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  1. #1
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    Angry Irresponsible Reporting

    Tape: 911 operators did little to help dying woman in ER

    http://www.cnn.com/2007/US/06/13/hos....ap/index.html


    CNN at its finest. I love how this article is construed to be the 911 dispatchers fault for the woman's death. The fact that the hospital she was in let her die is not the main focus of this article.


  2. #2
    MembersZone Subscriber firefighterbeau's Avatar
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    I would go as far to blame the dispatcher fully, I would have expected more than just sorry your already at a hospital we cant send anyone. If it was me dispatching, take the info tone out the nearest ambulance service and fire. When you call 911 you expect to get help! If I remember right thats why that number was created. The hospital is definately to blame but the dispatcher didnt help at all.

  3. #3
    MembersZone Subscriber dday05's Avatar
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    This situation is unfortunate, and it is sad that someone lost their life. Sounds like some people need to be evaluated at the hospital and the 911 dispatching center.This is all I will say at this time.

  4. #4
    Forum Member CdnFD24's Avatar
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    911 is a business. They are there to collect information from a caller during an emergency, then, forawrd that information to an emergency service (as per pre-determined protocal) when they dispatch them to the scene of the emergency....simply put.

    911 operators are not there to play doctor. This operator clearly played doctor by making the decision not to dispatch emergency care providers.

    This operator seemed to know alot more about the situation than the caller did...over the phone....which is very odd to me. If this operator only sees a job loss as a result of their impotence, then I'd be suprised.

    Like I said, they collect information from the caller, then forward that same information to an emergency care provider.

    They don't collect callers information, review the information, then make a quick decision on whether or not to call ECP's.

    "Vomiting blood"...."Dying"....sould be enough information for the operator to step up action and follow their protocals.
    "You see things and you ask, 'Why'? I dream of things that never were and I say, 'Why not'?

    "I used to work in a fire hydrant factory. You couldn't park anywhere near the place."

    "When you are kind to someone in trouble, you hope they'll remember and be kind to someone else. And it'll become like a wildfire."

  5. #5
    Forum Member CdnFD24's Avatar
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    I'm not saying the operator is 100% to blame. Obviously this situation never would arise if hospital staff were doing what they should be doing. But the operator is accountable just the same for not doing their parts as well.
    "You see things and you ask, 'Why'? I dream of things that never were and I say, 'Why not'?

    "I used to work in a fire hydrant factory. You couldn't park anywhere near the place."

    "When you are kind to someone in trouble, you hope they'll remember and be kind to someone else. And it'll become like a wildfire."

  6. #6
    Forum Member kprsn1's Avatar
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    I gotta stand up for the dispatcher on this one. C'mon what exactly is she supposed to do? The person was at the hospital. No doubt it was an unfortunate incident and the hospital is and should be in serious trouble but the dispatcher's fault? I don't agree.

    911 Center: "911, what is your emergency?"
    Caller: "My house is burning down!"
    911 Center: "I'll notify the fire department"
    Caller: "They're already here!"
    911 Center: "Then how can I help you?"
    Caller: "Send another department! This one sucks and they're letting my house burn down!"
    Click.

    Exaggeration? Maybe, but I don't think dispatchers should be singled out for some organizations not being able to do their jobs.
    SFPD Member MABAS Division 47
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  7. #7
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    Quote Originally Posted by kprsn1 View Post
    911 Center: "911, what is your emergency?"
    Caller: "My house is burning down!"
    911 Center: "I'll notify the fire department"
    Caller: "They're already here!"
    911 Center: "Then how can I help you?"
    Caller: "Send another department! This one sucks and they're letting my house burn down!"
    Click.
    What about this call

    911 Center: "911, what is your emergency?"
    Caller: "I am at the police station, a man just walked in with a bomb strapped to his chest and started shooting people"
    911 Center: "Well there are already cops there, nothing I can do!"
    Click...

    Your example has nothing to do with the case in hand, at least in your example the person was being helped. The fire department is supposed to respond after a 911 call and they did. But sometimes you need additional resources then whats present.

    In this case the person is sitting in a waiting room, not being seen by medical personel. 911 was called and NOBODY came.

    There are two entities at fault here: The 911 system who did not respond to an emergency. And the hospital who did not treat an emergency. But lets focus on the 911 system here:

    This certainly would not have been the first time I would have been dispatched to run Code 3 to a hospital ER waiting room for an emergency.
    Granted: Every call I ran so far in a waiting room was a smart-***** person with a problem their PCP could take care off who just got tired of waiting. They thought that because the ambulance is there they would get an automatic ride to another ER and get seen right away. And granted: After WE evaluated them, we would take them to another ER, and drop them off at the Triage Desk (Transfer Care to Hospital) and they would politely tell them to take a seat in the waiting room.

