EVENT Provider Violence Report - EMS Voluntary Event Notification ...

FIRST QUARTER 2016

E.V.E.N.T. Provider Violence Report Welcome!

PROVIDED BY:

Welcome to the EMS Voluntary Event Notification Tool (E.V.E.N.T.)! This is an aggregate report of the provider violence events reported to E.V.E.N.T. for the first quarter of 2016. We want to thank all of our organizational site partners. For a complete listing of site partners, see page 4. E.V.E.N.T. is a tool designed to improve the safety, quality and consistent delivery of Emergency Medical Services (EMS). It collects data submitted anonymously by EMS practitioners. The data collected will be used to develop policies, procedures and training programs to improve the safe delivery of EMS. A similar system used by airline pilots has led to important airline system improvements based upon pilot reported "near miss" situations and errors.

The Center for Leadership, Innovation, and Research in EMS (CLIR)

IN PARTNERSHIP WITH:

Any individual who encounters or recognizes a situation in which an EMS safety event occurred, or could have occurred, is strongly encouraged to submit a report by completing the appropriate E.V.E.N.T. Notification Tool (Patient Safety Event, Near Miss Event, Violence Event). The confidentiality and anonymity of this reporting tool is designed to encourage EMS practitioners to readily report EMS safety events without fear of repercussion.

“Experienced Female EMT transporting a Mental Health Patient from ER to Inpatient Treatment Facility was Sexually Assaulted by the patient while preparing to exit the Ambulance at the receiving facility. Due to Ambulance Construction (Type 1 Pickup Chassis) the EMT Driving was unaware of the assault occurring. – 1Q2016 EVENT Violence Report #12 This is the aggregate Provider Violence E.V.E.N.T. summary report for First Quarter 2016. 1

E.V.E.N.T. Provider Violence Report

Table 1: Violence Events Quarterly 2013

2014

Jan - Mar

3

10

9

Apr - Jun

5

5

6

Jul - Sep

18

5

19

Oct - Dec

10

5

5

Total

36

25

39

Near Miss Event Occurs with EMS

2015 2016 12

FIRST QUARTER 2016

As you review the data contained in this report, please consider helping us advertise the availability of the report by pointing your colleagues to www.emseventreport.com.

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E.V.E.N.T. Report Completed Online

CLIR Notified of EMS NME

Quarterly Reports Generated

When an anonymous EVENT report is submitted, our team is notified by email. In the United States, the anonymous event report is shared with the state EMS office of the state in which the event was reported to have occurred. The state name in the report is then removed and the record is shared through our Google Group and kept for this summary report. Canadian records have the Province name removed, and then the reports are shared through the Paramedic Chiefs of Canada, and kept for inclusion in aggregate reports.

Violence Events by State 8 7 6 5 4 3 2 1 0

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E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

Quarterly Violence Events by Country Canada 0

United States 5

Place Violence Occurred 7 6 5 4 3 2 1 0

3

E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

4

E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

Assailant Age

Victim Age 2.5 2 1.5 1 0.5 0

8 6 4 2 0 0-18

19-30

31-40

41-50

51-60

0-18

61+

Victim Race

6 4 2 0

51-60

61+

Male 75%

Male 67%

8

41-50

Female, 40%

Female 33%

10

31-40

Assailant Gender

Victim Gender

12

19-30

Asssailant Race 10 9 8 7 6 5 4 3 2 1 -

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E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

Paramedic's Perception of Harm 12 10 8 6

10

4 2

2

0 Low Level

Deadly

Type of Victim Injury 8 7 6 5 4 3 2 1 0

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E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

Type of Victim Treatment 7 6 5 4 3 2 1 0 None

Minor

Moderate

Serious

Method of Assault Note: Multiple Options Reported 6 5 4 3 2 1 0

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E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

Internal Agency Report Filed 12 10 8 6 4 2 0 Yes

No

Unknown

Law Enforcement Present or Notified 12 10 8 6 4 2 0 Yes

No

Unknown

Assailant Arrest 8 6 4 2 0 Yes

No

Unknown

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E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

#1

ALS responding to a seizure dispatch [run number], arrived on scene to find patient (21 yr. old male) being moved to ambulance by BLS with difficulty. Patient was on on stretcher, agitated, confused, with intermittent moments of calm and combativeness. ALS was advised that when BLS first arrived that police on scene were forcibly hold patient to keep from injuring self and others. Patient was at girlfriend’s home. Mother later advised patient on medication had not seized in over two years. Mother advised patient's medication was just changed by doctor. Girlfriend advised that patient seized for 5-7 minutes. During patient assessment in ambulance, patient continues with intermittent periods of calm, confusion, combativeness. Patient had calmed. ALS attempt to place IV in left hand for emergent medication requirement. ALS holding left arm during access attempt was explosively pushed and kicked, propelling into closed rear ambulance doors. ALS then drew up and administered 5mg Versed IM in left side thigh, which calmed patient, eliminated combativeness, anxiousness some agitation continued. ALS sustained skin cuts to right forearm and right calf, struck right occipital region of head, right shoulder, neck against rear door of ambulance. Mother arrived on scene and contributed to calming of patient. ALS allowed Mother with safety restraints to accompany patient in rear of ambulance. Patient transfer of care to ER without further incident.

