Engine (and Ladder) Co. EMS: To Force or Not to Force Entry

By Michael Morse

You respond to an apartment building to a “check the well-being” call. Additional information provided informs you that the elderly resident of apartment 302 has a number of health problems and has not been heard from for several days. The occupant’s daughter lives an hour away, has a key, and is on her way.

On arrival, you find a locked apartment door, nearly impossible widow access, and an army of concerned neighbors. The police have responded and they are more than willing to leave the decision whether or not to force entry up to you. EMS is also en route with an ETA of seven minutes.

This being a high-crime area, the door is secure, and damage will be done to the casing, door itself, jamb and locking mechanism if you use a halligan or K-tool. Aware that forcing the door might look a little silly, you knock, ring the bell and call out, “Hello! Anybody home?” Doing your best Captain Obvious impersonation, you, “try before you pry,” and lo and behold, the door is locked tight.

The dilemma you face is one fire companies around the world are all too familiar with. You have three options:

1. Leave

2. Force the door and perform a thorough search for the occupant

3. Wait for the key holder

Those three choices, simple as they may seem, are far from simple. By leaving or waiting for the key holder, you expose yourself and your crew to a number of liabilities, the first (and for me the worst) being the emotional repercussions of being a few feet away from a person in desperate need of help that you could have provided. That gnawing sense of something wrong is usually right. Waiting for a key could very well be the potential patient’s undoing. In addition to an ethical responsibility, we have legal obligations. The public tends not to look kindly on a crew of emergency responders who left a person to die on their bathroom floor, nor does the legal system.

Forcing the door only to find nobody home is a very real possibility. Fortunately, acting on information from a friend or relative makes doing so a perfect example of a good faith response. It is very unlikely that you would see legal repercussions for doing so. On the down side, if there is a person on the other side of the door, they are within their rights to defend themselves and their property from intruders. The occupant might have a mental health issue or could be armed. If they believe that the people breaking down their door are not doing so with the best intentions, they might react negatively.

Forcing the door to find a person intoxicated, sleeping or simply unwilling to respond to knocking is also a possibility. While embarrassing and awkward, the only harm done is to the door. Fire companies acting in good faith “probably” will not be expected to make repairs or reimburse for damages. Damage done to a door will usually be forgiven if there is a medical emergency behind it and you are able to intervene. This is especially true when you provide a chance for survival, comfort or resolve whatever caused the occupant to be unable to respond.

Although it may be our duty to respond, what we find is not always clear-cut. Difficult choices can arise, affecting a person’s life, your own, your crew’s safety, and the very real possibility of exposing your department to legal risks. Additionally, a public relations nightmare can result should you make the wrong decision. It is my experience that erring on the side of caution is usually the prudent action. A door and frame can be replaced; a person cannot. I would rather open a door with the tools at my disposal and find an empty house or apartment than wait outside anticipating the worst. The people we protect and serve will undoubtedly agree, most of the time.

More Fire EMS

Living or Dead?

Keeping the Crew Motivated

Apparatus Placement

The Sample Survey

Protecting Patients from the Dirty Work of Firefighting

 

ADDITIONAL LINKS

http://ceas.uc.edu/aerospace/FireScience/fire-ems-safety/chapter_13_-_ems.html

Article 13-52  (Jan. 22, 2016)

Link: IL – Woman calls 911 – difficulty breathing – EMS knock on door but no response – no forced entry, woman dies, lawsuit to proceed

http://www.illinoiscourts.gov/Opinions/SupremeCourt/2016/117952.pdf

Michael Morse is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.