AUGUSTA, Maine — The state board that oversees the licensing for paramedics and emergency medical technicians has voted to dismiss the complaint by the widow of man who died after a ski accident at Sugarloaf earlier in January.
A report issued Wednesday by Jay Bradshaw, director of Maine Emergency Medical Services, details the findings of an investigation into the treatment and death of David Morse, 41 of Kingston, Nova Scotia.
Morse’s widow, Dana Morse, had claimed she was kicked out of the NorthStar Ambulance that was taking her husband to a hospital and left on the side of the road in a snowstorm.
The report states that after its investigation, the board voted to dismiss the complaint but that one of the paramedics involved would receive a letter of guidance in his personnel file regarding proper documentation.
The report confirms that Dana Morse was left but apparently unintentionally at the side of the road as she attempted to move from the front seat to the patient compartment on the ambulance.
“It’s just an awful situation,” Bradshaw said Wednesday. He said Morse and his wife and their children were on a “mini-vacation in Maine and on the last day of that vacation.”
David Morse was injured when he lost control of his skis in soft snow on the side of the Timberline Trail and skied into a tree. It was snowing at the time of the ski accident, which occurred at about 3:45 p.m.
The ski patrol requested paramedics at 4:12 p.m., describing Morse’s injuries as serious, including a possible broken leg and internal bleeding.
Bradshaw said several factors, including the stormy weather, made treatment of Morse’s injuries likely unsuccessful.
“The nearest hospital that could have provided the type of surgical intervention that a patient like that requires was Lewiston,” Bradshaw said. “And the nature of his injuries were such that it wouldn’t have made any difference, unfortunately.”
The report details several breakdowns in communication and reveals that a member of the Sugarloaf Ski Patrol was asked to drive the ambulance and was at the wheel when Morse’s wife got out of the ambulance.
Dana Morse, a nurse practitioner, was concerned about the treatment her husband was receiving, the report stated.
“From the front seat, the patient’s wife could look into the rear of the ambulance and stated that she could see that emergency treatment was in progress, knew that this would not have a good outcome, and told the ski patroller that she needed to be in the back with her husband,” the report stated. “The ski patroller remembers hearing her express a need to be with children and her request to stop the vehicle. What is undisputed is that the patient’s wife exited the ambulance and the ambulance drove away.”
The report confirms Dana Morse’s account that she tried to catch the ambulance with her dying husband.
“As the ambulance continued down the access road, the patient’s wife chased after it and then flagged down two cars that were heading in the opposite direction (toward the mountain),” the report states. “The driver of the second car reported that the patient’s wife initially wanted to try and catch the ambulance, but it was snowing heavily and the driver said she did not recall seeing an ambulance. The patient’s wife then asked to go back to the first aid station, which is where she was taken.”
According to the report, the paramedics — upon realizing Dana Morse was no longer in the ambulance — contacted Franklin Memorial Hospital to notify them she was en route there with a friend.
When Dana Morse arrived at the hospital to inquire about her husband, a nurse called the paramedic base in Carrabassett Valley and handed the phone to her, according to the report. The paramedic informed Dana Morse that her husband had died en route to the hospital and that his body had been returned to the First Aid Station at Sugarloaf.
The Maine state medical examiner later determined that David Morse died from blunt force trauma to his chest.
An independent review of the investigation by Dr. Michael Baumann, an experienced emergency physician and interim chief of the Department of Emergency Medicine at Maine Medical Center, determined that NorthStar’s staff followed state protocol.
Baumann noted that “while some of the treatment provided could have been initiated sooner, it would not have affected the unfortunate outcome.”
Franklin Memorial Hospital in Farmington, which owns and operates NorthStar, issued a statement Wednesday from President and CEO Rebecca Ryder.
She extended appreciation to the NorthStar crew at the ambulance base in Carrabassett Valley for “their professionalism and dedication throughout this difficult ordeal.”
To view the full report, click here.
