LITTLE ROCK — Two paramedics who missed signs that a Little Rock woman was alive and stopped treating her because they thought she was dead won’t appeal the suspension of their licenses in the matter, according to a letter filed with the Arkansas Department of Health.
Metropolitan Emergency Medical Services paramedics Pat Bajorek and Brandi Johnson began serving 34-day suspensions in late March after they notified the Health Department that they disagreed with its findings but wouldn’t challenge punishment handed down over their care of 52-year-old Pamela Harper, the letter said.
Harper died more than a year ago after Bajorek and Johnson led two separate ambulance crews that missed signs that she was still alive over the course of about three hours while she lay outside her brother-in-law’s west Little Rock home.
“It’s the kind of an event that we will never forget, and we will apply the lessons learned from this as we go forward,” MEMS Executive Director Jon Swanson said Monday.
“It’s not behind us. It’s going to be with us ... from this point going forward.”
Harper’s death spurred MEMS to change its protocol, as well as an 11-month Health Department review of the paramedics’ actions on the morning of March 26, 2010.
The first responding ambulance crew led by Bajorek determined that Harper was dead and left. Later, a detective noticed her breathing and called the second crew, led by Johnson.
Johnson’s crew also found no signs of life, and a doctor, contacted by radio, pronounced Harper dead. But, about three hours after she was found, a coroner saw her breathing, and a third crew took her to a hospital.
During the time she lay outside, she was dressed only in a shirt and underwear in temperatures that ranged from 41 to 50 degrees. Harper died about two days later.
Harper’s death was ruled an intentional overdose of the narcotic painkiller Darvocet and alcohol, the levels of which the state medical examiner has said made it doubtful that earlier care would have saved her life.
In February, the Health Department cited the ambulance service for four violations of state emergency-medical protocol, according to a copy of the review obtained through the Arkansas Freedom of Information Act.
The Health Department, which oversees emergency medical services, also warned Bajorek’s and Johnson’s crew members, emergency medical technicians Miles McDonnell and Keith Summerlin.
The Health Department’s review found that Bajorek and Johnson each separately failed to detect signs of hypothermia, which - along with no visible signs of breathing or a heartbeat - led them to an “assumption” that Harper was dead.
Based on that belief, they mistakenly diagnosed rigor mortis and other signs of death. Johnson also failed to recognize Harper was experiencing “pulseless electrical activity,” a condition where electrical heart activity is present on an electrocardiogram but not accompanied by a detectable contraction of the heart in the body’s arteries.
The errors by the first two paramedics’ crews delayed her “eventual resuscitation” by a third crew, the review found.
The review reinforced earlier concerns over Harper’s care related to hypothermia that were identified in a report released in June by Pulaski County Coroner Garland Camper.
In a letter dated March 24, the paramedics, their crew members as well as Swanson and MEMS Medical Director Dr. Charles Mason said they would accept the Health Department’s decision but disagreed with its findings.
The letter restates earlier public comments from Swanson saying the paramedics made mistakes but were being incorrectly faulted for not performing medical procedures that either weren’t required by protocol at the time or they weren’t obligated to consider once they had determined a death.
In response to Harper’s death, MEMS changed its protocol for withholding life support to requiring paramedics to open patients’ airways and to use stethoscopes to check for heartbeats, which the letter notes among other steps.
It also pointed out that Johnson completed additional training and that the case is now used in paramedic and emergency medical technicians’ initial and “refresher” training.
Spokesman Ed Barham said the Health Department didn’t have a response to the letter from MEMS.
“The letter represents their confirmation that they don’t intend to pursue a legal remedy,” he said. “Other than that, I think the letter speaks for itself.”
Bajorek will return to paramedic duties April 29, and Johnson returns May 4, according to the letter.
Both paramedics were given credit for 26 days of earlier paid administrative leave as part of the Health Department’s 60-day suspension. The Health Department also placed them on at least six months of probation in the matter.
Arkansas, Pages 7 on 04/05/2011