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Investigation after death of elderly woman in Washington, DC. WTOP Radio reports medic on leave after failing to accompany patient to hospital.

From WTOP's Mark Segraves

A D.C. paramedic has been placed on leave and an investigation is under way after an 87-year-old woman died at a local hospital.

The incident occurred Nov. 17 when D.C. Fire and Emergency Medical Services responded to a call for a woman experiencing abdominal pains.

A fire engine and ambulance from Engine Company 11 — located at 14th Street and Park Road NW — responded to the call. According to sources familiar with the investigation, the paramedic who arrived on the fire engine determined the woman's condition was not serious and declined to accompany her to the hospital, despite the request of ambulance personnel that the paramedic stay with the patient.

The ambulance unit took the woman to Howard University Hospital, where she later died of an apparent heart attack. Her official cause of death is still to be determined.

Fire and EMS Chief Kenneth Ellerbe tells WTOP the medic who declined to stay with the victim has been placed on administrative leave with pay.

"I do take this matter very seriously," Ellerbe said. "The employee has been placed on administrative leave pending further action and there is a very serious ongoing investigation."

Howard University Hospital spokesman Ronald Harris says the woman did not die in the hospital waiting room as previously reported, but was seen by a doctor and a cardiologist just before her death. Harris says the hospital is looking into the matter.

The medic in question is a five-year veteran of D.C. Fire and EMS and is classified as an "intermediate paramedic," which is the a grade between emergency medical technician and paramedic.

Ellerbe says he personally briefed Mayor Vincent Gray about the incident.

"The mayor wants a quick resolution to this investigation," Ellerbe said.

The case is similar to the death of David Rosenbaum, who died in 2006 at Howard University Hospital after first responders failed to properly assess his condition and hospital staff failed to provide immediate treatment. An inspector general's report called the Rosenbaum incident "an unacceptable chain of failure."

Rosenbaum's family agreed to drop a $20 million lawsuit in exchange for improvements in the District's Fire and EMS protocol. Ellerbe says part of the investigation will be to determine if those protocols were followed in this latest incident.

Comments - Add Yours

  • pipeman

    How is this case similar to the Rosenbaum case? Are you sure you have all the facts? Way to stir the pot.

  • Just Sayin

    The ambulance was not from Engine 11

  • Baconater

    I don’t know what the protocols are for intermediates in DC, but up here in WNY the only thing I would have been able to do for this lady is oxygen, aspirin, and IV access. This would not change the outcome of her situation. Also, if the patient was seen by both a doctor AND a cardiologist previous to going into cardiac arrest as the article states, one would think she had been there for some time. I don’t see how the intermediate in question here can be held responsible for an 87yo woman dying in the ER after being seen by not one but two MDs. Sounds to me like someone is trying to shift the blame for her death to the bottom of the totem pole here. I wonder who it was that made this an issue in the first place…

  • clad cromwell

    The cases are similar in that both patients died after they had been seen by a physician at H.U.H.
    Lets see if lrb ( yes, I meant to use lower case) lets the mayor and H.U.H. push him around like the last visitor.

  • James

    Obviously that magic normal saline would have stopped a 87 year old woman from passing away from what seems like natural causes. The only thing they can get this poor guy on is not transporting with the basics. Other than that it sounds a lot like they’re blaming the guy that makes 40k a year. Too bad.

  • Dayton Dowd

    sign of the times. non caring ambulance stagers and 10mph code 3 runs. And walk very slow. It's digcusting.
     

  • liveevil

    The lady was probably not seen by a physician right away because she came in with no ALS observance, with a complaint of abdominal pain.  An ALS provider should have ruled out an atypical presentation cardiac event secondary to her age…and would have been able to give the hospital a better assessment…hospital stafff does not know if an EMT is ALS or not…they assume, because ALS is available at all FD's, that they are.  This is typical of "I HAVE to be a medic because I WANT to be a firefighter….and it sucks….I hope the city gets sued to hell and that the Rosenbaums can sue now, too, because obviously changes were not made, which should null their agreement…

    • CY

      I could not agree more, DCFD has been one to place the blame on others and I can tell you first hand, nothings changed nor will it. The last bunch of yo yos got rid of a program that was teaching EMTs to start IVs and administer basic drugs but that was cx  because of I  KNOW WHAT IM DOING  AND DO NOT NEED YOUR HELP MANTALITY

  • Stuart

    And…DC remains consistent (even the comments are the same). 
    Still don't see any obligation to do the job right. SIGH.

  • DCFD

    My grandmother died in the 90's but sometime during the late 70's she visited Washington DC. Therefore, I believe that she was not treated correctly by the city when she was sightseeing and this ultimately caused her death.

