REACH fine

[Flying Pig]

http://www.emsworld.com/news/11230022/air-ambulance-company-fined-for-straying-from-plan

 

Im not an EMS pilot, but Im slightly familiar with how they operate. Being that Im a pilot, my questions have to do with this situation from the view point of a pilot.

 

When something like this happens, is the pilot liable for anything since he is just driving the bus? Pilots are not part of the decision making chain for patient care are they aside from PIC issues, weather, fuel to make it, etc.

 

But in this particular case, all the pilot does is determine the flight can be made safely. They are not part of deciding which facility is most appropriate are they?

[Spike]

Nope, at least not in San Joaquin…

 

It’s to my understanding, the San Joaquin County EMS likes to control every aspect of air ambulance response(s) within the county and this includes where they can land (or can’t land) for scene calls….. Typical government hierarchy mismanagement….. Decision makers like this will kill someone, someday…..

[Flying Pig]

San Joaquin isn't exactly at the top of the food chain when it comes to competent governments.

[Gomer Pylot]

I do not get involved in this type decision at all. The med crew tells me where they want to go, and I go there if I can do it safely and legally. I've never heard of a county being involved in this type of decision. Here, we get called by the local EMS service, and we tell them where we're taking the patient, based on medical condition and/or patient/family preferences. We can't take pediatric patients just anywhere, because many hospitals won't take them. Having a county, or any other government entity, decide in advance where patients have to be taken seems to be remarkably stupid, or else someone is getting kickbacks from the hospitals. That would not surprise me in the least.

[Velocity173]

Yeah like Gomer said its out of the pilot's responsibility. The decision is made before we even get there. The patient goes to the nearest trauma center (wx permitting) or if a transfer, the hospital handling the specialized care like a heart center. Sometimes insurance comes into play as well and a patient has to go to XYZ hospital. All of that is approved prior to our arrival...or at least it should be.

 

The only time things get a bit blurry is when you can't get them to the requested hospital because of wx but you can get them to a trauma center. It's imperative that you make that known ASAP so all parties involved get approval. Of course if you can't get them to any hospital that's a big deal.

 

In the Reach case it's too hard to determine who screwed up here without details on the county's agreements with Reach. Also don't know the extent of the patient's injuries that made the flight paramedic change the plan enroute.

[JDHelicopterPilot]

My involvement in this discussion is limited, for obvious reasons.

 

The destination depends on many factors. In most cases the PT is taken to the nearest most appropriate level of care (level one, two or three Truama ) hospital. The medical crew will tell the pilot where they need to go. It will then be up to the PIC to determine if they can get there based on fuel, weather and other factors. Medically the pilot has no say in destination. I have never seen any lawsuits or other action taken against a pilot due to an issue in destination.

 

This County has very explicit direction as to where PT's can be taken to. This Truama plan had just been changed following the designation of a local hospital as a Truama center by the County.

 

I know all of the details of how this all happened as I was the pilot involved. What you read in the news is just a snap shot and many details are left out. I would love to share these details as I have strong opinions about this but it is best I remain neutral.

 

Spike says it well.

[Velocity173]

Well JD hope all goes well for you. None of that should even affect you. Regardless of buerocratic county agreements, the crew made a decision on what was best for the patient. You should never get in trouble for doing that.

[JDHelicopterPilot]

Thanks! That is the REACH motto, "do what is right for the patient".

[Flying Pig]

I think SJ County still negotiates debts with chickens and bags of apples like the old west. I spent 10 yrs in that area working in LE.