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Roland Imperial v. Drapeau8/27/1998
istress.
The balance of Imperial's letter raises a series of questions, to most of which Imperial gives his personal response. For example, he asks, "Why did Private Wayne Drapeau transport Ruth [England] to the Suburban Hospital Emergency Room?" Imperial's answer is that Drapeau "panicked ... because of low blood pressure" and that he had a "lack of clinical skill and lack of knowledge on how to differentiate between Hypotension and Acute Shock," and that Drapeau's reading of the signs was "clinical incompetence." Imperial asked, "What is the qualification and how much training does Private Wayne Drapeau have to justify countermanding a physician's specific and explicit order to transport Ruth to Sibley Hospital?" In answer Imperial reviewed his own qualifications and submitted that it was on his authority, as the attending physician, that "Drapeau" was even in England's apartment. Asking what the "bad effect of transporting" England to Suburban was, Imperial said that Suburban did not have England's medical history. Suburban did not know that she was "infected with a Methicillin Resistant Staph Aureus" that required isolation, and Suburban did not know that she and her son did not want "heroic measures [taken] to prolong life."
Imperial, answering his own question as to whether Drapeau's action was "unethical and illegal," said that Drapeau countermanded the attending physician's order; he "stole the patient without having the decency to say that he was transporting" England to Suburban; he disrupted fifteen years of excellent patient-physician relationship, and he caused Imperial to lose revenue for the almost two-week period that he would not be attending England at Suburban.
The letter concluded:
"Can the Rescue Squad be trusted with a sick patient when they disregard the Physician's instruction? Are we giving the Rescue Squad extraordinary power to supercede an Attending Physician's order?
"I bring this to the attention of the office of [the two addressees], to investigate this unethical and illegal misconduct by [BCCRS's] Drapeau. The investigation should be conducted by an Independent External Peer Review with no ties to the Rescue Squad Agency and to the Emergency Room Physician Society, to avoid the allegation of a cover up."
Governor Glendening forwarded his counterpart of the letter to the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The Executive Director of the latter, by letter of August 29, 1995, wrote to Imperial advising that his "letter was received with great concern and a comprehensive review of [Imperial's] patient's care was conducted." MIEMSS said that the EMTs had "acted in the best interest of the patient." England's "status significantly deteriorated by the time the rescue squad arrived." The EMTs assessed England to be "in profound shock" and, on her arrival at Suburban, her blood pressure was "65/30 as a result of a significant gastrointestinal hemorrhage due to the duodenal ulcer." MIEMSS concluded that the EMTs had followed appropriately the applicable MIEMSS protocols.
Congresswoman Morella, stating that she "certainly share[d Imperial's] concern," forwarded Imperial's letter to the County Executive of Montgomery County. The County Executive provided a copy of the letter to the Chief of BCCRS. The BCCRS Chief deliberately withheld replying to Imperial until completion of the MIEMSS investigation. By a three-page, single-spaced letter of September 25, the Chief furnished Imperial with a step-by-step review of the EMTs' actions, concluded that they had acted entirely appropriately, and strongly suggested that Imperial provide a written apology to Drapeau.
Dr
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