  • Sick and Tired

    Several points here – neither Fenty nor HUH ever pushed the prior Fire Chief around as he was too big of a bully himself to allow anyone to push him around.  Since HUH allegedly quietly paid off the Rosenbaum's, they have no motivation to out this incident since it shines the spotlight back on them.  The Rosenbaum family allegedly signed off on their ability to sue once the city made it look like they were making changes, so they probably have no recourse.   This poor lady may have died from natural causes, but it is the process of abandonment that this intermediate "appears" to have done that is a huge issue.  If she truly died from a cardiac issue that the intermediate could and should have recognized and acted on, then that should end his career.  It is a culture of apathy that appears to be pervasive in this agency that needs to end and this fire chief is not the one to do it.

  • not me

    Ellerbe says he personally briefed Mayor Vincent Gray about the incident.
    "The mayor wants a quick resolution to this investigation," Ellerbe said.

    And people are wondering why paramedics are leaving the department in droves.  The department will try to quickly fire this paramedic before all the facts are in and the Fire Administrator will use this as an opportunity to continue to push his asinine agenda. God I can’t wait for Gray to get voted out.

  • SOF

    It's obvious that DC FEMS is not going to be a cutting edge, evidence-based EMS system like Seattle or Boston.  It's going to be a service based on equal opportunity employment and fear of looking bad.  It NEEDS an all-ALS transport fleet, to avoid problems like this.  (Of course, it seems that a lot of problems could be avoided by not transporting to Howard Hospital).

    Starting tomorrow, the mayor should declare an EMS emergency, and call for an All-hands-on-deck for ALS personnel in the DCFEMS.  Get them out from behind desks, out of SUVs, and off of fire trucks.  Put them on each and every transport unit.  Make an emergency purchase of 10 more GSA ambulances, and put them on those, too.  If you've got any ALS left over, put the best ones in SUVs, and let them squirrel codes, GSWs, etc.   Give the Engine officers the tools to check the chute times and response speed of the incoming units — they'll take care of the foot-draggers.  Put a fire captain at the big hospitals, they'll take care of the sandbaggers.  It's not the way to save lives, but it is the way to show the public that you have sent an ALS provider to their percieved emergency.

  • Lucky

    First of all this is only similar to the Rosenbaum case in the regard that once again Howard University Hospital ED failed to properly monitor a patient.  As a former DCFD Medic I know first hand how they place people "in the back" and rarely check on them.  Once again HUH is trying to place the blame somewhere else, and because DCFD has no backbone to stick up for it's providers, it automatically blames the Paramedic.
    Shame on you Chief Ellerbe for not backing up your providers.  This just creates a dangerous and scary environment for your medics.  Your first instinct is to hang them out to dry, instead of looking at ALL of the facts first.  It's a wonder how anybody would want to practice being a medic in your department in which they have absolutely no support from management.

  • concerned resident

    Dave, I dont really care about this article because you seem to have used the WRONG patch as a cover photo for this article. I think you should of known better.

    • dave statter

      So sorry concerned resident. I will try to do better in the future.

      • Anonymous

         i'm sure you will summoned to the FEMS Administrators office for this transgression

  • Anonymous

    I think SOF is on to something.  A smart fire chief will figure out a way to get more resources to the citizens he is sworn to serve.  Medics on every transport unit, additional transport units, EMS supervisors on the street and at the hospitals and engine company officers with the tools to make sure they aren't the ones sitting on a scene waiting for a foot-dragging ambulance/medic crew to arrive.  What's not to like? 
    Common Ellerbe, show us what you've got.

  • Hydro Engineer

    MONDAY (Tuesday) MORNING QUARTERBACK's. The lady did not die jn the care of the DCFD. She died at H.U.H. the same place that killed Rosenbuam. We do not daignos, we treat symptoms. She needed to go to the doctor, They took her. She was alive when they left. SO I guess, all you "think you know better Medic's" If the EMT-I transported that would have saved her because he/she took her B/P

  • Gil

    Of course you can not put blame on the Howard they never kill any one.

  • Outta here

    DC FEMS is a breeding ground for anti EMS.

  • Anonymous

    The only feet dragging going on in transport units is the members feet in the morning after the beat down they just took.  I think these guys deserve a little more credit and respect for how much they actually do for the citizens of the District.  For the number of runs the DCFD takes and the amount of abuse of the healthcare system, there is always going to be a mess up somewhere.  From what we have been told so far, I believe this one wasn't due to lack of care from the DCFD.  According to the article, the woman arrived at the hospital alive and was seen by two doctors, one of which was a cariologist.  Let's just wait for the facts of the case before we decide to talk about how out of touch the DCFD system is.  

