Flordia Duty to Act...

[BCmdepas3280]

I just read the article about the Ft Lauderdale medics and was a little bit ****ed off about the way they were notified about there dismissing and the circumstances behind it all. We all have a duty to act ,but what bothers me is the fact 4 medic must have seen something that would have made them come to the conclusion that he could not be saved. I believe that there is more to this story than what I have read and would like to hear from our brothers in Flordia and see what they say.

http://cms.firehouse.com/content/article/article.jsp?sectionId=46&id=16948

[Ohiovolffemtp]

I'd like to hear more also. The civilian press is not likely to have the sort of clinical information we would like to see to come to understand what happened.

The only information in the article is that the man was asystolic. Our protocol states that resuscitation does not have to be initiated in situations of obvious death: rigor, lividity, pulselessness with penetrating trauma, etc. It also states that resuscitation can be terminated if the pt. remains asystolic after intubation, IV, several rounds of drugs, etc.

An asystolic patient has minimal chance of successful resuscitation. However, we need to hear more about the physical findings and the local protocol before we know whether the medics were right or wrong.

[ThNozzleman]

They should have known the protocol and followed it, of course. However, I can't help but to smell a rat on the police side of the matter.

[distchief60b]

Firefighters Support Medic

Firefighters back fired paramedics in Lauderdale

By Shannon O'Boye & Brittany Wallman
Staff Writers
Posted August 14 2003

Fort Lauderdale · Fire Rescue Chief Otis Latin gave four firefighter/paramedics letters Wednesday telling them they are suspended without pay and will be fired effective Sept. 11 unless they appeal.

They were dismissed because they did not start CPR on a 21-year-old man who collapsed outside the city jail after running from police, struggling with them and getting pepper-sprayed, according to their notification letters.

It's the first time in fire department history that four paramedics are being fired at once, a city spokeswoman said. That may look harsh on the surface, but termination is appropriate "if the problem was serious enough," Mayor Jim Naugle said.

Two of the paramedics, Keith Webster and Michael Bucher, checked out the victim, Raymond Sterling Jr., at the jail on April 19 and left. Minutes later Sterling, 21, collapsed and police called them back. Lt. Michael Hicks and Driver/Engineer Walter Schrubb responded, as well. All four agreed that Sterling was dead and could not be revived.

Union representatives said the paramedics followed the proper protocols for pronouncing someone dead in the field, but fire administrators disagreed.

"You failed to provide appropriate care by not starting cardio-pulmonary resuscitation on the young adult arrestee in the circumstance of an `unexpected death' of a patient you had determined to be `lucid' only minutes earlier," Latin wrote to Webster and Bucher.

The South Florida Regional EMS protocols state: "Only in cases of obvious prolonged death should CPR not be started or discontinued on infants, children, young adults or cases in which an unexpected death has occurred."

Hicks, the fire-rescue lieutenant, said all deaths can be considered "unexpected" unless a person is very old or very sick and has a "do not resuscitate" order. He said paramedics use discretion and make judgment calls every day and it was their opinion that Sterling could not be revived.

None of the police officers outside the jail attempted CPR on Sterling either, but they were cleared after a joint investigation by the police and fire-rescue departments.

"I think for the police if they had to put their mouth on [Sterling's] mouth, his mouth was bleeding, so that may have made them say we're not going to try to resuscitate him that way," said Sterling's aunt, Toni Pompa. "I believe his life was very insignificant because he's black, has gold teeth and has corn rows."

Community activists agree. Leola McCoy, of northwest Fort Lauderdale, said African-Americans are growing weary of "the police always investigating themselves and declaring they have done nothing wrong."

"The paramedics are not the only ones culpable," she said. "He was in the police department's custody. They are trying to relay the blame on one department vs. another. The casual attitude [on the part of authorities] is deplorable. This was negligence."

Police spokesman Detective Mike Reed said the department knows there are unanswered questions. Those questions will be answered when the State Attorney's Office completes its investigation into the case, he said.

"We are by no means done answering all the questions of the community," Reed said. "We will have a follow-up meeting."

Reed said police will publicize the community meeting and bring investigative records and reports so residents can see all the facts and make up their own minds.

"We're open to questions and their responses 100 percent," he said.

When the four fired paramedics arrived at the fire chief's office Wednesday morning to get their termination letters, nearly 50 of their off-duty co-workers greeted them. The group marched from a nearby fire station to the office building and then walked each of the firefighters straight into the chief's office as a show of support. They waited outside in the hallway during the meetings and then walked each of the firefighters out.

