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Paramedics opt for shift change, patient dies

17 Sep 2012, 08:56

Published: 17 Sep 2012 08:56 GMT+02:00

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The ambulance was on the E4 motorway near Linköping when drivers were notified of a priority-1 call, the most urgent classification of emergency call for patients with "life-threatening symptoms".

At the time, they were headed back to the station as their shift had just ended.

But instead of responding directly to the call, the drivers entered the address from which the call was made into their GPS and determined they could still manage to swing by the station on their way, the local Norrköpings Tidiningar (NT) reported.

"That's against guidelines. You don't delay a priority-1 call," Christer Andersson, a doctor with the Linköping University Hospital told the paper.

Andersson explained that the drivers in the ambulance had called ahead to their colleagues to ensure that the change in drivers would happen quickly.

Despite their best efforts, however, the waiting patient died after suffering from cardiac arrest.

Following the fatal incident, which took place on June 5th, 2012, the ambulance drivers estimated that changing drivers delayed their arrival by 50 to 90 seconds.

Andersson has since reported the matter to the National Board of Health and Welfare (Socialstyrelsen) in accordance with Sweden's Lex-Maria laws, the informal name for regulations governing the reporting of injuries or incidents in the Swedish health care system.

Story continues below…

He explained that an autopsy to determine the patient's exact cause of death has yet to be completed.

TT/The Local/dl

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Your comments about this article

09:51 September 17, 2012 by StockholmSam
While it might be difficult to determine whether that 90 seconds would have made a difference in saving the patient's life, the main issue here is that this episode is indicative of a broader systemic problem. And when I say systemic problem, I do not mean just in the emergency services but in all of Swedish culture. Think about it, at least three emergency workers had to agree to the driver switch, two on the ambulance and at least one at the base station that agreed to the switch. Someone along the way should have said no to this idea. Just one person! It is merely indicative of a much larger problem that will continue to cause problems in our community.
09:58 September 17, 2012 by RobinHood
".... an autopsy to determine the patient's exact cause of death has yet to be completed."

So, right at the end, we learn that it is not yet known how the patient died, or if the 50 to 90 second delay had anything to do with it.

Wouldn't it be best for the relatives, the drivers, and even the good doctor, if those vital questions were answered first, and the hue and cry reserved until after?
10:06 September 17, 2012 by OopSan
"Following the fatal incident, which took place on June 5th, 2012"

"an autopsy to determine the patient's exact cause of death has yet to be completed"

It is not surprise that patient has died. Damn lagom everywhere.
10:12 September 17, 2012 by Swedishmyth
This is pure Swedish culture. So many functions are governmental in Sweden that there is no sense of accountability. Wrongdoers just hide within the mass of an untargetable public.

Yet people here still thinks government equals responsibility, and private companies equal fraud at every opportunity. But it is private companies' continued existence that depends on their conduct. Government is forever, unconditionally.
10:26 September 17, 2012 by Reason abd Realism
Unless the paramedics honestly felt that a shift change would improve the chances of patient survival (for example if they had just finished an all night shift and were uncertain that they could operate the defibrillator properly, or some super cardiac expert was waiting with the new group of paramedics - two scenarios that I doubt highly), then I have to agree with post #1. This is unacceptable behaviour for a group of emergency responders. In addition to heart attacks, stroke victims for example can in some cases be prevented from serious brain damage if they are administered a powerful drug within the first hour that they have suffered the stroke.
10:33 September 17, 2012 by Rishonim
The driver had to make it home in time to watch the highly intellectual show, Bonde Soker Fru
10:41 September 17, 2012 by Boo2027
I am not surprised they want to go home early. The medical system that makes people in "Akuten" wait for hours and hours (sometimes up to 15 hours) just to meet a doctor for a check-up. Come on, in 15 hours only ONE doctor is available?? The tax payers are not paying you to expand your fika time. It appears that everybody just think for themselves, they don´t think about the people who needs their services.
11:07 September 17, 2012 by Reason abd Realism
... further to my post #5. My point about the stroke is that every passing minute before that drug is administered within the first hour results in increased accumulated brain damage, so a 50 or 90 second delay can significantly affect the quality of life of the patient after the stroke. If you suspect that someone you know is having a stroke (you can find a list of in some cases non obvious stroke symptoms on the web) then get that person to a hospital as fast as humanly possible. Obviously this may not have been a survivable stroke emergency, but it could conceivably have been, and so for this reason among others I feel that (based on what we are told in this TL article at least) the behaviour of the emergency response team was unacceptable in this case.
11:25 September 17, 2012 by Lavaux
Is your health care free? Well you certainly get what you pay for, don't you? Try explaining that to a Swede who has been indoctrinated from daycare to today to love all the free stuff the state provides and all the paid time off they get from work. I've gotten as far as an intellectual acknowledgment that all of the free stuff isn't free and that employers don't pay workers not to work, but never further to the next consideration - what are the trade-offs and are they worth it? You see, that warm, fuzzy frisson that Swedes get when contemplating their welfare state cannot be intellectually transcended.