My heart goes out to Dana. Losing a spouse is unimaginable, but to lose him and to go through what is detailed in the report is inexcusable.
Interesting. So, the paramedics didn’t know the patient’s wife had been abandoned. The driver, a ski patrol person, was the one who took off and left her.
Seems to me some major miscommunication was going on here. The driver heard her ask to be with her children?? And forgot she went outside?
The report does not address this, as Maine EMS has no authority over the Ski Patrol. I wonder if there will be any disciplinary charges brought against the driver?
I’ve said since the beginning that I wasn’t there, and can’t comment on the treatment (which apparently was adequate), but that the driving off and leaving the wife was poor judgement and unconscionable.
A side note: this all appears to have an element of poor drivers. First the ski patrol one, who apparently has severe memory lapses, and secondly, the driver that stopped to pick up the wife. She has no memory of seeing an ambulance? Was the snowstorm that bad you couldn’t see a big vehicle coming at you?
How does Maine EMS have no authority over the ski patrol? Last I knew an EMT has authority and a duty to act over someone with first aid training! And by the way, ever been in an ambulance with a screaming family member?
I believe that she was refering to the Maine EMS Board having no authority over the ski patrol, not an EMT having authority over a first responder. If the ski patrol is not licensed through Maine EMS, I suppose thats how Maine EMS would have no authority over them. Are they licensed with Maine EMS? Beats me……
Read the report. Mr. Bradshaw clearly states in the beginning that Maine EMS has no jurisdiction over the Ski Patrol. And they don’t. The Ski Patrol in question is not an EMS agency, and are trained in first aid according to the National Ski Patrol guidelines and do not operate under local EMS rules and protocols.
Note this from the report:
The Sugarloaf Ski Patrol First Aid Station is not staffed with medical personnel. However,Ski Patrol members are trained in emergency first aid and certified by the National SkiPatrol. The Ski Patrol Dispatch Center is located at the First Aid Station and was staffed bya dispatcher who is a former Maine licensed EMT and is currently CPR certified.That is nationwide, by the way. The Ski Patrol is its own thing, separate from EMS systems.To answer your other question, yes I have been with screaming family members. Many times. But that still didn’t mean I tossed them out into the storm.
Maybe the ambulance arrived staffed by two people and they realized the seriousness of the case so they elected to have the ski patrol person drive the ambulance so they could treat the patient. I have been in the case where we had a fireman drive our ambulance so we could treat a patient and have it rolling toward a care facility. It is possible that if the patrol person was comendeered to drive, compounded by the fact that a hysterical realitive was sitting next to him, he probably was in a high state of stress to begin with and then add poor roads and light conditions. It was possible that he was all too relieved when he heard her say “stop and let me out’, figuring she would use a side or back door to access the back of the rig. There is alot of adrenaline involved in runs of this type and if he was not used to that to begin with, it made the situation worse.
Ambulances do not always run lights and sirens and maybe the driver was not familiar with them. In dealing with poor visibility and heavy snow, the other driver was fortunate to see the wife and help her out.
This was a really sad case–condolences to the widow.
BUT–the man died of chest trauma and internal bleeding. She was trying (succeeding for a while) to administer CPR to him in the ambulance. I am not an MD or an RN, but I think this may not have been the right thing to do considering the circumstances.
If a person’s heart is not beating, then CPR is always the right thing to do, no matter the injury. No heartbeat means death, and you can do no more harm to the patient at that point by attempting CPR.
That’s why we have protocols. If you don’t like it then complain to the doctors that set the rules!
I was responding to ro60tsdad ‘s comment about the appropriateness of the wife doing CPR in relation to his injuries.
Who is question protocols?? And who is we? I was a certified EMT probably before you were born! Your comment has no bearing on the above discussion, and you may want to try to be a little more civil when you respond!
sometimes not so much. sometimes you just need to let it go
Why do these news articles keep saying that Mrs. Morse complained she was “kicked out” of the ambulance when it does not appear she made that claim?
