Tag Archives: liability

What the fuck do you want me to do about it?

Code 3 for shortness of breath. At the university, in a classroom.

Typical.

I think I’ve only ever been to 2 actual medical emergencies at the university. IN YEARS.

We walk into the classroom full of people and find… exactly nothing. Everyone appears healthy.

“Soooo, who called 911?”

“I did,” the instructor speaks up.

“And what for?”

I’m just asking an innocent question, since there obviously is no medical emergency visible to the naked eye.

“She was coughing a lot,” the instructor points toward a student.

“Well, she’s obviously fine.”

“I AM fine,” the student corroborates, “I’ve just had a cough for a few days.”

“Yeah, that’s going around – it took me a month to get over my cough,” I add to the small talk.

“She was coughing so much it was disrupting the class.”

“You couldn’t have asked her to step outside for a second?”

<Silence>

“And instead you called 911?”

“She seemed like she couldn’t breathe,” the instructor weakly offers.

“Did you even ask her if she wanted a 911 response?”

<Silence>

“She did not ask me.”

“And what do you want me to do about this?”

<Silence>

“I’m fine, thanks.”

“We’re leaving.”

Guess who abuses 911 even more than civilians?

You shouldn’t be surprised.

Readers from San Jose, California have brought to my attention this piece from NBC Bay Area’s Investigative Unit, which aired recently about a clinic 213 yards away from an emergency room belonging to the same health system on the same campus AT THE SAME ADDRESS that routinely used 911 as transport instead of just pushing a wheelchair or a gurney over there.

Obviously, those of us who actually work 911 already know that this isn’t really that out of the ordinary. Clinics are some of the worst abusers of 911, along with doctors’ offices, drug rehabs, nursing facilities, staffed elderly living facilities, psychiatric group homes, homeless shelters, schools (where they have nurses), jails (where some even have doctors), etc. When confronted and asked to explain themselves, they always use as their excuse “liability” and “protocol.”

Civilians abuse/misuse 911 too, but they’re civilians, and we don’t expect them to know any better. People who know better don’t misuse 911; they abuse 911.

One of the best parts of the story has got to be Dr. Jeffrey Arnold, the Chief Medical Officer at Santa Clara Valley Health and Hospital System, who claimed with a straight face that he had no idea this was going on at the clinic. He also attempted to shift the blame onto EMS by, more than once, saying that someone could have said something sooner to “medical leadership here,” which is completely laughable as we all know this type of stuff has been plaguing all sorts of EMS systems for a long, long time without anyone in management actually doing anything about it no matter who we in the field complain to, including the press. Watch this story lead to exactly zero improvements.

“I think taking somebody by ambulance is the safest way to transport them,” Dr. Arnold insisted. “It is very typical for large health systems, large campuses, to use 9-1-1 to call for emergency assistance. It did not register as something unusual.”

Except most of these calls are not for emergencies and staff could have just walked them over to the ED, assuming the ED needed to be involved in the first place. I mean, I don’t take an armored car to the bank to deposit money even though it “is the safest way” too; I drive myself. Sometimes I even walk.

I wonder what the ED staff would say about all this. That particular ED is very busy even without this flood of non-emergencies and is so infamous for 2-hour destination delays for ambulances that crews would do anything and everything to avoid transporting patients there.

Now, the EMS director for the county did not respond to questions from the Investigative Unit, and I think that is a huge missed opportunity. Santa Clara County’s EMS Agency even has what is known as EMS Reference 808, which is a document they wrote specifically as a guide for such facilities to interfacility transports. It’s certainly one of the more detailed documents on the subject, and the fact that they even have one is slightly uplifting and somewhat surprising considering the general wussiness of EMS managers everywhere.

Download (PDF, 381KB)

Now if only bureaucrats everywhere would grow some balls and stop giving us so many reasons to dismissively roll our collective eyes at the status quo.

CYA culture run amok

One of my most hated things is going to the airport for calls. Some of the most ridiculous calls I’ve been to were at the airport. In short, airlines love passing the buck to 911 so they can cover their asses.

Obviously, many of you are familiar with this phenomenon of entities calling 911 so they can pass on the liability. Not just airlines, but doctor’s offices, schools, SNFs, dorms, rehab, shelters, group homes, buses, trains, taxis, etc. Basically everyone. Instead of THINKING, it’s easier to press a few buttons on the phone and let someone else take care of the problem. Just because it’s ubiquitous doesn’t mean it’s right.

