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Home > Fire Topics > Communications and Interoperability > 911 call: Woman dies after nurse refuses to do CPR

March 04, 2013

911 call: Woman dies after nurse refuses to do CPR

911 dispatcher was pleading for someone to help the woman

The Associated Press

BAKERSFIELD, Calif. — A central California retirement home is defending one of its nurses who refused pleas by a 911 operator to perform CPR on an elderly woman who later died, saying the nurse was following policy.

"Is there anybody that's willing to help this lady and not let her die," dispatcher Tracey Halvorson says on a 911 tape released by the Bakersfield Fire Department aired by several media outlets on Sunday.

"Not at this time," said the nurse, who didn't give her full name and said facility policy prevented her from giving the woman medical help.

At the beginning of the Tuesday morning call, the nurse asked for paramedics to come and help the 87-year-old woman who had collapsed in the home's dining room and was barely breathing.

Halvorson pleads for the nurse to perform CPR, and after several refusals she starts pleading for her to find a resident, or a gardener, or anyone not employed by the home to get on the phone, take her instructions and help the woman.

"Can we flag someone down in the street and get them to help this lady?" Halvorson says on the call. "Can we flag a stranger down? I bet a stranger would help her."

The woman was later declared dead at Mercy Southwest Hospital, officials said.

The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse's actions, saying she did indeed follow policy.

"In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said in a written statement. "That is the protocol we followed."

Toomer offered condolences to the woman's family and said a "thorough internal review" of the incident would be conducted.

He told KGET-TV that residents of the home's independent living community are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.

A call to the facility by The Associated Press seeking more information was not immediately returned.

Comments

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Alain Duane Monday, March 04, 2013 11:44:33 AM I think that is bullshit! they need to redo their policy on that!

Joakim Sandor Monday, March 04, 2013 11:50:46 AM That is insane.

Lori Pepper Monday, March 04, 2013 11:50:51 AM I really do not understand how someone who takes an oath is not responsible for rendering aid within their scope of practice regardless of what their employer's policies are. They are putting their employees in danger of being sued due to outright negligence, and if I were the victim's family, I would sure find this negligent and a blatant failure to ACT! How is she not liable even if she is on the clock for an employer?

Adam Hill Monday, March 04, 2013 11:50:53 AM Why even hire nurses, if they cant do something as simple as providing CPR.

Sean Tomaso Monday, March 04, 2013 11:50:57 AM what's the point of being a registered nurse if you cant give any medical help?

Adam Hill Monday, March 04, 2013 11:52:49 AM The only way this is justified is if the resident had a Valid up to date official DNR on hand.

Wes Thurmann Mon Mar 4 11:56:16 PST 2013 If it is the policy of the nursing home to awaith paramedics, why in the hell do they even have nurses on staff?

Mike Weller II Mon Mar 4 12:08:00 PST 2013 In the beginingof vid they did point out she didn't have a DNR, that possibility is gone

Kathi Wheeler Mon Mar 4 20:53:54 PST 2013 Wes Thurmann I totally agree with you Wes, if the policy of the nursing home is to call paramedics, why in the world would they even need a nurse on staff.. And if there was no Active DNR on file.. and she coded in the dining room? I guess.. she still should have started CPR until that was found.. but once CPR is started.. being an EMT, unless otherwise told by a Dr. or a Paramedic that the woman indeed has passed away.. you are suppose to keep up the CPR until you are too tired to continue to do so, or someone else takes over for you...something definitely sounds fishy here.. I would have started CPR immediately, and then awaited paramedics to arrive to assess the situation and see if there was indeed a DNR in sight..At least that is what I was taught as an EMT and Firefighter. Otherwise, why bother having nurses there to begin with.. they could hire cheaper Nursing Aids rather then pay an RN, who refuses to give CPR to a dying patient.. unless I haven't gotten all the information on the case so far.. Just from what I am reading on here..

Terianne Sutcliffe Monday, March 04, 2013 11:53:20 AM Okay, let's say the nurse did do CPR and this lady had a DNR on file, do you have any idea what kind of lawsuit that would have caused? If the nurse was indeed following policy then I commend her for her actions. But even at that had any one done CPR and it had gone wrong...The family could have sued for millions.