  • CY

    All I hear is Howard Hospital OK, How many times at GW, GEORGETOWN< PROVIDENCE, GSEH have you waited 40minutes or more for someone to triage your pt  Do not put the blame on one hospital when others are just as bad  I no I do not work for HOWARD

  • Anonymous

    The one that needs to be fired is the one who came up with the all BLS transport service with the primary ALS care coming from a single provider off the Engine. He set the ALS providers up for failure. All the people who come on here and say we don't care couldn't be more wrong. Our Companies take a beating all day every day. We are one of the most abused EMS systems in the world. The Administration only cares about how quick we can get ALS on the scene and not the quality of care. How can you expect one provider with 5 years of experience to make a critical decision to transport or not, on every run, usually well over 15 to 20 daily. I can't think of another system that requires this of their providers. ALS engines are supposed to be" FIRST RESPONDER" ALS PROVIDERS not the only and primary source.
    I'm sure this EMT I did not "refuse to go". People don't spend all that time getting certified to that level without some love for it. He or she probably made a bad decision based on initial assesment. Thats why an 87 y/o woman w/ CP should have had a ALS transport unit dispatched in the first place. I would have hoped the new Medical Director would have changed this by now.
    I can't solve all our problems in one post, but please people don't assume we don't care. I am an Officer on a very busy Engine and I see the tough hard work our men and women put in each and every day. Sure we are human and sometimes the tireless beatings and frequent abuse of the 911 system gets the best of us, but we do care and we are eager to do our job each and every run.
    My suggestion is to put a BLS unit in every multi company fire house for the Alpha and Bravo runs. The unit can be staffed by Company personnel under the direction of the Company Officer. As many 2 person ALS units as possible should be staffed to run Charlie Delta and Echo runs. Charlie runs should get a BLS first responder and Delta and Echo should get a ALS Engine first responder. These engines should be geographically placed according to need. All engines need not be ALS. Why have we not figured it out yet is beyond me. Finally for those that don't like my suggestion it is just that. A SUGGESTION. There are many ways that would work. The bottom line is that the system we use now does not! It is unfair to put our ALS providers in this situation.
     

  • Exasperated!

    Dave,
    You are missing the bigger scandal associated with this.  Apparently during recent training, several paramedics, including the one in question, did not produce the required results in a mandatory training exercise which involved shouting "Lazarus!!,Come Out!!"

  • Flymetothemoon

    You have to be kidding me right? 
    With broken down, beat up, and overutilized ambulances and overworked, underpaid fireman who never signed up to ride the ambulance in the first place does breed anti-ems. What kind of care does that set up for the patient? And then it is somehow the Intermediates fault when 12 leads arent taught in their natonal curriculum and DC doesnt even have the capabilities to take care of patient who actually presents with a full blown MI.
    For once the department should realize that staffing engines with paramedics and intermediates is a no win situation for both the department and the citizens. Make two tracts like Arlington and put the medics on 3/3/3. Then maybe you can actually treat people instead underutilizing a service that is screaming for help.
    The medic isnt the problem, a chief without a clue and a roll over medical director are.

  • Stuart

    It is simply amazing how many times we read the same comments when it comes to a DC patient death. What? We took her to the ER….she died there. What does that have to do with us?
    Proof positive that there is no reason DCFEMS or FEMS or whatever it is called now should be doing EMS in the city. It is an embarrassment to every PARAMEDIC in this country who understands their role and obligation. 
    Here is the basic run down….a basic crew repeatedly asked a higher trained individual to go to the ER with a patient. They weren't comfortable with her presentation. The engine "medic" didn't want to go. She DID die at the er because she was obviously seriously ill at the ER….in the ambulance…AND when the highest trained person there REFUSED to transport her. His/Her job was to be there for HER then. If it would have made a difference or not…we will never know. The point is he/she was supposed to TRY!!!!!!!!!!
     

  • DCFDmember

    Rosenbaum died when we were DCFD, so we changed to FEMS.  This 87 y/o lady died when we were FEMS, so I guess we need to change the department's acronym again.

  • DCFDmember

    I am wondering if there may be more to the story.  And how much of this is being misrepresented by the media like in the Rosenbaum case?  

  • pipeman

    Stuart, were you there? I didn’t think so, shut the f up a**hole. It’s tough enough working in this city without all you yahoos from god knows where piling on all the time. You think you can save everyone? This city will break you quick.

  • pipeman

    He/she can’t refuse to go with the patient. Somewhere along the line what really happened is getting skewed.

  • DCFDmember

    We've now read the media's version of this situation.  What do the ePRC patient reports say, what is said during the radio transmissions to the ELO prior to transport, and what does the patient's medical records at Howard say?  After being 'Rosenbaumed' by the media last time, let's see all the facts before passing judgement.

  • DCFDmember

    Hmm…Rosenbaum is delivered alive and although not conscious fairly stable to Howard.  His care is transferred over to the Howard ER staff and placed aside and ignored.  90 minutes later his condition worsens, and two days later he dies.  He dies from internal injuries which a pre-hospital provider would not have been able to do anything definitive about.  
     
