Intoxication, Reports, Facts And Conclusions

Today’s Burning Question: I am a firefighter paramedic and we were told that noting in a patient care report that we suspect that a patient is under the influence of alcohol can get us into trouble. In fact one paramedic reportedly got ripped apart in court by even using the word alcohol in his report. What are we supposed to do? If I write in my report that the patient smelled of alcohol am I really sticking my neck out?

Answer: Like most questions that are asked of an attorney, my answer has to start with the obligatory: “it depends”. In this case it really does depend.

It is “possible” that a paramedic who puts in a PCR that a patient is “under the influence” or perhaps simply notes “ETOH”, will incur the wrath of a skilled trial attorney. Any time an attorney wants to discredit a medic he will scour the report searching for “low hanging fruit.” One such “low hanging fruit” that attorneys may seek to use on cross-examination are conclusions such as “ETOH”.

That is why it is so important for paramedics and firefighters alike to write their reports stating FACTS not CONCLUSIONS. The report needs to state the facts upon which the conclusion is based so that the reader is led to the conclusion WITHOUT the report writer even having to state it.

In the case of a patient who appears to be intoxicated – recognize that intoxication is a conclusion. Like any conclusion that we reach, the conclusion must be based upon facts. Simply state the facts upon which the conclusion is based: The patient was unsteady on her feet, spoke with slurred speech, had bloodshot eyes and had a beer-like odor on her breath.

Even better would be another statement of fact: “Patient stated she consumed four beers prior to feeling ill.” Facts are things that you observe with your own five senses: sight, smell, touch, hearing and taste (try to avoid the last one on runs when ever possible…).

Get in the habit of writing down facts and avoiding conclusions when writing reports. Besides making any cross examination go better, the facts will be there for your recollection. Two or three years later when you are called upon in a deposition or at trial to recollect an incident from a report, the facts you include will be there to assist your recollection. A simple conclusion of “ETOH” will likely be of little to no help.

About Curt Varone

Curt Varone has over 40 years of fire service experience and 30 as a practicing attorney licensed in both Rhode Island and Maine. His background includes 29 years as a career firefighter in Providence (retiring as a Deputy Assistant Chief), as well as volunteer and paid on call experience. He is the author of two books: Legal Considerations for Fire and Emergency Services, (2006, 2nd ed. 2011, 3rd ed. 2014) and Fire Officer’s Legal Handbook (2007), and is a contributing editor for Firehouse Magazine writing the Fire Law column.

  • mr618

    FOUR beers? In almost 40 years of emergency services work, I have yet to encounter ANYONE who will admit to more than two, hence “JACOB” Syndrome (“Just a couple of beers”)

    • Al Sharpe

      I learned early in my nursing career ( 17 years in level 1 trauma) that if you over exaggerate the amount of alcohol someone has taken, they will admit to a lesser amount that is fairly accurte. I also work full time in a professional dept outside of Boston and the same works on the street. Me: ” so what did you have?, about 14 beers?” answer–> ” Oh God no, I cant drink that much, I probably had 8″

      • mr618

        Makes sense. We used to have to record weight in arrest reports, and even *I* was not stupid enough to ask a woman under arrest how much she weighed, so I would say, “I have to record your weight… about 205?” “What are you, nuts? I only weigh 147!” “Thank you.”


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