Paramedic accused of misconduct following death of patient near Thetford

Paramedic Fiona Turner after the Catherine Barton inquest.  Photo: Bill Smith Paramedic Fiona Turner after the Catherine Barton inquest. Photo: Bill Smith

Tuesday, October 22, 2013
2:41 PM

A paramedic made “fundamental failings” in the treatment of a critically-injured woman by not carrying out basic checks at the scene of fatal car crash near Thetford, a conduct hearing heard.

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Catherine Barton died at the scene of a head-on accident on the B1107 in 2011.Catherine Barton died at the scene of a head-on accident on the B1107 in 2011.

Fiona Turner is accused of misconduct and lack of competence in the way she treated Catherine Barton, who died at the scene of a head-on crash with another vehicle on August 5 2011.

A tribunal today heard that the medical assessment and monitoring of the driver by the East of England Ambulance Service paramedic was “woefully inadequate”, a representative of the Health and Care Professions Council (HCPC) said.

Student died while waiting for almost two hours to be removed from car in Thetford crash

Timetable of events on August 5, 2011

10.06pm – The first 999 call is made about the collision between a Ford Ka and a Volkswagen Golf near Thetford.

10.13pm – First fire crews arrive.

10.22pm – A volunteer RAF first responder arrives.

10.34pm – Ambulance with Fiona Turner and a student paramedic reaches the scene.

10.53pm – A ambulance staffed by an emergency care assistant and technician attends.

11.05pm – Another ambulance staffed by an experienced paramedic arrives and attends to the injured men in the Volkswagen.

11.11pm – The third ambulance leaves to take the driver of the Volkswagen to hospital.

Between 11.39pm and 11.46pm – Catherine Barton is removed from the car and it is identified that she has stopped breathing.

11.46pm – Critical care paramedic arrives and emergency doctor arrives and take over efforts to resuscitate.

12.22am – Miss Barton is pronounced dead at the scene.

Service vows to overhaul road accident response in East Anglia

Miss Barton, 27, of Brandon, who was described in the hearing as “Patient A”, died two hours following the collision between her Ford Ka car and a Volkswagen Golf on the B1107 Brandon Road, near Thetford, which injured three others.

The paramedic, who was suspended following an investigation, denied allegations by the HCPC that her fitness to practice was impaired.

Inquest findings

A coroner ruled earlier this year that “systemic and individual” failings within the East of England Ambulance Service had “substantially” reduced a young veterinary nurse’s chances of survival.

Twenty-seven-year-old Catherine Barton died on the B1107 near Thetford golf club when her Ford Ka was in collision with a Volkswagen Golf which had lost control as the driver attempted to avoid an animal.

Coroner William Armstrong found that failures included inadequate treatment of Miss Barton, failure to follow trust guidelines and recognise the serious nature of the accident and not providing ambulances and medics quickly enough.

He ruled: “As a consequence of these failures Catherine Barton’s prospects of survival were substantially reduced. I make that statement boldly and confidently.”

The inquest heard how paramedic Fiona Turner had struggled to deal with the crash and a lack of medical back-up meant Miss Barton was not removed from her car for more than 90 minutes.

In a statement, Miss Barton’s family said they had been left “devastated” by the “tragic chain of events” which had caused “indescribable distress”.

A spokesman for the East of England Ambulance Service, said: “We acknowledge the coroner’s comments and recommendations and we are confident that a similar situation would be managed better in 2013 than it was in 2011.”

The medic, who joined the East of England Ambulance Service in 2005 as a student and qualified in 2009, was the first paramedic to attend the scene of the two vehicle crash, near Thetford Gold Club.

An ambulance service manager told the conduct and competence committee that it was a situation that he would not wish on any member of staff.

Miss Turner arrived at the scene of the collision more than 30 minutes after the first 999 call was made about the crash. As the first paramedic to attend, she was designated as the lead medic for the incident, the tribunal was told. The next qualified paramedic to arrive was more than 30 minutes later.

Sarah Harris, for the Health and Care Professions Council (HCPC) said Miss Barton, who was trapped in the Ford Ka, was the most significantly injured of the four people involved in the crash. However, it took more than an hour for the patient to be removed from the vehicle, despite a warning from a firefighter that she had stopped breathing and did not have a pulse.

The HCPC representative claimed that Miss Turner did not appreciate the seriousness of the situation.

“The assessment of Patient A was woefully inadequate. There are basic things that should have been done.”

“It is right to say that it is easy to analyse in the cold light of day in a high stress situation and it is important not to be overly critical. However, we have to assess that performance against training that has been received and what is expected by the guidelines and training. It is not about making a few mistakes - there were fundamental failings in the provision of care by the registrant. There is no allegation that any of these failings were responsible for the ultimate outcome of this case,” said Miss Harris.

Miss Turner is accused of failing to assess and monitor the patient adequately and did not undertake appropriate intervention such as basic ABC. The HCPC claim that the paramedic failed to respond appropriately to a concern raised by a firefighter that the patient may have stopped breathing, she did not organise and prioritise resources on the scene and did not prioritise clinical priorities effectively. It is also claimed that the medic did not keep an adequate record of assessment and did not instigate an attempt at resuscitation on the patient until she was in the ambulance.

Nick Cason, a duty operations manager for the ambulance service, who was asked to conduct an investigation following the collision said Miss Turner should have ordered a quicker extrication because of her deteriorating condition and that attempts should have been made immediately to resuscitate Miss Barton when she stopped breathing rather than wait to get her in the back of an ambulance.

“There is no doubt in my mind that the registrant was placed in a situation where I would never want to place any of our staff,” he said.

David Pleszko, retained firefighter and trained trauma carer, who cared for Miss Barton, said he twice told the paramedic that he thought the patient had stopped breathing and no longer had a pulse. He told the hearing that Miss Turner had said the patient had shallow breathing.

“I have been in the fire service for nine years and been to hundreds of road traffic collisions and have never felt that level of frustration. Nothing seemed to be happening for such a long time and I felt that the lady had died in front of me, perhaps needlessly,” he said.

Kate Annand, representing Miss Turner, said a paramedic of 20 years experience had been daunted by the incident and told the hearing that a more senior medic should have been sent to manage the response.

The hearing continues.

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