Video: Is deeply disturbing patient care murder?

On Dec. 18, 2022, police and EMS responded to the home of a man suffering from hallucinations secondary to alcohol withdrawal. The patient, Earl J. Moore Jr., died following an ambulance ride to the hospital. Steve Wirth and Doug Wolfberg have laid out the facts of the incident, as we know them, and the first-degree murder charges against LifeStar Ambulance Service providers Peter Cadigan, 50; and Peggy Finley, 44.

Sangamon County (Ill.) has released the body camera video from one of the officers who responded to the call for help. In reviewing the footage, the police officers generally perform how I’d expect them to. They assess the safety of the scene, gather some information from the 911 caller, make sure the patient doesn’t have immediate and obvious life threats they are able to treat, and begin to gather some patient history. There is nothing heroic in their actions, but there is also nothing overtly harmful. Everything about the call feels like calls I have responded to for alcohol withdrawal until EMS arrives. The actual medical emergency probably feels familiar to you.

The video, capturing the actions and inactions of EMS, is deeply disturbing to watch and should send shockwaves through the heart of any EMS professional. Please watch the video to affirm your oath to provide care to others in need and to step forward when another caregiver breaks that oath. As I watched and rewatched the video, here are the things that came to mind immediately for me.

Greet the patient

How an EMT or paramedic greets the patient often sets the tone for the entire call.

I used to greet patients with, “I am Greg. I am a paramedic and I am here to help.”

I suspect you have a standard greeting which includes your name and certification as you begin to gather information about the patient. You likely follow your greeting, like I did, with a question, like “Can you tell me what’s wrong?” or “Why did you call?”

Even when I was responding to a patient I knew from previous calls, I always introduced myself and began asking questions. The greeting and initial questions only take a few seconds and are critical to determining if this is an emergency or not an emergency.

Finley enters the room at 16:18 in the bodycam video. As far as I can tell from the video, she asks Moore for his birthday, walks over to him and says, “Sit up. Quit acting stupid.”

Even if Finley had previously responded to Moore, which seems likely based on her tone and affect, this is exceptionally bad EMS, by every subjective and objective measure.

Duty to intervene

Two-twenty a.m. rarely catches any of us at our best and we don’t know how many hours Finley and Cadigan had been on duty; how many calls they’d responded to since their last break; or their previous experiences with Moore, the 911 caller or the police officers.

Nonetheless, lots of red flags were waving. The patient was waving several red flags for all to see. He had altered mental status, respiratory distress, diaphoresis and was complaining of being hot. Finley was also waving red flags with her angry words, impatience towards the patient and indifference to assessing his medical emergency. Cadigan was waving his own red flag through his detachment to the incident and standing outside with the cot while the cops struggled to move Moore through the house and down the porch steps.

I don’t know if a police officer’s legal duty to intervene extends to other first responders or if it is just an obligation to other law enforcement officers. I also realize it is unreasonable to expect police officers, on top of everything else we expect of them, to recognize terrible EMS and take action that EMS providers are failing to take. But it is hard to watch the video and not think if someone had put a hand on Finley’s shoulder and said, “Let’s step outside, catch our breath and make a plan for how to move forward,” that this incident might have gone differently.

We are caregivers, not ePCR filler-outers

Finley’s only question to Moore is his date of birth, arguably the least interesting detail for this medical emergency. As an EMS caregiver, our primary responsibility is and always has been to provide competent and compassionate care. Yes, we need information for the ePCR, but there are plenty of opportunities to collect that information.

Moore whisper gasps, “I can’t breathe,” another red flag, at 19:02 in the video. This phrase, “I can’t breathe,” is a trigger for a new extrication and treatment plan. As I’ve written before, we need to hear “I can’t breathe” as:

• I need help! NOW!

• I am scared that I might die. Help me, please.

• I am fighting for my life, and I am going to keep fighting against your efforts to restrain me or not take my complaints seriously because I am dying.

• I might die soon because my brain, heart and lungs are not getting enough oxygen.

• Will you do something to save me?

Appreciation for the police

I appreciate that the officers kept their cool with Moore. They offered more help with lifting and moving the patient than I’d ever expect from law enforcement. Police, in my experience, were always glad to help when I asked, but these officers did most of the work without being asked or thanked.

Finally, I don’t know anything about the assessment and treatment Finley and Cadigan gave to Moore in the ambulance and the bodycam video ends with them raising the stretcher and moving it down the sidewalk. In the weeks and months ahead, we are sure to learn more about the case as they begin the difficult task of defending themselves and the care they failed to provide against charges of first-degree murder.