Injured Woman refused air lift by HEMS and dies
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Overweight Patient's Family Sues Air Ambulance
Injured Woman refused air lift by HEMS and dies
Interesting case here.....who is at fault and accountable for the death of the victim?
What would you do in a case like this?
What would you do in a case like this?
Lawsuit challenges Collier’s weight rule for transporting trauma patients
One calamity after another led to the death of Diana Lopez, a 37-year-old business owner in Naples who cared for her disabled parents and helped raise a niece and nephew.
She was the victim of a tire blowout one January afternoon last year on Interstate 75 and was thrown from her Ford Expedition after the vehicle flipped.
She wasn’t wearing her seat belt.
The next disaster came when the Collier County Emergency Medical Services Medflight helicopter declined to fly her to the trauma unit at Lee Memorial Hospital in Fort Myers because she exceeded the 300-pound weight limit per patient.
Instead, she was put in a ground ambulance for transport to Downtown Naples Hospital, which doesn’t have a trauma unit.
The third disaster struck three miles later when her ambulance broke down. A second ambulance had to be sent out to get her.
By the time she got to the hospital, nearly two hours after EMS initially got to the accident scene, Lopez was in heart failure and unresponsive. Emergency room doctors tried to revive her but it was too late.
The wrongful death lawsuit claims, among other things, that EMS was negligent in failing to assess the seriousness of Lopez’s injuries by deciding to transport her by ambulance instead of Medflight because of her weight. She met criteria as a trauma patient, having been thrown from her vehicle, and should have been transported by the fastest way possible to the nearest trauma unit, the lawsuit says.
Moreover, EMS was negligent by not maintaining ambulances in good operating order and failed to remove from service an ambulance with mechanical problems, according to the lawsuit.
“The ambulance had significant maintenance issues in the past, electrical problems, transmission problems, engine problems,” Hanlon said. “That is our review of the previous maintenance records.”
Lopez, who owned a trucking company to haul construction material, weighed 394 pounds at the time of her death. She had lost 94 pounds after gastric bypass surgery a few months earlier at a Miami hospital.
Her niece, Jane Trevino, was with her that day and so was Trevino’s 1-month-old son, who was in a car seat in the rear passenger seat. Trevino, now 21, and her son were not seriously injured.
The EMS rule of not transporting patients who weigh more than an estimated 300 pounds is arbitrary and not required by any regulatory agency, Hanlon said.
“I was shocked when I learned of the 300-pound limit. It doesn’t make sense,” she said. “I can’t find any state or national standard for that (rule).”
The EMS rule likewise says the maximum weight limit for each medic on board and the pilot is 200 pounds, yet Hanlon said the Medflight helicopter can handle a total of 1,300 pounds, which includes all equipment on board.
“With the amount of fuel and the patient’s weight, we would have exceeded the weight limit for that aircraft,” the Chief Pilot said.
Henderson said he doesn’t know how much fuel the Medflight was carrying when it responded to Lopez’s accident. The flight manifest with that information is no longer on file. By law, those documents must only be kept for 30 days, he said.
“I don’t know whether they had information of a large patient before they got at the scene,” he said.
Medflight pilots have had to make the same call before not to transport someone, usually when there are two injured patients and both are heavy, he said.
“Frequently it happens,” he said. “We can’t take both patients.”
One calamity after another led to the death of Diana Lopez, a 37-year-old business owner in Naples who cared for her disabled parents and helped raise a niece and nephew.
She was the victim of a tire blowout one January afternoon last year on Interstate 75 and was thrown from her Ford Expedition after the vehicle flipped.
She wasn’t wearing her seat belt.
The next disaster came when the Collier County Emergency Medical Services Medflight helicopter declined to fly her to the trauma unit at Lee Memorial Hospital in Fort Myers because she exceeded the 300-pound weight limit per patient.
Instead, she was put in a ground ambulance for transport to Downtown Naples Hospital, which doesn’t have a trauma unit.
The third disaster struck three miles later when her ambulance broke down. A second ambulance had to be sent out to get her.
By the time she got to the hospital, nearly two hours after EMS initially got to the accident scene, Lopez was in heart failure and unresponsive. Emergency room doctors tried to revive her but it was too late.
The wrongful death lawsuit claims, among other things, that EMS was negligent in failing to assess the seriousness of Lopez’s injuries by deciding to transport her by ambulance instead of Medflight because of her weight. She met criteria as a trauma patient, having been thrown from her vehicle, and should have been transported by the fastest way possible to the nearest trauma unit, the lawsuit says.
Moreover, EMS was negligent by not maintaining ambulances in good operating order and failed to remove from service an ambulance with mechanical problems, according to the lawsuit.