    The point is: WE got called, WE were able to see and touch the patient, and then WE could make a decision about what to do with the patient, not somebody in dispatch who only talks to the person.

    Dispatch is hard, Dispatch is underappreciated, Dispatch probably feels like it is the Bastard Child of the whole system. We don't let them know enough what a great job they do. But sometimes you have to remember that you are only using your sense of hearing to try to determine how emergent a situation is. Get some people on the scene to find out firsthand what is going on.

    This brings back memories from the dispatcher that let the BBQ place burn down.

  8. #8
    IACOJ BOD FlyingKiwi's Avatar
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    C'mon what exactly is she supposed to do? The person was at the hospital
    Read it again.

    There were TWO seperate dispatchers a male and a female.

    And how did you miss THIS wee gem in the first recording.

    OK, and why aren't they helping her?" the dispatcher asked.

    "They're watching her there and they're not doing anything. They're just watching her," Prado said.


    Now that is enough to say "There is a life at risk here"

    This Dispatchers job is to recieve calls and respond the appropriate emergency services.

    In this case an Ambulance.

    Second dispatcher then gets this

    "She's definitely sick and there's a guy that's ignoring her," the woman told a male dispatcher.

    He then has the bottle to ARGUE about if the person was sick?????

    Here is a clue,
    1. Writhing in pain on the floor.
    2. Bleeding from the mouth.

    Nah, she is a healthy as, no worries mate, give her an asprin.

    Yes the dispatchers filter calls, but making judgement calls that big is a whole new level of SHTUPID.
    Last edited by FlyingKiwi; 06-13-2007 at 05:52 PM.
    Psychiatrists state 1 in 4 people has a mental illness.
    Look at three of your friends, if they are ok, your it.

  9. #9
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    And two additional things that are not going to help the 911 system's side of the story any: (From CNN)

    1st The Dispatcher:
    During the call, the dispatcher argued with the woman over whether there really was an emergency.

    "I cannot do anything for you for the quality of the hospital. ... It is not an emergency. It is not an emergency ma'am," he said.

    "You're not here to see how they're treating her," the woman replied.

    The dispatcher refused to call paramedics and told the woman that she should contact hospital supervisors "and let them know" if she is unhappy.

    "May God strike you too for acting the way you just acted," the woman said finally.

    "No, negative ma'am, you're the one," he said.
    My emphasis, I'm not even going to elaborate on my opinion about that comment. The caller should not have said that, but we as emergency workers are held to a higher standart.

    2nd the police response
    County and state authorities are now investigating Rodriguez's death. Relatives reported she died as police were wheeling her out of the hospital after the officers they had asked to help Rodriguez arrested her instead on a parole violation. Sheriff's Department spokesman Duane Allen said Wednesday that the investigation is ongoing.
    But the hospital is also getting its due:
    Federal inspectors last week said emergency room patients were in "immediate jeopardy" of harm or death, and King-Harbor was given 23 days to shape up or risk losing federal funding.

    Dr. Bruce Chernof, director of the county Department of Health Services, which oversees the facility, has called Rodriguez's death "inexcusable" and said it was "important to understand that this was fundamentally a failure of caring." He has said conditions are improving, though.

    Dr. Roger Peeks, the chief medical officer at the hospital, was placed on "ordered absence" Monday, the Times reported. Health officials declined to elaborate, saying it was a personnel matter. Dr. Robert Splawn, chief medical officer for the health department, was named interim chief medical officer, the newspaper said.

    There were many people at fault here. And this is gonna get a lot worse before it gets any better.