Sean Tomaso Mon Mar 4 11:55:47 PST 2013 NREMT policy is you continue within the scope of practice until the DNR is physically presented to you with proper signatures, idk if thats the same for nurses though

Adam Hill Mon Mar 4 11:56:45 PST 2013 Nurses and EMS are protected from such lawsuits in pretty much every state. Unless the person walks around with a DNR pinned to there shirt it can be hard to find and verify a DNR is valid. Its best to start CPR and worry about the DNR once its found and verifed to be legal. If it isnt found or is filled out in correctly and you didnt do CPR you are open to worse litigation then if you would have saved the womans life.

Terianne Sutcliffe Mon Mar 4 12:00:28 PST 2013 My Mother's DNR is on file and on her wheelchair as well as her bed, each has a copy taped in an envelope!!! No questions about what she wants!!!

Bob Rhoades Mon Mar 4 12:04:53 PST 2013 How long have you been an attorney?

Mike Weller II Mon Mar 4 12:06:05 PST 2013 If you watch the video they do state in the beginning that ahe didn't have a DNR order.

Chris Peterson Mon Mar 4 12:13:22 PST 2013 nurse should know what patients do and dont have one. and without the paperwork there you do cpr period

Adam Hill Mon Mar 4 12:13:52 PST 2013 When was the last time you ran a code? How long ago did you get your EMT license? Are you NREMT Certified? Not doing CPR on someone who does not have a valid DNR or does not have the DNR Available for you to see and examine is a dereliction of duties as an EMT. If we as EMS personnel have any reason to believe a DNR is invalid we have the duty to provide basic life support including CPR. If you disagree you need to go back through EMT-B classes.

Kyle Masters Mon Mar 4 12:45:37 PST 2013 Unknown DNR is a valid defense against that. As is the Good Samaritan Law, which prevents lawsuits from attempted life-saving actions. Your arguments are invalid.

Kyle Masters Mon Mar 4 12:47:07 PST 2013 Another point, I'm unsure of this states Good Samaritan Laws, but in certain states, if you are a certified medic, you are both criminally and civilly liable if you do NOT render aid if you see a person in distress. Plus, to be a nurse you take the Hippocratic Oath to assist anyone in any way possible.

Roberta Levesque Tue Mar 5 11:01:09 PST 2013 My brothers DNR was with him and still a young staff on a ambulance transfer from a hospital to a facility stopped at another hospital where they ignored his DNR and put him on a vent. In my opinion that crew and hospital did more trauma to my family that should have never happened.

Mike Weller II Monday, March 04, 2013 11:53:50 AM She may not be penalized by the employer, but shouldn't the goverment be taking away her nursing license?!

Bob Rhoades Monday, March 04, 2013 11:59:15 AM Unfortunately it's called stock rotation! The jackass who developed the polcy won't get whacked, the nurse will for violating her oath as a nurse and the home will get to drag a new person in for the room at a higher price then the 87 year old was paying.

Karen Lowder Mon Mar 4 13:15:20 PST 2013 I wonder if the residents understood the policy ? The resident's daughter seemed ok with the decision, hmmmmm.

Greg Rodgers Monday, March 04, 2013 12:02:35 PM The retirement home probably has that policy so the will not get sued by someone and the residence agree to this policy when they move in. It is not but a overly litigious society has made rules like this necessary.

Veona Ackerman Monday, March 04, 2013 12:06:05 PM crazy, the lady called 911, so why didn't she help the Lady? Or Get Help for her..If she had a DNR on File then don't call 911..they should have gotten the lady help..Big Law Suit I see in the Making..

Charles Brooks Monday, March 04, 2013 12:17:54 PM This nurse is gonna get eaten alive in court if the relatives wise up and realize that the nurse let the woman die. If I'd have done that as an EMT, I'd still be in jail.

Shane Ratliff Mon Mar 4 15:29:26 PST 2013 Obviously you didn't listen to the entire news story.

Nathan Dove Monday, March 04, 2013 12:26:14 PM that is the most rediculous policy ive ever heard. why would anyone even want to live there.

Nick Gavin Monday, March 04, 2013 12:34:24 PM I say shut the facility down and any nurse refusing to perform CPR should lose their license, if there are no nurses then the person should not have identified them self as a nurse. Apparently saving the life of another human being is trumped by company policy. Using the excuse this is an independent living facility not a nursing home is just plain ignorant. If the person is trained in CPR don't stop them from doing it. People and Companies like this make me sick.

Billy Buecker Monday, March 04, 2013 12:41:47 PM If she is unresponsive, there is no opportunity to be sued successfully... its called implied consent.

Roberta Levesque Mon Mar 4 14:12:21 PST 2013 implied consent would mean they could do cpr against her wishes. By following the contract for lack of a better word the family and her made a decision not to have cpr on site.

