Jersey paramedics perform c-section on dead mother/newborn infant
danny burstein
Attached please find some paragraphs from the NY Times of Sat
27-Sept-1997. This event lots of other coverage as well.
(The Times piece is available at www.nytimes.com)
NOTE: if there's someone from the Jersey group reading this, please drop
me a note. There are a couple of points that you might find helpful.
September 27, 1997
N.J. Paramedics Face Inquiry Over Emergency C-Section
By DAVID W. CHEN
N ew Jersey health officials are investigating the actions of two
paramedics who performed an emergency Caesarean section on Thursday
to deliver the baby of a woman in North Bergen who was in cardiac
arrest and could not be revived.
The paramedics acted while consulting by radio with emergency room
doctors at Jersey City Medical Center, officials said, but state
health regulations forbid paramedics to perform surgical
operations. The emergency workers said they believed the procedure
was their only hope of saving the baby.
The full-term baby girl survived but is in critical condition; the
mother, who was 37, died.
[snip]
It was the first time anyone at Jersey City Medical Center could
recall such a case, Dauster said. But he added that everyone was
proud of the paramedics.
"What they did was step over what regulators have outlined for them
into the moral arena," he said. "Most people are going to view this
as an act of heroic endeavor; that's how we're viewing it."
bk...@vgernet.net
danny burstein <dan...@panix.com> wrote:
>N.J. Paramedics Face Inquiry Over Emergency C-Section
>
> By DAVID W. CHEN
>
>
>
> "What they did was step over what regulators have outlined for them
> into the moral arena," he said. "Most people are going to view this
> as an act of heroic endeavor; that's how we're viewing it."
>
Jesus cripes!!! What's next everybody who's seen open heart
massage in the ED will be able to it in the field, as long as they
talk to the Dr on the radio.
Brian K. Andrews, NREMT-P
email: bk...@vgernet.net
Visit my web site at: http://www.vgernet.net/bkand
sheryl
if said medics were acting under order by medical control why should there
be any question concerning their actions? my hat's off to them and my heart
goes out to them on THAT call. definately a top 5% 'bad-un'
sheryl
EMSadvoc8
Just curious...
How much time was wasted on the scene contemplating, discussing and
finally performing a surgical intervention FAR outside the scope of
paramedic training when they could have been transporting?
sheryl
the concept of transport as main priority is rapidly becoming outdated as
our training becomes broader and more intense. one of the hardest things
to deal with are family members on a scene who think the medics are there
only to hurry up and get the patient to the hospital so that they 'receive
care'. i can understand the publics ignorance of the fact that serious
care begins on the scene...but we as medics surely shouldn't perpetuate the
misinformation. some paramedics are trained in emergency c-sections as
pertains to a field emergency. rapid transport will always be one of a
field medic's most valuable tool but use of our skills is what ultimately
helps our pts the most.
EMSadvoc8 <emsa...@aol.com> wrote in article
<19970928022...@ladder01.news.aol.com>...
RSy2717
In article <342f6b07...@news.fast.net>, dood...@fast.net (Bob
Morgan, EMT-P) writes:
>
>If the baby lives, I'm sure that people will view this as an act of
>heroic endeavor , if the baby dies, I think it will be much different.
Sad, but true.
>As a medic, I too feel for the paramedics that were on this call, and
>can imagine the stress and mental anguish that they went through
>trying to make the decision to finally do the procedure. I don't know
>what I would have done. I read another reply from some one that
>basically stated that given medical authorization, how far can this
>go? I feel that there are limitations and restrictions in place for a
>reason, and that there must be limits and restrictions, otherwise
>doctors will be having paramedics do things that would be way beyond a
>Caesarean section.
Certainly either the doc or the medics could have said no, and been acting
properly. The issue is, in a very unusual setting, are they heros or bad
guys for walking out on the limb.
>Something else to consider, we all know that there
>are paramedics at all levels of proficiency, would you want a medic
>performing a procedure like this that is not quite up to speed on a
>family member or relative of yours?
Well, what were the choices? The mother was dead. No further harm could
be done to her no matter how incompetent the medic. As for the baby, this
was a chance at life. Had they done nothing the baby would have died. Had
they botched it the baby would have died. They took a chance at success
and the baby lived.
I'll call them heroes.
Bob S
>Bob Morgan, EMT-P
>doodaman@fast.
Bob Morgan, EMT-P
On Sat, 27 Sep 1997 01:25:37 -0400, danny burstein <dan...@panix.com>
wrote:
> September 27, 1997
>
>N.J. Paramedics Face Inquiry Over Emergency C-Section
>
> By DAVID W. CHEN
>
> N ew Jersey health officials are investigating the actions of two
> paramedics who performed an emergency Caesarean section on Thursday
> to deliver the baby of a woman in North Bergen who was in cardiac
> arrest and could not be revived.
> <snip>
> "What they did was step over what regulators have outlined for them
> into the moral arena," he said. "Most people are going to view this
> as an act of heroic endeavor; that's how we're viewing it."
If the baby lives, I'm sure that people will view this as an act of
heroic endeavor , if the baby dies, I think it will be much different.
As a medic, I too feel for the paramedics that were on this call, and
can imagine the stress and mental anguish that they went through
trying to make the decision to finally do the procedure. I don't know
what I would have done. I read another reply from some one that
basically stated that given medical authorization, how far can this
go? I feel that there are limitations and restrictions in place for a
reason, and that there must be limits and restrictions, otherwise
doctors will be having paramedics do things that would be way beyond a
Caesarean section. Something else to consider, we all know that there
are paramedics at all levels of proficiency, would you want a medic
performing a procedure like this that is not quite up to speed on a
family member or relative of yours?