    Now a lady complaining of abdominal pains is delivered alive and I'm assuming stable to Howard.  Her care is transferred over to the Howard ER staff and is seen by a doctor in the ER.  At some point she is also seen by a cardiologist.  At some point after being seen by the cardiologist she dies apparently due to a heart attack.  
     
    So, how is this on the DCFD and not Howard?  Both times the patients had their conditions worsen after having their care be transferred to the hospital, and in both cases the patient has their situation worsen a good amount of time after they had their care transferred to the hospital staff.  

  • DC member

    1. Have you ever taken a Pt to Howard even a priority pt ALS they make you wait then put you in the hall without even doing an assessment.
    2. Putting every Medic on an ambulance will not solve the problem there are days we run out of units all the time, are you telling me you are gonna have ALS units sitting at a hospital with stub my toe runs on their cots for 30mins while people who need ALS will be SOL, get real. There needs to be a whole system revamping. You will see medics leave in mass exodus if they sign paramedics full time to units then were will the ALS care come from. Put medics on a detail just like EMT's so medics dont have to jump off the rig and can actually be assigned other places than Wagons for life.
    3. What is definitive care? The paramedic would not change the out come she needed a diesel bolus to get to the hospital for a cardiologist to take her to the cath lab or give thrombolitics, EMT's and paramedic can only treat what is there to treat we are not doctors.
    4. To stuart, there are tons of paramedics on the job that should be doctors and have taken the mkats and scored in the 30s, so to say that dc medics are an embarrasment is just play foolish, obviously you sound like an EMS for life fire hating kind of person.
    5. PEOPLE DIE every day get over it she was old, what do you want to say aww its a shame she coulda lived a very fulling life and completed many things like cure hunger and disease, she probable lived a very full filling life. But your right lets round up crew and put him in shackles and put his head in the guillotine, because thats all DCFEMS knows how to do when stuff hits the fan.
    6. Paramedics are dropping like flies in DC either they are dropping their card or just saying screw this and going other places with less drama, I can gurantee if this goes the wrong way you will see alot worse happen than has already.

  • DestinedForFailure

    The solution is to put more work hours on your paramedics, still no training, and a dispatch system that talks clearly BLS calls into needing paramedic evaluations. In case you don't understand how our welfare to work (yes thats what it is) communications department works I will give you an example.
    911: Whats your emergency?
    Patient:. Ya I been drinkin for 3 days and I dropped my EBT card, when I picked it up off the floor I noticed an unsmoked crack rock next to my bed. I tried to grab the rock when a cockroach bit my finger. Now iza wanna go to the hospital
    911: Are you having any chest pain? Are you having any shortness of breath? Have you changed colors at all lately? Do you have an altered mental status? Do you have a cardiac history? Does anyone along your ancestry line have any cardiac history? Are you a diabetic?Have you ever had a sudden headache? Do you feel any numbness or tingling? Does your mothers first cousin's in laws have heart murmurs?
    Patient: Um yeeahhh, my finger is really hurtin and ya its hurtin so bad that I'm havin trouble breathin.
    911: Ok sir I want you to to take an albuterol inhaler and some aspirin.
    Patient: What? I dont have asthma
    911: No sir go take an inhaler. The paramedics are en route.
    911: Units responding on the medical box alarm for the Echo Trouble breathing (yes the code thats reserved for cardiac arrests).
    Paramedic Engine reads the notes on the Echo (highest priority) call. "20 year old man reporting bit by a cockroach and his finger hurts"
    And we are wondering why medics in this system are leaving in droves and the ones who stay are purely incompetent and stay because being a welfare taxi requires no thinking.
     

  • internet

    If I was shot in front of HUH I would ask to be transported to Medstar. The only reason I ever take a trauma patient there is in a situation where I cannot justify bypassing it because they are never ready, they run around like chickens with their heads cut off, and they are not proffesional. DCFD and HUH are both powder kegs just waiting to explode over and over again when situations like this arise. Truth be told PECs suck, some of the hospitals in the District are dangerous (you think I'll ever take a stroke to Providence? Not even my worst enemy), and the ALS memebers of the DCFD are basically on their own. Want to talk about burn out? I'd like to see you suburban county big wigs try to operate in DC as "smoothly" as you do where ever it is you work. Point is we do our best in a fractured system where no one looks out for us, no one cares about us, and our own department is looking to stab us in the back. Most of us do it because we want to help, just like all of you, and we do so with our own admistration against us. Some brotherhood would be nice. But if you all want to brag about who has the most polished brass on their class A's feel free. We'll be holding it down like usual without a peep watching the mouthpieces do what they do, talk about make beleive.
    Let the medical director direct, let us get our asses kicked on medics just like the BLS fireman get it on the ambulances, give us worth while training (both fire and ems), make PECs secondary ALS resources, and develop relationships with the hospitals so things like this don't happen. This wild west BS can't go on forever and the exodus of medics is a pretty powerful symptom that nothing has or will change unless this mystery hold on progress is let loose.

