What do you do with an incompetent paramedic?

Question

This is a true story. My boyfriend was intoxicated and took 55 units of Humalog instead of 55 units of Lantus. I walked into his house where he was sweating so hard he was drenched, gray colored and confused. I asked him to let me check his blood sugar and it was 39. I gave him a regular pepsi out of desperation and called the ER where I work and they told me to send him via ambulance to the hospital. The paramedic arrived and told him, he could start a IV if he wanted him to then told him he could probably have a snack and it would cover him. I went ballistic and insisted he be given an IV and 1 amp D-50 STAT and even offered to start the IV. The paramedic proceeded to tell me if I did not leave he would call the police. I once again insisted on an amp of D50 immediately or would call in another ambulance and informed them I had already spoken to the ER. He finally gave the D-50 and allowed him to sign a waiver. I waited 30 minutes and had to drive him to the ER. Accucheck 29.

It took all nite to get his blood sugar high enough. The ER physician was outraged that he was not immediatly brought to the hospital and I had to drive him in my own car. Clearly, the paramedic was not competent in this situation. Who do you complain to. I called the ambulance company he works for and informed them not only did he discuss other patients he had picked up in the same condition, but he did not tell inform him of the medical ramifications of having taken 55 units of fast acting insulin. Including hypoglycemia and death.

Discussing pts who have been under your care is a hippa violation and a serious breach of patient confidentiality.

regarding the hippa violation. He violated the confidentiality of the other guy by naming his first and last name and the town he lives in. My boyfriend knew the guy.
2. I was very patient with the paramedic until he clearly was not competent. He told him if he gave him the D-50, he would stay hi for the day and he really didnt want him to stay hi all day, therefore indicating to him it was not a good thing to do. They gave the amp of D-50 because I insisted and left so fast they did not see him drop to the 30's again. It was Saturday nite and they had other things they would rather do in this small town of 850 people.

Just to let you know, I am an RN in a big hospital x 12 years and very competent at my job. We are required to take yearly exams on subjects such as insulin administration and diabetes, cardiac life
support, HIPPA and all many other comptencies to do with health issues.
I did report him to his supervisor and was told they could not discuss the case with me because it was a hippa violation. Well, I think it is there way of not discussing a serious violation on their part and getting in trouble. I should have told the pt they were talking about what they did I will never use that ambulance service again and anyone who asks me will not get a reccomendation for that ambulance service because they are incompetent.

Answer 1

I don't know who you should report this to but I hope you find someone. It might tick off nurses and paramedica and doctors off when a family member is answering questions but I don't think someone who has a blood sugar of 39 and just tool 55 units of fast acting insulin like Humalog is the person that should answering questions! Add to that this guy was drunk, which means he has no other defense than outside glucose to get his blood sugar up...I think the paramedic might have let his frustration over someone telling him what needed to be done cloud his judgement..or he was complete idiot! I'm assuming that this guys 55 units of Lantus was his full long acting dose? With most people's fast acting insulin needs being half their long acting and half going to meals, He took his whole days fast acting at one time! Anyone that has knowledge of diabetes and insulins would know that this guy needed to go to the ER! PERIOD! A snack is not going to be enough to get someone's glucose up that has OD'd on insulin! Please, report this guy and make sure that he pays...at least out of pocket!

Answer 2

Wow...I'm a paramedic, and I can't believe that someone would do that! I'm pretty new at this job, and even I know that a BS of 39 is a bad thing! If he had altered mental status, there's no reason why he shouldn't have given D50. If he was AOX3, I'd probably start out with oral glucose, but with a BS of 39, oral glucose is not going to get him high enough, fast enough. I really hope that you don't think all paramedics are incompetent as that one. The vast majority of medics are good at what they do. There's always a few bad apples...
I would talk with the highest person that I could reach at the ambulance company, and explain to him or her, that if you did not have the medical training that enabled you to know to take your boyfriend to the hospital, that he would have died or been seroiusly brain-injured. I would also contact the state board of EMS and explain what happened. If you have the paramedic's name, that will help greatly. They can open up their own investigation into what happened, and they are the ones that have the authority to take this paramedic's license away. At my service, they actually would rather us take all patients that we push D50 on to the hospital, rather than letting them refuse, just because of the legal liability.
Hope this helps!

I also completely agree with the answerer below me. I hate it when the family tries to answer for the patient, but I need to talk to the patient myself and perform my own assessment before I treat. I'm sure you are a great RN, but when my medical director chews my butt for missing something important during my assessment, I can't use the excuse "the patient's girlfriend was an RN and told me what I needed to do". I've seen people with a BS in the 30's be AOx3, and I can't make them go to the hospital no matter how bad they need to. I've actually had to ask a patient's family to step out of the room because they were interfering to the point that I could not assess the patient. Another good question (not to be judgemental); were you drinking? If you were, that might have affected your perception of the situation.
Hope everything works out.

