The Metropolitan Police Department is now handling the investigation of a paramedic who was in charge of the care for two-year-old Stephanie Stephens when a decision was made not to take the little girl to the hospital in the early morning hours of February 10th. A second crew transported Stephens to Children’s National Medical Center about nine-hours later. She died the next day at the hospital. Her family says the girl had pneumonia.
Officials have not said why the girl wasn’t taken to the hospital after the first call, but Mayor Adrian Fenty, flanked by his attorney general, police chief and fire chief said at a press conference there is enough concern that a criminal review of the unidentified veteran paramedic’s actions is warranted. Police Chief Cathy Lanier says that investigation will be handled by the homicide detectives in the Special Victim’s Unit. Lanier says the detectives specialize in dealing with the deaths of children.
The family of the girl has indicated an EMS crew member pointed out the difficulty of traveling on snow clogged streets in the middle of the second of two back-to-back blizzards to hit Washington.
Sources have indicated the paramedic crew failed to get a signed release from the girl’s mother or fill out an electronic patient care report. Fire Chief Dennis Rubin indicated there is a specific protocol on handling an incident where the patient is not transported to the hospital.
Attorney General Peter Nickles says the criminal review only involves the paramedic and not the EMT who was her partner on the call.
In today’s Washington Post an editorial is critical of the progress made by the city since the death of former New York Times reporter David Rosenbaum in 2006. It echoes a recent letter to the editor by a top doctor at Children’s National Medical Center.
When asked about such criticism, Mayor Adrian Fenty points to the more than 140,000 EMS calls in the city that are handled without incident. When asked by a reporter, Fenty says he has full confidence in Dennis Rubin who is about to celebrate his third year as chief.
Also on STATter911 …
- Investigation after death of elderly woman in Washington, DC. WTOP Radio reports medic on leave after failing to accompany patient to hospital. – November 29, 2011
- DC Fire Chief Dennis Rubin tells friends he is moving on. Last day is January 2 as new administration takes over. – October 22, 2010
- Must see video: Wilmington, Delaware firefighters rescue two children from a rowhouse fire. – December 10, 2011
- Five children dead in Citra, Florida house fire. Marion County Fire Rescue says 1 woman burned, two others escaped. – November 9, 2010
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I hate that it has come to that. I think the call was bungled but it appears that Fenty and Rubin are setting up this one medic to be the fall guy for this mess.
If there is going to be a criminal probe, maybe they should look at negligence by the city on not fixing a vital public safety service.
When asked about such criticism, Mayor Adrian Fenty points to the more than 140,000 EMS calls in the city that are handled without incident.
Without incident? Says who? How do we know? What does the Mayor consider an “incident”?
Yeah……….and what about this guy:
http://www.washingtontimes.com/news/2009/may/21/ems-chief-promoted-despite-suit-over-death/
I will second your theory Stuart.Needless to say they need a fall guy. How many EMS runs have been bungled before this happened.Now all of a sudden they are paying attention. As a result of this everyone will be transported to the hospital to CYA. Rubin instead of thinking about reducing staff you better add more “buses”.
I completely agree with what Stuart has to say. This situation is different from that in Pittsburgh, but there are similarities in management’s response. The paramedics in both cases are being sacrificed to divert attention from systemic problems.
I posted this on my blog last week,
“The next biggest problem is that there has been, and continues to be, a culture at DC FD/EMS that allows, if not encourages, this sort of behavior. This despite reforms put in place in 2008 after the death of NY Times reporter David Rosenbaum after being transported by a DC ambulance crew. “
This should be a wake up call for everyone who rides the ambulance and for every jurisdiction out there. There are a great deal of highly dedicated EMS workers. But for every dedicated EMT/Medic there is a disgruntled firefighter who hates being on the unit.
For all those who are riding the “Gut Bucket” and hating it, leave your attitude at home and do the right thing or quit and get another job and stop putting lives at risk.
Yes Dave, it could be a book. Unfortunately, I believe no one has all the answers but there are several consistent factors over the years. Listed in no particular order:
a.no true leadership for two decades in the DCFD – and that has been from each consecutive mayor on down with regard to the FD. IMO, Rubin is the best Chief we have had in that time period, but some crucial mistakes by some underlings were made and have put him behind the eight ball. Oh, did I mention that Fenty had an opportunity to put a man into the position that could have fixed most of these problems but turned his bipolar back on the solution.
b.Despite all this talk and today’s Post article re culture differences, the mistake on this ped was made by a mediocre at best civilian hire with an EMS career tract. Can you imagine the outcry the Local and the anti-fire based EMS cadre would have been against a paramedic-firefighter on an engine co.