Bob Morgan, EMT-P
dood...@fast.net
Carey Gregory
bk...@vgernet.net wrote:
>
> Jesus cripes!!! What's next everybody who's seen open heart
> massage in the ED will be able to it in the field, as long as they
> talk to the Dr on the radio.
Lessee...
Alternative #1: mother dead, baby dead.
Alternative #2: mother dead, baby alive.
What's difficult about this choice? With a window of about 4 minutes to
deliver the baby with any hope of survival, rapid transport isn't an
option. The only other option is follow protocols, keep your job safe,
and deliver a guaranteed dead pregnant lady with her guaranteed dead
baby to the hospital.
I applaud these paramedics for having one hell of a lot of guts, for
having the courage to do what was morally right instead of what was
legally right. The doctors also deserve credit for to putting their
licenses on the line right along with the paramedics.
I hope that when I or someone I know needs a paramedic, they get one
with the sense of purpose and courage these individuals displayed, and
not someone who puts rules, regulations, and their job security ahead of
a viable life.
--
Carey Gregory, EMT-I
Chief of EMS
Canton (CT) Fire & EMS
Carey Gregory
Bob Morgan, EMT-P wrote:
>
> Something else to consider, we all know that there
> are paramedics at all levels of proficiency, would you want a medic
> performing a procedure like this that is not quite up to speed on a
> family member or relative of yours?
Let's keep in mind she was dead and not responding to resuscitation.
Carey Gregory
EMSadvoc8 wrote:
>
> Just curious...
>
> How much time was wasted on the scene contemplating, discussing and
> finally performing a surgical intervention FAR outside the scope of
> paramedic training when they could have been transporting?
I don't know. Do you?
It's probably safe to assume that the time they spent on scene was spent
working her, which is completely appropriate. I would further assume
that after it became apparent she wasn't responding to interventions,
they were left with approximately 4 minutes in which to deliver the baby
with any chance of it living. With that kind of time, the kid wouldn't
make it a block down the road, much less into an ED.
Chris Bonin
Hi there from New Jersey, land of the field c-section.
I know very little about this incident, other than what I've heard/read
in the local news, but I'll just add my $.02!
Personally, I probably would have opted for supportive measures into the
ER and let them have an OB/GYN team standing by to take the baby.
The incident happened in North Bergen, NJ, which is receives ALS from
Jersey City Medical Center. There is a hospital in North Bergen, so I
doubt they were more than a couple of minutes out. However, I do not
know if they were on the 5th floor of a tenement walkup, or the first
floor living room of a house, so I can't say for sure how far they were,
in actual package/transport time, from this local hospital.
One thing noone seems to notice is that the mother was pronounced dead
via telemetry. I've never heard of surgery being performed on a dead
patient, (ie once the patients dead, it's not surgery!). So, the medics
are really not in violation of any state laws prohibiting them from
performing surgery. The mother was dead - it's not surgery. I guess it
could be logged under, um, extrication? Yeah that's it - is was a
RESCUE call!
Anyway, if I see anything else in the papers or hear anything through
the Coconut Telegraph, I'll let the group know.
The comment running around the state however, was that their positions
were posted before they got back to base and two state cert numbers
became suddenly available! But we'll see.
Anyone know who the medics were? One things for sure - it sure took
guts. Medical control or not, that was a hell of a professional risk to
take in this state.
Chris B.
NJ Medic
danny burstein wrote:
>
> Attached please find some paragraphs from the NY Times of Sat
> 27-Sept-1997. This event lots of other coverage as well.
>
> (The Times piece is available at www.nytimes.com)
>
> NOTE: if there's someone from the Jersey group reading this, please drop
> me a note. There are a couple of points that you might find helpful.
>
> September 27, 1997
>
> N.J. Paramedics Face Inquiry Over Emergency C-Section
>
> By DAVID W. CHEN
>
> N ew Jersey health officials are investigating the actions of two
> paramedics who performed an emergency Caesarean section on Thursday
> to deliver the baby of a woman in North Bergen who was in cardiac
> arrest and could not be revived.
>
> The paramedics acted while consulting by radio with emergency room
> doctors at Jersey City Medical Center, officials said, but state
> health regulations forbid paramedics to perform surgical
> operations. The emergency workers said they believed the procedure
> was their only hope of saving the baby.
>
> The full-term baby girl survived but is in critical condition; the
> mother, who was 37, died.
> [snip]
>
> It was the first time anyone at Jersey City Medical Center could
> recall such a case, Dauster said. But he added that everyone was
> proud of the paramedics.
>
sheryl
Bob Morgan, EMT-P <dood...@fast.net> wrote in article
<342f6b07...@news.fast.net>...
> On Sat, 27 Sep 1997 01:25:37 -0400, danny burstein <dan...@panix.com>
> wrote:
>
> > September 27, 1997
> >
> >N.J. Paramedics Face Inquiry Over Emergency C-Section
> >
> > By DAVID W. CHEN
> >
> > N ew Jersey health officials are investigating the actions of two
> > paramedics who performed an emergency Caesarean section on Thursday
> > to deliver the baby of a woman in North Bergen who was in cardiac
> > arrest and could not be revived.
> > <snip>
> > "What they did was step over what regulators have outlined for them
> > into the moral arena," he said. "Most people are going to view this
> > as an act of heroic endeavor; that's how we're viewing it."
>
> If the baby lives, I'm sure that people will view this as an act of
> heroic endeavor , if the baby dies, I think it will be much different.