Answer 3

As a paramedic with 16 years of experience I can say that the one thing that really gets under most medic's (and nurse's) skin is a family member who insists on answering questions for my patient while I'm trying to assess them. You give a partial picture, but I need more information before I can really know what this particular medic was thinking. If you had already given your BF something to eat/drink his LOC could have been at the level that HE might have refused. You never said whether HE had agreed to treatment or refused. I will not treat a competent patient who refuses. That's assault and battery. Transporting someone who refuses is kidnapping. Today's America is the most letigious society that has ever been. I've seen medics and services sued for treating people who obviously needed treatment and for witholding treatment at the patient's request. You say that you insisted that the medic treat him, but did he agree to treatment? Most men (especially when they have been drinking) will refuse. They have that right. EMS is not law enforcement and cannot take a person who is alert and oriented without a court order and then it is still a sticky situation and sometimes requires law enforcement.
BTW, today's paramedic programs are usually associate degree programs, (just like most RN programs). Most states require National Registry testing prior to an individual being licensed in that state. My state requires 200 hours of continuing education every 2 years to keep your paramedic cert. The RN's at our hospital are taught ACLS, BTLS, PALS, NRP, AMLS, and PHTLS by ED Physicians and Paramedics.

Answer 4

I am a less than a 6 month aortic heart valve replacement recipient. I had several relapses that landed me in the hospital (three times) after the initial surgery and hospital stay. During one of the relapses I had one of the ambulance paramedics tell me that I was imaging the pain I was in and did not take me into the ambulance until my wife screamed at him to load me into the back. She waited until I got to the hospital then she called the paramedics supervisor and complained.

We came to find out that I had periocarditis and my cardiologist drew 2.5 liters of fluid out of my chest.

By the way, talking about someone else's medical history is a HIPAA violation and the paramedic could easily get fired.
1st offense - $5,000 fine
2nd offense - $15,000 fine
3rd offense - $100,000 fine and license revoked
HIPAA violations are NO JOKE!

Answer 5

Discussing other patients is only a violation if you release personal info as far as specific names, SSN, etc.. but just discussing his experience with this condition is legal

As far has his incompetency, you were directly involved in the situation and a loved one was in trouble. This can cause you to have an emotional surge and perhaps maybe you should have allowed the paramedic to do his job. Again, i dont know all of your extenuating circumstances, but there are reason as to why medical personnell do not care for relatives; they are too emotionally involved. Be sure that he actually over-stepped his bounds and was grossly negligent before you go file a complaint. It may be your emotions and the situation getting the best of you! I hope it all turned out okay! G/L

Answer 6

That is completely outrageous! Complain to his supervisor and to the fire chief. Demand that they get back to you about what was done about this guy. He could have cost your boyfriend his life!
Talking about other patients is such a major HIPPA violation! I heard that's a $5,000 fine just for the first offense.
They need to tell you what they plan to do about this and not just say, "We'll take care of it."
I have always found that a letter gets better results than a verbal complaint.

Answer 7

Hopefully you know who the medic was. Contact the fire house or service he is assigned to and talk with their supervisor. If that doesn't work, go up the food chain, firing off certified letters if need be.

Being in emergency medicine myself for over 15 years, I've seen it all. Sounds like this medic is burnt out and should be recognizing the signs. If you work in an ER, you already know the attitude.

Answer 8

I have worked for a paramedic service for 11 yrs. Are you sure he did not intend to give him D50 once he established the IV? Did you even give him a chance to explain that before you went off half ******? D50 and staying on scene until they have eaten something with protein in it and a blood glucose above 120 is the standard of care. Know that in future reference that D50 is a simple sugar. IT ONLY STAYS IN THE SYSTEM FOR ABOUT 20MIN!!! Thus the low blood sugar later. Remember the "incompetent" paramedic mentioning the SNACK??!! There is a reason for that. Also too,..... ummm yah....ALCOHOL decreases your blood sugar dangerously quick DUH!!!! If there are still concerns about his care than contact the department manager of the department that responded and file a complaint there is no excuse for REAL incompetent care. Make sure it is real and not just perceived out of ignorance on your part.


For the person questioning their training: Paramedics have 1-1 1/2 yrs of training through private programs and most have 2year Associates degrees through accredited colleges.

Answer 9

he can discuss other cases as much as he wants as long as he doesnt personaly identify the patient information (its ok to say "i treated this guy with so and so condition once" but its not ok to say "Roy Rogers had a bad diabetic emergency last week")

dont know what to tell you, unless you take legal action i guess all you can do is talk to the company. paramedics really arent trained all that well, they only have like 12 weeks of training i think. they really should have more extensive training, a 2 year degree minimum in my opinion

Answer 10

Looks to me like more than one mistake was made here. This all could have been avoided if your bf wasn't intoxicated. Surely, he must have known better. I think that perhaps you might want to focus your efforts on making sure this doesn't happen again. This story reinforces that old saying "an ounce of prevention, is worth a pound of cure".