he finally got a doctor to do more tests and then discover he needed stents. I don't get it. I thought the blood test measured heart attack markers very well.

[Mist]

10. Some heart problems can conceal themselves well. My mother had a similar

problem to your friend's.

[davsand]

6. Paramedics diagnose? I thought their job was to stabilize and transport.

Seriously. I know an EKG is SOP whenever there is a suspected cardiac problem, but I have NEVER heard of paramedics diagnosing and I can't begin to imagine any doc at the other end of that EKG daring to diagnose without actually SEEING that patient in the flesh.

A couple of months ago I ended up seeing a doc on the fly because they thought I was having a cardiac event. They did an EKG that was inconclusive, but they also screened me in person, and let me leave with the instruction that if ANYTHING further happened to call 911 post haste. They also scheduled me for further stress testing in a cardiac lab at a later date just to be certain there was nothing going on.

I am sorry this man died, but I have to wonder about the details of this story.



Laura

[xchrom]

8. it must be a kind of first line of triage.

that's the only thing i could think of -- cause this is crazy.

[Midlodemocrat]

9. It is. They do not have the authority to diagnose.

They do a H and P if possible and report all vitals to the nearest ER upon arrival. Think ER the show.

This group was hugely negligent if this story is correct.

[rainbow4321]

14. Some like to think they can

I work in an outpatient clinic and we sometimes get very sick patients who require a trip to the ER. We will call 911, the ambulance arrives, we've had a few paramedics question if the patient really needs to go, kind of hmm and hawww and all but come out and say that they don't feel a need to take the patient...So we've had to tell them "Um, this person's MEDICAL DOCTOR has assessed the patient and determined that they are UNstable and NEED to go to the ER."


When I did homecare and needed to call 911 more than a few times I've had run ins with the paramedics who as soon as they would enter the house would look at the patient, (ignore me and my assessment findings as well as me telling them that I have already spoken with the patient's doctor and was instructed to call 911) and ask the patient in a condescending tone "do you REALLY want to go to the ER??". They tried it with one of my elderly female patients and she shut them up real quick with "I don't WANT to go but I HAVE to go, now don't I??"


If the ones in the story did take it upon themselves to diagnose, the city will be handing over a hefty check to the family..but more importantly, the crew who made the decision needs to be fired and lose any kind of license they may have.

[AngryOldDem]

18. Some like to play doctor.

Especially if the person needing help is poor, and the paramedics just don't want to be bothered. No offense to those paramedics reading this who actually DO do their jobs, but I've seen this more often than not, and have also had to put up with absolutely uncalled-for and disgusting comments some make as well.

[dipsydoodle]

7. I had the opposite happen

back in April '02. I thought I had wind which wouldn't go away and 'phoned our UK National Health helpline for advice. A doctor 'phoned me back a short while later and told me to get myself the nearest hospital. My appendix was removed the following morning in the nick of time as it was just about to pop.

[sandnsea]

13. National health helpline? With a doctor??

Oh yeah, that's just a horrible thing. We certainly can't have that here.

Gads. It would be wonderful to pick up the phone and talk to a doctor. I can rarely get through to the nurse, let alone actually talk to the doctor on the phone anymore.

Glad everything worked out for you.

[dipsydoodle]

16. That's 24/7 here in the UK

and it was a Saturday afternoon so my own doctor's was closed - their out of hours ansamachine gave me the number to call. It's an integral part of our National Health Service which partly serves to help prevent hospital A&E units getting blocked up with trivial stuff but also acts as a screening device for the provision of emergency doctors visits.

Hospital accommodation and operation were both obviously at no cost and I got a refund from my private medical insurance for use of an NHS bed instead of the extortionate cost it would've been to them for a private bed and room. I enjoy the company of others anyway but I was bored by the Tuesday 2 days later so got checked out and a taxi back home - just slept on the sofa for a few days cos I couldn't face walking up the steep staircase in my Victorian cottage.....lol.

BTW - our NHS is not FREE but it is universal so it covers all children and adults too who do not contribute for whatever reason - retired, unemployed whatever. Cost is born by 11% of employee's gross wages 12.8% of employers same :
both above amounts of c. £5000. Been more or less like that, other than current percentages and initial start point, since 1940's when it started. Just another tax really which covers State retirement pensions and other benefits too such as incapacity to work benefit etc. :hi:

edit - meant to give you this link ; http://www.nhsdirect.nhs.uk/

[sandnsea]

22. What does it cover?

Because we pay 6.2% for social security retirement, and then 1.45% for Medicare for seniors and disabled, and business pays the same. That's on ALL income, although we have an earned income credit which kicks it back for very low income people. Unemployment and workman's comp for injuries is through the state and is paid mostly by employer, although sometimes employee too.

So do you pay 11% for all of that - plus you get health insurance too?

[dipsydoodle]

25. In terms of healthcare

everything you could possibly imagine from being hospitalised for 2 weeks when I was mown flat by a car when I was 5 years old, lol , to my wife's first brain operation when they didn't realise she was covered privately anyway. Not sure if it still applies but when my daughter was born '69 we were getting free orange juice for young minors too. Some , but not all , dental work is also covered. I suppose they might draw the line at hip replacements for a ninety year old but they do them for eighty year olds anyway. From age sixty all prescriptions become free as well.

We just take this all for granted as its always been there for most of us.

Our own and the employers NHS payments / contibutions are just another tax on top of personal income tax and and rate changes these days are regarded as being stealth taxes. Not all receipts go to healthcare etc. War in Iraq would've been partly funded from this. x(

[Aristus]

21. yoo frickin' COMMY!!11do yo want COMMINISTMARXIST HELTH CARE in merica???/?

Not with my tackses!1!! id rather dye!!11! soshul medisin is frum teh devvil!!11!



:+

[Warpy]

12. Now there's a great lawsuit!

Paramedics are trained to deal with a wide variety of emergencies and they're very good at that, but they are not trained to diagnose anything beyond a rhythm strip. Like sharp nurses, they can suggest things to work up to doctors, but that's the end of it. The doctor is the diagnostician.

This should never have happened. Anybody with enough pain to call paramedics needs to be seen by a doc. If it's gastric reflux to that extreme an extent or gall bladder pain or even gas, it needs to be seen and that patient needs to be counseled about what to do about it.

[TwilightGardener]

15. Right--even RN's in the ICU and telemetry, reading rhythm strips and

staring at monitors all the time, can only ALERT to problems--they can't officially diagnose and treat, and if someone is reporting symptoms, then you WATCH and LISTEN TO THE PATIENT, rather than dismissing their complaints because of what you see on the monitor or their vital signs--you'd call the doc and get a 12-lead EKG for him to read right away, at the very least (in a facility). These guys were idiots--way overstepped their scope of practice.

[petronius]

17. Let me guess: a black guy? Perhaps a bit overweight?

There is such a blitz of information out there about how chest pain is not something to ignore, and when this guy does the right thing he gets blown off. What a fuck up...

[MsLeopard]

19. And equally important

Did he have insurance?

[petronius]

20. Indeed, another very good question...

Would it be a productive use of time to speculate on whether the answer to that one is 'yes' or 'no'? :(

[sandnsea]

24. And did it cover ambulance transport?

That was my thought too. He got the ambulance there because he was scared, got the read-outs from the EMT's, and then decided not to go because of money. I think we need to be talking to EMT's about how many people are using them as the emergency room now.

[hedgehog]

23. You took the words right out of my mouth!