In reply to mmmlllddd:
Previous articles have indicated that the skier’s wife, a nurse practitioner with years of experience in critical care, did indeed question the care that her husband received. If you read the EMS report, the doctor who reviewed the case for the state found that “some of the treatment could have been initiated sooner, (but) it would not have affected the unfortunate outcome and that the NorthStar crew appeared to act in accordance with the Maine EMS Treatment Protocols. [The doctor also] noted that the EMS run report documentation could be improved in several areas.” The skier’s wife told her hometown newspaper that her husband “didn’t have a physical exam from the time he arrived into the clinic, nor did he have his blood pressure (taken)… (The ambulance crew) didn’t bring a (blood pressure) monitor into the clinic and he didn’t even have an IV started.”When Dana Morse asked the paramedics to take her husband’s blood pressure, they told her they were getting to that but splinted his elbow, which they suspected was fractured, she said.”I didn’t think that was the priority . . . given the fact that he had presumptive fractured ribs and internal bleeding. “They did not listen to his chest. They did not have their stethoscopes on.”Her claims are not specifically addressed by the EMS report, which says only that EMS protocols were followed.
When Dana Morse asked the paramedics to take her husband’s blood pressure, they told her they were getting to that but splinted his elbow, which they suspected was fractured, she said.
“I didn’t think that was the priority . . . given the fact that he had presumptive fractured ribs and internal bleeding. “They did not listen to his chest. They did not have their stethoscopes on.”
Her claims are not specifically addressed by the EMS report, which says only that EMS protocols were followed.
But the report states that the crew conducted an initial primary assessment and removed his clothing. Having spent just a few years in the field I can state that an “initial primary assessment” includes baseline vital signs (pulse, BP, respiration, capillary refill), etc…and you cannot treat what you cannot see so exposing and examining is part of any trauma call.
I will also note that Maine EMS Protocol includes obtaining baseline vital signs and the report states that treatment met Maine EMS Protocol. My condolences to his family but in the “heat of the moment” it is very easy for a family member (even a medically trained family member) to miss what treatment is being rendered.
What this person in all likely hood needed was a trauma surgeon and blood. Splinting an arm is completely unnecessary and appears that the medics got distracted by a distraction injury.
Peter…if the Level 2 Trauma Center OR at CMMC or EMMC had dropped itself on the side of the mountain the outcome would not have changed.
You are making statements not supported by facts. There was no mention in the report that time was taken to splint an arm. An independent ER physician and Professor of Medicine reviewed the run report and stated that some treatment could have been quicker that it would not have changed the outcome and he did find fault with documentation. (Side note: as the person that has to review every single run report my service makes, I would state that documentation can be approved across the board in EMS).
I agree that splinting an arm was unnecessary but their is nothing in the report that indicates this was done.
Vital signs are part of the secondary assessment, not the primary. A primary assessment is ABC’s In almost all cases, patients within the care of EMT’s will have their vitals taken, EXCEPT patients who are so critically injured that the EMT’s are too busy treating other life threatening injuries that they cannot do them. This is literally a textbook explanation of this situation. I wouldn’t have done it any different myself, because this is what I was taught.
Yes, I understand that Mrs. Morse questioned the care that the EMTs provided to her husband, and was unhappy that she was left at the side of the road, but my comment goes to one thing only, and that is this paper’s reporting – apparently false – that Mrs. Morse “claimed she was KICKED OUT of the NorthStar ambulance . . .” [my emphasis].
This is what the BDN reported on Jan. 15, in a piece written by Seth Koenig: “In Dana Morse’s account of the incident – first published Sunday by the Halifax-based newspaper The Chronicle Herald – the grieving wife said emergency medical responders were slow to treat for internal bleeding and, when she asked to hold her dying husband’s hand in the back of the ambulance, she was kicked out of the ambulance instead.” Today’s piece repeats the “kicked out” claim, even though there’s no evidence Dana Morse ever made that claim.