“The ambulance had significant maintenance issues in the past, electrical problems, transmission problems, engine problems,” Hanlon said. “That is our review of the previous maintenance records.”
Lopez, who owned a trucking company to haul construction material, weighed 394 pounds at the time of her death. She had lost 94 pounds after gastric bypass surgery a few months earlier at a Miami hospital.
Her niece, Jane Trevino, was with her that day and so was Trevino’s 1-month-old son, who was in a car seat in the rear passenger seat. Trevino, now 21, and her son were not seriously injured.
The EMS rule of not transporting patients who weigh more than an estimated 300 pounds is arbitrary and not required by any regulatory agency, Hanlon said.
“I was shocked when I learned of the 300-pound limit. It doesn’t make sense,” she said. “I can’t find any state or national standard for that (rule).”
The EMS rule likewise says the maximum weight limit for each medic on board and the pilot is 200 pounds, yet Hanlon said the Medflight helicopter can handle a total of 1,300 pounds, which includes all equipment on board.
“With the amount of fuel and the patient’s weight, we would have exceeded the weight limit for that aircraft,” the Chief Pilot said.
Henderson said he doesn’t know how much fuel the Medflight was carrying when it responded to Lopez’s accident. The flight manifest with that information is no longer on file. By law, those documents must only be kept for 30 days, he said.
“I don’t know whether they had information of a large patient before they got at the scene,” he said.
Medflight pilots have had to make the same call before not to transport someone, usually when there are two injured patients and both are heavy, he said.
“Frequently it happens,” he said. “We can’t take both patients.”
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394 lbs!!! Even if you could carry the weight I think it would be a case of baulking out first! Of the HEMS stretchers I've worked with and seen I doubt very much she would fit in the first place!!
What kind of helo is it?
What kind of helo is it?
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Damned if you do, damned if you dont.
You don't take her, she dies. Family sue you.
You take her, you are found to be overweight (no pun intended) after an accident. Family sue you.
Your employer finds you flying in breach of SOP's, they fire you.
Sad all round when life is ruled by the fear of litigation.
You don't take her, she dies. Family sue you.
You take her, you are found to be overweight (no pun intended) after an accident. Family sue you.
Your employer finds you flying in breach of SOP's, they fire you.
Sad all round when life is ruled by the fear of litigation.
Gatvol
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How much can you put on the hook..........
EMS Pilots have to make those decisions. He hauls and the crew dies.......No Way.
Pilot was doing the right thing.
"and was thrown from her Ford Expedition after the vehicle flipped.
She wasn’t wearing her seat belt."
OK, Do they even make seat belts for someone that size, and thrown.......Say again thrown from the vehicle. We are talkin serious physics here. She must have been haulin........well yes I guess she was..
But Im sure that the buzzards will storm on this like stink on poo poo.
EMS Pilots have to make those decisions. He hauls and the crew dies.......No Way.
Pilot was doing the right thing.
"and was thrown from her Ford Expedition after the vehicle flipped.
She wasn’t wearing her seat belt."
OK, Do they even make seat belts for someone that size, and thrown.......Say again thrown from the vehicle. We are talkin serious physics here. She must have been haulin........well yes I guess she was..
But Im sure that the buzzards will storm on this like stink on poo poo.
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This reminds me of a job request many moons ago...
Get a phone call asking if we can fit a pallet on the rear of the aircraft (bk 117). I respond " yes, why?", "well we have a lady weighing 250 kg needing hospital transfer. The only way we can lift her is with a forklift."
Not sure what happened as the job got cancelled.
Get a phone call asking if we can fit a pallet on the rear of the aircraft (bk 117). I respond " yes, why?", "well we have a lady weighing 250 kg needing hospital transfer. The only way we can lift her is with a forklift."
Not sure what happened as the job got cancelled.
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Mmmmm....
Even if they had been able to carry her ..... if she had arrested in flight there PROBABLY would have been no way to to get her back ....
Obese patients are one of those things all paramedics and air crew hate!
And its not the air crews fault the patients are that size is it???
You'd need a fork lift to load 'em and prob a 412 to fly 'em!
Even if they had been able to carry her ..... if she had arrested in flight there PROBABLY would have been no way to to get her back ....
Obese patients are one of those things all paramedics and air crew hate!
And its not the air crews fault the patients are that size is it???
You'd need a fork lift to load 'em and prob a 412 to fly 'em!
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Crew made a decision, I fully support it. Pushing the limits was/is a common acceptance amongst HEMS operations, "to save the life", but in far too many cases it has a crew theirs. If they had enough concern to put a restriction on this situation in advance, then they obviously conciously thought about it and decided it was a risk.
If the crew is persecuted for this, next thing you know, a crew somewhere will (based on the repurcussions from this mission) try to drive on anyways, and get themselves killed.
