A paramedic and emergency medical technician (EMT) failed to care for an elderly man who later needed two amputations while in their care, a report has found.
In October 2019, the man, aged in his late 80s at the time, had been working underneath a van for a few hours when his left leg became painful and numb. He called for an ambulance, and after he was clinically assessed over the phone a paramedic and EMT attended to him.
Although they assessed the man's leg, they didn't remove his sock, the report says. They considered his pain was musculoskeletal and decided not to transfer him to hospital.
The next day, the man woke up with severe pain and a blue foot and was admitted to hospital with an ischaemic left lower limb. He underwent a left below-knee amputation but later needed a further amputation above the knee.
Kevin Allan, the Deputy Health and Disability Commissioner, released a report on Monday saying the ambulance service and paramedic were in breach of the Code of Health and Disability Services Consumers' Rights for their care of the man.
Allan considered the paramedic's assessment of the man was incomplete and resulted in the decision not to transfer him to hospital. He also considered that the paramedic's documentation was below accepted standards and didn't adhere to the ambulance service's guidelines.
Allan accepts the EMT wasn't the most senior clinician responsible for the care given to the man, but he was critical of the lack of reflection and responsibility shown by them in response to the man's care.
He says the need for effective communication, collaborative working, and collective ownership of the challenges are evident in this case.
The paramedic has since retired from this job and has given the man a written apology. Allan recommends that if they should return to being a paramedic, they arrange for further training on clinical procedures and guidelines, challenging assumptions, and managing inter-professional relationships.
Allan also recommended the ambulance service report to the Health and Disability Commission (HDC) on the outcome of the EMT's competency review and subsequent training, and give HDC evidence of training to staff on conflict and communication breakdowns, once completed.
