Recently, I've been closely monitoring the jury trial of two Colorado paramedics, facing charges of negligent criminal homicide for a patient incident that occurred in 2019. This event unfolded in my own county, and the trial is taking place just a few miles from my home. Consequently, on Monday, December 4, 2023, I took the opportunity to witness the proceedings firsthand at the local courthouse. The trial's ramifications are significant, impacting not only the local community and the defendants but also echoing throughout the EMS profession. The trial probes a pivotal issue: When does imperfect medical care become criminal?
The ongoing trial is live-streamed, and I urge EMS leaders, educators, and providers to watch. You can find it under Adams County Division L at: https://live.coloradojudicial.gov/
As a paramedic with nearly three decades of experience and nearly a decade of that as a state EMS official, today's trial provided me a new profound reflection on the current realities faced by EMS providers. Sitting in the courtroom, flanked by EMS & Fire personnel there to support their colleagues, the weight of each testimony and the intense scrutiny of the EMS personnel's actions resonated deeply with me.
The trial rigorously assessed every decision and action, highlighting the fact that EMS personnel often have mere seconds to assess and respond in their daily duties. The prosecution's frame-by-frame analysis of police body camera footage underscored how the EMS environment has evolved significantly since my days as a full-time paramedic. In the current era, every urgent and unpredictable action is documented on video from various angles. However, strikingly, none of these videos capture the actual perspective of the EMTs or Paramedics. Their viewpoints are only inferred from the police body cameras, offering a different narrative. This incident has brought to light the distinct differences in training, objectives, roles, and responsibilities between police and EMS.
Today, a key witness was the agency's EMS Physician Medical Director. His testimony offered the jury professional insights into the protocols and decision-making frameworks guiding EMS personnel. He highlighted the immense responsibilities of EMS teams, who often make critical, split-second decisions in life-threatening situations, frequently in challenging conditions. The prosecution focused on the nuances of local-level credentialing, training records, and the difference between direct physician delegation and paramedic practice. While paramedics adhere to medical protocols established by physicians, they are also individually licensed with a defined scope of practice. Addressing the prosecution's query, "Paramedics practice under your medical license, right?", the EMS Medical Director clarified that EMTs and Paramedics hold individual state licenses.
The courtroom atmosphere was a mix of solidarity among EMS personnel and a palpable anxiety, reflecting a shared understanding of the fine line they walk with every emergency call. Multiple times throughout the day, the defense emphasized the time elapsed since the incident (over 4 ½ years) and the number of patient calls the EMT witnesses have treated since (over 8,000!). Another striking observation was the EMT partners of the paramedics on trial, facing the intense scrutiny of relentless questions from both the prosecution and defense. Every word, every syllable was examined by the legal team, the jury, and their peers, highlighting the constant exposure EMS personnel face to high-pressure situations, where every decision can later be dissected and questioned.
The testimony from a police sergeant was equally complex. The perspective from law enforcement underscored the often complicated interaction EMS has with the police, where roles can blur in the heat of a crisis. His words highlighted the challenges of navigating these dynamic scenarios and foreshadowed the complexities the industry is certain to face in the future in some localities.
Throughout today's proceedings, what resonated most was the unspoken bond among the numerous EMS and Fire personnel in the observation gallery. The weight of the proceedings, not just for those on trial but on the entire profession, was apparent by proxy of those sitting in the courtroom. During a break, conversations of EMTs and Paramedics stricken by their own fear were overheard – will the next call they respond to be the career-ending patient encounter for them? Did they miss something in one of the last 2,000 patient encounters of the last year, or the last 8,000 over the past four?
Today wasn't just about the two paramedics on trial; it reflected the experiences of the entire field. While there are concerns over the quality of care provided to the patient, and areas for improvement are apparent, from my perspective it does not seem to be criminal. After listening to the trial thus far, and observing body cam video dissected frame by frame, the situation was as complicated as it was unfortunate. It served as a stark reminder of the fears and uncertainties harbored within the profession - what if the next call is the one that leads to a similar situation?
As the court recessed for the evening, and everyone stepped out into the fading light, I reflected on how different the EMS profession is today than it was in the 1990s. The roles and responsibilities of EMTs and Paramedics have evolved substantially, but equally the challanges and risks have substantially changed also.
The opinions shared in today's post are solely my own and do not represent the views of any organization or employer, past or present.