Our policy is -- if the crew makes a decision based on safety, it's supported 100% unless grossly negligent. If there was a better way, it's discussed and worked with so that future scenerios can be handled better. Sure, it sucks when we picked up a guy who died after a delay involving a safety issue, but if we go john wayne every time someone is "critical", we'd be playing russian roulette.
The lady should have worn her seatbelt if she really wanted the best chance of living through an accident.
-Mike
If the crew is persecuted for this, next thing you know, a crew somewhere will (based on the repurcussions from this mission) try to drive on anyways, and get themselves killed.
Our policy is -- if the crew makes a decision based on safety, it's supported 100% unless grossly negligent. If there was a better way, it's discussed and worked with so that future scenerios can be handled better. Sure, it sucks when we picked up a guy who died after a delay involving a safety issue, but if we go john wayne every time someone is "critical", we'd be playing russian roulette.
The lady should have worn her seatbelt if she really wanted the best chance of living through an accident.
-Mike
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Spinwing
Comment;
Even if they had been able to carry her ..... if she had arrested in flight there PROBABLY would have been no way to to get her back .... Rubbish!!!
1. Could you have defibrillated the patient in-flight ?
2. If the patient went into a shockable rhythm, then why not consider landing. resus guidelines now say 2 mins CPR then shock
http://www.resus.org.uk/pages/als.pdf
3. Could easily maintain airway with laryngeal mask.
4. Drug therapy
Obese patients are one of those things all paramedics and air crew hate!
1. I think your comment 'HATE' above is too strong. individuals of the larger size may be difficult to manually handle but they deserve the same life saving clinical interventions as the next person ! I certainly don't hate people who are overweight and i can say that you do not speak on behalf of All Paramedics
Comment;
Even if they had been able to carry her ..... if she had arrested in flight there PROBABLY would have been no way to to get her back .... Rubbish!!!
1. Could you have defibrillated the patient in-flight ?
2. If the patient went into a shockable rhythm, then why not consider landing. resus guidelines now say 2 mins CPR then shock
http://www.resus.org.uk/pages/als.pdf
3. Could easily maintain airway with laryngeal mask.
4. Drug therapy
Obese patients are one of those things all paramedics and air crew hate!
1. I think your comment 'HATE' above is too strong. individuals of the larger size may be difficult to manually handle but they deserve the same life saving clinical interventions as the next person ! I certainly don't hate people who are overweight and i can say that you do not speak on behalf of All Paramedics
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Our stretchers have a weight limit of 350 lb. That's a limitation, in the flight manual. The belts on the stretcher also have to be able to be fastened around the patient. If either of these factors come into account, we cannot legally fly the patient, no matter what the medical condition.
Medical condition does not concern me at all, and I don't even want to know it. If the helicopter wasn't there, the patient's condition would be the same. Someone else's carelessness or bad luck does not compel me to do anything I wouldn't do under other circumstances, nor to ignore regulations. I hope the jury finds for the defense in this case. Someone is just trying to make a lot of money for themselves.
Medical condition does not concern me at all, and I don't even want to know it. If the helicopter wasn't there, the patient's condition would be the same. Someone else's carelessness or bad luck does not compel me to do anything I wouldn't do under other circumstances, nor to ignore regulations. I hope the jury finds for the defense in this case. Someone is just trying to make a lot of money for themselves.
Gatvol
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"that you do not speak on behalf of All Paramedics"
Thankfully its the Pilot that made the decision. As your only a passenger it does not seem that you may have made the correct one.
Thankfully its the Pilot that made the decision. As your only a passenger it does not seem that you may have made the correct one.
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Someone on another board made a good point about this case. In almost every country the population is increasing in weight and girth. Something to do with Twinkies maybe. Whatever the reason (and however much healthy, slim people may personally be offended by fatties), EMS services have to adapt to the changing shape of their customers. Of course there are always going to be patients who fall so far outside of the norm that they can't be accommodated. But as a rule, if the average customer gets bigger then as an industry we need to provide a bigger vehicle. Like, maybe, an EC145 or uh, an AW139. A guy can dream can't he
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I once transported a 580 lb woman from a hospital pad on Vancouver Island to an awaiting ambulance at Vancouver International. Had to take the normal stretcher units out and strap 3/4 inch plywood to the floor so that we could roll the entire hospital bed and her into the chopper. When we landed at the airport, we didn't have the EMS staff as the ambulance hadn't arrived but was on way, fortunately the airport firefighters were on a training exercise and wanted to see the chopper. They assisted in getting her off. The ambulance showed up but couldn't take the bed, nor was their stretcher able to take the wait, so another ambulance had to come. EMS coordination at their best.
