“I guess I was panicking a little bit because women don’t have the same symptoms as men for heart attack,” Sarrel said.

She dialed 911, and soon a team of North Shore emergency medical technicians were at her door. Her vitals were OK; so was the electrocardiogram. They told her she wasn’t having a heart attack.

A couple of thoughts. First, Mrs. Sorrel is smarter than the EMS crew that came to her house. She at least knew that women often have atypical presentations. That’s partially because what we are taught in EMT and paramedic classes about cardiac disease is based on outmoded models. Which unfortunately doesn’t make us all that different from most of the rest of medicine. Sad, that.

More fail by the EMS crew. Never, ever, tell a patient that they aren’t having a heart attack. The most I ever told anyone was “Everything that we can look at, looks good. BUT, the hospital can do some tests that we can’t and we think a trip to the hospital would be in your best interest.” As I tell my students, especially those that are already practicing as paramedics, the 12 Lead ECG (or EKG if you prefer) is confirmatory, not diagnostic. A patient can have a cardiac event going on and still have a normal looking ECG. The determination should be made based on the history and physical examination of the patient, not some squiggly lines on a screen or piece of paper.

Third fail. Sending people bills when they decide not to go to the hospital. As the story points out, that will either result in a complaint or they will decide not to call 9-1-1 in the future.

Here’s a thought for you legal types. If actions of an EMS service discourage a person from calling 9-1-1 in the future AND that person suffers harm as a result of not calling, has an actionable tort occurred?

North Shore Fire Chief Robert Whitaker told WISN 12 News that many residents don’t know their taxes don’t completely cover 911 costs, so the department posts fees on its website.

Friday afternoon, a Medicare spokeswoman told WISN 12 News the agency doesn’t want to discourage anyone from calling 911. She said a case worker will contact Sarrel to review her claim.