But the Chronicle Herald article, still available on-line, doesn’t say what the BDN says it says. It doesn’t say that Dana Morse complained about being “kicked out” of the ambulance. Now the difference between being left at the side of the road – by the driver’s mistaken understanding as it turns out – and being kicked out may seem like a nit-picking distinction, especially if you want to sensationalize the story and make the EMTs look bad, but I’m sure it’s important to the EMTs, and Dana Morse as well, to say nothing of this paper’s readers who want fair and honest reporting.
I can imagine that the EMT’s probably followed this order : Airway, breathing, circulation, control major bleeding, life threatening injuries, treat for shock. Long before any one pulls out a stethoscope all of these things need to be looked at QUICKLY! Internal bleeding cannot be seen, and therefore on their primary impression of this patient they saw fractures (leg and arm apparently) and jumped in to treat them. If the man was breathing, had a pulse, and was not visibly bleeding out upon initial impression, that is the way they are trained to start.. Baseline vital signs don’t come into play until much later in the assessment. Upon initially arriving, they only care if the vitals are there or not, not what the specific numbers are, therefore no blood pressure was ever needed to be obtained. At the point they realized this man was bleeding out internally he was already in cardiac arrest. In a series of events like this, EMT’s are not God. They do everything they can to help the patient, and everything they know to do, and sometimes people die. This poor woman lost her husband, but it wasn’t from lack of trying by the EMT’s.
I hope that the EMT’s sought help after this tragedy, and the wife can find peace some day.
All we can do is speculate, which I prefer not to do. I only wished to point out that it is unfortunate that so many questions remain unanswered because of the manner in which the point is written.
I do, however, respectfully disagree with your assertions regarding vital signs and assessment of internal bleeding. If a patient is hemorrhaging, a weak and thready pulse and a low blood pressure — not to mention cold and clammy skin — are signs. If a patient’s BP is disappearing, his blood is going somewhere. And while you correctly point out that airway, breathing and circulation need to be assessed quickly, Mr. Morse was in the care of ski patrol, EMTs and a single paramedic for well over an hour before he died.
As for Mrs. Morse being left on the side of the road, I can only presume that this was an unfortunate mistake made by a driver inexperienced with life-threatening situations and who was doing the best that s/he could.
All of those symptoms of shock you indicated are late signs. By the time most of them are recognizable, its already too late. The body has a compensatory system that avoids making those signs happen until the body can’t compensate anymore and then begins to shut down. Even if they HAD taken a bp, pulse, anything, there was nothing possible that they can do for him. Warm him up, re-set his broken arm to prevent him being in too much pain, and try to get him to a hospital as fast as they can. What else would you have done? Cut open his chest, find the bleeder and clamp it? What realistically would taking his BP or listening to his chest have done?
As an EMT myself, I express condolences to the family. Some of you are asking how could you “forget” that there was someone who went outside…when you are working a serious trauma patient in the back, your concern is that patient. Nothing else. The driver was not an employee of Northstar and when stopping the crew in the back could have been yelling to him to get going. When there isn’t communication between the front and back of that ambulance, anything can happen. I am not saying they were entirely right to leave her, but I would be questioning Ski Patrol as to why the driver stopped unless the crew in back directed it. We really aren’t getting the full story here, and we never will because if HIPAA laws.
From the previous articles it appeared that the care this man was given was NEVER questioned. It was the TREATMENT of the wife by the ambulance driver!!! It sounded like they dumped her out on the side of the road and then took the dead body back to the mountain?????????
