Not my patient

Have you heard of the Addison Chess case involving EVAC Ambulance in Florida and the $10 million in punitive damages?

Even now, months later, I still have a hard time digesting this case. It makes me very uncomfortable.

And it absolutely should make EMS agencies uncomfortable too. Only I don’t see much of that discomfort. In fact, most people have not even heard of this case.

Last month, a Volusia jury held EVAC liable for transporting Margarita Chess, six months pregnant when she gave birth to her son in the ambulance en route to Arnold Palmer Hospital for Children in Orlando. The boy, Addison Chess, survived but suffered brain damage and has cerebral palsy.

In 2003, Chess, who lives in southeast Volusia, had originally come to the emergency room at Bert Fish Medical Center in New Smyrna Beach for premature labor pains. But the doctor there, Dr. John Milton, decided to transfer her elsewhere because his hospital didn’t have an obstetrician or the right equipment to handle a premature baby, according to court records.

Milton talked to Dr. Thomas Stavoy, an obstetrician for Halifax Medical Center in Daytona Beach, but he didn’t accept the transfer, deciding that Halifax wasn’t the right hospital for such an extremely premature baby. EVAC was called to transport Chess to the Orlando hospital.

Some more details here at Verdict Search and JEMS.

I sat in a class once and heard W. Ann Maggiore describe this case as nothing but tragic for everyone involved, a case in which the ambulance crew performed admirably but was likely deemed to be grossly negligent by an emotional but ignorant civilian jury simply because a baby is now disabled.

This raises a lot of questions that have no real answers. As far as I can tell, this jury is saying that patients should be kept at the sending hospital and hope for the impossible instead of getting transferred to another hospital for the specialty care that they need. Never mind that the sending hospital initiates the transfer because they know they don’t have the appropriate expertise and equipment.

Over at the CafeMom website, we actually have mothers who are responsible for children posting some of the following:

Snippet of hopelessly dumb but self-righteous comments

One can only pray that people figure out which hospitals have labor and delivery capabilities and which hospitals don’t before they – God forbid – need to suddenly go to the hospital for their labor and delivery needs. Because here we come, mindful of the Addison Chess verdict, to refuse the transfer.

“Sorry, the Chess jury said no transfers – remember? Not my patient. Good luck. Bye.”

2 thoughts on “Not my patient”

  1. As the saying goes, bad cases make bad law. I’ve heard bits and pieces of this case, but not enough to draw any conclusions about the facts or the law. I have no doubt that this will be appealed. Whether that will be successful or not, I have no way to predict.

    Ideally, the receiving hospital would have sent a high risk team to the sending hospital to oversee the transport, but we know that doesn’t happen very often.

  2. This case is a prime example of why lay people are lousy at medical decsionmaking. It sounds like this was a situation where no matter what was done it was not going to turn out well and somebody must be responsible. I feel for the mother but given even the small amount of detail about the situation, this was going to be a sick kid with a very difficult road ahead. I don’t see that EVAC could have done anything to have changed the outcome, and would they have incurred a legal liability by refusing the transport and forcing the mother and child to recieve care at a hospital that was not equipped to deal with the situation and made a good faith attempt to get her transferred elsewhere?

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