  • Anonymous

    Who cares? EMS blows

  • Gil

    Lets try something new. Lets put the medics on the transport units and the firemen on the fire trucks. Second thought that might not work.

  • Sad for our Dept.

    First of all, Anonymous posting on 11-29 at 8:49 PM, thank you for saying what needs to be said.  The majority of our Providers do their best in a broken system with the fear of massive reprisals when they make an error on any one of their hundreds of runs. 
    Does anyone remember who the biggest advocate for Paramedic Engine Companies was? It was Local 36 whose President went on to become the Fire Chief. This is one reason why this broken system will not change.  The Local will not seek to significantly change a system they were instrumental in creating and they are usually the ones that shed the light and common sense that  leads to change.  The Thompson and Rubin administrations then doubled down on this system, recruiting Medics and promising them they would never be assigned to transport units. Does anyone think the current administrator will implement any significant change to this system??  Does he do anything other than threaten layoffs and shift changes, worry about patches and uniform shirts and blame the Rubin administration, company officers, and back step firefighters who don't live in the city for all the problems the Depts currently faces to the extent that, accordng to him,  the current low morale is due to the "passive aggessive behavior of the company officers"?!?  Under his watch, our transport fleet will continue to shrink, the EMS system will continue to degrade, and Medics will drop their cards or leave in droves  leaving the citizens of the city with the worst EMS system since the 80s-early 90s.
    The only saving grace is that he is so paranoid, vindictive and driven by racial ideology that he has surrounded himself with a senior staff that is either too incompetent (AFC-S) or nutless (AFC-O) to counter any of his bad decisions.  He will eventually implode to the point that he cannot blame it on someone else and will be forced out blaming his ousting on racists and those who serve under him.  In the meantime, he will continue to dismantle any vestige of tradition, what he perceives to be the Rubin Administration (Special Operations and white officers) and refusing to take responsibility for any of the Dept's ills.
    Buckle down, men and women of the DCFD, it is going to be a rough ride…..

  • Sick and Tired

    Wow, DCFDMember, you see everything so clearly, you must have been on the Rosenbaum transport!  Since clarity is never achieved in these incidents, let me share some facts with you.  The fact that a patient is delivered alive to a hospital does not, in any way, relieve EMS of the responsibility for ASSESSING and TREATING an illness or injury.  A failure to fully assess Mr. Rosenbaum by BOTH EMS and HUH was the major issue for both institutions.  Would Mr. Rosenbaum have died even with proper and timely intervention, nobody can truthfully say.  If you want to be a "world-class system" then you better learn your responsibilities to the patient.  Merely putting "dropped off alive" on an ePCR does not mean you did the right thing and you are free and clear.

  • DCFD-LT

    Well said, Sad for our Dept., well said………

  • Anonymous

    In reading the comments here, it clearly speaks of the concern for an improved DC Fire and EMS System. I really believe criticism against anyone of the Professional DC Fire and EMS Personnel is wrong and uncalled for. I believe the Facts once known and brought to the attention of the Authorities will speak volumes of the need for what has been commented. The comments against the Paramedic was somewhat out of line. Yes the EMT-S did ask the Paramedic to accompany the Patient. The Paramedic apparently did a patient assessment and was satisfied that BLS Transport was in order. Who among us can say with any degree of certainty it was a mistake? The Woman complaint was Abdominal Pains. OK we donot know any Medical Reason that may have occurred to cause her condition to deteriate once she was in HUH. An ER Doctor and a Cardiologist checked her. Was enough real information given to the 911 Call taker? Did the patient or anyone who may have been with her, speak of any significant Medical History such as "Chest Pains or any Cardiac Illness which could/may have Triggered her condition to the level at the scene and again at HUH? The 911 Call taker asked scripted Questions that were relevant to the call type. The Echo Call Type is for Cardiac Arrest was this lady in Cardiac Arrest upon arrival at the scene, during Transport, and/or at HUH?  As has been stated "Wait for the Investigation by DC Fire and EMS/Medical Director, HUH and yes the 911 Authorities to be complete". I am inclined to believe there wasn't any real Blame towards anyone that occurred. Something everyone should stop and ask yourself, (1) How many DC Fire and EMS ALS/BLS Transport vehicles sit in a station for any length of time during a 24 Hour Day? (2) Instead of always being critical of EMS Stop and realize EMS is today a very integral part of any Fire and EMS Dept. During any 24 Hour Day these Professional Men and Women work very hard to levels of Stress and exhaustion to serve the citizens. If on any one call a Life is Saved by these People then their Job is proven to be a critical entity. Yes there is abuse of DC Fire and EMS System, beginning with 911 to a call where somewhere calls 911 when they should have called a Taxi Cab. That is a given. The Primary concern here would seem to be to make whatever chan ges/upgrades and /or improvements to the DC Fire and EMS Service System with 911. That is where it all starts.
     
