Alleged EMS Errors Probed in California

State regulators have launched investigations of three cases in which ambulance and fire department rescuers in Los Angeles and Orange counties allegedly failed to provide proper patient care, a top official said.

The incidents were highlighted in a Times investigation published this month that disclosed breakdowns in oversight of the state's 85,000 medical rescuers.

Nothing ensures that potentially problematic cases are reported and investigated, increasing the risk of harm to patients, the newspaper found.

"These are going to be fairly complex investigations," said Dr. Cesar A. Aristeiguieta, director of the state Emergency Medical Services Authority, noting that the inquiries had just begun.

His investigators will review a case in which rescuers allegedly neglected to flush the eyes of a car accident victim who was rendered nearly blind by harsh chemicals, another in which a woman seriously ill with pneumonia was allegedly misdiagnosed with the flu and a third in which a heart attack victim was allegedly misdiagnosed with anxiety and advised to have a beer. Rescuers did not take the latter two patients to a hospital.

None of the cases, which occurred between 2000 and 2005, had previously been brought to the attention of the state or regional regulators who oversee paramedics and emergency medical technicians. The system largely relies on ambulance and fire officials to report their own possible failings.

Investigators will try to determine whether state laws governing emergency care were violated. Paramedics and lesser-trained EMTs can be disciplined or lose their credentials for lapses such as gross or repeated negligence, failing to accurately document patient care and performing medical procedures without authorization.

The cases involve the Santa Ana Fire Department and the Los Angeles city and county fire departments, as well as a private ambulance company.

"I think any and all attention in this area will be a good thing," Santa Ana businesswoman Theresa Hankins said Wednesday.

She had alleged that Santa Ana Fire Department officials buried her June 2005 complaint about care given to her husband, Gene Hankins, who had collapsed on the floor of the family-owned electronics store. The couple said paramedics hastily concluded that Hankins was suffering an "anxiety attack" and discouraged him from taking an ambulance to an emergency room.

"I was then advised 'to take him home, get him a beer and let him rest,' " Theresa Hankins wrote to fire officials in her complaint.

He underwent successful emergency surgery for a heart attack after she rushed him to a hospital, records show.

The Fire Department said in a letter to Hankins that a rescuer was admonished for making the beer comment, but officials concluded that medical care was appropriate. Department officials did not respond Wednesday to requests for comment.

A failure to transport was also alleged in a complaint against the Los Angeles Fire Department after the death of Armenui Agazaryan, a 48-year-old grandmother, in 2000.

In a lawsuit, her family said paramedics quickly concluded that the woman only had the flu and scolded them for dialing 911. When the family called a second time, a different rescue crew rushed her to a hospital, where she was pronounced dead, records show. The city argued that care was appropriate but paid the family $150,000 to settle the wrongful death suit.

The Times found that the case was one of 13 wrongful death claims in the last six years involving city rescuers that were never forwarded to the Fire Department physician charged with overseeing emergency medical care. A department spokesman declined to comment Wednesday.

Aristeiguieta said one of his top concerns is patients in need of treatment who are not being transported to hospitals.

"If somebody calls 911," he said, "99% of the time they need an ambulance."

Many rescuers, however, contend that people abuse the system by calling for nonemergency problems.

The third case being investigated stems from a June 2002 car crash in Palmdale that left Kathy Schroeder with permanently blurred vision. She alleged that Los Angeles County paramedics and EMTs with a private ambulance firm failed to flush a toxic substance from her eyes, even though she told them her eyes were burning.

Chief Deputy Gary Lockhart said Wednesday that a department review concluded that paramedics did nothing wrong in caring for Schroeder. The ambulance firm, American Medical Response, paid Schroeder a $400,000 legal settlement.

A company spokesman declined Wednesday to comment about the state probe.

Schroeder, however, said she was glad to see the state step in. "I just welcome the fact they are going to do an independent evaluation," she said.

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