An expert witness in a $25 million lawsuit against the city of Bakersfield and Hall Ambulance testified Wednesday that a Hall paramedic committed "abandonment of a patient" in 2007 when he left stroke victim Dr. Mohamad Harb in the custody of police rather than immediately taking Harb to a local hospital.
Ted Blankenheim, a career paramedic and registered nurse from Redding who has extensive experience in emergency medical training and reviews, told the jury that the actions of Hall paramedic Brian Dumont -- a co-defendant in the ongoing civil trial -- represented "a gross departure from the standards of medical care."
According to Blankenheim, all paramedics must be well-versed and well-trained in state law, which ultimately gives authority over patient care to the top-ranking medical personnel at an accident scene.
"It's not OK to leave," Blankenheim told the jury. Especially not when you're treating a 57-year-old exhibiting a "mentally altered" state of confusion and bizarre behavior.
Even if police are resistant to releasing the patient into the care of emergency workers -- as Dumont testified earlier in the trial -- Dumont should have insisted, or asked for assistance from higher authorities, such as the on-duty ER doctor at the hospital, a watch commander at the police department or another authority.
But Jim Braze, the attorney representing Hall and Dumont; and Mick Marderosian, representing the city and former Bakersfield police officer Claudia Payne, worked to poke holes in Blankenheim's testimony. (Witnesses for the defense won't be called until plaintiff attorneys Thomas Brill and Steve Nichols have rested their case.)
In his earlier testimony, Dumont said he has always operated on the assumption that the person at the scene "with a badge and a gun" has ultimate authority. And he testified that Payne insisted that she would transport Harb in her patrol car, and that Dumont needed to move his ambulance because it was blocking her exit.
But there appears to be a clear dispute about the facts between his version of the incident and Payne's, who apparently testified in a deposition that Dumont indicated Harb's vital signs were normal and that he didn't need to be transported via ambulance.
Marderosian said the evidence will show that Payne's actions that day were those of a competent law enforcement officer.
Additional evidence has also come to light showing that Harb had suffered a prior stroke, that he wasn't taking his blood pressure medication against the advice of his personal physician and, according to lawyer Marderosian, that the nature of the hemorrhagic stroke in 2007 was so severe that the damage to Harb's brain was inevitable, even if his care was delayed.
Adding to the complexity of the lawsuit is the fact that the interests of the two main defendants, Hall Ambulance and the city, sometimes are at odds.
Dumont was at the scene for just 10 minutes, Braze said earlier in the trial. "That's the entire case against Hall Ambulance: that 10 minutes."
The incident that would transform the lives of Harb and his family -- and lead to their ongoing legal battle -- occurred in November 2007 as Harb, still wearing surgical scrubs, was driving his Mercedes after leaving a 12-hour shift at Kern Medical Center.
As he headed west on 24th Street, Harb's car came to rest at the right side of the roadway, near Oak Street, flattening a tire against the curb.
Payne arrived at the scene minutes later, where she saw that Harb had urinated on the sidewalk and vomited on his shirt.
He was given two alcohol breath tests, both of which registered zero, according to Dumont's written report -- although there appears to be disagreement about that as well.
Medical tests later showed Harb had suffered a life-threatening stroke, yet the first Hall Ambulance crew called to the scene, headed by Dumont, departed without him, according to the company's own reports, leaving Harb sitting on the curb, one shoe off and lying in the gutter.
Apparently believing the disoriented man was under the influence of alcohol or drugs, police handcuffed him behind his back and sat him down on a curb for several minutes -- precious minutes that Blankenheim, the witness from Redding, testified are crucial in responding to stroke symptoms.
"Time is brain," is the cardinal rule for dealing with stroke victims, he testified.
The trial is expected to continue well into December.