No kidding!

http://www.wjla.com/news/stories/0108/488422.html

"A construction worker claimed in a lawsuit claiming that when he went to a hospital after being hit on the forehead by a falling wooden beam, emergency room staffers forcibly gave him a rectal examination. Brian Persaud, 38, says in court papers that after he denied a request by NewYork-Presbyterian Hospital emergency room employees to examine his rectum, he was "assaulted, battered and falsely imprisoned." His lawyer, Gerrard M. Marrone, said he and Persaud later learned the exam was one way of determining whether he had suffered spinal damage in the accident."

"....emergency room staffers insisted on examining his rectum and held him down while he begged, "Please don't do that." He said Persaud hit a doctor while flailing around and staffers gave him an injection, which knocked him out, and performed the rectal exam.

Persaud woke up handcuffed to a bed and with an oxygen tube down his throat, the lawyer said, and spent three days in a detention center."
------------------------------

I say it is perfectly normal when someone is complaining about a headache to have a look at his rectum, just in case....

doctors are Gods above us, they can do anything they want as long as we stay alive and they can weasel their way out of inflicted damages if any

As i am training to be a paramedic we learn about A&E procidures and i have never herd of a rectal exam for a suspected spinal injury (will ask my sister though, she is studying physio and may have herd of it). The standed trauma procedures are, trauma serise of bloods, head and neck, chest and abdoman x-rays, abdoman ultrasound then off for an MRI.

As for the implications he is compleatly correct it does constitue assult, battery, and false inprisionment.

A patient has the right to refuse ANY treatment they do not wish to have performed UNLESS they are under a mental health order issued by the police and reviewed by a shrink. Further more any such order must be reviewed by the guardianship board.

Both chemical and physical restraints consitute assult and false inprisionment
a forced rectal exam could be classed as sexual assult as well.

What a sick case

He has a good case against the hospital that's for certain. An MRI or CAT scan could have found out if his spine was injured, they didn't have to go against his wishes. As anyone knows that you have the right to refuse any treatment that is going to be administered to you at a hospital in most instances.

UNLESS he was ruled mentally incopitant

UNLESS he was ruled mentally incopitant

Yep, I guess his head could be up his ass if he were a mentally ill person.:shrug:

These doctors. Any excuse to get their finger up your a***
I went to my doctor, and told him that there was blood in my stool. Guess what?

What I don't get why did he spend 3 days in the detention center??? maybe he was under some kind of influence....

Maybe they found him to be healthy with no brain injury. That means he hit them on purpose, so off to detention for him. :rolleyes:

From all the stories so far, it seems like he was competent enough to understand what they were going to do, why they were going to do it, and repeatedly deny consent. I think the hospital's fucked.

Any forced medical exam is immoral. Our bodies belong to us, not to some doctor or technician. I hope the guy wins a huge settlement.

This is totally ethical and moral. If he had not survived due to the staff failing to recognize some damage, his relatives could have sued the hospital.

So you are saying the hospital was in a lose-lose situation from the get go?

I don't follow. Sometimes accident victims can be combative, but you have to do the exam for their own good.

This is totally ethical and moral. If he had not survived due to the staff failing to recognize some damage, his relatives could have sued the hospital.

Not if he denied the medical opinion that was offered to him, which he did. I'm sure it would've been noted somewhere that the patient refused to have a rectal exam.

can i please bring so reality back to this debate. As i am studying paramedics we do a LOT on informed concent. Its the INFORMED that causes the problems in emergency situations. Take this for example

You arive at a car acident
There are 2 people in the car, a father and his young daughter
The daughter wasnt wearing her seatbelt because of whatever reason and was ejected from the car and killed on impact
The father who was driving had the steering wheel collom driven into his leg severing the femoral vain
The father seeing his dead daughter refuses ANY treatment

What do you do?


Another
A single occupant MVA
the occupant has probable spinal injurys and there is a chance he will never walk again
he has a deep lac to his abdoman
he refuses treatment when he realise he cant feel his toes because he doesnt want to end up in a wheel chair

Next case
you arive at an atempted suicide
you cut the patient down
the patient has spinal injurys but refuses treatment


Can the occupant in any of these cases give INFORMED CONCENT?

if you follow there wishes what will be the result of the coronors inquest?

according to ambulance guidelines NO they cant give informed concent and its your job to threaten, cadjule, anything to get that patient to agree with treatment. Futher more if you DONT the families will have a VERY strong suite against you and the ambulance service

Informed concent is not as easy as it seems to be at first glance, its very complicated. Yes it seemed on the surface like this this man could make an informed choice but none of us really know how he was in the A&E

The question is is it immoral, I say no. Is it legal? Perhaps, given what Asguard said.

Hhhhhmmmmm......

That depends if you like having your rectum plugged against your will or not.

spidergoat we dont just study the LEGAL aspects we also study the ETHICAL ones as well. Is it ethical to condem someone to death or a wheel chair because they arnt in a fit state to make a rational decision. Im not saying its an easy decision or even that the doctors did the right thing in this case but i am saying its not as black and white as everyone has made out. Yes i am as guilty as everyone else, it wasnt till i reread the thread this morning that i realised my mestake

He must have a really bangin ass.