  10. #10
    makes good girls go bad BLSboy's Avatar
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    Whoa there guys. Anyone remember EMTALA? Im fairly sure that an ambulance canNOT go into a hospital and touch a pt. They are the hospitals responsability. If the pt wants to leave AMA and walk outside and call, thats fine. If hospital want to call, we can do that. But in order for a pt to be taken from a healthcare facility, pt care needs to be ceeded to us, and and EMTALA form needs to be in hand. Think I am joking, go ahead and try it. Hospital is to blame. When you step foot in ED, you are technically under care. It sounds like this woman was under care of triage RN. And she f*cked up. Majorly.
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  11. #11
    Forum Member kprsn1's Avatar
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    You can make all the arguments you want but it still does not shift the blame of this hospital failing the patient to the 911 dispatcher. As BLSBoy put it the hospital is the final step. Sign out, go outside, and call 911. I'm all for higher standards for anyone in the emergency profession but to place blame on this dispatcher or dispatchers for the inability of this hospital staff to admister care is in my opinion ludicrous. Why is the argument getting past point one: The hospital failed to render appropriate care to point two: The dispatchers didn't help.? Take care of point one and there is no point two. I'm done with this.
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  12. #12
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    Quote Originally Posted by BLSboy View Post
    Whoa there guys. Anyone remember EMTALA? Im fairly sure that an ambulance canNOT go into a hospital and touch a pt. They are the hospitals responsability. If the pt wants to leave AMA and walk outside and call, thats fine. If hospital want to call, we can do that. But in order for a pt to be taken from a healthcare facility, pt care needs to be ceeded to us, and and EMTALA form needs to be in hand. Think I am joking, go ahead and try it. Hospital is to blame. When you step foot in ED, you are technically under care. It sounds like this woman was under care of triage RN. And she f*cked up. Majorly.
    EMTALA is in place to protect the patient from the hospital. It states that the hospital is not allowed to FORCE a patient to leave the hospital and transfer them somewhere else unless the gave stabilizing treatment first within the scope of their abilities. EMTALA was enacted because hospitals were not taking care of patients that didn't have insurance and were just punting them from hospital from hospital. Read the EMTALA sign at the outside of the ER door next time you pull up. EMTALA does not prevent us from caring for a patient., it prevents the hospital from dumping a patient. It does not prevent us from seeing a patient that has requested our presence there.

    The patient has a choice in picking his healthcare provider, to seek consultation, to participate in his plan of care, to disagree with his plan of care, to request discharge, to make desicions in his treatment. These are all federally protected rights in the "Patients Bill of Rights" This patient made the decision to disagree with his providers plan of care, which was "ignore the patient" and was seeking consultation "EMS" to provide transfer. These are all the patients rights.

    From the EMTALA regulations:
    Transfer means the movement (including the discharge) of an individual outside a hospital's facilities at the direction of any person employed by (or affiliated or associated, directly or indirectly, with) the hospital, but does not include such a movement of an individual who (i) has been declared dead, or (ii) leaves the facility without the permission of any such person.

    EMTALA places the burden of proof on the hospital as to WHY they discharged a patient. It does not require us to have their permission to touch a patient.

    I guess if you are colapsed on the floor, throwing out blood, and can't move out the waiting room you will just die on a technicality.

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    Quote Originally Posted by kprsn1 View Post
    I gotta stand up for the dispatcher on this one. C'mon what exactly is she supposed to do? The person was at the hospital. No doubt it was an unfortunate incident and the hospital is and should be in serious trouble but the dispatcher's fault? I don't agree.

    911 Center: "911, what is your emergency?"
    Caller: "My house is burning down!"
    911 Center: "I'll notify the fire department"
    Caller: "They're already here!"
    911 Center: "Then how can I help you?"
    Caller: "Send another department! This one sucks and they're letting my house burn down!"
    Click.

    Exaggeration? Maybe, but I don't think dispatchers should be singled out for some organizations not being able to do their jobs.
    While I know what you're saying, take a look. An example where, perhaps, a dispatcher should find out what's going on exactly.

  14. #14
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    Quote Originally Posted by kprsn1 View Post
    Why is the argument getting past point one: The hospital failed to render appropriate care to point two: The dispatchers didn't help.? Take care of point one and there is no point two. I'm done with this.
    Point one: Jimmy-Bob shot Dale.
    Point two: The Dispatcher didn't sent an ambulance.

    Why is this argument getting past point one? Keep Jimmy-Bob from shooting people, and there is no point two.......

  15. #15
    makes good girls go bad BLSboy's Avatar
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    Quote Originally Posted by MarcusKspn View Post
    EMTALA is in place to protect the patient from the hospital. It states that the hospital is not allowed to FORCE a patient to leave the hospital and transfer them somewhere else unless the gave stabilizing treatment first within the scope of their abilities. EMTALA was enacted because hospitals were not taking care of patients that didn't have insurance and were just punting them from hospital from hospital. Read the EMTALA sign at the outside of the ER door next time you pull up. EMTALA does not prevent us from caring for a patient., it prevents the hospital from dumping a patient. It does not prevent us from seeing a patient that has requested our presence there.

    The patient has a choice in picking his healthcare provider, to seek consultation, to participate in his plan of care, to disagree with his plan of care, to request discharge, to make desicions in his treatment. These are all federally protected rights in the "Patients Bill of Rights" This patient made the decision to disagree with his providers plan of care, which was "ignore the patient" and was seeking consultation "EMS" to provide transfer. These are all the patients rights.