    Thank You
     

  • mark

    So not really understanding what sounds like a clusterfoxtrot of an EMS system, it appears to me that at worst this guy may be guilty of abandonment?
     
    Good ole gov't at work again. These idiots in the federal system can't even run a city much less an entire country.

  • pipeman

    Why is it always someone’s fault?

  • EMS

    The then mayoral candidate Gray published a document on his plan to improve EMS delivery through reinvigorating the Rosenbaum Task Force items that had stalled.  In the Task Force Recommendations it was very clear that improved leadership was needed to include an AFC of EMS, and 24 hour operational EMS Chiefs to provide leadership and support for the new EMS Capts.  Immediately upon taking over, LRB fired two EMS Chiefs and over the course of the last few months he has dessimated EMS leadership.  When LRB started at the beginning of the year, DCFD had an AFC of EMS, a DFC of EMS, an EMS Batt chief of Training, and 4 operational BFC's of EMS 24/7/365.  NOW after only a few short months there is only ONE Acting BFC of EMS on day work during the week! He has wiped out all other EMS chief positions!  He has completely dessimated EMS leadership and support in record time.   This is completely counter to the promises made by Gray during the campaign.  It is a systematic dismantling of the Task Force Recommendations.  This is the REAL scandal!  

  • Anonymous

    Wow.  With how stuck the media seems to be on the Rosenbaum Task Force stuff, how hasn't one of the news agencies picked up this story yet? 

  • Hydro Engineer

    Sick and tired…… You have no idea what we do everyday. we  ASSESS and TREAT every illness or injury we run. She had AB pains. Most of the EMT's want ALS to go with them just so they are not the ones in liable. Anyone old is a liability in this dept on a transport. However if she were to have had a Heart attack in the Basic Ambulance the crew would have inserted a King airway started CPR and attached the AED. Now what would a Medic do that would be better??????

  • dcfdtruckman

    I think that things would be better if the medics were on the ambulance. Thats where the need to be. That way they would not have to think about getting on the ambo.

  • Ted Hake

    Sounds like plenty of blame to go around.
    Can someone tell me if EMT-Ps and EMT-Is in DC have 12-lead EKGs and if so, can they transmit them to an ER Doc for a second opinion/Cath-Lab activation?
     

  • Jersey Medic

    . . . And this is why I almost *never* release anybody back to the BLS in my intercept system.  Why?  Because the BLS, the ER, and your medical director will throw you under the train, every time.  I'm more than happy to sit there and babysit a stable patient. . . besides, the ER docs practice such defensive medicine that they'll write cardiac enzymes and telemetry admission orders on anyone who can't outrun them to the parking lot.   
    I have long stopped caring about whether this stance makes me miss jobs where my skills might make more of a difference. 

  • Sad for our Dept.

    Excellent points "EMS Says".  So in addition to dismantling key crucial gains to EMS leadership that were recommended by the Rosie Task Force that could actually affect operations in a positive way, what recommendations does our esteemed leader latch onto?  Eliminating any mention of "DCFD" and going to 12 hour shifts.  Does ANYONE in the US even work 3-3-3 anymore???  Why not??  Because it is an incredibly bad idea: bad for the health of the responders, bad for productivity of the officers and it WILL increase overtime as will any 12 hour shift.  Can you imagine trying to get 40+ ambulance crews relieved everyday at peak times during rush hour??
    <P>Make no mistake we will be on a 12 hour shift by early spring at the latest but it won't be 3-3-3, it will be 2-2-4.  And it will be under the guise of following the Rosie Task Force Recs for providers working shorter hours.  But the real reason has been slipped out by some of the very few loyal followers of our "leader" who just can't keep quiet about the payback that  is coming. This is targeted at the individuals that do not live in or near the city in hopes that more commuting will force them out, specifcally those PA folks.
    <P>Hang in there troops, I guarantee that you will outlast him and then we can put OUR Dept back together to truly serve the citizens of our Nation's Capitol.
    <P>Finally, for all that think we are hurting the chief's feelings by calling him the administrator, I have my doubts.  I suspect he wears it as a badge of honor and a break from the "horrible" traditions of the Fire Service in general and the DCFD specifically.   I only wish there was a thread like this on the Watchdesk for longevity because these things need to be said but will be gone from this site with next weeks news.  And, Dave, that is not meant as a shot at all. I understand that your site it not meant to keep things up for extended lengths of time.  But thanks for using the "old/new" patch for the story lead, whether it was intentional or not.  It's a good thing you don't work for the Dept. or you would be in a heap o' trouble.