Rhonda Pittman Mon Mar 4 15:26:58 PST 2013 If she is unresponsive, she is not autonomous and therefore someone else makes the decision for her. Implied consent is when I need to give you shot or some such other procedure, and you hold your arm out.

Richard John Hocking Monday, March 04, 2013 12:57:42 PM I feel the owner of this place should be charge murder, manslaughter, etc, as I feel every one should chance of life, over here in hospital it is the family/doctors choice on DNR, but I do not know about care homes and nurses home, as it might be different.

Roberta Levesque Mon Mar 4 14:15:43 PST 2013 actually it is the the patients choice if they have a DNR or are a NO CODE per their wish and that is good everywhere in the street nursing home or hospital.

Rhonda Pittman Monday, March 04, 2013 1:57:43 PM Was the resident a DNR and was this an RN, LPN, CNA, or just someone off the street?

Roberta Levesque Monday, March 04, 2013 2:09:43 PM well first of all do not know what this ladies code status was. Patients have the right to refuse treatment and they can do this by signing a DNR or no code status. They have not said that this "nurse" was a RN, LPN, CNA, PCA or what. This society we now find ourselves in are very litigious and that will at times make for a very conflicting morals,& ethics. We do not know the facts here at all so take a step back and reason things out if this woman and her family signed this contract she may have not wanted a code run on her. Most independent living facilities do not staff nurses. To say it is policy does turn my stomach because that is a cop out I hate it when I'm told "BECAUSE IT IS POLICY". It feels like a line to me. The bottom line is we have to honor the wishes of the patient and their family.

Rhonda Pittman Monday, March 04, 2013 2:19:52 PM Last I heard no one was obligated to perform CPR within the general public. Medical personal and teachers are a different story.

Roberta Levesque Mon Mar 4 16:09:01 PST 2013 When I say in the street that is EMS.

Rhonda Pittman Mon Mar 4 16:24:19 PST 2013 The EMS makes you a medical personal

Roberta Levesque Mon Mar 4 16:39:33 PST 2013 I do know that I have both nursing and ems back ground. And have it for over 20 years. The full story here has not been told to the public I'm sure and it shouldn't be. HIPPA prohibits it. We do not know the background of this patient her wishes or the families. The fact that they knew of the policy before moving in there is very telling that this could have been what the patient and her family wanted. I just hope for everyone involved that this is used as a learning experience within themselves and their position they put themselves and their families in. This should not be being judged by the media. Who made that tape public knowledge by releasing it to the media and why did they do that?

Andrew Bechyne Monday, March 04, 2013 3:21:34 PM Was there a DNR?

David Gregg Monday, March 04, 2013 3:51:32 PM I would be owning that place!

Keri Anderson Monday, March 04, 2013 4:10:34 PM Don't judge...would you loose your job and risk being jobless and maybe homeless? The women was 87 and at the end of her life, she probably wouldn't have survived anyway and if she did it wouldn't have been long before her life ended anyway...you don't know what you would do in that situation! That's just life

Gerald Dworkin Monday, March 04, 2013 4:24:09 PM Regardless of the policies and procedures implemented/mandated by the employer, the nurse employees had a duty to act and a duty to uphold the Standard of Care expected of a licensed nurse.

Crystal Miller Mon Mar 4 16:36:49 PST 2013 These places need to be shut down. This is sub-standard care and bullshit!! What care facility has in place stupid policies like this? These patients/clients are PAYING for this care, this so-called 'nurse' should have her license pulled and NEVER ALLOWED to do nursing care AGAIN! But you know what they say "What Comes......Round Goes Round". One day she'll get her dues.

Keri Anderson Monday, March 04, 2013 4:28:10 PM And the residents know this when they move in, her daughter said she was satisfied with the care of the facility

Gerald Dworkin Monday, March 04, 2013 4:50:35 PM Supposedly, the family is not concerned by the facility's lack of appropriate response to this emergency. And, the media is having a field day because they don't know or have all the facts. Regardless, a certified nurse is expected to act in accordance to their level of training. This patient was under the care and protection of this facility, and they had the duty to uphold the Standard of Care expected. Lifesaving Resources www.lifesaving.com

Charles Brooks Monday, March 04, 2013 5:22:24 PM Mr. Ratliff, I know the woman's daughter said she's ok with the nurse doing nothing. She may wise up. Did you miss that part of my comment ?

Walter Waganka Monday, March 04, 2013 5:25:03 PM Sad state of affairs. Refusing to hand the phone over to another individual. Let the lawsuits begin.