Similar things happen to Serena Williams all the time. One time when she was accused of being a drug cheat they suddenly changed protocol and forcibly probed up her ass "in case she was hiding steroids with intent to distribute". Also she can recount many instances when, during routine medicals, the "mouth thermometer" mercury was "worn out" and it was "necessarry" to take her temperature via the rectal thermometer, when someone told her they were the same thermometer and that it's actually unheard of for mercury to inexplicably wear out, let alone common, she just slumped into her favourite rock hard chair, stared into the distance, and wept softly.

At which point her team of trainers and nutritionists said "quick! she's hysterical", before restraining her and checking the inside of her bottom for "hysteria-inducing microbes".

This is her life. Day in, day out. If you talk to her she's quite obviously demented from the abuse, and seems to just assume the ass is the centre of everyone's daily lives. That's all she knows.

Looks like this 38 year old construction worker is similarly cursed.

That's hot.

Any forced medical exam is immoral. Our bodies belong to us, not to some doctor or technician. I hope the guy wins a huge settlement.

Completely agree with this. ^^

Another
A single occupant MVA
the occupant has probable spinal injurys and there is a chance he will never walk again
he has a deep lac to his abdoman
he refuses treatment when he realise he cant feel his toes because he doesnt want to end up in a wheel chair
...according to ambulance guidelines NO they cant give informed concent and its your job to threaten, cadjule, anything to get that patient to agree with treatment. Futher more if you DONT the families will have a VERY strong suite against you and the ambulance service


But that sounds sane to me! I know the standard argument is that someone in that position is sick in the mind as well as the body and cannot make an informed decision. But I am a sane and healthy person and I can say definitely that I would rather be dead than never walk again.

What about children. They have exams they don't want. They get shots they don't want.

thats my point. Spinal injuries cant be clinically diognosed they require an MRI, so there is no garentie that this person is actually never going to walk again. Even if he cant he can live a normal life in a wheel chair and thats the WORST case.

Blood loss can also cause loss of feeling and tingling ie shock. Shock can cause a LOT of nero symptoms (thats real shock not "oh i had a shock when i saw such and such"). Not to mention that having half a car crushing your leg DEFINITLY will. That was a hypothetical case based on a REAL case we were taught about in a lecture by the Medical Director of SAAS. The ambulance service WAS sued because the ambos left a man with suspected spinal injurys and he later died. The family won a fortune

None of those cases take into account the fact that people with head injuries are OFTEN combative, infact its one of the indicators for a nero complaint.

Not everything is as black and white as we would like, esspecially in emergency care

You know what the most comon reaction is after the treatment for a herion overdose? For the ambo's to end up with a black eye because the adict lost there hit.

I would MUCH rather atend a biky war than a drug adict because bikies concider the green uniform to be sacrosit because they know that if they atack the ambo's they are on there own when they go down. A meth adict doesnt have the same rational thinking.

I sugest that if you REALLY want to know what its like you get involved in the emergency services, or volenteer in an A&E.

Issues of concent are not always "an old lady with terminal cancer who doesnt want and more pointless treatment"

Orleander not sure where you live but in Australia they have changed the laws of concent such that if a child is capable of making a rational decision they should be lissioned to. For instance a 14 year old (too young to concent to medical treatment under old laws) can recive the pill (without parental concent or even knowlage) if they can show the doctor that they are mature enough to understand the implications of the actions, both of taking the pill and having sex ect

Orleander not sure where you live but in Australia they have changed the laws of concent such that if a child is capable of making a rational decision they should be lissioned to. ....

right, a rational decision. The man just took a blow to the head. Were they to assume that because he spoke well, that he was fine?

Orleander i have been arguing that for the last 2 hours. If he had a falling GCS (glasco coma scale) there is no way that the emergency staff could trust what he was saying was rational

And this happens in almost all serious head injuries

I agree.
But if he wasn't rational when they did the exam, then he wasn't rational when he hit them. I don't think he'd win on the exam/restraints/drugging, but the 3 day lock up. Oh yeah, I hope he wins that one.

umm again that depends on there definition of lock up. If its a police lock up then i hope they get sued for all they are worth, I am sick of the police putting people who should be in hospital in lock up but if they were talking about a secure ward in hospital i would want to see the shrinks report before i made any judgement.

Oh and my comment about the police goes for drunks and drug effected as well. To many times a "drunk" has been thrown in the lock up and when they come to let them out they are dead because it was really a brain aneurysm or they aspirated (i hope i spelt that correctly) and died in the night

Edit to add: by the same token i dont want any heroin OD to atack me either because i ruined there hit

He spent 3 days in a detention center. 3 DAYS!!! I'd sue and sue and sue.

