Safe At Home

A good friend of mine is being sued by a former patient. I don’t know if that statement gives you anxiety the way it gives me anxiety. I’ll admit it, I have an underlying fear of having to defend myself and my actions in a court of law.

I’m not scared of being held accountable for the medical decisions I make. I feel that I tend to make fairly good decisions, thank you very much, but the legal process can be expensive. And let’s be honest…because this is just you and me talking right? Sometimes the right thing to do is far from clear.

In a court of law, everyone is allowed the benefit of months of preparation, and then days and weeks are spent mulling over decisions that were made in real time. In EMS, real time moves faster than you might think. And good, well meaning, experienced paramedics labor to do the right thing.

Such was the case on May 24th 2008, when my friend was called to the home of man who wasn’t answering questions appropriately. Gerald Schlenker, a quirky resident of Arvada, CO, was admittedly a bit drunk when he walked back home and went to bed in his own bedroom.

He awoke to the Arvada police department in his apartment. They were there to arrest his roommate for his role in some sort of disturbance issue and they wanted him to answer some questions as well. He clammed up. He refused to say anything except rude and non-sensical statements. That’s when my buddy got involved.

Have you ever been in this situation before? Someone is drunk in their own home. They may or may not have initiated a call for help. Now they want to stay home. What are our options?

Frankly I can see this guys frustration. You find your way safely home, you go to bed and you wake up to a bunch of police officers in your home, wanting answers to questions about who you are and what you’re doing. I could see being pretty pissed off.

I can also see my friends vantage point. (All to well.) The guy won’t answer basic orientation questions. How can you possibly allow him to refuse your care? How can you document that he’s competent and able to care for himself? Is he really safe at home? Where does your need for documentation end and his human rights begin?

My friend opted to transport. If I was in his shoes, I could easily see myself making the same decision. Then Mr. Schlenker got downright belligerent. He eventually needed to be restrained. And then he was sedated. At the E.R. he was eventually granted a psychiatric evaluation. He sobered up, cooperated, and was released the next day. Then he was sent a $6,000 bill for his troubles.

As you might imagine, Mr Schlenker is suing everyone involved, the police department, the hospital, the ambulance service, and even my friend, the paramedic. He made a decision that he felt was in the best interest of the patient and now he’ll need to defend his actions in court. He’s a great paramedic. I’m certain he gave Gerald outstanding, compassionate care. He did everything to ensure his safety and well being. Sometimes you just can’t win.

Maybe it’s my king-of-my-castle mindset, or my mid-west style patriotism talking here, but I’m inclined to give people a lot of leeway when it comes to allowing them to stay in their homes when they choose to stay. Removing people from their homes against their will sits poorly with me.

Sometimes I still do it. It’s my job. But I never like it.

Regardless of their medical condition, the potential for a dangerous outcome, their level of intoxication, or even their willingness to cooperate, I feel like people have the right to make bad decisions in their own homes. And it’s not our job to always fix it. I feel bad for everyone involved in this mess.

What about you? How would you have handled this case. What do you use to guide your decisions when you’re trying to decide if someone can stay home on their own?

Want More Articles Like This One?:

Regarding The Duty To Act

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The Oklahoma State Trooper vs. EMS Mess

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Comments

  1. I have had almost the same situation yet we had to leave the patient at home. The police wouldn’t help us and even tho the guy was obviously intoxicated it is not illegal to be drunk in your own home.

    All the convincing in the world didn’t do us any justice and the police were of no help either. We told them we can’t leave him his condition alone yet they saw it differently. We did end up leaving him there alone after an hour and a half. He could answer all the basics by the time we left but I still think we should of transported him.

  2. If there is a person with them I leave them at home. If they are alone, they have to be mighty intoxicated or otherwise impaired from me to drag them out of their own home, unless it was they who initiated the 911 call, then it’s off to the ER, no matter what.

  3. I would have done the exact same thing that your friend did. Our Medical Director put it best:

    “Its easier to defend yourself for doing what you felt was in the best interest of the patient, rather than leaving them there, and dealing with a potential patient abandonment issue.”

    While I’m becoming less and less of a fan of CYA Medicine, in this day and age with the “sue everyone” mentality this fine citizen is displaying, it becomes a necessity.

    Pat him on the back. I’m sure many, if not all, of us in the EMS community would stand behind him.

  4. Sean Fontaine says:

    Well said, after having worked w/our friend as a peer and partner, I am also confident in his care and his reasons for transporting versus leaving Mr. Schlenker @ home that evening. Glad to see this make it out to the public forum in this capacity and I’m glad it’s someone who knows him well putting it out there.
    There’s the potential for lawsuits w/every patient contact, I was taught to always provide the level of care and interventions I would be proud to defend, our friend was one of the people who taught me that.

  5. im in a similar situation as that guy i was carted off against my will and imprisoned at the hospital because i practice humanure. has this case gone to trial yet? im looking for a lawyer that will take my case. i dont want to sue the emt’s just the doctors involved. i was released and there is nothing wrong with me. thinking about this makes my blood boil. please email me back

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