Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

Trauma in the Emergency Room by hedumpsitacross

VIEWS: 0 PAGES: 21

									Trauma in the Emergency Room
   The Medical Examiner Perspective
      Case Synopsis: David Gunby
        11-12-2001 @ 1030 hrs
   Nurse- I’m calling to report the natural death of
    a patient due to renal failure. The doctor at the
    hospital will sign the death certificate.
   Investigator- How long has this person been on
    dialysis?
   Nurse- 35 years.
   Investigator- What happened 35 years ago to
    require dialysis?
   Nurse- Oh, he was shot and lost a kidney.
   Investigator- Shot where?
   Nurse- In his back.
Who investigates the death?

         Deceased Person




Police       Hospital      Medical Examiner
 The Tarrant County Medical
 Examiner’s Office obtains it’s
authority from the Texas Code
 of Criminal Procedure 49.25.
    Type of deaths to be investigated
            by the ME office
   Death of a person within      Unknown cause or
    24-hours of admission to       circumstances
    a hospital                     surrounding death
   Death of a person in          Suspicious deaths
    prison or jail                Suicide
   Any unnatural death           Unattended death (home
    (Homicide/Accident)            deaths without medical
   Unattended or not              staff present)
    witnessed death               All deaths of children
                                   under 6 y.o.a.
    When should medical staff report
             the death?
   State law CCP 49.25, section 7 states that
    any death falling under the previously
    listed circumstances “shall immediately”
    be reported to the ME office.
   A delay in reporting the death could
    jeopardize the police and ME investigation.
   Failure to report a death in a timely
    manner puts undue stress on family
    members.
               Reporting the death
                  3 things to have ready

   Death has been pronounced
   Preferably, next of kin is still present at the
    hospital to answer any additional questions
   Have available the EMS run sheet, hospital
    admit cover sheet and your paperwork
           Reporting the death
      Calling the Medical Examiner
   Call 817-920-5700, extension 1 to report a
    death.
   Incoming calls are answered by a field
    investigator or investigative clerk.
   The amount of time spent reporting a
    death depends on how well you are
    organized and how complex the death is.
Is trauma or foul play involved?
   What is trauma?
   What is foul play?
           It’s all in the details
     The Who, What, Where, When, Why & How
   Who- is reporting the incident, who is
    dead, who is the next of kin
   What- occurred
   Where- did the incident take place and where
    is the decedent
   When- did the incident occur and when was
    the person pronounced
   Why- did they die? Diagnosis or injury details
   How- were they identified, how did they arrive
    at the hospital, how do you get in touch with
    the family
              Location of incident
               Where is the crime scene?
   Location in the hospital where the death occurred.
   Location where the original incident occurred.
                 Next of kin
   Locate next of kin through prior hospital
    visits, personal property or friends.
   Assist with identifying the decedent.
   Obtain or confirm medical history.
   Obtain incident details.
   Explain hospital and medical examiner
    protocols.
   Locate or provide emotional support
                   Case Direction


                     Reporting a death




                                             No Jurisdiction
Medical Examiner      Medical Examiner
                                           Or involvement from
  Jurisdiction       Jurisdiction Waived
                                                 The ME
     Case                   Case
              Jurisdiction Case
   All cases where the Medical Examiner’s office
    assumes custody of the case and the decedent.
   Body will be transported to the ME office for an
    examination which can be up to and including a
    full autopsy.
   Prepare body by leaving all medical intervention
    in place and following hospital protocols.
   Copy paperwork for ME review.
      Health Insurance Portability &
       Accountability Act of 1996
   Commonly referred to as HIPAA
   Primarily deals with insurance details
   Has no bearing in death investigations &
    does not apply to Medical Examiner office
   Sec. 1178(a),(2)(B)(b): “Public Health- Nothing in this
    part shall be construed to invalidate or limit the
    authority, power, or procedures established under any
    law providing for the reporting of disease or injury, child
    abuse, birth, or death, public health surveillance, or
    public health investigation or intervention.”
        Jurisdiction Waived Case
   Reportable deaths to the Medical Examiner’s
    office under CCP 49.25 in which jurisdiction is
    not retained.
   Natural deaths where a physician will sign the
    death certificate based on medical history or
    diagnosis. There is no trauma or foul play
    suspected in the death.
   The decedent is sent to a funeral home with no
    further action by the ME office.
   The police are not normally involved.
Police department and crime scene
        officer involvement
   Trauma, foul play or suspicious deaths should always be
    reported to the law enforcement jurisdiction where the
    incident occurred.
   Some agencies will respond to the hospital to
    photograph the decedent and interview witnesses.
   Homicide or gunshot victims should have their hands
    bagged in paper sacks to preserve evidence.
   All clothing should be preserved and either turned over
    to the crime scene officer at the hospital or sent with the
    body to the ME office
   Property removed by EMS or hospital staff will not be
    transferred to the ME office.
        Organ / Tissue Donation
   Hospitals are required to also report the death to the
    local organ / tissue procurement group.
   Victims qualify medically and must have family approval.
   The ME office must be notified of the organ / tissue
    request as soon as possible. In most cases requests are
    approved by the pathologist. An exception to the
    approval would be if the approval could effect pending
    criminal litigation.
   ME investigators usually respond to the hospital to
    photograph the decedent prior to the donation and
    obtain blood/urine samples.
      Case Synopsis: David Gunby
        11-12-2001 @ 1030 hrs
   Nurse- I’m calling to report the natural death of
    a patient due to renal failure. The doctor at the
    hospital will sign the death certificate.
   Investigator- How long has this person been on
    dialysis?
   Nurse- 35 years.
   Investigator- What happened 35 years ago to
    require dialysis?
   Nurse- Oh, he was shot and lost a kidney.
   Investigator- Shot where?
   Nurse- In his back.
       Case Synopsis: David Gunby
         11-12-2001 @ 1030 hrs
   Investigator- No, where was he shot as in
    address or location?
   Nurse- Oh, in Austin, TX.
   Investigator- (Thinks: year 2001 minus 35 years
    = 1966. Victim shot in back, 1966, in
    Austin, TX.)
  On August 1, 1966 Charles Whitman began a shooting
    spree from the UT Austin tower killing sixteen and
 wounding thirty-one. One of those wounded was David
Gunby. David was one of the first people shot but survived
  his wound until 2001 when he died in Fort Worth. His
              death was ruled a Homicide.

								
To top