Paramedic Punches Drunk Patient

Case #227

A young man was driving while intoxicated and crashed his vehicle.

At the scene, he complained primarily of right hand and right-sided trunk pain.

The patient was initially cooperative and was placed in the ambulance.

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On the way to the hospital, an incident happened in the back of the ambulance.

The patient claimed that the paramedic punched him in the face.

The paramedic told police that the patient became combative and in an attempt to restrain him (for both the patient’s safety and the medic’s safety), his hand slipped and accidentally struck the left side of the patient’s face.

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In the ED, a CT scan showed facial fractures.

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The patient sued the paramedic and his employer, alleging that he was assaulted.

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The plaintiff also hired an ENT physician to opine about the patient’s injuries:

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The defense countered that the paramedic was simply protecting himself from an assault.

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The plaintiff offered to settle for $100,000.

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The two sides reached a confidential settlement and the lawsuit was withdrawn.

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MedMalReviewer Analysis:

1. Its difficult to have sympathy for someone who drives drunk and assaults healthcare workers. However, that doesn’t give us free reign to punch patients in the face. I think there is some room for nuance in cases like this based on the context and the degree of combativeness. A paramedic is one-on-one with a patient in tight quarters in the back of an ambulance, and doesn’t have an entire department of security staff protecting them like I do in a hospital. If there is a legitimate threat of serious bodily harm, I think closed-fist blows may be appropriate in some extremely narrow circumstances. If the patient is just being a run-of-the-mill uncooperative drunk, its absolutely unethical to punch them in the face. Its impossible for me to make a judgment call in this case.

2. The paramedic’s run report mentions “abrasions, bleeding, and swelling to the head”. Its entirely possible the patient could have suffered his facial fractures in the accident itself, not from being punched. Alternatively, the paramedic may have been trying to avoid liability by writing a dishonest report suggesting the fractures happened before the assault.

3. The paramedic told the police that he slipped and accidentally struck the patient. Later, the special defense indicates that the paramedic acted in “self defense”. This fact that he initially denied any intentional aspect of the incident, then later admitted it was intentional, seems suspicious.

4. The expert report by the paramedic is poorly written. He uses poor grammar and has multiple run-on sentences. I don’t think an attorney should write the expert witness opinion and just have the expert sign it, but some proofreading would have been useful here.

5. The settlement offer for $100,000 is relatively low. I don’t think the plaintiff’s attorney ever intended to take this to trial. He is a very unsympathetic character and while there were obvious injuries, claiming that they caused permanent debility is a bit of a stretch.

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A question for subscribers:

I’m debating publishing a lawsuit about a male patient with breast cancer.

Its an interesting case given the relative rarity of this diagnosis.

The case centers around a radiologist missing a lesion on mammography and ultrasound.

However, they did not include any of the actual images in the court records.

Are you interested in seeing the case anyway, despite the lack of images?