c. That being said, the public health service which is what the DCFD has primarily become is more difficult than ever and mistake will ALWAYS happen. No action like CRM has been taken to MINIMIZE this.
d. Criminal action against this medic instead of QA? Maybe the fair-impartiality of the police dept will fix the actions of and scare those stupid employees into compliance. What a joke. Abandonment to be prosecuted criminally. A criminally willful act? Yep, she wanted the ped to die. Hell, who needs a medical director or a QA process? I am pretty sure this action will turn into a farce. Sure will be interesting to see how Kenny Lyons reacts.
e. workload and unit utilization rates have yet to be addressed. With the budget situation, I doubt this will be addressed in my career, and the working conditions and anti-union bias towards the fire fighters (who are doing a great job, probably better than ever in the City’s history, at least from an EMS service delivery effort) will continue to deteriorate. Try comparing the working conditions for medics in London or LA Fire or Charlotte or Miami to what is happening to them in DC. No doubt we have been and continue to be second world – not second rate as the media would imply but operationally second world.
And on, and on
You can’t blame “the system” for this! The system has nothing to do with this if the system is being carried out by people that are performing their jobs as they are supposed to be. The medic in charge was (in no question) not performing his duties as he is entrusted to do by the citizens of the community in which he works and should be held accountable. It is what it is and this wildcard didn’t follow his own departments SOP’s and you act surprised when there is a tragic outcome like this? Tell me you would feel the same if this was YOUR child? If these people have this level of total disregard and lack of care for the job then step aside and let the people standing in line for your job have it!
The crew obviously did not act in the patients best interest. That’s what it all comes down to.
My only comment to this “police investigation” is: If you do a witch hunt on a Paramedic, you better start a police investigation on EVERY death where a patient has been to their Dr or ER within the 3 weeks prior to their death.
This situation is not a criminal matter, it is a civil matter. Doctors aren’t arrested for their screwups, they are sued in civil court for malpractice and their license can be pulled by a medical review board.
This is just grand standing.
The medic is a SHE. Not a HE. And she is a singlr role ems only provider. 3rd service looking better and better each day.
No question that the medic did the wrong thing, and those actions results in bad consequences, and the medic owns those consequences. Not knowing all the details, why is the EMT exempt? If the medic won’t transport, the EMT has their own license, they need to point out the poor care and act on it! If they can’t (medic overrules, has dept policy against this, etc), then the EMT should write a run report of how things were from their perspective and how they attempted to transport/provide care, etc. In an ER, a RN is not exempt from liabiliy just because a MD “dumps a patient”…they have a legal obligation to speak up and do something. Silence is commission…..
There’s plenty of blame to go around but what no one is mentioning is why the parents/ grandmother waited so long to call for help or seek medical attention this child had to be ill for sometime prior to this unfortunate incident.
White firefighters are the downfall of the fire service, thank god the black firefighters are still there. Especially the real ghetto ones with long dreads and who cant speak proper english, while they are first due to the white house. Thank god for black history month.
What does HOOKMAN, Attorney at law, have to say?
What is third service going to accomplish if you seperate the same employess, with the same attitudes, with the same work ethic, the same half-a$$ed approach to patient care, lead by the same supervisors, trained by the same people, under the same governmental leadership going to accomplish?
Criminal investigation??? How about dog and pony show for the same reasons Truth mentions. Is the approach the dept. is now taking “do your job or get arrested”? That will certainly boost morale and “internal customer” attitudes. We’ll become a “you call, we hall, that’s all” organization. Where’s the quality care in that?
Dennis Ruben is the best Fire Chief? What has he actually accomplished since he’s been here? Has the quality of ems care become better? Obviously not. His ems chief can’t even tell the difference between a gunshotwound to the head and one to the torso. What should you expect from those under him? He’s been ordered to rehire employees fired under his administration. He even threw one of his AFCs under the bus at a council hearing. There’s been more scandal under him then any other chief and it all seems to center around him. Oh…wait a minute…we have double the amount of DFCs now then under any other chief. Gee…how did we ever manage without them? He’s a career fire chief. Never stays in one place long. I wonder why?
I won’t even begin to discuss Kenny Lyons.
Maybe it’s time for the city council(not the fire chief)to form a Q/A committee.
Anonymous said “If the medic won’t transport, the EMT has their own license, they need to point out the poor care and act on it! If they can’t (medic overrules, has dept policy against this, etc), then the EMT should write a run report of how things were from their perspective and how they attempted to transport/provide care, etc.”
Great point. We’ve all had our run-ins with piss poor providers. The best thing to keep yourself out of a mess is to always do the right thing by following protocals/SOP’s, documenting and reporting incidents to a supervisor. Unfortunately, I have to document things way to often during ambulance time.