> As a medic, I too feel for the paramedics that were on this call, and
> can imagine the stress and mental anguish that they went through
> trying to make the decision to finally do the procedure. I don't know
> what I would have done. I read another reply from some one that
> basically stated that given medical authorization, how far can this
> go? I feel that there are limitations and restrictions in place for a
> reason, and that there must be limits and restrictions, otherwise
> doctors will be having paramedics do things that would be way beyond a
> Caesarean section. Something else to consider, we all know that there
> are paramedics at all levels of proficiency, would you want a medic
> performing a procedure like this that is not quite up to speed on a
> family member or relative of yours?
>
> Bob Morgan, EMT-P
> dood...@fast.net
>
> you made some excellent points re if and if...such is human nature...
that's the ordeal we operate under...if it's a good outcome or not...
thaat's where we part company with the real world....yes...from MY
perspestive that's the kind of medic i would want...but then how many have
MY perspective?
TRobin3215
I agree that this may be a bit out of the scope of a Paramedics training
but what other chance did the baby have. Even with perfect CPR the oxygen
supply to the fetus would be greatly diminished. I have seen a lot of dead
bodies and to this point I don't know of any way we can do any more harm to
them.
We had basically the same scenario several years ago but the unit was only
minutes from the nearest hospital. The crew opted to scoope and run they
were 4 minutes from arrival on the scene to arrival at the nearest ED. When
they arrived at the first hospital they were met at the back of the unit by
the physician and instructed to transport to the next facility because they
had an OB/GYN on call. To make a long ordeal short both the 25 yo mother
and the baby died.
I don't know who the medics were on this call but as far as I'm concerned
GREAT WORK Fellows.
MEDICT
I find it distressing and inevitable that other
emergency medical personnel are so ready and
willing to make judgements about the care provided
by their peers. Sure is easy to decide they are wrong,
particularly when there are NO specific circumstances
given about the case.
I've seen this occur time after time in peer review sessions.
Someone will present the general overview of a call and the
frenzy to make judgements will start. Then, as the case
presentation expands on the specific circumstances of the
case, the responses from around the table slowly begin
to change as those with the maturity to do so, mentally
slide themselves into someone elses very tight fitting shoes>>!!!!!
I wasn't at this scene, but I wish I had been so that I could
assist these medics in coming to terms with the aftermath.
Whether they were right or wrong is no longer important.
However, how they think of themselves is very important
to their healing process.
In this light, please consider your responses to this case
very carefully.
Vaya con Dios.
MedicT
Shawn C. Robak
Carey Gregory (cgre...@gw-tech.com) scribbled in misc.emerg-services:
>I applaud these paramedics for having one hell of a lot of guts, for
>having the courage to do what was morally right instead of what was
>legally right. The doctors also deserve credit for to putting their
>licenses on the line right along with the paramedics.
Here here!... Much agreed. Those boys did the right thing. If they dont get
their jobs back, they could always move to Indiana - where by law, when
instructed by a medical doctor (in such a scenario), a paramedic CAN perform
surgical operations. However, the MD takes full responsibility. This has
backfired a couple of times, but overall out here, has worked out really well.
>I hope that when I or someone I know needs a paramedic, they get one
>with the sense of purpose and courage these individuals displayed, and
>not someone who puts rules, regulations, and their job security ahead of
>a viable life.
Unfortunately - the two medics in question most likely arent going to do
something like that again for fear of loss of job again.
The Jersey board needs to be given a wakeup call for saying these folks did a
bad thing.
--
Support Search and Rescue - Get Lost!
----------------------------------------------------
Shawn C. Robak net.kiva@srobak (reverse it)
IU Division of Recreational Sports Technical Support
BTFD #538 Fire/Rescue/HazMat
Jason Cerovac
Carey Gregory (cgre...@gw-tech.com) wrote:
: Bob Morgan, EMT-P wrote:
: >
: > Something else to consider, we all know that there
: > are paramedics at all levels of proficiency, would you want a medic
: > performing a procedure like this that is not quite up to speed on a
: > family member or relative of yours?
: Let's keep in mind she was dead and not responding to resuscitation.
Lets also keep in mind that we do not simply STOP resucitation efforts
merely because we feel they are not responding to resuscitation efforts.
I am glad the baby is alive, and hope she does well. But I pitty the
person who will be asked the question "how do you know the mother was not
responding to resucitation." and "did your emergency c-section cause
further damage to the mother, thus preventing any chances of recovery?"
These, and other similar quesitons will be asked, I'm certain!
I belive these paramedics and doctors are hero's. They may have just
gave up thier careers for that baby - which is a great sacrafice. I only
hope that if ever put in a similar position I can respond as bravely.
Jason
--
jcer...@panix.com | I will defend to the death | New York State EMT-P
finger for contact | your right to free speech, | Woodstock 94 Medical Team
information. | You shall be free | Learn CPR - Ask me how!
<All unsolicited E-Mailers (spam) will be charge a $20 processing fee>
Jeff McCann
Well said, Carey! I've had occasion to defend paramedics who have
stepped out of bounds for the good of their patients. The general rule
seems to be that the authorities can't really argue with success. So,
if you do it, you better do it right and have a good patient outcome, as
well. Otherwise, the Man, with the advantage of 20/20 hindsight, is
gonna come down on you hard.
Kinda tough to pull that license in a hearing when daddy's in the front
row, holding his child, and obviously expressing his gratitude and
approval of the kid's two godparents.
From a legal point of view, I like the extrication argument and would
probably go with it.
Those guys (or gals) were heroes.
--
=============================================
Jeffrey Allen McCann, P.A. Attorney at Law
j.mc...@worldnet.att.net (850) 477-0820
P.O. Box 10833 Pensacola, FL 32524-0833
=============================================
DISCLAIMER/WARNING:
This message is NOT legal advice and is not confidential.
Legal concepts mentioned probably don't apply to your jurisdiction or
circumstances, so consult your attorney for specific legal advice.