Lucky we had the only chopper able to do this mission!
Lucky we had the only chopper able to do this mission!
Gatvol
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Revolutionary has a point. At least in the states. Folks are getting larger as in huge. AND its always someone elses fault. I can say that after dumping 20 pounds after the last flight physical. Its called pay attention. What really brings it home is watching the guy on the tube do a 30 day Mcdonalds only diet. He dam near died. Many are in a hurry, cant cook, off to work to survive and need the quick shot of food. Others have nothing to do, watch the tube and eat. Both are now leading this generation to become huge.
Back on track a bit. As they get bigger you will notice that the B206 Jet Ranger and long Ranger, even the A-star are not prepared to haul the load. Also consider that the Medical equipment on board has got the look and weight of the latest ER room. Pilots NOW can only weigh so much as they are the lowest common denominator ( albeit I have seen some pretty big heffers in the back, called Nurses)
Aircraft now have to be larger and most are going to twins, for more than one reason.
There are going to be exceptions as to who can fly as an evacuee, this case is one of them.
Since it is a case of life and death, it falls on the Pilot to determine go/no go.(not the Passengers, Nurse-Paramedic) That goes with the territory and in this case, sadly, he did the right thing.
Back on track a bit. As they get bigger you will notice that the B206 Jet Ranger and long Ranger, even the A-star are not prepared to haul the load. Also consider that the Medical equipment on board has got the look and weight of the latest ER room. Pilots NOW can only weigh so much as they are the lowest common denominator ( albeit I have seen some pretty big heffers in the back, called Nurses)
Aircraft now have to be larger and most are going to twins, for more than one reason.
There are going to be exceptions as to who can fly as an evacuee, this case is one of them.
Since it is a case of life and death, it falls on the Pilot to determine go/no go.(not the Passengers, Nurse-Paramedic) That goes with the territory and in this case, sadly, he did the right thing.
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Have the utmost respect for the job the EMS guys/gals do and the calls they are obliged to make at times. The accident rate suggests they may be trying too hard with the equipment they have to hand. I found a book given to me by the author Dan Green "In The Footsteps Of Angels" made me somewhat glad that it was a carreer path I never had to contemplate. I lie in bed at night and listen to our local IFR 412 EMS bird go over on God aweful nights and offer a quiet prayer and glad its him and not me.
I did have one memorable EMS call out in the middle of one night for a suspected heart attack on an oil rig. Picked up the patient with two medics on board. Returning home and passing over the top of another rig they called and said they had an accident on the rig where a guy had been hit in the head by a crane hook and in bad shape. The patient we had was concious and I asked the medics was it possible to get him off the stretcher and sit him up as it was obvious the other was a stretcher case. No was the answer so had to return to home. I asked one of the medics to return offshore with me while the other transported the heart case to hospital in the ambulance but they have to operate the ambulance with a crew of two so that was a no go. We cooled our heels for a good two hours while a doctor was rounded up to come offshore with us. Turned out the original guy had merely tripped going down some steps and the medic on board the rig went to assume the worse mode (litigation possibilities again?). The head injuries to the second guy resulted in him surviving with severe physical and mental disabilities (and somewhat ironically he was the son of a local doctor).
I salute all you EMS guys/gals. Just be careful out there.
I did have one memorable EMS call out in the middle of one night for a suspected heart attack on an oil rig. Picked up the patient with two medics on board. Returning home and passing over the top of another rig they called and said they had an accident on the rig where a guy had been hit in the head by a crane hook and in bad shape. The patient we had was concious and I asked the medics was it possible to get him off the stretcher and sit him up as it was obvious the other was a stretcher case. No was the answer so had to return to home. I asked one of the medics to return offshore with me while the other transported the heart case to hospital in the ambulance but they have to operate the ambulance with a crew of two so that was a no go. We cooled our heels for a good two hours while a doctor was rounded up to come offshore with us. Turned out the original guy had merely tripped going down some steps and the medic on board the rig went to assume the worse mode (litigation possibilities again?). The head injuries to the second guy resulted in him surviving with severe physical and mental disabilities (and somewhat ironically he was the son of a local doctor).
I salute all you EMS guys/gals. Just be careful out there.
Gatvol
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Had that in the Military. The old addage we never refuse a mission. Got called out in the zero moon to pick up a guy whos leg was a compound fracture. Guided in by Illum. from a tank. We went and picked him up. Risked the crew for what turned out to be a Sprained Ankle. No problem with that but got a piece of the troopers CO's ass for that one later.
Pilots make the aircraft decisions and Medics make the medic decisions, hopefully they work out for the best, but sometimes things happen.....
Pilots make the aircraft decisions and Medics make the medic decisions, hopefully they work out for the best, but sometimes things happen.....