Kari Cain Monday, March 04, 2013 8:32:14 PM I would much rather loose my job for performing CPR to a patient than to allow my patient to pass away because of some cracked out company policy. I don't know that the nurse should loose her license for this but I know that if she worked in Emergency Medicine & didn't not perform CPR she would indeed not only loose her job but would be taken in front of the medical review board where we would request that her license be revoked for life with possible charges being filed against her for neglect of a dependent resulting in death! This makes me sick that this Nurse would not help, we get into this field all for the same reason & that being to help others, there's a saying that we go by that is "do no harm" shouldn't she be held accountable for doing just that & causing harm? Whom ever this Nurse is needs to get out of the Medical Field already. This facility needs to be shut down for good this makes no sense to me how can the state allow for a facility to put a policy like this in place & knowingly allow it to stay open. I can understand if it's a slip & fall or seizure don't move the patient until further rescue can get there but not perform CPR are you kidding me, is this facility for all patients with a DNR order that reside there only?

Jeffrey Street Monday, March 04, 2013 8:37:02 PM I think several people need to dig your books out and read up on "implied consent". Also, what is the argument about? Why CPR if the woman was unconscious and breathing? Maybe an AHA refresher would be in order.

Janice Poston Woodberry Monday, March 04, 2013 8:51:18 PM It is my understanding that the caller was not a nurse but an activities worker. Also the resident had a DNR signed. Most people that age do not want to be resusitated or kept alive by artificial means.

Roberta Levesque Tue Mar 5 11:03:42 PST 2013 thank you for this information. you will notice most will not like it because you have taken their right away to judge this family and facility. I have dedicated over half my life to the medical field and this is always a hot topic its good to see another reasonable person.

Janice Poston Woodberry Tue Mar 5 13:04:26 PST 2013 According to news reports today there was not a DNR but the resident and family understood that no medical treatment would be given and EMS would be called. This was the followed policy which the resident's daughter who is a nurse was satisfied with.

Vicki Harp Garrett Monday, March 04, 2013 8:51:41 PM CPR was not even warranted in this situation...the patient was unconscious, BUT breathing, which means she had a pulse....CPR not warranted...I'm sure that "nurse" did not have cardiac monitors, and other equipment needed to fully assess the situation...but last I was taught, if they are breathing and have a pulse, CPR is not needed.

Jeffrey Street Mon Mar 4 21:00:32 PST 2013 Thank you Vicki. I've been teaching CPR for 20 years and was hoping someone would notice the obvious. We are so quick to jump in on a witch hunt.

Roberta Levesque Tue Mar 5 10:57:27 PST 2013 I have also been teaching CPR and first aid for years and the current guidelines do have you do CPR or rescue breathing if their own rate is not life sustaining. I still Stand with the patient and her family though. We do not know this ladies health status. I was once told a wonderful line when taking ACLS and it was "just because you know how to do it does not men you should" The patients and their POA or families have the right to not have treatments performed. My brother was 42 when he died form a disease that my own 20 YO daughter has. It would have been very wrong to have done CPR or advanced treatment on him but a very young new daughter put him on a vent, then we as a family had to remove it that was much harder to do and it was against his wishes. But because he could not say to not do it they did.

Vicki Harp Garrett Sun Mar 10 16:45:02 PDT 2013 I agree with you both, but we have no way of knowing "how" her breathing was, just that she was breathing, apparantly this "nurse" does not know how to assess breathing, or heart rate, I never heard the dispatcher ask those questions either...makes a big difference as to whether her respirations were adequate or not...or if rescue breathing was needed...but as you said Roberta, this must have been the patient and her familys wishes, they knew that this could not be done to her while living there.

Andrew Mayer Tuesday, March 05, 2013 11:56:30 AM smh.....

Arthur Mcculley Saturday, March 09, 2013 8:57:08 AM I may misunderstand , but doesn't this go below the standard of care and if so why is this facility being allowed to supersede medical standards. I had a similar incident happen a few yrs ago and I had a camp director tell me not to call for an ambulance for a child that his parents were Christian scientists. by not doing so I would have endangered this young mans life because of the medical emergency he was experiencing. so if I had followed the directors orders a young man would not be a grown man at this point and I would feel guilty for allowing myself to go against the oath that I took. I guess some people hold that oath higher than others.

Saturday, March 09, 2013 12:53:38 PM If the policy of the facility is not to DNR why call 911? Why is a nurse even there? Maybe to justify charging as much as they do? Sounds like a con job to me.