Would you suggest they drive the dead body over an hour in a blizzard tying up one of the only ambulances in the sugarloaf region? What good does bringing the body to FMH do? Funeral Directors transport dead bodies, not ambulances. Although I do not agree that pulling over on the side of the road and driving off without the wife was the best decision and clearly was a case of poor communication, it is quite clear to me who on this discussion board has actually taken care of a cardiac arrest patient in an enclosed 8×8 box while driving in blizzard conditions. It is a horribly unfortunate event but these things happen with sports. Extreme sports carry risks, especially those that take place 2 hours from the closest trauma center. Cardiac Arrest after chest trauma has close to a 0% survival rate, thats right 0. There is nothing a paramedic, EMT, NP, MD, DO, RN Chief of Surgery can do with a patient who has suffered trauma significant enough to put him into Cardiac Arrest. A patient like this is unlikely to survive even if he were to crash into an operating table at a level 1 trauma center instead of a tree on the side of a mountain. Lastly I will say, people need to understand that this was a terrible situation for all those involved. EMS is a thankless job and this is one of the worst days you can have as a paramedic. A young guy with a loving family who dies in front of you despite treatment to the best of your ability. I applaud Paramedic Twitchell, The NorthStar staff and the Sugarloaf Ski Patrol. These people are putting there lives on the line, providing care and safe transport to sick and critically injured, coping with the emotional stress and heartbreak the job brings all for a salary similar to that of a sandwich artist at subway. Have some respect.
Thank you for comment about salaries. I have a full time position and I also work two per-diem positions as well. Salaries in Maine are crap, yet RN’s and those with similar educational requirements get paid double.
I was surprised at the fact that they turned the ambulance around and took the man’s body back to Sugarloaf. I’ve never heard of an ambulance taking the body of a patient who died en route to the hospital back to the place where the patient had been originally injured. It just seems weird to me.
What protocol should ski resorts follow when their customers ski on man made glaciers that end abruptly at the wood line thusly sending errant skiers catapulting down a rough icy grade into trees, rocks, and stumps? Low snow years are dangerous on the edge.
The law is on the side of ski resorts. The skier assumes the “inherent” risks of skiing, which includes natural and manmade objects in the trail. The ski area would have to be grossly negligent to be successfully sued. Catching an edge is a risk a skier takes with every turn. The best thing a skier can do is to slow down and not ski too close to the trees. By 3:45 p.m. on a snowy day in early winter, the light is very flat. Poor visibility is a possible contributing factor to Mr. Morse’s tragic accident.
What a God-awful mess.
These guys and gals save lives, always have someone complaining…. I mean really….
EMT’s go above and beyond the call of duty!!!
The only poor judgement was performed by the deceased. He had the accident and in previous articles was out of bounds ( off the authorized slopes ). If a person has a car accident and dies due to injures, is it the cop directing traffic or the fireman that cut him out of the vehicle? NO
So why are these emergency medical teams being blamed.
At least know there won`t be any petty law suits.
Oh I can almost guarantee that someone will sue someone over something. The report does not prevent a law suit but will go a long way in defending the care provided.
really a sad event for sure, but did you expect them to say they did something wrong? i don’t think so.
Condolences to the family as well as to the EMTs who did their best to save this man. That said, shame on the BDN for their one-sided reporting of this terrible accident, right from day one. Now that ALL the facts have been reviewed by the state board that oversees licensing for paramedics and emergency medical technicians, BDN is still trying to get the most bang from this man’s death. Not because they care about the truth, but because controversy sells.
Anyone in public safety occasionally has to remove the knife from their back placed there by someone they helped. It’s a thankless profession – not my profession – but people really need to thank law enforcement, EMT’s/EMS, and firefighters when they help them. Police receive most of the verbal abuse and lawsuits for helping people because that’s how ungrateful and selfish people say thanks.
Good…..I think the woman was too overwhelmingly upset to be objective- certainly don’t blame her, my sympathy to her, but believe the right decision was made. kudos to those who do their best to help others….
Thanks once again to the EMT’s that responded to this call. Shesh this one is probably in the books as your worst call. I’m sure that in the urgency of the emergency it was not the best thing to leave the wife on the side of the road, but it was probably a relief to those in the back of the rig, not to have her presence dictating what to do. This was a tough call and one reason why we do not allow reletives to ride with us on calls. Glad the record was cleared and you are able to keep responding.