Opinions expressed are mine alone, and probably don't reflect the views
of my clients or employers.
Shawn C. Robak
Jeff McCann (j.mc...@worldnet.att.net) scribbled in misc.emerg-services:
>Well said, Carey! I've had occasion to defend paramedics who have
> From a legal point of view, I like the extrication argument and would
>probably go with it.
Actually, I thinkyou will findthat any one on the partof the statewill say that
it was vivisection... or does that apply only to animals?
> Those guys (or gals) were heroes.
--
Shawn C. Robak
sheryl (she...@jas.net) scribbled in misc.emerg-services:
>if said medics were acting under order by medical control why should there
>be any question concerning their actions?
Not all states have this allowance/law.
David Scruggs
Chris Bonin wrote:
>
> Hi there from New Jersey, land of the field c-section.
>
> I know very little about this incident, other than what I've heard/read
>
> So, the medics
> are really not in violation of any state laws prohibiting them from
> performing surgery. The mother was dead - it's not surgery. I guess it
> could be logged under, um, extrication? Yeah that's it - is was a
> RESCUE call!
>
the
giggles all the way home.
--
Dave Scruggs - Firefighter, EMT1-A - SMTS III
Boulder Creek Fire Department GTE Government Systems
Boulder Creek CA Mountain View Ca
Carey Gregory
Jason Cerovac wrote:
>
> Carey Gregory (cgre...@gw-tech.com) wrote:
>
> : Let's keep in mind she was dead and not responding to resuscitation.
>
> Lets also keep in mind that we do not simply STOP resucitation efforts
> merely because we feel they are not responding to resuscitation efforts.
Actually, in many jurisdictions "we" do exactly that. Protocols for
ending efforts are clearly spelled out and doing so is a common event.
--
Carey Gregory
Carey Gregory
Shawn C. Robak wrote:
>
> Actually, I thinkyou will findthat any one on the partof the statewill say that
> it was vivisection... or does that apply only to animals?
By definition, vivisection is done on the living. She had been
pronounced dead by the med control MD.
--
Carey Gregory
Chris Bonin
> Lets also keep in mind that we do not simply STOP resucitation efforts
> merely because we feel they are not responding to resuscitation efforts.
>
> person who will be asked the question "how do you know the mother was not
> responding to resucitation." and "did your emergency c-section cause
> further damage to the mother, thus preventing any chances of recovery?"
Important point of clarification folks: The mother was PRONOUNCED DEAD
via telemetry by the MD. You can't make dead worse, so the csection did
no further harm.
Chris B.
NJ Medic
Jake
> Important point of clarification folks: The mother was PRONOUNCED DEAD
> via telemetry by the MD. You can't make dead worse, so the csection did
> no further harm.
> Chris B.
> NJ Medic
Actually, some states have laws regarding corpse mutilation!!! ;-)
jake
(Hey! It's true but I had to lighten up this topic! Those medics are
HEROES!!! Oh, my!!! I've agreed with Shawn!!!!! What have I
become!!!!!)
Rick VanGessel
jcer...@panix.com (Jason Cerovac) writes:
>Carey Gregory (cgre...@gw-tech.com) wrote:
>: Bob Morgan, EMT-P wrote:
>: >
>: > Something else to consider, we all know that there
>: > are paramedics at all levels of proficiency, would you want a medic
>: > performing a procedure like this that is not quite up to speed on a
>: > family member or relative of yours?
>
>
>merely because we feel they are not responding to resuscitation efforts.
Actually, here in Michigan we ARE beginning the switch to stoping resusitation in the field if it is obvious that the patient is not responding. This holds true to a couple of articles in the EMS magazines which have brought this subject out and appear to support it.
I support what the two paramedics did and wish them the best of luck. We are about saving lives, because of those two medics, that baby has a chance to live.
Rick
GNelson259
>I've seen this occur time after time in peer review sessions.
>Someone will present the general overview of a call and the
>frenzy to make judgements will start. Then, as the case
>presentation expands on the specific circumstances of the
>case, the responses from around the table slowly begin
>to change as those with the maturity to do so, mentally
>slide themselves into someone elses very tight fitting shoes>>!!!!!
>
>I wasn't at this scene, but I wish I had been so that I could
>assist these medics in coming to terms with the aftermath.
>Whether they were right or wrong is no longer important.
>However, how they think of themselves is very important
>to their healing process.
I have to agree with this, we have all been there where someone wishes to judge
us for what we did. The one thing you must remember is that while we have
time to think about it, those two emt-p's had to make a snap decision. That
is what I was taught to do and what I hope to have the guts to do if a simular
situation happens to me.
Gary G. Nelson
CRT
Baltimore, Maryland
Larry Torrey
On 30 Sep 1997 04:51:44 GMT, sro...@sherrill.kiva.net (Shawn C. Robak)
said:
>Here here!... Much agreed. Those boys did the right thing...
I believe one of the 'boys' is a female.
Larry
** to reply please remove the "X" from my address **
Shawn C. Robak
Jake (fr...@mediamajor-NortheasternIllinoisUniv.org) scribbled in misc.emerg-services:
>Actually, some states have laws regarding corpse mutilation!!! ;-)
>Oh, my!!! I've agreed with Shawn!!!!! What have I
>become!!!!!)
Heh... :)
Seriously tho - give the right attorney enough incentive, and he will attack
the case like that... they will take the law to the letter in a fashion that
iwas never meant to be, yet it will still have to hold, cause thats how it
reads. Technicality or not - *shrugs*
Jeff McCann
The technical legal term for such an idiot lawyer is "Counsel for the
non-prevailing party." Actually, common sense and intent win over
nonsensical "letter of the law" distortions most of the time. The
"letter of the law" is properly wielded only as a shield, to protect a
defendant's civil rights, for example; it is not to be used as a sword,
to strike down the innocent at heart.
