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EMS policy questioned

December 7, 2012
By John Wickline - Staff Writer ( , The Inter-Mountain

An Upshur County commissioner said a doctor's orders should have trumped a local emergency squad's policy during a recent event which could have put a patient's life in jeopardy.

Commissioner Creed Pletcher argued Thursday that an Upshur County Emergency Medical Squad's policy of first taking a patient to St. Joseph's Hospital in Buckhannon not only added needless costs to a medical bill, but in one instance went against a doctor's orders to take a patient needing specialized care to United Hospital Center in Clarksburg.

"My understanding is that St. Joseph's Hospital could not handle the situation," Pletcher said. "So why take them to St. Joseph's Hospital? Paying for a trip to St. Joseph's and then paying for a trip to Clarksburg doesn't make sense to me."

Teresa Kahn said a patient with a fever of 103 degrees and with an abscess came to her husband's office in Buckhannon in November. The doctor called for an ambulance to take the patient to UHC because of the need for a vascular surgeon and a infectious disease specialist. Kahn said St. Joseph's Hospital does not have such medical personnel on its regular staff.

A first responder offered to transport the patient to the Buckhannon hospital instead, as per the squad's protocols of going to the closest available hospital, which Kahn said went against the doctor's orders. But an attorney for the EMS said the doctor never told the responders it was a medical emergency.

"If those words (medical emergency) had come out of the doctor's mouth, it would have been a much clearer situation," Fairmont attorney J.T. Hodges said. "He didn't indicate it was a life-threatening situation. As the doctor is talking to the paramedic, it is easy to say this is medically necessary."

Commissioner Donnie Tenney asked what would be the difference between the doctor saying the patient needs to be seen in Clarksburg and saying it is a medical emergency. Pletcher again countered that the treating physician already knew the local hospital would not be capable of handling the situation. The patient eventually was transported to UHC in a private vehicle and later underwent emergency surgery.

"It was a word play because he didn't say 'medical emergency,'" Kahn said. "(The local doctor) had been the medical director for the squad for 12 years. Do you think he would tie up an ambulance if he didn't have to? Nobody ever responded to see what the situation was."

Kahn said if the patient had been taken to St. Joseph's emergency room, then a doctor there would have had to make another evaluation. That could have resulted in being flown by medical helicopter to another hospital or being transported by ambulance. Either way, she said, it would have been an unnecessary delay.

"This went right down to the wire," Kahn said, "and if this were an isolated incident, I would not be here. We have to have people who are first responders who are capable of following a doctor's orders. In our county, do we want an EMS to have their own checks and balances that don't check or balance anything?"



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