    • dave statter

      It’s funny. Not something I even thought about when I posted it. Just grabbed it from my file. It wouldn’t be the first fire chief I pissed off.

      Statter

  • Anonymous

     
    "And people are wondering why paramedics are leaving the department in droves.  The department will try to quickly fire this paramedic before all the facts are in and the Fire Administrator will use this as an opportunity to continue to push his asinine agenda. God I can’t wait for Gray to get voted out."
    So can we count on your VOTE? You can vote in D.C. right?

  • pipeman

    Won’t there be a pay increase for us because of more work hours?

  • Dcfd ff/p

    Here’s something to think about….the ff/p recently filed a request to drop his ALS cert. stating he didn’t feel comfortable providing Als care in this system….this was denied by the admin. so isn’t it safe to say that they are at fault by letting someone provide care who isn’t comfortable……hhmmm

  • Sick and Tired

    Hydro Engineer – you have no idea who I am.  How can you say that I don't know what you do every day?  I could be someone who sits behind a desk at Grimke or someone who rides a wagon in Southeast so stop assuming you know me.  I know EXACTLY what the men and women of this department do every day.  So are you trying to tell me that an Intermediate wouldn't be able to do anything more for a heart attack than a Basic Ambulance?  Maybe you are the one who doesn't know goes on in the field every day!

  • DC member

    I like the comments about sending ALS providers to ambulances only, yeah sounds like a great idea! Who the heck do you think would stay for that, most ALS providers in DC came from somewhere else. What makes you think that they would stay in DC they would all leave. People can run on an ambulance ANYWHERE, what makes you think they would stay with the high cost of living and riding a ambulance full time, get real! If your ALS providers all leave then where does the Dept. turn to? Private ambulance then you can cut out 1/2 of DCFD you telling me you need 6 guys on a back step? Think of this from a managers stand point. You couldn't train or recruit enough paramedics to fill the gap for atleast 2 yrs. if you go that route. Yeah ambulance details suck, duh but your going to punish the ALS providers for spending their own money and time to better themselves? Especially when other cities its a promotion to be a paramedic. Just have the Medics ride details like everyone else problem solved.

  • DCFDmember

     
    "pipeman says
    Won’t there be a pay increase for us because of more work hours?"
     
    That is one question that needs to be answered.  By looking at the savings he mentions, LRB believes that we will go from a 42 hour workweek to a 53-56 hour workweek with no increase in pay.  I doubt that is the case, and if that is true then he won't have the big savings he predicts as whether we have 2000 employees or 1600 employees he will still be paying the same total amount of dollars in salaries.  There would be some savings in reducing the amount of employees, but the savings in salary which is the biggest cost would not be there if we will be paid for the additional hours.

  • Anonymous

     
    A few points, Dave; I know you understand the situation better than most.   I will keep it anony as an “insider” and stakeholder. My proposition is that  EMS in DC in on the verge of collapse.  Issues did not start with the Grey Admin, however, it is finally coming to a head. 
     

    The front loaded system architecture to meet ALS response times is a farce.  The Nov 29, 8:49 poster is succinct on his evaluation.  An ideological chief with the complicity of Local 36 wanted fire side tasking of ALS for the belief that there would be greater efficiency and compensation.  Unfortunately, they were both wrong on both counts.  Firefighter- Paramedics made 4500 a year in December 2001 and ten years later the salary is the same.  Compensation should be about 25000 on top of firefighting duties.
     There is no system of crew resource management for medics working by themselves.  With the workload and utilization rates of the medics, errors will happen.  Medics have no support from a system that utilizes discipline over quality assurance.  They have little support from other firefighters who are disdainful for the significant time it takes to do a thorough medical assessment and are not trained at a level to assist.  The medics are subject to minimal truth in dispatching through the Clauson Code System and certain under -capacitized supervisors created by the Rosenbaum TF who pick and choose their responses.
    The Rosenbaum TF was headed by a man who was not even an EMT- Dennis Rubin.  The two guys (from FDNY EMS and a Boston Med Director) which knew the most about how to proceed were muscled out .  Honestly, at this point, a hospital -based system is the best way to go.  Hospitals are for profit businesses.  Let them profit from the transport and assume liability – or cover it up when something goes wrong.  Obviously, when something goes wrong, they place blame on the public safety agency , which in reality, had little to do with patient outcome.
    The current fire chief and his ops chief are not capable of changing anything either from a cognitive, qualification based or political standpoint.  He threated this medic with termination,which was completely unjustified until investigated by the Med Director.  This medic was an intermediate who probably did not do a 12 lead ecg but it didn’t matter, she needed a cardiac surgeon and thrombolytics.