Orleander i have been arguing that for the last 2 hours. If he had a falling GCS (glasco coma scale) there is no way that the emergency staff could trust what he was saying was rational

And this happens in almost all serious head injuries

That's right. My friend recently fell into a coma due to a thyroid condition. But before he was unconscious, he fought with the orderlies. It took a bunch of them to hold him still, since he's a martial arts master (and an escape artist). They had to put him in restraints. He doesn't remember any of it.

spider it doesnt matter about his self defence skills. In one class were were taught how to restrain someone without giving injury (unlike the police way of the knee in the back). A normal male takes ATLEAST 6 people to restrain them and then you need at least one more to actually administer the medaz. Thats a real problem when a ambulance crew is 2 people so we get taught "if you need more men, call the fire crew":p They come in groups of 6-8. Otherwise we need a LOT of ambulance crews or lots of cops to help us

I don't follow.

How come?:

1. Dude doesn't want to get exemined, he sues.
2. Relatives don't like that hospital didn't do test, they sue.

Sounds like a lose-lose situation to me...

What could he claim as damages?

Isn't it obvious!? They made him gay!
;)

Syzygys yep happens alot in the ambulance service. Person refuses treatment and you treat anyway its assult or you DONT treat and they die "well they wernt mentally capable of making that choice" I am SOOO glad that the ambulance service has to pay those bills not me

He claimed assault charges although the judge threw that one out. Restricting personal freedom would be my guess, maybe bodily harm.

Asguard (hm, ironic name in this discussion) I guess there is a difference between test and treatment. The rectal exam was just part of the test, not a treatment.

He would have had to be injured as a result of the exam, which is unlikely. Judges don't often grant money for mental anguish (at least Judge Judy doesn't).

Umm have you ever delt with someone with a suspected spinal injury and a falling GCS?

Its not an experiance i am rushing to have again, trying to get the collor on with them fighting you all the way and stablising the head with them thrashing around while your partner trys to get a back brace on. trying to stop them injuring themselves while the emergency room staff get the x-rays ect

I wasnt just pulling those situations out of my ass so to speak, they are from REAL cases.

So you are saying the hospital was in a lose-lose situation from the get go?

Lose-lose is a daily occurrence for hospitals. Indeed, this might be one of those occasions.

I'm still flipping a coin between the right to refuse treatment and the question of a sound mind after being struck in the head on a construction site.

To the other, what a freakin' tight-ass pansy. If it comes out that this patient was, as a child, raped by his father or a priest or something like that, I'll withdraw that point. But, really. Why would he beg to forego that exam?

Errmm ok.

The guy received a knock on the head so they do a rectal exam?:bugeye:

Aside from the obligatory 'what the hell'...

What the hell?

Was there any indication that the knock to his forehead may have caused spinal injuries? Had he fallen over or collapsed, causing possible injury to his lower spine? And then to be detained for 3 days afterwards for refusing the exam and charging him with assault? At least the judge saw fit to dismiss that charge.

But seriously.. knock to the forehead now means you need to have a rectal exam? Again.. What the hell?!?

bell ALL head injuries are automatically treated by both ambo's and A&E's as potential spinal injurys.

That means the collor, the spinal board, the blood tests, the x-rays, the whole works

Its better to over test than to miss an injury

Besides which from a methods and pattens of injuries stand point a hit to the top of the head can compress the spine, a blow to the chin can strech it

I was a little surprised that they did it by exam rather than MRI but if thats the procidure they were doing the right thing

@Asguard, what does GCS mean?

what does GCS mean?

Refers to the Glasgow Coma Scale (mentioned in #27 above (http://www.sciforums.com/showpost.php?p=1715778&postcount=27)). For more detailed information regarding the function and parameters of the GCS, see Wikipedia (http://en.wikipedia.org/wiki/Glasgow_Coma_Scale).

im sorry thats by fault

GCS is Glasgow Coma Scale

Its a much more acurate measure of someones nerological state
you assess three things

eyes (4open spontaeously, 3to speach, 2to pain, 1unresponcive)
Verbal responce (5orientated, 4confused, 3inapropriate words, 2incomprehensable sounds, 1nil)
motor control (6obeys comands, 5purposeful movement, 4withdraws to pain, 3flexion to pain, 2exstention to pain, 1nil)

You add up the patients score for all of these and if its less than 8 they are in a coma. Even a corps scores a 3


Its used by ambulance services, A&E's and neroliogists to indicate a nerological condition although it a falling GCS can be caused by a range of conditions.

Thanks for the information, Asguard.

I think if you are a conscious adult, you should be allowed to refuse treatment. even if it confirms you are an idiot to do so.

I mean hell, maybe there was a .01% chance it the test would help him and the guy had been raped as a kid. I think he damn well gets to choose. And if they did not spend some time explaining the reason they wanted to look in his ass and what the dangers and statistics are if they don't do the test, they are even more to blame.

sowhatifit'sdark problem is that a hit to the head can give you concussion. If they are doing a neroexam to check for Cerebral spinal injurys then there is a high chance that they couldnt trust what he was saying was the same thing they would say if he HADNT had the knock on the head