None of the four signed their termination letters, and all said they will fight to get their jobs back. The first step will be requesting a hearing with a grievance resolution committee. If nothing changes after that hearing, the firefighters will ask an arbitrator to decide if their terminations were justified.

That process could take as long as a year. The paramedics will be without pay or benefits during that time, so their fellow firefighters are taking up a collection to help them make ends meet.

"We're upset four of our brother firefighters are being terminated," said Mike Salzano, a union representative. "We've been collecting money. ... We've got a benevolent association with 400 firefighters, and we've got thousands of firefighters ready to support them."

Mayor Naugle said he had not been briefed on the specifics of the investigation, but he had been told that "the protocols weren't followed and that resulted in a man's death."

"Everyone deserves to be treated the same, whether they are a prisoner in custody or a citizen on the street or a person who collapsed here at City Hall," he said.

Staff Writer Gregory Lewis and Staff Photographer Lou Toman contributed to this report.

Shannon O'Boye can be reach at [email protected] or 954-356-4597.

[DaSharkie]

Right, wrong, or indifferent, police, or fire responsibility, there is certainly going to be chaeck with a lot of zeroes written over this matter.

Are police officers in Florida required to be CPR or first responder certified? If so they have a duty to act as well. CPR should hav ebeen initiated if they are certified, mouth to mouth - can't say, it all comes down to scene safety and unless I have a facemask or BVM I don't blame 'em for not doing ventilations. The CPR is inexcusable.

Firefighters not doing CPR and working the code, well, it sounds like fresh code, asystolic or not, I think he should have been worked. I realize that this is armchair quarterbacking, but this is just my opinion.

ACLS allows for cardiac arrests to be worked. The Paramedics claimed that they were not told he was sprayed with pepper spray. Hello? Can you not smell it? I guarantee if the guy was sprayed you would know it.

I feel that they probably should have called the doc on the radio and get medical control approval to not work the patient. Pass the buck and let him take the responsibility, he makes several times what I do and has a much better liability policy. It basically sounds like the protocols were violated by these guys and at the very least a department wide review of protocols needs to be initiated.

As for a suspension without pay? These guys have not been found guilty and the process and investigation appears to be ongoing, so they should be suspended with pay until a determination has been made.

[punksurfer024]

as far as I know, police are required to be certified first responders, which includes AHA CPR cert. as well

[SCOOBY14B]

Have any of you sat through ACLS within the last year or so. During our lest recert we watched an AHA "round table discussion". One topic was Asystole. Their exact words were "in our opinion no asystole patient should be worked".

I think I would get ahold of AHA on this one.

Asystole = DEAD!!! Whether they are 14 or 80. Only exception should be children due to hypoxia.

[DaSharkie]

So following this philosophy no cardiac arrest patient should be worked because of the reduced likelihood of being resuscitated? The general figures are that less than 5% of patients that have a cardiac arrest actually leave a hospital with no deficit. Most of them are candidates for being in nursing homes because of brain damage so why should we work them?

These guys did NOTHING for this patient other than put him on a monitor and go "Hey, lookie there Vern, it's asystole. Let's not work him." This violates ACLS, regardless of what is shown on a video tape in class. He was still a "fresh code" and these guys violated their protocols. They didn't even start compressions, like they are trained and expected to do, even make an attempt to go through the first round of drugs. No contact with a doctor to get medical control authorization not to work a person.

The only times we don't work a patient is a DNR, decapitation, brain matter exposed, rigor mortis set in, relative lividity. Any other times, we can call the doc on the radio. These guys violated department policy and protocols. I don't necessarily agree with firing them, but punishment is definitely in order. This along with department wide re-training to ensure nothing else is done like this again.

As for the police, they are just as wrong as the medics for not initiating CPR or connecting a defib to the patient if they were equiped to do so. If they weren't, they damned sure better get equipped.

[ThNozzleman]

I think the ball was fumbled on the first call out; he should have been transported the first time.

[distchief60b]

?????Fire Chief Demotes Another Medic

Here is another story that relates to the entire incident. Can someone who has been around a while (like me) tell me if this is the same Otis Latin that came from Washington D.C.? Didn't he make a shambles of that department??? Someone has to put a stop to this nonsense. I am not completely familiar with the details of the entire incident...but this is a bit much I believe....
______________________________________

Lauderdale fire chief demotes EMS veteran

By Shannon O'Boye
Staff Writer
Posted August 16 2003

It's been a rough week for Fort Lauderdale Fire-Rescue.

