2 Alberta paramedics sanctioned for forcing drug on unconscious patient in RCMP custody

WARNING: This story contains distressing details.

Two paramedics have been sanctioned for unprofessional conduct after using forceps to insert an oral drug into the rectum of an incapacitated man in RCMP custody in northeastern Alberta.

Documents from a hearing tribunal provide details on the October 2020 incident in Elk Point, and how the Alberta College of Paramedics (ACP) wrestled over how Donald Hingley and Ryley Pals should be disciplined.

Hingley and Pals have been fined and reprimanded and ordered to take ethics training.

They had also faced eight-day suspensions but those penalties were overturned after a rare internal appeal.

During a hearing tribunal last July, Hingley and Pals admitted that they incorrectly administered the anti-epilepsy drug Keppra rectally, using large angular forceps.

The hearing documents indicate the patient had been previously assessed for his symptoms on the Frog Lake First Nation but do not clarify if he is a member of the Cree community. Frog Lake First Nation leadership could not be reached for comment.

According to an agreed statement of facts, Hingley and Pals were working at Medavie Health Services West-Prairie EMS, a private ambulance provider in the town of Elk Point, 215 kilometres northeast of Edmonton.

On Oct. 7, 2020, they were dispatched to the local RCMP detachment to assist a man who appeared to be having seizures. Hingley, an advanced care paramedic, was supervising. Pals was a primary care paramedic.

The patient — identified as "Patient A" in the hearing documents — was unconscious in a holding cell when the paramedics administered the drug. The tribunal found they incorrectly administered the medication and failed to conduct a proper assessment on an unresponsive, vulnerable patient.

Hingley was also sanctioned for derogatory comments he made suggesting the patient was faking his symptoms.

In a patient care report, Hingley wrote that the man had been previously assessed on Frog Lake First Nation for "seizure activity" that was actually "more of a voluntary muscle twitching." The patient did that so he could spend time in a hospital room rather than being incarcerated by the RCMP, Hingley wrote.

"The conduct of the regulated members was egregious, reckless and was a significant departure from the standards expected of a regulated member," tribunal chair Belle Clark wrote in a decision dated Sept. 23, 2021.

The decision noted that there are no current protocols that allow for the rectal administration of anti-seizure medications, and that even if there were, Keppra is not a drug that can be administered rectally. The use of forceps was described as unacceptable.