Case Study:
A mother expecting her first child miscarried at home on June 22, 2010. The pregnancy was six months along. An ambulance was called at 4:57 a.m. The EMTs helped the mother to the stretcher and then went inside to retrieve the fetus from the bathroom floor. The baby was seen moving its head. The EMTs requested ALS to the scene. The baby was placed inside a small container. The ALS personnel visually assessed the fetus and stated the fetus was “non-viable”. There was never a fetal heart check in the field. Mother and fetus were transported to the hospital arriving at 5:16 a.m.
At the hospital, a nurse noticed that the fetus was warm and had a heartbeat. The baby was raced to the special care nursery and placed on a warmer. The staff then proceeded to resuscitate the baby. The baby was dusky and noted to have a heart rate of 30 with respirations of 6-8 at 5:40 a.m., and cardiopulmonary resuscitation was initiated. The oxygen saturation was 2-10%. The baby was intubated at 5:55 a.m. At 6:05 a.m., the blood pressure was 44/24. By 6:15 a.m., the baby was on a ventilator with oxygen saturation of 96%, a heart rate of 102, but remained dusky. By 6:30 a.m., the baby’s heart rate was 120 and blood pressure 52/24.
At 7:45 a.m., the baby was transported to a Boston hospital NICU for further care and treatment. Unfortunately, the baby died on August 10, 2010 at age 1 month and 16 days, not from prematurity but rather from brain damage due to lack of oxygen.
The plaintiffs’ claimed the accepted standard of care for basic and paramedic emergency medicine technicians in Massachusetts in 2010 required basic and paramedic EMTs to provide appropriate evaluation and treatment by following established protocols. It is beyond the scope of practice for EMTs at any level to make determinations in regard to viability of a patient. As a result of the negligence, the baby was improperly designated as “non-viable”, was placed in a Pizzeria Uno’s delivery plastic bag inside of a box with a lid on it further depriving the baby of oxygen, and as a result was not resuscitated for the first several minutes of life.
ANSWER THIS QUESTION
1) If you were a member of the ethics committee at this facility, what actions or changes would you recommend changing? Why?