On September 8th I was approached by my supervisor about a complaint from parents of a 18 month old child that fell. I explained to her that the parents brought the toddler into ER. I met them at the door and asked them what was wrong. The mother stated she left her toddler on the bed and left her bedroom to do some things. She said she heard the toddler crying a few minutes later in her room. She found the toddler on the floor, and he was unable to move his right arm.
I then was asking questions about the floor he fell onto. Was it tile or carpet. While talking to the mother, I went to grab to feel for pulses above and below the elbow area. At this time the toddler pulled his arm back, because he didn’t want me to touch him. At this time while holding his arm. His elbow popped back into place, and he was able to move his arm again. More than likely it was nursemaids elbow from the fall.
I then told Mom, well its fixed now. She said it is? Yep he popped his arm back into place while he was fighting me from touching him. I then showed her that the toddler had full range of motion of his right arm. He cried shortly and then stopped. As I showed the mother he had full range of motion to the arm, the child never cried again. There was no deformity, redness, swelling, bruising, good pulses, capillary refill was good, and full range of motion. No point tenderness or any inability to move his arm on his own.
At this time I took my car keys out of my pocket and jingled them, so the toddler would reach out with an out-stretched arm and grab my keys. He did. And pulled them back to his chest. I then gently tried to get my keys back to see if there was any pain with resistance of the toddler to keep hold of the keys. No pain or crying.
The father was holding the child the entire time. I then said let me triage you so the doctor can see you. The father then said, well he wasn’t moving his arm before and it looks fine now. I said, Ill be more than happy to triage you. But if you leave, that’s up to you. I can only advise you to stay for treatment. The father and mother spoke about it, and decided to leave. They said they would come back if there were anymore problems. It was a Saturday when this happened. I advised them that were open 24/7, and don’t hesitate to return if you need to. Right before they left I grabbed the toddlers arm once more to see if I would get any response of pain to the arm. There was no grimace, no crying, not a whimper from the child when they left. And then they thanked me and left.
Approximately 4-5 days after they refused care, the mother stated in her complaint that her son was still in pain and took him to her doctor and they took an x-ray and found a displaced mid-shaft radial fracture of the right arm. I was shocked. I told my Director, there was no way possible that arm was fractured the way I did my assessment on him, before and after he self reduced his nursemaids elbow. He would have been screaming in pain if his arm was fractured then. Climbing the ceiling in pain. Couldn’t be possible.
It took 11 days till my Director approached me about any complaint from the mother. It takes a lot of force to have a displaced fracture from a toddler. Their bones are almost rubber at that age. Greenstick is more common, but displaced? From a fall off the bed at no more than 2 feet?
I was asked then to do an incident report. I was then asked if I had them sign AMA. I didn’t. I was alone in triage and had people waiting to be triaged. So I did my incident report and e-mailed it to my Director. After I did the incident report, I went to both Charge Nurses and told them to please use me in triage as a last resort cause of this complaint. After I told them what the mother had accuse me of.
My Director said that the mother had some medical knowledge. And she stated that I reduced her toddlers nursemaids elbow and basically said I told her it was alright to leave. Say What? I never said or did anything like that. I don’t remember the section in Paramedics class 20 years ago about instructions on reducing Nursemaids elbow, I don’t have a clue how to do it. I have seen the ER Pediatrician do it hundreds of times. And see the results after. Back to normal in minutes for the child.
And if the mother had medical knowledge why did she leave that day. Or come back the next day or the next or the next day. If that toddlers arm was fractured as the report from the Ortho doctors office said days later. The toddler could have never crawled on the floor or walk a few feet and fall without screaming in pain. They left on their own free will that day. Nothing I said to them even comes close to the thought of saying its ok to leave.
On Sept 9th I was called to Human Resources. I said to my co workers it was nice working with you, cause I’m probably going to get fired over this complaint. I knew right then that I would be terminated. It’s the Palms West way. And being a man in a woman’s world, makes it even worse.
Palms West always listens to the patients complaints and you have no defense to the truth of incidents that patients complain about. They lie, blow it up more than what actually happens. And employees have no chance of defense. Got to keep the patients happy so the money rolls in at my career and many others that lost their jobs due to bogus complaints from patients. Mostly to get their bills erased.