Oh, I suppose that the medics might get sued, but remember that the
jury assigns fault and sets damages, not the lawyers or judge. So, what
are the damages here? A live baby instead of a dead one?
As for licensure revocation, the regulatory guys won't want this one
reviewed by the Court, so they are a heck of alot more likely to go go
with a polite and meaningless censure or warning letter than a
revocation.
The medics have a rough road ahead, but I think they'll be all right in
the end. Being a stand-up guy or gal is tough, and doing the right
thing isn't always easy, but a clean conscience is the softest pillow,
and they can rest easy.
Jeff
The techShawn C. Robak wrote:
> Jake (fr...@mediamajor-NortheasternIllinoisUniv.org) scribbled in misc.emerg-services:
> >Actually, some states have laws regarding corpse mutilation!!! ;-)
[snip]
> Seriously tho - give the right attorney enough incentive, and he will attack
> the case like that... they will take the law to the letter in a fashion that
> iwas never meant to be, yet it will still have to hold, cause thats how it
> reads. Technicality or not - *shrugs*
>
> --
> Support Search and Rescue - Get Lost!
> ----------------------------------------------------
> Shawn C. Robak net.kiva@srobak (reverse it)
> IU Division of Recreational Sports Technical Support
> BTFD #538 Fire/Rescue/HazMat
--
Jason Cerovac
Chris Bonin (cbo...@mitre.org) wrote:
: Important point of clarification folks: The mother was PRONOUNCED DEAD
: via telemetry by the MD. You can't make dead worse, so the csection did
: no further harm.
If a person is truely dead, than yes - therre would have been no further
harm. But pronouncement by radio is the result of the medic's telling the
doc nothing is happening and then the doc saying 'OK, call the code...'
I don't think the medic's did the worng thing. We can all sit here and
debate this 'til we're blue in the face - it dosn't matter! The lawyers,
those seeking compensation, will be out for blood! The medic's and the
doctors on medical control will have to face them, and they may lose.
Like I said, I hope they are seen as hero's, but given the litigous nature
of society - they may be brought forth and slaughterd in court.
go...@erols.com
I now forget from the origional post, but did they try resucitating the
mother. If so than I am skepical about stopping the efforts. Maybe
with those efforts the kid could have made it to the ED. If they didn't
try, than good for them for doing that and saving the kids life.
Jason Cerovac wrote:
> Carey Gregory (cgre...@gw-tech.com) wrote:
> : Bob Morgan, EMT-P wrote:
> : >
> : > Something else to consider, we all know that there
> : > are paramedics at all levels of proficiency, would you want a
> medic
> : > performing a procedure like this that is not quite up to speed on
> a
> : > family member or relative of yours?
>
> : Let's keep in mind she was dead and not responding to resuscitation.
>
> Lets also keep in mind that we do not simply STOP resucitation efforts
>
> merely because we feel they are not responding to resuscitation
> efforts.
>
> I am glad the baby is alive, and hope she does well. But I pitty the
> person who will be asked the question "how do you know the mother was
> not
> responding to resucitation." and "did your emergency c-section cause
> further damage to the mother, thus preventing any chances of
> recovery?"
>
> These, and other similar quesitons will be asked, I'm certain!
>
> I belive these paramedics and doctors are hero's. They may have just
> gave up thier careers for that baby - which is a great sacrafice. I
> only
> hope that if ever put in a similar position I can respond as bravely.
>
Shawn C. Robak
Oh... thought that was for the dead... too many damn definitions.. . :)
So whats the one that applies to the dead?
And would a state attorney go after it based on that ?
Shawn C. Robak
Larry Torrey (lto...@maine.rr.comX) scribbled in misc.emerg-services:
>I believe one of the 'boys' is a female.
Just cant leave it alone, can you ?
If the women in my office were as trite as you when I come through the door in
the morning and say, 'Mornin guys... how are things?'...
Often when I refer to boys and guys while talking shop - whichever shop it
might be - it is meant in the neuter/family sense. Get it?
Francis A. Ney, Jr.
In article <60sq35$fjc$1...@gretle.intersource.com> sro...@sherrill.kiva.net writes:
> >Actually, some states have laws regarding corpse mutilation!!! ;-)
>
> >Oh, my!!! I've agreed with Shawn!!!!! What have I
> >become!!!!!)
>
> Heh... :)
>
> Seriously tho - give the right attorney enough incentive, and he will attack
> the case like that... they will take the law to the letter in a fashion that
> iwas never meant to be, yet it will still have to hold, cause thats how it
> reads. Technicality or not - *shrugs*
In theory, this is why we have juries.
Unfortunately, anyone with a modicum of common sense tends to be dismissed
from jury pools for cause.
---
Frank Ney WV/EMT-B VA/EMT-A N4ZHG LPWV NRA(L) GOA CCRKBA JPFO
Sponsor, BATF Abuse page http://www.access.digex.net/~croaker/batfabus.html
West Virginia Coordinator, Libertarian Second Amendment Caucus
NOTICE: Flaming email received will be posted to the appropriate newsgroups
- --
"Whether the authorities be invaders or merely local tyrants, the
effect of such [gun] laws is to place the individual at the mercy of
the state, unable to resist."
- Robert Heinlein, in a 1949 letter concerning _Red Planet_
Carey Gregory
Shawn C. Robak wrote:
>
> Oh... thought that was for the dead... too many damn definitions.. . :)
>
> So whats the one that applies to the dead?
Maybe you're thinking of laws against desecration of the dead?
> And would a state attorney go after it based on that ?
Seems pretty unlikely.