By now I’m sure many of you have heard of The Great You-Can’t-Fly-Alaska-Airlines-If-You-Have-Cancer Incident. Basically, on Monday, Elizabeth Sedway, a woman with a 5-year ongoing battle with cancer, was kicked off her flight home after Alaska’s on-call doctors said she didn’t have a doctor’s note and wasn’t fit to fly. Of course, as usual, Alaska said it was “policy” to consult with their on-call doctors, who obviously remotely determined that she was too ill to fly. Good job. A monkey can do that. Stranded in Hawaii, she then missed chemotherapy back home in California on Tuesday, and her husband and kids missed work and school.

Like Ms. Sedway said, in more polite words, how the fuck did Alaska think she got to Hawaii in the first fucking place?

This is just like those stupid advice line nurses who insist everyone who calls them calls 911 instead.

So what if she had a doctor’s note? Is the note a guarantee that absolutely nothing bad will happen? Can you blame her doctor if something happens to her while having a note in her possession? What about everyone else on the plane who doesn’t have a note? Shouldn’t they have notes to guarantee that they won’t have a medical emergency? If airlines are so worried about safety, isn’t there more of a chance that some drunk asshole will disrupt the flight instead?

Touché, sir. Touché.

Code 3 for female unconscious in a cab.

“M17, RP is reporting that he does not want to wake the subject up.”

“Well, why the hell not?”

So a young woman is drunk and asleep in the back of the cab in front of her residence. We wake her up and send her inside with her family.

“So why didn’t you just wake her up?”

“I don’t want her to say tomorrow that I touched her.”

I got nothing.

No one can argue with that.

This has got to be the line of the year

Code 3 for rectal bleed. At the drug rehab. Nearly midnight.

A male in his 20s is sitting in the office, in no apparent distress, as usual.

“All this for me?”

We just drove code 3 for this guy for no good outward reason. Don’t piss me off with stupid comments like that.

“That’s what happens when you call 911. What are we here for?”

“I have hemorrhoids and it ripped, so it just bleeds when I wipe.
Can’t I just get a ride from my girl?”

“I don’t see why not.”

“Well, they won’t let me.”

These drug rehabs are so stupid sometimes. I’m sure it’s their “policy.” It’s not uncommon for these “clients” to be in rehab because of conditions of their sentencing, so these facilities are responsible for keeping them there, but really, these are adults, and if they don’t want to act like adults – well, hey, adulthood comes with choices, and choices come with consequences.

“Are you here as part of a court arrangement?”

“Yeah.”

“That’s probably why.”

I wait for the only staff member present to get off the phone.

“Why can’t he get a ride from his girlfriend?”

I already know he’s not going to be allowed to get a ride, but I ask anyway, just to make a point. The point being how ridiculous this situation is.

I have to amuse myself somehow.

“The director said it’s either 911 or wait until tomorrow.”

“What’s tomorrow?”

“Tomorrow, daytime, we have transportation for him. He said it hurt, so we called you guys tonight.”

“Alright, let’s go.”

There you have it, the line of the year, “It’s either 911 or wait
until tomorrow.”

Go back to fucking bed

Code 2 for numb finger. It’s 3am.

You have got to be fucking kidding me.

Two minutes later…

“M18, the caller is requesting cancellation.”

You don’t have to ask twice. Good thing we haven’t left the station yet.

I can only imagine that conversation between the caller and the dispatcher. I know if I was taking that call there’d be all kinds of awkward pauses. And hopefully no profanity.

***

Code 2 for allergic reaction to meds. At the drug rehab. Again. It’s 4am.

A “client” is sitting in the lobby. As usual.

“I took my meds and my face feels numb.”

Psych meds.

“You can feel me touching your face, right?”

“Yes.”

“So what do you mean by numb?”

“My fingers feel numb too.”

I leave the room. I can’t take this place. I hear the staff behind me.

“Sorry but we had to call. We’re not doctors.”

“Hey, do you guys EVER tell your ‘clients’ to just go back to bed instead of calling for EVERY little thing they say is wrong with them?”

Explaining Public Safety to Civilians #2: Ingrates

Getting sued when someone is boo-boo butt-hurt, whose feelings are hurt:

The most common one has got to be civilians calling cops for some violent behavioral/psych subject – usually a family member – and then complaining when the cops use force to mitigate the violence.

If you don’t like it, don’t call us and handle your own shit.