Interesting case from KS involving Durable Power of Attorney

[WAS967 97]

State medical board reviewing EMS case

Local woman says EMS negligence contributed to mother's death

By Joshua Roberts

Thursday, August 12, 2004

A Basehor resident said the recent action of a state medical board is the

"first step" in producing long-lasting change in procedures to ambulance

services in Leavenworth County.

Tammy Potts has brought a case before the investigations committee of the

state board of emergency medical services. On Thursday, committee members

directed lawyers from the Kansas Attorney General's office to research legal

aspects of durable power of attorney and guardianship rights.

State officials said the determination of the committee could have ripple

effects statewide not only for ambulance services but also for patients and

family members entrusted with their care.

Potts has two complaints pending against Leavenworth County Emergency

Medical Service, both of which stem from failures by the service to

transport her mother, Alene Wilson of Basehor, in 2003. The failure by the

county's EMS service to transport her mother contributed to her death in

December of that year, Potts said.

Potts, who possessed durable power of attorney documents that were prepared

so she could make financial and medical decisions for her mother, claims EMS

attendants ignored her wishes that Wilson be transported to the hospital for

treatment of a broken hip. EMS attendants ignored the wish because Wilson,

whom they deemed competent at the scene, told them she didn't want to be

transported.

Hospital assessments indicate Wilson suffered from dementia and

hallucinations.

A crowd of EMS attendants and others in the medical profession crammed into

the room for the investigation's committee meeting last week. The board

delayed its decision until their next meeting, Sept. 30.

Jerry Cunningham, a state EMS board investigator, said EMS attendants and

others in the medical profession are listening closely for the investigation

committee's decision.

"I'm sure this case was being reviewed with high interest partially because

the outcome could affect all the ambulance services in the state,"

Cunningham said. He added that the issues raised by Potts are uncharted

territory for the board and EMS services.

"The laws that govern EMS don't cover this," he said. "The current

regulations simply do not address DPA's or guardianship.

"There's really no laws or guidelines -- there's nothing."

Potts, who has not hired an attorney, presented her side of the case

Thursday in Topeka. Representatives of Leavenworth County EMS did not

address the board.

Potts said she's encouraged by the board's decision to review the DPA

procedure but is by no means satisfied enough to withdraw her bid to have

the certification of Leavenworth County's EMS service revoked.

"It's important the protocol be changed so the next time someone will

respect (a DPA) for what it is," Potts said. "There has to be a standard.

"That the disciplinary issue hasn't been addressed yet really bothers me. A

verbal reprimand, to me, is a slap on the wrist."

Cunningham said the state board has yet to take disciplinary action against

Leavenworth County's EMS service. Any possible action would pend on the

board's final decision.

Potts said paramedics at the scene of her mother's home in 2003 didn't read

the DPA order and shoved the paperwork back in her face when she attempted

to show them the orders.

Potts said one of the EMS board members called the case an example of

"amateur hour" during the hearing last week, a sentiment she wholeheartedly

agrees with.

After EMS attendants left the 68-year-old Wilson at home with a broken hip,

Potts and family members scrambled to find alternative means of health care

or transportation to the hospital. Finally, after hours of searching, Potts

was able to locate and purchase a wheelchair she could use to move her

mother.

Wilson arrived at the hospital 17 hours after her fall. Potts transported

her mother to the hospital by mini-van. They were greeted at the hospital by

one of the EMS attendants who failed to transport Wilson. He told Wilson

"maybe next time you'll take the easier route," Potts said.

Days passed before doctors could operate on Wilson. She was released from

the hospital on Dec. 3 and was taken home the same way she arrived -- by her

daughter's mini-van -- because for the second time Leavenworth County EMS

failed to respond to the call for transport.

Wilson died Dec. 6 from pneumonia, one of the side effects from a broken hip

and caused by prolonged immobility.

Potts said she's eager to learn of the board's decision so that her mother's

death won't be in vain and that the failures of Leavenworth County EMS won't

harm any future patients.

"The first goal has always been to change how they handle things," she said.

"That's what we're looking for. They should have listened to me, but worse

they should have used common sense."

Kind of makes you wonder. If someone shoves a DPA in YOUR face and demands certain things on the part of the patient, what do YOU do?

[DMA327 12]

That's why it's best to push everyone into going to the hospital! No More RMA's!!!!

[WAS967 97]

A good, safe answer. But what if the patient (as in this case) appears C/A/Ox4 and refuses to go? Then what? DPAs are only good if the patient is unable to make decisions for themselves right?" She sure seems okay to me, we can't FORCE her to go." Or can we? Sounds like a job for the bat phone.