#2

Patient was attempting to get out of his litter restraints when the EMT attempted to control the situation the patient grabbed her arm and twisted [it].

#3

Patient became violent with the staff and then providers he kicked one provider in the head and arm the second provider was spit on and kicked.

#4

Ambulance Crew posted during dynamic deployment. They parked in a public vehicular area adjacent to a restaurant and home improvement store. After parking, the subject in question came our of the restaurant and approached the ambulance. The subject in question became hostile toward the crew stating that they (EMS personnel in general) were stalking him and have been for some time. He stated that EMS people drive by his house at 4am with their lights off. He also stated that EMS personnel entered his bedroom through the door on the same day and left it open. The crew tried to explain things to him and he got more frustrated. The crew then had to leave. Eventually, he went back in the restaurant and called the police to make a harassment complaint. The Police Officer came and spoke to the subject in question. The Police Officer was very cooperative with our investigation of the subject in question. The Police Officer stated that the subject in question most likely was having issues with some Paranoid / Schizophrenia and may be off his meds. Through further investigation, this has happened several times before. We have increased our situational awareness and changed our posting position to prevent this from happening again, as the subject in question works at the restaurant. Our Admin staff has chosen to take a proactive stance about our crew safety. They encourage us to report all incidents like this.

#5

Family observer, drunk and belligerent, refused to move to facilitate access to patient, shoved EMT when he attempted to pass.

#6

On a traffic collision in [neighborhood] area. On arrival patient was conscious but acting under the influence in his vehicle. This vehicle drove into another truck and impacted a parked pickup truck. 9

E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

Patient was removed from vehicle and taken to the ambulance. He indicated he stole the car. During patient exam he became verbally and physically aggressive. He tensed his upper body and proceeded to punch the paramedic. He was physically restrained by the paramedic in a control hold and then taken to the ground in a control hold. He was subsequently handcuffed and turned over to PD without further incident. Transported to the hospital for jail clearance.

#7

On a response to a bar for an ETOH intoxicated 27 y/o female, the crew & police on the scene attempted to walk the combative patient up into the ambulance side door. When partially up the step, she began flailing & swinging at EMS & LE eventually falling forward into the crew member standing in the patient compartment. The medic was knocked over into the stretcher striking & injuring her back which required time-off and then a light-duty period when returning to work. No apparent injury or harm to the patient.

#8

One medic was assisting an officer to remove an ETOH intoxicated female from the police squad in the hospital ED garage. This patient was not transported by ambulance, she was transported by LE due to all EMS busy on New Year's eve. The hand-cuffed patient was just being removed from the caged back seat of the squad and placed in a wheelchair when she kicked the officer in the chest and knocked him backwards. While attempting to protect and assist the officer by restraining the patient, the medic was also kicked in the right side of his jaw. No treatment was needed or time loss for this injury.

#9

Handcuffed patient threatened to come find me at my home and kill my wife and children. Police were not present in ambulance (had refused to come in ambulance with handcuffed patient). Police did follow ambulance to hospital. Threats were repeated at the hospital, and were overheard by numerous nurses, doctor, police and other staff. At the hospital the arresting officer (from nearby town) said there wasn't anything to do. I called our local police station to check on the history of the patient, and they advised me that he was "all talk" and I shouldn't expect him to show up at my house...

A police officer transferred from their squad car to the ambulance a 24 y/o female who had punched a wall in a group home. The patient was cooperative with the police officer and he indicated initially to the crew that handcuffs were not required and he did not see the patient as a threat. #10 While assessing the patient's pain and injury to her hand, the medic was punched without warning or provocation. The police officer & other medic now subdued & handcuffed the patient before transport to the hospital in the ambulance. The patient also began spitting at any provider who came close. No additional injury sustained by the patient.

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E.V.E.N.T. Provider Violence Report

FIRST QUARTER 2016

EMS responded to single family residence to assist a sick female. FD arrived on scene and initiated initial contact/care. Female on front porch of home w/ male subject. Male met EMS and started cursing at EMS and threw off his coat and made verbal threats at EMS. EMS requested PD on scene #11 to remove male who was displaying violence toward EMS. Male subject then came at EMS and attempted to punch/shove and grab EMS. PD intercepted male subject and after a brief scuffle, arrested male for assault against a public official. EMS or FD personnel not injured. 2 PD obtained minor scrapes from altercation. Experienced Female EMT transporting a Mental Health Patient from ER to Inpatient Treatment Facility was Sexually Assaulted by the patient while preparing to exit the Ambulance at the receiving facility. Due to Ambulance Construction (Type 1 Pickup Chassis) the EMT Driving was unaware of the #12 assault occurring. Patient had no documented history of Sexual Assault, however had assaulted family caregiver recently. Also patient history of Cognitive Disorder in addition to Mental Health conditions. EMT was able to escape ambulance without injury due to the assault occurring as vehicle as being parked. Prosecutors office seeking Arrest Warrant.

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