Someone posted some info here earlier on NJ paramedic regs. Seems NJ
prohibits paramedics from exceeding their scope of practice even when
ordered to do so by their med control. That would seem the most likely
problem they'll face.
--
Carey Gregory
Carey Gregory
go...@erols.com wrote:
>
> I now forget from the origional post, but did they try resucitating the
> mother. If so than I am skepical about stopping the efforts. Maybe
> with those efforts the kid could have made it to the ED. If they didn't
> try, than good for them for doing that and saving the kids life.
Yes, they tried.
I don't think we have enough facts to judge one way or another whether
the decision was the right decision. We don't know down time, how long
they worked the mother, cause of the arrest, or even whether they had
transport capability on the scene.
--
Carey Gregory
Ian B. Leber
Shawn C. Robak wrote:
> >go...@erols.com wrote:
> >>
> >> I now forget from the origional post, but did they try resucitating the
> >> mother. If so than I am skepical about stopping the efforts. Maybe
> >> with those efforts the kid could have made it to the ED. If they didn't
> >> try, than good for them for doing that and saving the kids life.
>
> Hrm... even if they continued en route to the ED - would they have been able to
> save the child? A couple medics I showed this original article to said that
> toxins buildup in the mother upon her death would have surely killed the
> child... thoughts/
>
> --
> Support Search and Rescue - Get Lost!
> ----------------------------------------------------
> Shawn C. Robak net.kiva@srobak (reverse it)
> IU Division of Recreational Sports Technical Support
> BTFD #538 Fire/Rescue/HazMat
Interestingly enough, we just discussed this scenario at Emergency Medicine Grand
rounds today. The concensus was that continuing CPR would not have improved the
fetus's chance of survival. The placenta receives about 30% of Cardiac output (CO)
in the near term female. The best CPR only delivers about 30% of normal CO. That
means only about 10% of normal blood flow to the placenta. Not conducive to life
--
************************************************************************
Ian B. Leber, MD
Resident Physician
Clinical Instructor of Emergency Medicine
Affiliated Residency in Emergency Medicine
University of Pittsburgh Medical Center
Pittsburgh, PA
E-mail: leb...@pitt.edu
************************************************************************
Shawn C. Robak
Larry Torrey
On 2 Oct 1997 04:13:48 GMT, sro...@sherrill.kiva.net (Shawn C. Robak)
said:
>Just cant leave it alone, can you ?
>
>If the women in my office were as trite as you when I come through the door in
>the morning and say, 'Mornin guys... how are things?'...
>
>Often when I refer to boys and guys while talking shop - whichever shop it
>might be - it is meant in the neuter/family sense. Get it?
Yes, Ma'am! And I mean that in a neuter/family sort of way.
Shawn C. Robak
Larry Torrey (lto...@maine.rr.comX) scribbled in misc.emerg-services:
>Yes, Ma'am! And I mean that in a neuter/family sort of way.
*Curtseys to you*
Nicholas Sicora
Carey,
I was going to stay out of this thread being from Nj but I had to
put my 3 cents in here. Being from NJ it is refreshing to know that there
are some medics still there, from when I was volunteering with the local
medics in another part of the state, that are brave and willing to take a
chance to help. Most people I know would scoop and run! I probably would
have done the same thing. My only real concern is why these medics did
this. If it was for the right reasons then they should be commended for
their actions. If it was for their own egos then there has to be some
sort of repremand. From the info I read here it seems like they were
assisted in doing this by an er doc and that most likely means that they
were doing this because of family wishes and kindness not to be a
heromedic!!! These are the medics in NJ that I am proud to say I once
volunteered with!!!!! This type of medic is what made me persue EMS on a
volunteer basis even though I have other issues that most people think I
shouldn't be allowed to cert. I just hope if I ever need a medic, one of
the few and the brave and dedicated medics like this shows up!!!!! An
act like this makes me proud to say I am from NJ!!!!!!!!Bravo guys!!!!!!!
Nicholas S. Sicora III
SAM President, Temple University Student Chapter
Vice President and Executive Board Member, SAM International
On Sun, 28 Sep 1997, Carey Gregory wrote:
> bk...@vgernet.net wrote:
> >
> > Jesus cripes!!! What's next everybody who's seen open heart
> > massage in the ED will be able to it in the field, as long as they
> > talk to the Dr on the radio.
>
> Lessee...
>
> Alternative #1: mother dead, baby dead.
>
> Alternative #2: mother dead, baby alive.
>
> What's difficult about this choice? With a window of about 4 minutes to
> deliver the baby with any hope of survival, rapid transport isn't an
> option. The only other option is follow protocols, keep your job safe,
> and deliver a guaranteed dead pregnant lady with her guaranteed dead
> baby to the hospital.
>
> I applaud these paramedics for having one hell of a lot of guts, for
> having the courage to do what was morally right instead of what was
> legally right. The doctors also deserve credit for to putting their
> licenses on the line right along with the paramedics.
>
> I hope that when I or someone I know needs a paramedic, they get one
> with the sense of purpose and courage these individuals displayed, and
> not someone who puts rules, regulations, and their job security ahead of
> a viable life.
>
> --
> Carey Gregory, EMT-I
> Chief of EMS
> Canton (CT) Fire & EMS
>
>
>
Caleb Hess
In article <34315C...@mediamajor-NortheasternIllinoisUniv.org>,
Jake <fr...@mediamajor-NortheasternIllinoisUniv.org> wrote:
>
>Actually, some states have laws regarding corpse mutilation!!! ;-)
Yes, in some cases it is legally mandated - it's called an autopsy.
Allen Goodman
Jason Cerovac wrote:
<SNIP>
> Lets also keep in mind that we do not simply STOP resucitation efforts
> merely because we feel they are not responding to resuscitation
> efforts.