On Tuesday, City Manager Floyd Johnson announced on a live radio show that four paramedics were being fired before the men had been notified.

The next day, more than 50 firefighters descended on the fire-rescue administration office to protest the firings.

On Friday, Fire Chief Otis Latin demoted a popular, 18-year veteran based on accusations that he was bad-mouthing the chief and the department's medical director, union officials said.

Keith Earle, who technically held the rank of lieutenant but who had been acting as an EMS captain for the past five years, got no advanced warning or hearing. Latin simply called him to his office Friday afternoon and told him he was being demoted, said union president Ian Kemp.

Earle, 52, will lose 5 percent of his pay and will go from driving an SUV as a supervisor to working on a fire engine.

Latin did not return several calls seeking comment Friday afternoon. Neither of his deputy chiefs could be reached, and Latin's assistant, Jeff Justinak, declined to comment.

Earle "is an EMS guru," union representative Mike Salzano said. "He's one of the most senior guys when it comes to EMS and training, and we're going through all these problems with EMS and training.

"This has been a rough week," he said. "It puts us down even more."

Latin this week fired four paramedics who did not try to resuscitate a young man who died in police custody after being pepper sprayed. One of those paramedics, Keith Webster, could not pass an exam that tested his paramedic skills, but Latin hired him anyway and then allowed him to become the lead medic on a rescue truck.

The fired medics said they did not try to resuscitate the man, Raymond Sterling Jr., because he was dead by the time they got to him.

Department rank-and-file are standing by them. They had a fund-raiser for the men Wednesday.

Union officials reviewed their contract Friday to see what they can do to get Earle's position back.

"The sad part of this story is he's not being removed for his qualifications or lack of performing his duties," said union president Kemp. "He's being removed from his duties because the information the chief has -- and it's not substantiated -- is [Earle] has concerns on the way things are being done, as a large majority of our members do."

Shannon O'Boye can be reached at [email protected] or 954-356-4597.

[Bones42]

One of those paramedics, Keith Webster, could not pass an exam that tested his paramedic skills, but Latin hired him anyway and then allowed him to become the lead medic on a rescue truck.

????!!!!!

[E229Lt]

A Kitchen Lawyer's Defense:

Keith Webster, could not pass an exam that tested his paramedic skills, but Latin hired him anyway and then allowed him to become the lead medic on a rescue truck.

As the lead medic, Mr. Webster made the DNR call and his subordinates followed his direction.

Florida has a statute which defines the standard of care as that level of care, skill and treatment which is recognized as acceptable and appropriate by reasonably prudent similar healthcare providers under similar circumstances. In other words, the standard of care may sometimes be described as doing what a reasonably prudent doctor (or nurse, dentist, etc.) would do under the circumstances.

Since Mr. Webster, failed the skills portion of his training and certification, the jury cannot expect him to perform to the levels stated in the statute.

The co-defendants likely were unaware of Mr Websters failure in this area and thus followed his direction due to his position as lead medic on the scene.

The fact is, Mr. Otis Latin placed a unqualified person in this position and bears the responsibility for his actions and/or inactions.

I have nothing further.

[CollegeBuff]

Since Mr. Webster, failed the skills portion of his training and certification, the jury cannot expect him to perform to the levels stated in the statute.

Don't necessarily dissagree, but can we honestly say that a jury would look at it that way, instead of looking at the teary-eyed "victim's" family?

[Bones42]

But CPR (which was not performed) is not a paramedic skill.

I know, Latin has his share of trouble to explain in this, but I won't forgive 4 guys because Latin hired someone he shouldn't have. That's too close to the Bob Moran "they're only volunteers" defense.

And yes, this is only based on the news articles which I doubt are anywhere near the whole true story.

[PAVolunteer]

NOTE OF DISCLAIMER: I am not an EMS expert, I am far from it. Furthermore, I was not there. I do not know the exact circumstances of the situation. With that said ...

Percentage of patients saved by performing CPR, even after it seems as if there is no chance of saving them = something greater than 0%

Percentage of patients saved by NOT performing CPR, even after it seems as if there is no chance of saving them = 0%

Again, I was not there, I don't know exactly what happened ... however, I would probably tend to error on the side of "something greater than 0%", especially when, in terms of the rescuers, there is no life-safety issue.

Stay Safe