We should all step back and look at the reality of the situation. It all comes down to RESPONSIBILITY. That being said, PERSONAL responsibility and FIRE DEPT. responsibility are the issues here.
May the first person with out fault cast the first stone. We have all had our lack of better judgements. In this case a grave one resulted in a terrible situation. YES this medic should have done alot of things. I am sure if she had the chance she would do things dramaticly different.
FIRE DEPT responsibility: before this situation happened. why was there no quality control in place with review of personal actions and protocol compliance. I can atest that there is NO regular QA. Where has the continued education been, especially PEDIACTRICS before and AFTER THIS INCIDENT. There hasn’t been any dept case review, education of best practices, or memo on compliance of protocols pasted down to it’s members
In the end we need not let this little girls death be a blame game. We need to use her and educate ourselves for our own responsibility, use it to put in place Fire Dept responsibility and teach everyone not to make the same mistakes. Allowing us to point a finger without pointing one back at oursleves would do a great diservice to Stephanie and all the other Stephanies that have occured in every other EMS jurisidiction. Let her be the voice in all of our heads to ALWAYS do what’s right for the patient.
Words to live by a great Lt.
First time is a mistake, Second time is just stupid, Third time just isn’t going to happen.
The medic is at fault for no acting properly. However, the system is at fault where something like this can happen again and again. There is obviously a total lack of control. How do people get away with not completing refusals or any ticket on runs? There should be controls in place to monitor what is happening on these calls.
It isn’t a police matter but malpractice.
A 3rd service would be a good direction at this point, but start fresh. Louisville “de-merged” Fire and EMS a couple years ago. It wasn’t perfect but they could use that as an example. It is run by a doctor now and uses evidence based policies. Begin with a sense of pride and professionalism where the standards are set from the beginning, strong QA and leadership.
Chief Thompson, you say that white firefighters with generational ties to the department are the problem? Did any white firefighters kill rosenbaum? what about the 2 year old in 33′s area? I dont think so.
b.Despite all this talk and today’s Post article re culture differences, the mistake on this ped was made by a mediocre at best civilian hire with an EMS career tract. Can you imagine the outcry the Local and the anti-fire based EMS cadre would have been against a paramedic-firefighter on an engine co.
Do you see any of us defending him/her/them?
I’m willing to bet a HUGE part of the problem IS that “civilian” designation by the Fire Department, as if the EMS providers were no better than bystanders. I can only imagine how they’re treated in the firehouses. FDNY*EMS aren’t treated much better, but at least nobody calls them civilians.
c. That being said, the public health service which is what the DCFD has primarily become is more difficult than ever and mistake will ALWAYS happen
Which brings us to the issue of what a FIRE Department knows about PUBLIC HEALTH anyway.
The medic is a SHE. Not a HE. And she is a singlr role ems only provider. 3rd service looking better and better each day.
There’s a difference between a dingle-role provider and a single-role provider under the control of a fire department that cares about her job so much that she’s considered a civilian.
CBEMT – you got it right! The “civilian” and “single-role” titles have allowed the agency (headed by men, who until recently, were not even EMT certified!) to marginalize and demoralize the entire group of people who CHOSE to provide EMS to the citizens of D.C. That’s right, I said “chose” because that was their choice. If they had wanted to become “dual-role” or “cross-trained,” they would have signed on for that years ago when it became an option. They didn’t because that was not what they wanted to do and it cost them loads! It cost them money, because “dual-role” firefighter/EMTs and FF/paramedics make more and it cost some of them their dignity as they have been shunted aside and treated like second-class citizens by firefighters who are still wet behind the ears. And as much as everyone (firefighters) wants to decry what Chief Thompson said, he was right. But it’s not just the racial bigotry, it is also the “I hate the gut bucket” or “sh*t box” mentality that makes single-role providers feel as though they and their chosen profession are less worthy.
Classic “Pavlov’s dog” response. Tell me day in and day out that my job stinks and I will begin to do a stinky job at it.
you know anonymous, i like some of the the things you have said. Given that by the way im an officer in this department and i would admit there are areas that need improvement just like any other department or job. But for those of you who complain of D-O-I-N-G Y=O=U=R J-O-B (RIDING THE AMBULANCE) I say please leave the job.Stop waisting the citizens time and putting them at risk because your heart isnt in it to do the job you are payed to do. I get tired of hearing firefighters talk about other members like calling them (loads) when it comes to work regarding F/FING. Well what does that make you if you dont want to do all the aspects of your job(EMS care).In closing do your job like its suppose to be done, respect the citizens of this great city and if you dont like it here(riding the ambulance) please leave go back where you came from I know plenty of people that would love to come on namely my sons and serve the citizens by any means necessary