>
> I am glad the baby is alive, and hope she does well. But I pitty the
> person who will be asked the question "how do you know the mother was
> not
> responding to resucitation." and "did your emergency c-section cause
> further damage to the mother, thus preventing any chances of
> recovery?"
>
> These, and other similar quesitons will be asked, I'm certain!
>
> I belive these paramedics and doctors are hero's. They may have just
> gave up thier careers for that baby - which is a great sacrafice. I
> only hope that if ever put in a similar position I can
> respond as bravely.
>
> Jason
If I'm not mistaken it has been said that the ER MD had already called
it before they preformed the c-section
--
======================
Allen Goodman
AZ FF/EMT
----------------------
Email:
goo...@dancris.com
----------------------
homepage
http://www.dancris.com/~goodman
Jason Cerovac
Allen Goodman (goo...@dancris.com) wrote:
: Jason Cerovac wrote:
: > Lets also keep in mind that we do not simply STOP resucitation efforts
: > merely because we feel they are not responding to resuscitation
: > efforts.
: If I'm not mistaken it has been said that the ER MD had already called
: it before they preformed the c-section
Ahh, yes the MD gave the order to call the code, but the paramedics are
the eyes in the field.
If an MD tells me to do something, and it is the wrong thing to do, and I
do it - we both swing! This is a fact of the ever litigant world of
paramedicine.
Carey Gregory
Jason Cerovac wrote:
>
> Allen Goodman (goo...@dancris.com) wrote:
> : If I'm not mistaken it has been said that the ER MD had already called
> : it before they preformed the c-section
>
> Ahh, yes the MD gave the order to call the code, but the paramedics are
> the eyes in the field.
They had telemetry.
BTW, do you know if they even had transport capability at the scene?
No, didn't think so. I don't know either.
> If an MD tells me to do something, and it is the wrong thing to do, and I
> do it - we both swing! This is a fact of the ever litigant world of
> paramedicine.
Wrong thing to do? Since we don't know all the facts, I prefer to
assume the medics and the doc followed protocol and did everything in
their power to save this woman's life, but eventually reached the point
where it was obviously futile. I would normally grant you the same
benefit of the doubt, but instead maybe you'd like to put a case or two
of yours up here with limited information so we can all *guess* whether
what you did was the "wrong thing to do"?
Sometimes patients die. It isn't wrong, it just is.
Jason Cerovac
Carey Gregory (cgre...@gw-tech.com) wrote:
: Jason Cerovac wrote:
: They had telemetry.
: BTW, do you know if they even had transport capability at the scene?
: No, didn't think so. I don't know either.
: > If an MD tells me to do something, and it is the wrong thing to do, and I
: > do it - we both swing! This is a fact of the ever litigant world of
: > paramedicine.
: Wrong thing to do? Since we don't know all the facts, I prefer to
: assume the medics and the doc followed protocol and did everything in
: their power to save this woman's life, but eventually reached the point
: where it was obviously futile. I would normally grant you the same
: benefit of the doubt, but instead maybe you'd like to put a case or two
: of yours up here with limited information so we can all *guess* whether
: what you did was the "wrong thing to do"?
: Sometimes patients die. It isn't wrong, it just is.
You're sig mentions that you are the Cheif of a Fire / EMS agency.
Presumably, you have a long and detailed history with the emergency
services and know full well what to expect from most situations.
But it dosn't say anything about being a lawyer, or legal person of some
type.
I have previously mentioned that if I was ever put in the same situation -
that I will perform as bravely and us unselfishly as the NJ medic's did.
However, given the world we live - where people sue and win because they
burn hot coffee on themselves, I realize that my career might not have a
fair outcome.
They did the right thing. This is uncontested. However, given that what
they did was clearly out of the scope of practice, and that it was done on
a very recently deceased person, it is very likely that there will be a
lawsuit claiming that they further complicated the mothers condtion.
I am not, nor have I ever said they did the wrong thing.
Sometimes, the patient dies.... Unfortunate, but true.
Matthew Poole
In article <61a3bp$3...@panix.com>, jcer...@panix.com (Jason Cerovac) wrote:
>By the way - Where is Heromedic?
>
>I wonder what his take on the situation woudl be...
He was one of the medics. He heard the call on his ultra-sensitive radio, and
flew there to assist. There was but one medic on-scene, until heromedic
arrived.
The C-Sec was done in heromedic's special plane, under full surgical
conditions. The doc's were viewing the progress via vid/conf!
heromedic is quiet, because he doesn't want to jeapordise a possible court
hearing.
Matthew Poole HTML designer
http://www.geocities.com/Paris/3046
"Veni, vidi, velcro...
I came, I saw, I stuck around"
This post is not intended to solicit, or give permission for sending of, commercial e-mail.
As per United States Code Title 47 Sec. 227, such an act is illegal, and I will charge $500US for any such e-mail.
Jason Cerovac
3ku$jc8$2...@gretle.intersource.com>
Organization: Society for the prevention of Organizations
Distribution:
Shawn C. Robak (sro...@sherrill.kiva.net) wrote:
: Oh cmon... you dont work in this field without making damn sure you know a
: little about the law, and what you _can_ and _cant_ do... its called
: Covering Your Ass... because even tho your only intention is to help
: those in need, there are still a bazillion people out there who would
: love to take advantage of you and pin your financial ass to the wall.
My point exactly. No matter how right the medic's were, they did open
themselves to legal action. And sure enough, there is a preditor in the
croud waiting to pounce. (Read - Lawyer taking notes, contacting the
family telling them how much money they could win). Sick, but true.
: Support Search and Rescue - Get Lost!
