Doctor: EMS inaction contributed to woman’s death
The doctor of a late Basehor woman said this week that the failure of Leavenworth County paramedics to transport his patient to the hospital during a call in 2003 was a contributing factor to her death days later.
"Obviously it contributed to her final demise," said Dr. Peter Cristiano, a Leavenworth physician who cared for the late Alene Wilson. "It definitely contributed to it. It contributed to her general weakness and it lowered her resistance."
The December 2003 death of Alene Wilson is at the center of a case now under review by the investigations committee of the Kansas State Board of Emergency Medical Services. Wilson's daughter, Tammy Potts of Basehor, has two complaints pending against the county's EMS service, both of which stem from failures by the service to transport her mother to the hospital.
Medical professionals said the decision of the board, due later this month, could send ripple effects statewide -- affecting ambulance services as well as elderly patients and those entrusted with their care.
How it started
In November 2003, Wilson fell and broke her hip. Wilson, who had been diagnosed as suffering from hallucinations and dementia, told paramedics she didn't want to be transported to the hospital. Potts, who possessed durable power of attorney documents granting her financial and medical decision-making powers for her mother, told EMS attendants to take her anyway.
But they didn't.
Wilson died 14 days later from pneumonia.
For Cristiano, Wilson's doctor for five years, there is a simple answer to the question that's become muddied in legalities and shrouded in uncertainty arising from the Wilson case.
Picture this, he said. You're walking down the street and you come across someone lying on the ground, immobile and in pain. Now what do you do? What would any good Samaritan, let alone a medical professional, someone dedicated to helping people, do in that situation?
"If you come across someone with a broken leg, would you just leave them there? No, you wouldn't. You have to put it in the pretext of common sense. Whether it's EMS, you or me walking down the street, you do it. People help other people.
"In the case of a medical professional seeing a patient in need, you have a right, an obligation, to see to that patient. Leaving is just not acceptable."
Getting to the hospital
At the Wilson home in 2003, Potts said the EMS attendants ignored her wishes, the power of attorney documents and Wilson's prior medical history of suffering from diminished mental faculties.
After the paramedics left Wilson, Potts scrambled to find alternative means of getting her mother to the hospital. When that failed, she took her mother the only way she could. Wilson arrived at St. John's Hospital in Leavenworth via her daughter's mini-van -- approximately 17 hours after her fall.
At the hospital, doctors said Wilson was suffering from a broken hip, dementia and hallucinations.
While leaving Wilson at home shouldn't have been one of them, Cristiano said EMS attendants had plenty of options in helping the elderly woman.
"In a physical and mental trauma, pain causes people not to think right. (Paramedics) should have tried to convince her," he said. "They could have called me and I could have come down and convinced her.
"(They could have) asked, 'Is this person rational?' It becomes irrational that a person with a broken leg doesn't want attention.
"This seems to be pretty common sense."
Once she arrived at the hospital, days passed before doctors could operate on Wilson. She was released from the hospital Dec. 3. Once again, Leavenworth County EMS failed to respond to a call requesting a transport for Wilson. She was taken home from the hospital the same way she arrived -- by mini-van.
She died three days later.
Potts' complaints to the state EMS board center on the failure to transport her mother during both calls. Potts said Cristiano's comments come as confirmation that she and her family aren't on some left-wing crusade to overhaul a smooth functioning system.
"It's reassuring to know he sees things the same way I do -- that this could have been prevented," Potts said.
"I think it's admirable that he is willing to step up for my mother's cause. In our society, doctors are so hesitant to get in the middle of something any more because it means they might end up in a big pile of quick sand. It's a whole lot easier not to do the right thing. He's chosen to do the right thing."
Certification at issue
Potts, who's bidding to change EMS protocol as well as revoke the certification of Leavenworth County EMS, said she has retained an attorney. Daniel Matula, an attorney licensed in Kansas and Missouri, is representing Potts. They have filed no lawsuit against the county or its ambulance service as of yet, but Potts said the notion has been discussed.
"It was obvious to my family we needed legal counsel at this point," Potts said. "We feel the disciplinary action needs to be addressed. We've asked the board to step up and pull the certification of these two EMT's and so far they've left us in left field on that."
For now, Potts said she is concentrating on the decision by the state medical board. In August, members of the investigation's committee directed lawyers from the Kansas Attorney General's office to research legal aspects of attorney and guardianship rights. They are expected to reconvene Sept. 30.
"We want to change the system so (paramedics) don't have this impression they can leave someone like that," Potts said. "There has to be a better way. The system failed my mother. It cannot fail again."