Ambulance district opens internal investigation

Wednesday, January 14, 2015

Purdy police chief: Issues with paramedics, emergency room come and go

The Barry-Lawrence Ambulance District is conducting an internal investigation in responses to a report by a Barry County sheriff's deputy saying one of the organization's paramedics argued with him about taking a Purdy man to the hospital.

Jeaneittia Pierce, Barry-Lawrence Ambulance District office manager, said she is conducting an internal investigation about the incident involving Pedro Martinez, 59, of Purdy, and just because an ambulance is called does not mean a person needs transporting.

"An assessment of the patient when we arrive on scene determines if the patient is transported," she said. "Also, if a patient refuses care, we do not transport them. The paramedic has the final say. We will not deny a patient transport who requires transport by ambulance."

Pierce said she has not spoken with Cox Monett Hospital representatives, nor the Barry County Sheriff's Office, and she has received no more information other than what was published in Jan. 7 edition of The Monett Times.

"We are doing our own investigation," she said. "I have received no information other than what was in the newspaper, so I have been looking into it. We take these issues seriously and will address them.

"If issues like this come up, it is appropriate for us to look into them fairly, and I am available 24-7 to anybody."

Medic Randy Haycook, who was named in the report filed by Zabala and allegedly argued with Zabala over transporting Martinez, did not appear on a staff listing sent to The Monett Times on Friday.

When asked if Haycook was still employed by the organization, Pierce said she could not discuss Haycook's employment status.

In the early morning hours of Jan. 1, Barry County Sheriff's Deputy Al Zabala reported having difficulty getting transportation and treatment for Martinez, who was allegedly intoxicated and fell out of a chair, injuring his head. According to Zabala, Martinez's wife said he was a mental health patient and asked that he be taken to Cox Monett Hospital to be treated for the fall and placed in the hospital's mental ward. Martinez had allegedly been drinking, mixing the alcohol with his medications, leading his wife to become concerned for his health.

Zabala said Haycook, who arrived on the scene to transport Martinez, said Martinez was just intoxicated and needed to sleep it off. After 15 minutes of deliberations, Zabala said Martinez was transported to the Cox Monett Hospital Emergency Room. Zabala said Martinez was refused treatment at the hospital by Dr. Tommy Trent, leading him to take Martinez to Mercy Hospital in Cassville. Sonya Kullman, senior media relations specialist with Mercy Hospital, confirmed Martinez was treated and released on Jan. 1.

Jackie Lowe, Purdy police chief, said such issues with the ambulance district and the hospital come and go, and paramedics have refused to transport patients to the hospital as recently as Christmas.

"On Christmas, we had a man on a 96-hour hold [because he was threatening to harm himself], and they refused to transport the subject," he said. "They did not say why they wouldn't transport him, they just debated it and said they wouldn't.

"[Purdy police] took him to the Barry County jail in Cassville to meet with a Cox ambulance, and they would not take him either. The man wanted to commit himself, and he needed transport. So, my officer called the Clark Community Mental Health Center, and they advised to take him to Cox Monett."

Lowe said when a subject threatens self-injury, police may put the subject on a 96-hour hold and transport the subject to be committed to a mental health facility for evaluation.

"[Barry-Lawrence] had been transporting those subjects by ambulance, because they have to be medically cleared by a doctor before being put in a mental health facility," Lowe said. "If they commit themselves, they can sign themselves out whenever, but if we commit them, they must stay for the full 96 hours.

"Ambulances had transported these patients before, and for whatever reason this time, they refused to do it."

Pierce said she was not aware of such an incident.

Lowe said he has also had issues in the past with the Cox Monett Emergency Room, albeit not as recent as with the ambulance district.

"About four years ago, there was an intoxicated man who said he was trying to drink himself to death and had overdosed on alcohol," Lowe said. "When we took him to the hospital, they asked if he intended to harm himself, he said no, and they said to take him home and they wouldn't treat him. The next day, he collapsed and was transported by ambulance to the hospital, and he was treated at that time."

Lowe said there was no police report available detailing the incident.

Yvette Williams, director of corporate communication with CoxHealth in Springfield, said some of the issues with Martinez come down to terminology.

"Every patient that come to the ER receives a medical screening evaluation," she said. "That's the minimum standard. Not every patient is treated and not every patient needs to be treated.

"And we do not admit all patients. Only 30 percent of patients who come to the ER in Springfield are admitted."

Williams said a patient may be treated by emergency room personnel, but may not be admitted. An admitted patient is housed in a room with a bed for a certain period of time, generally overnight, according to Williams.

"The patient we are talking about, [Martinez], received a medical screening evaluation and was released into the custody of the sheriff's department," she said. "Just because someone thinks they need to be admitted does not mean they need to be. In general, if medical care is necessary, they will be treated. If anything needed to be done beyond that, it would have happened. We did not and do not turn patients away from our emergency departments."

According to Williams, a medical screening examination involves whatever level of care the physician deems necessary to determine if an emergency medical condition exists.

"This could include anything from a medical history and a physical exam, to ordering tests and admission into the hospital," she said. "Due to patient privacy, we aren't able to provide specific details about this case other than to say an appropriate medical screening and evaluation were provided in this situation."

Lowe said relations between the police department and the Barry-Lawrence Ambulance District and Cox Monett Hospital vary depending on the day.

"We've been getting along with the paramedics fine except for the Christmas day incident," he said. "At the ER, it just depends on who is working. Sometimes, they are friendly and helpful, and other times, they do not want to help us out with anything."

Martinez, who was treated at Mercy Hospital in Cassville on Jan. 1, was held in the Barry County jail on Jan. 7. According to Mick Epperly, Barry County sheriff, Martinez was placed on a 12-hour domestic hold, from 2:30 p.m. on Jan. 7 to 3:20 a.m. on Jan. 8, and no charges were filed in the incident.

Lowe said he has dealt with Martinez a few times, but never for anything substantial. Lowe said Barry County deputies responded to the Martinez call on Jan. 1 because Purdy Police did not have an officer on duty.

"They have different family issues that go on and I've dealt with them a couple times," he said. "But, it's never been for anything major."

Monett Police Chief Tim Schweder said he has never had any issue with the Barry-Lawrence Ambulance District, nor Cox Monett Hospital, in the past. Lawrence County Sheriff Brad DeLay said his office also has not had any issues with either organization.

Mike Abramovitz, Pierce City police chief, said he has not had issues with either organization.

"One or two times per year, we'll put someone on a 96-hour hold and ride over with them, but [the Barry-Lawrence Ambulance District and Cox Monett Hospital] have been pretty cordial to us," he said.

Cassville Police Chief Dana Kammerlohr said she has not had any issues, but her department deals more with Cox ambulance service and Mercy Hospital in Cassville.

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