Support EMS - Eat High-Fat, High Sugar diet and watch TV All day.
Support your local Fire Department - Leave the iron on when you go shopping.
Though, I like your better.
Jason Cerovac
By the way - Where is Heromedic?
I wonder what his take on the situation woudl be...
:)
Carey Gregory
Jason Cerovac wrote:
>
> They did the right thing. This is uncontested.
Okay, I'm sorry I misunderstood your views.
> However, given that what
> they did was clearly out of the scope of practice, and that it was done on
> a very recently deceased person, it is very likely that there will be a
> lawsuit claiming that they further complicated the mothers condtion.
Since she was declared dead by a licensed physician prior to the
c-section, her condition can't be affected by anything they did. I'm
not a lawyer, but you don't need to be one to know that formal
pronouncement of death ends that person's life in the eyes of the law.
You can't cause medical harm to a dead body.
> I am not, nor have I ever said they did the wrong thing.
I apologize. I misinterpreted your statement.
John Mateus
Actually, I'm about 5 miles from the service area where those medics
work. My information is that they requested the c-section 40 minutes
into arrest, the MD granted the procedure without knowing it was out
of their scope of practice (big surprise!) and that the patient was
not pronounced until arrival at the ER. Also, the baby unfortunately,
shows little to no brain activity.
I will not swear by my source but I personally trust it. I'll let you
take it for face value.
-------------------------------------------------
John Mateus
Less Stress Instructional Services
http://www.lessstress.com - Play our Ambulance Simulator!
Shawn C. Robak
Jason Cerovac (jcer...@panix.com) scribbled in misc.emerg-services:
>By the way - Where is Heromedic?
>I wonder what his take on the situation woudl be...
He would have performed recus on both patients, while the child was still in
the womb, and driving the HeroMedic Rescue Vehicle (tm) at Mach3 all at the
same time.
Not to mention single handedly loading and unloading the pt's.
And the mother woulda lived. :)
--
Support Search and Rescue - Get Lost!
Shawn C. Robak
Jason Cerovac (jcer...@panix.com) scribbled in misc.emerg-services:
>You're sig mentions that you are the Cheif of a Fire / EMS agency.
>Presumably, you have a long and detailed history with the emergency
>services and know full well what to expect from most situations.
>But it dosn't say anything about being a lawyer, or legal person of some
>type.
Oh cmon... you dont work in this field without making damn sure you know a
little about the law, and what you _can_ and _cant_ do... its called Covering
Your Ass... because even tho your only intention is to help those in need,
there are still a bazillion people out there who would love to take advantage
of you and pin your financial ass to the wall.
--
Chris Bonin
John Mateus wrote:
>
> Actually, I'm about 5 miles from the service area where those medics
> work. My information is that they requested the c-section 40 minutes
> into arrest, the MD granted the procedure without knowing it was out
> of their scope of practice (big surprise!) and that the patient was
> not pronounced until arrival at the ER. Also, the baby unfortunately,
> shows little to no brain activity.
>
> I will not swear by my source but I personally trust it. I'll let you
> take it for face value.
>
Also from EMS Grapevine, fairly trusted source: Medics are still
working, MD was fired.
Chris B.
NJ Medic
Nicholas Sicora
Carey you're right here because alot of medics in NJ use vehicles that
are jeeps and can't transport so they have to get a BLS unit to transport
to the hospital I know several counties that are run this way. Just a
little note!!! They may have had to depend on a volly squad for BLS and
maybe they couldn't get a unit out fast enough. There is just too much
missing to make a rash judgement. I do give them credit though because it
takes guts to do what they did in the field. I applaud medics that go
above and beyond the call of duty to do something like this!!!!!
Nicholas S. Sicora III
SAM President, Temple University Student Chapter
Vice President and Executive Board Member, SAM International
On Thu, 2 Oct 1997, Carey Gregory wrote:
> go...@erols.com wrote:
> >
> > I now forget from the origional post, but did they try resucitating the
> > mother. If so than I am skepical about stopping the efforts. Maybe
> > with those efforts the kid could have made it to the ED. If they didn't
> > try, than good for them for doing that and saving the kids life.
>
Metro7226
I can certainly appreciate that situation.
I am a Paramedic on a 911 ambulance service that operates from 7a-7a. Six
months ago, at about 7:05a, i received a 911 dispatch to "Unresponsive", and
further info advised pt was a 20 YOF with 40 week gestation and the husband
witnessed the arrest. Dispatch gave husband CPR instructions but he was
unable to comply due to emotional distress. I contacted ON-LINE Medical
Control and advised of the situation, and also requested Physcian's Orders to
perform a Prehospital Emergency C-Section per ACLS. I advised the Physcian
that estimated down time was less than 8 minutes and my rural scene was 40+
minutes from any initial receiving facility. Orders were given and i arrived
on-scene about 2 minutes later.
The scene was chaotic. The father was wailing and circling his downed wife,
and the first resonse firefighter/emt was crying in the kitchen. Luckily i
had a great emt partner, and we initiated care per ACLS. We had no response
with the mother, so her code was discontinued (due to lack of man power to
adequately work two cardiac arrest scenario's) and a prehospital emergency
c-section was performed.
I won't get into the details of the procedure, i will just say that from my
arrived scene time to the completion of the procedure was only 7 minutes and
the transport time was nearly another 40 minutes. The neonate was treated per
PALS/Broslow guidelines but without success.
We performed to the best of our abilities but it wasn't enough that day. I
would like to thank the individuals that helped give the mother and 4kg baby
boy the best chance that we could give......thanks Steve K. and Hugh H. You
guys did great, and without you i would have probably been sobbing in the
kitchen with the firefighter.
Metro7226
.