     I was starting to wonder if the Fire Chief is actually trying to displace ALS from the fire side or if he is really that clueless about what is going to happen in 2012.  The intermediate bridge class is about 400 hours of which 50 Members must attend.  How many will either attend or pass is anyone’s guess.  The other medics will have to either work overtime or units will be downgraded.  Either way, they are bag holders.  Get ready, the fun has just begun

  • STAKEHOLDER

    There are TOO many problems with everything about this run. This is only the TIP of the iceberg.
    Most ff/ medics in this are disliked by fellow firemen for various reasons.  One main reason is because ff/medics get to ride the fire engine far more than the average ff/emt.  This is often seen as " that FF/PM is taking MY spot of the engine"  This leads to friction and disdain that is evident on medical locals where a PEC and BLS ambo are present.  The attitude is "let the POS medic do all the work bc they make 4400 more than me" I have been on many MANY runs where the BLS providers simply stand around while the ALS provider does everything.  Some guys even have to ASK guys to do the most basic tasks like put patients on oxygen.  Many BLS providers use the pharse " I'm not comfortable with this Pt" on an OBVIOUS BLS patient in order to get the ff/pm off the engine and on the ambo.  This allows the BLS provider to get on the engine, even if for a short time while the provider goes to the hospital.  A lot of this is  done out of spite to punish the ff/medic for 1. being a medic, 2. taking MY spot on the fire engine, and 3. I wanna make them earn the extra 4400 bucks.  IF YOU DON'T believe me ask some of the ff/pm that work in DC.  This patient passed due to multiple reasons, did the provider have a duty to act? , Did Hospital 5 fail to act?  WE NEED TO LOOK AT ALL THE FACTS BEFORE ASSUMING ANYTHING.  But a Pt dying at a hospital after being seen by a cardiologist CANNOT be put on DCFD.  IF a cardiologist didn't catch the problem , I doubt a FF/EMT-IP would of!
     
    FF/PMs are the ONLY ones held accountable on these EMS calls.  ALS providers must sit infront of a medical director every 2 years and pass an evaluation by the doc in order to continue to practice.  BLS providers have to do nothing but stay awake for a 40hr EMT refresher class. NO ACCOUNTABILITY for the BLS providers further puts a wedge between the two FFs who are allegedly suppose to be "brother" What a joke.  I remember when the interim med director tried to evaluate BLS providers last year.  It was great to see them being held accountable just  as ALS providers.  It was SAD to see many of them FAILING for not knowing basic EMT skills.  These evaluations were stopped because TOO many BLS providers were being pulled from the streets and it created overtime.
     
    What we need here is a full investgation and revamp of the system.  KNOW YOUR JOB AND DO YOUR JOB,  READ the job descriptions for both FF/PM and FF/EMT.  There should be no question what your duties are.  TAKE OWNERSHIP.  Too all the FF/PMs: Do a full assessment on all Pts NO MATTER what time of the day it is. DOCUMENT DOCUMENT DOCUMENT on everything.  IF U BLS A PT, write full details to incldue VITALS and PRESENTATION.  ITS NOT WHAT U KNOW, ITS WHAT U CAN PROVE!!!!!!! REMEMBER THIS. Also, notify the ELO yourself to get a hosp destination, on all runs.  ALWAYS ask the BLS crew if they can handle the Pt. EVEN IF you know the crew and trust them, ALWAYS ASK.  IF there are any doubts, TRANSPORT THE PT even if its just to babysit.  I know it sucks but the system puts ALL the responsibility on  the ALS provider.  The majority of ALS transports are babysitting runs.  Lastly, WE must all stick together and do whats right for the citizens, visitors and fellow members of the DCFD. It was going to be a tough fight but we gotta stick together and look out for one another. I'm done

  • Enough is Enough

    This is getting very old! Again, another citizen was transported to Howard University Hosp. and died under the care of doctors, and nurses…….. When is the department and the city going to attack Howard, and leave DCFD alone? Whether the ambulance/Medic , or the family drove the patient to the hospitol, the outcome would have been the same! It's not like the patient died as they rolled her through the doors of the ER, she died hours after the fact……… Rosenbaum was the same result! Howard is awful at giving care, and I would not take a dog there for treatment. For years we have joked about them and the citizens of DC think the hospitol is great. It would be nice for once to have a Fire Chief that would stand up and throw the blame where it belongs. The department will investigate the actions of the medic and will handle any resonable discipline that they should get (within reason)…. Everybody makes mistakes from time to time, but for DCFD to take all of the heat is crazy…… Enough is Enough!

  • Anonymous

    Well said Dec, 1st anonymous.  You stated the Intermediate to Paramedic bridge class was 400 hours, according to NREMT there is no class hour requirement for the new transition. (http://www.nremt.org/nremt/downloads/Newsletter_99_FINAL.pdf).   I assume the bridge criteria  will be set by DC DOH.  Otherwise, a spot on assessment.