A doctor doing research in Rhode Island stumbled upon 11 cases of medical negligence that resulted in patient deaths.

According to hospital records, patients had arrived via ambulance with breathing tubes mistakenly sending air to the their stomachs instead of to their lungs. Without air making it to their lungs, the patients suffocated.

Rhode Island is one of the few states that allow Emergency Medical Service (EMS) workers other than paramedics to intubate patients. While paramedics are the most highly trained EMS personnel, Rhode Island has a unique classification of EMS provider called an EMT-Cardiac. Even though the EMT-Cardiacs do not receive the extensive training provided to paramedics, the EMT-Cardiacs are licensed to perform intubations.

Of the 11 patients who died, eight had received intubations by EMT-Cardiacs. One had been intubated by a paramedic, but two of the deceased’s records didn’t reveal the person who committed EMT negligence.

Intubating someone is not as simple as it might seem. One study published in 2012 in the Annals of Emergency Medicine: An International Journal determined that 12 percent of intubations require more than one attempt.

How Can Medical Negligence Be Prevented?

According to ProPublica, Rhode Island hospitals must report errors they commit, such as an MRI ordered or surgery performed on the wrong body part, but hospitals are not held accountable to report errors committed outside their facilities. The instances of intubation mistakes appear to be medical malpractice situations that fell through the cracks.

When an EMS unit fails to properly insert a breathing tube, but doesn’t even realize the error, the mistake fails to be reported to state health regulators at all. After the ambulance drops the patient off at the hospital, the EMS personnel are gone by the time the hospital staff realizes the patient is suffocating.

Asselin’s research was focused on cardiac arrests in the state of Rhode Island when his assistant pointed out several hospital records referred to misplaced breathing tubes. Asselin told ProPublica the finding “sort of sent a chill down my spine.”

Not recognizing that a breathing tube is directing air to the stomach instead of to the lungs is something that is never supposed to occur in the world of emergency medicine. Still, Asselin found it happened about 4 percent of the time within the last three years in Rhode Island. In general, patients had heart failure or heart attacks that they very likely could have survived, said Asselin.

Despite Asselin’s findings, the 25-member Ambulance Service Coordinating Advisory Board was largely opposed to restricting EMT-Cardiacs from intubating patients. The board did vote to require EMS employees to only use intubation as a last resort, only if less invasive airway measures don’t work.

According to ProPublica, the state of Rhode Island’s firefighters union has accused doctors of invading their territory and trying to increase medical care costs. Asselin spent more than decade as a firefighter and EMT himself before becoming a doctor, and was shocked he was being seen as an enemy at the meeting.

Days after the board decided not to stop EMT-Cardiacs from performing intubations, a 12^thvictim died of alleged medical negligence. A mother of four, 38-year-old Paula Duarte arrived in a Providence emergency room where a doctor realized the breathing tube was filling her stomach with air. Even though he removed the tube and reinserted it to fill her lungs right away, Paula died at the hospital.

This article is not legal advice. It is presented
for informational purposes only.