Regarding the story, I wonder whether the ambulance crew was acting as an agent of the state providing a public service, whether "tjänstefel" or negligence will come into play, whether the ambulance company was insured against malpractice, or whether some other legal remedies exist (in favor of whom?) should causation between the delay and death be established. I'm not saying the article is insufficient; I'm just curious how a possible wrongful death claim would work in Sweden.
11:32 September 17, 2012 by eppie

quote: But it is private companies' continued existence that depends on their conduct.unquote

You mean like goldman sachs. :)
11:37 September 17, 2012 by johan rebel
This is just an extreme example of the culture that pervades and permeates the entire Swedish public service sector, employees as well as unions. They have long since forgotten that they are there to provide the taxpayers with the best service possible at the lowest possible cost. Instead, they have come to believe that the public sector is there to provide them with jobs and pensions, which results in their behavior being guided by a sense of entitlement instead of obligation.

In summer, proper health care is not available, fire departments are staffed by unqualified and inexperienced temps, there are fewer cops, etc. etc. only because the employees' right to vacation trumps everything else. Welcome to the uniquely Swedish version of Through the Looking Glass, which often has fatal consequences.
12:07 September 17, 2012 by Swedishmyth
@johan rebel

You are absolutely correct. But why expect anything different when these functions are funded by force? Theft and extortion don't change their nature just because they're made legal and grander in scope.

Only a mutually voluntary deal between two parties can ever result in respectful conduct and service from both sides. Force is not a proper way to deal with fellow human beings, unless they, well, force you to.
12:37 September 17, 2012 by Snood
@ Boo2027 #7.

I disagree with your statement about doctors having extended fika instead of treating patients. My sambo works in an A&E department. I get really annoyed that she will often come home after a 10 hour shift and she won't have had any munch, never mind fika. Why? Because she's been rushed off her feet dealing with patients. On the whole, doctors do care and are dedicated to serving their patients first.

Also, A&E departments need to prioritise based on the severity of the injury. if you come with a slightly broken bone then a stream of more serious incidents come in, the broken bone patient, even though they were there first, get pushed back in the queue.
13:28 September 17, 2012 by StockholmSam
@Lavaux (#9)

Um, no, Swedish healthcare is NOT FREE. What it is is UNIVERSAL and that is not the same thing. We all pay for our healthcare system. And it is very expensive, although on a social level rather than an individual level. Imagine all that tax revenue being spent on something else, such as roads or education or the military. It would be an enormous sum of money. So to spend it on healthcare means we give up the opportunity to spend it on something else. This is called opportunity cost. So no, our healthcare system is NOT FREE.
18:13 September 17, 2012 by Lavaux
@StockholmSam (immediately above)

You almost made it to trade-offs until you assumed that the level of taxation sans the obligation to pay for a UNIVERSAL health care system would be the same. How so? Always question your assumptions. Always.

The true opportunity costs arising from paying for Sweden's UNIVERSAL health care system "on a social level" are (1) your opportunity to spend your tax krona on something other than a UNIVERSAL health system, on something that would get you closer to happiness, and (2) the wealth creation that would result if those who know how to make money with money had more money to spend or invest to make money. A rising tide lifts all boats, of course.

I know how Sweden works because I've been here too long. What's your excuse? BTW, the reason I'm not a socialist is that I don't believe that either Rheinfeld, Salin, Oly, or the rest of Sweden's leftist politicians can spend my or Jens Spendrups' money better than I or Jens can, either to attain the common good or merely my own. Do you?
21:33 September 17, 2012 by dizzymoe33
They should not have stopped to switch out the drivers. They should have gone straight to the woman's house and helped her. Don't they have overtime pay in Sweden?
23:27 September 17, 2012 by BackpackerKev
I've given up trying to make sense of the Swedish Culture and the lack of Swedish accountability.. To many nonsense, dumb events happening on a regular basis for a country of 9 million. Every day is like playing the lottery, only the odds are much higher and the outcome is not positive.
14:16 September 18, 2012 by cogito
@Lavaux, I wish you would post more often.
19:47 September 18, 2012 by cattie
Ambulance services have been privatized in Sweden. Private companies have contracts with local authorities. The problem is that the oversight and consquences are still the same as if emergencies services were still a public utility.

Until the remedies and consquences are appropriately punitive to for-profit firms who underperform in their contracted services... we will continue to see a deterioration of such services.
05:52 September 22, 2012 by schmuck281
I just retired after twenty years as a dispatcher in America. Here is how it would have been handled here:

First, the dispatcher would have sent the call to both the ambulance and the station. We have spare apparatus at all our stations. Both the ambulance ending its shift AND the oncoming shift would have responded.

Whatever ambulance crew arrived first would have started assessment and the crew just coming on would have transported.

In my experience as delay of 50 to 90 seconds would not have affected the outcome.
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