    From the EMTALA regulations:
    Transfer means the movement (including the discharge) of an individual outside a hospital's facilities at the direction of any person employed by (or affiliated or associated, directly or indirectly, with) the hospital, but does not include such a movement of an individual who (i) has been declared dead, or (ii) leaves the facility without the permission of any such person.

    EMTALA places the burden of proof on the hospital as to WHY they discharged a patient. It does not require us to have their permission to touch a patient.

    I guess if you are colapsed on the floor, throwing out blood, and can't move out the waiting room you will just die on a technicality.
    OK, lets just pretend that she dispatched an ALS response. Lets just play. You AOS, make pt. contact. You stabilize. Now what?

    I was taught to get an EMTALA form for every pt. we take from hospital. Why? It is a Dr. saying why this pt could not be treated at that facility for their illness/injuries.

    EMTALA also states "you have a right to be stabilized then transfer." Or something to that affect. I cannot remember off hand. However, you want me to pick up an unstable pt from an ED and take them to another one? Not gonna happen. The 911 dispatcher should have called the facility the pt was at. Not dispatched anyone. When you enter a healthcare facility, you get stabilized.
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  16. #16
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    I can't believe this is even a discussion trying to blame the dispatch center. It is true this is unfortunate. But if you call me and tell me you are in a Hospital and you need medical help I will think it is a prank call. The paramedics have already turned the lady over to medical staff with more training. One would assume that the hospital staff evaluated the person in question. The only people to blame here are the hospital people, 911 dispatch is totally blameless.

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    Don't know about other places, but as I was informed today, here in my neck of the woods, you can call for an ambulance via 911 from the trauma room, and request to be taken elsewhere, if you feel you aren't getting the care you need.

    So here, the dispatcher's, hospital, and sherriffs deputies would all be held accountable.

  18. #18
    Forum Member t0asty's Avatar
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    I don't know much about dispatch operations but I don't believe that dispatch is the one to blame. I would like to read the dispatch log though to find out more about the calls and not trust CNN or FOX or MSNBC about what was going on. But all that this is besides my main point. Could they not call a private service like AMR or Tri-Med to get transfered to a different hospital? Just a question.
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  19. #19
    MembersZone Subscriber mcaldwell's Avatar
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    I have to agree that IMO (which is neither informed, nor qualified ), this is a major hospital problem, worthy of "heads and jobs", and a minor dispatch problem, worthy of a "review of procedure".

    In a perfect world, with a perfect call volume, and a perfect attitude by every Health Care worker, this wouldn't have happened. But I have to ask this:

    If someone called 911 for assistance, and recieved a dramatically delayed response because the nearest crew was sent to the Hospital and tied up for a looksee on this call, would you consider the failure of the EMS (Ambulance) system to be for the pt in the hospital, or the pt in the home?

    I think the pt in the Hospital has a chance, the pt in the home does not. I can "potentially" understand why the dispatcher did not tie up a unit on this type of call.

    I guess if the service had multiple units in the station, and no other priorities, a looksee would be fine. But ultimately, the Hospital screwed this pooch and should pay the price. The dispatch issues are for the oversight committee to review and approve/disapprove the existing protocol.
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  20. #20
    Forum Member jlcooke3's Avatar
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    There is more than enough fault to go around in this case. The first point of failure occurred at the hospital. Every time I have gone to the ED for an injury or illness, I had to check in with 1. a triage nurse who evaluated my condition and 2. somebody to collect info so I can get a bill. IMO, once the triage nurse evaluated the pt, the pt. become the responsibility of the hospital and is now under the care of a nurse. The second point of failure is with the dispatcher. Once an individual calls 911 the dispatcher has a responsibility to provide the appropriate assistance to the caller. A key point would be that the pt was lying on the floor writhing in pain and vomiting blood. As a dispatcher I would have 1. made contact with either the chare nurse or a doctor and tried to ascertain as to why the pt wasn't being seen, 2. Contacted the EMS supervisor and request input from the supervisor, and 3. if unable to get satisfactory answer out of either one, send an ambo and let someone else deal with it. The third point of failure was with the sheriff's office the officer's should have been able to recognize that the pt was as sick as she appeared and request that she be tended to.

    Placing blame on one individual or one component is doing an injustice to the problem as a whole. The basic problem isn't a failure of the hospital, the dispatch center, or the sheriff's office. The basic problem is that individual didn't care enough about there fellow man to help them when they needed it most. This is just indicator of the overall apathy our society has.

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