I walked into the office and said I resign. I will not be terminated over this mess. I am not suppose to be in triage and the argument began. They insisted I was allowed. And I had to hear about why I was being terminated, even though I resigned under duress before they could say anything about termination.
They wanted to terminate me for practicing beyond the scope of a paramedic and EMTALA violations, for not having the AMA signed. You will see it in my personnel file. Having a Paramedic in Triage alone, they violated the laws they wanted to terminate me for. Makes a lot of sense.
We argued about the toddler and his fractured arm. No way it was fractured then. So I shut my mouth, and let them have their glory. Knowing that they have just violated the laws that I knew were in place for years. I never wanted to be insubordinate and refuse to go to Triage when I was assigned there. I just did what I was told. I always knew that one day if something happened, I had the knowledge of the State of Florida Laws and Statues. I just wanted to keep my job. Do as I’m told.
Plus there is a camera that points to the triage door. They refused ,nor even tried to view the allegations the mother stating that I reduced the elbow from the surveillance video. It would show the toddler pulled from me and started crying cause I was touching him, and then the elbow popped back into place. Then the video would have shown me checking for full range of motion without the toddler crying at all. And them leaving and still no crying from the toddler. Mother states differently. Profits over truth again.
Over the years it would be, medics cant do triage, and then when it was short RN‘s, we would be sent out to triage. Back and forth, back and forth.
I was employed at the hospital for 11 years and never had any reprimands on patient care. Thousands I have triaged and never had a problem. And when I was sent out to triage, I was placed there because there wasn’t enough RN’s to staff it. No matter how busy I got, I was alone. When the RN was out in Triage and they got busy, I would be sent out to help them get caught up. Not enough RN’s on staff on a certain day, then the medic is sent out for the 12 hour shift alone.
I have filed a complaint with DCF on the parents. And have not heard back from them on the case. When I filed the report, the call taker said that leaving the toddler on the bed was neglect alone. And they would get back with me on the investigation results.
To this day the remaining paramedics are still being placed in triage alone. If you do a on-site review. Ask to look at the Daily Assignment Sheets in the ER for the past few months, and you’ll see my name Greg, Joe and Sean, with a letter “T” that is circled for triage. We are the 3 paramedics there. Or should I say the 2 remaining medics there.
I was placed in Triage illegally. And they wanted to terminate me for it? There guilt is written in proof in my file. Cant deny what was typed and signed.
I have never been to an in-service about EMTALA regulations. The RN’s had to go to a course that was called Triage First for triage training. The medics were not required to go. And after studying EMTALA to its fullest. No where does it say anything about Paramedics. Its all Physicians and Nursing. So how could they terminate me for EMTALA violations, when they violated EMTALA themselves by having me alone in Triage.
Paramedics do no charting on patients charts. So we are not really informed on the new AMA forms. The RN’s do that when someone leaves AMA, not the medics. Plus triage is not part of a Paramedic’s Annual Competency for reorientation, nor part of our job description.
So my long standing career is over after 11 years. I have taken a 20k cut in pay a year with my new job alone. For the sake of a patient complaint and keep the monies coming in. I was advised that the CEO is being moved to another hospital. Possibly all the proof I sent to HCA’s corporate Ethics and Compliance Group in Nashville of the statues, laws, and administrative codes of Florida they violated when all this happened by placing me in triage. Maybe not.
Basically it comes down to this. They lied over and over about medics being allowed in triage. And they took their chances by putting me and my fellow paramedics in triage hoping nothing would happen. And their ways of pleasing the patients for profits over all else, has now come to bite them right where it hurts. Now they have to pay. I am worried about my fellow paramedics still being placed out in triage still. They have families and work for Palm Beach County Fire/Rescue as their main jobs, and supplement their income to support their families at Palms West. I am single and have no family. This has to stop now before the same thing happens to them over a bogus complaint. Just like it happened to me. So I have to look over my fellow brotherhood of Firefighters. I am a retired 20 year Firefighter/Paramedic.
So my plan is to bring legal procedures against the hospital now. All I worked for, over an 11 year period is gone. And being banned from the grounds. I cant even visit my friends either.
Lastly, if they would have followed the laws. I would have never been in this position in the first place. And would still have been employed at Palms West.
Do I have a wrongful termination case? I walked in HR and said i resign, I'm not going to let you terminate me for your unlawful practices. Constructive or Disparate discharge?

