How to recognize feigned illness or injury
Abuse of EMS comes in all forms. Earlier this month, a Lake Placid, NY man called for an ambulance because he was “too drunk to walk home.” Similar stories abound of those who, for one reason or another, view the EMS system as a free taxi service.
Writing in jems.com, paramedic Steve Berry discusses a related phenomenon that he terms “Incarceritis.” He defines the condition as “when a patient intentionally falsifies or grossly exaggerates symptoms of illness or trauma in order to avoid incarceration.” Some of the more common forms of Incarceritis that Berry has encountered include contrived chest or abdominal pain, hallucinations, and “sham shaking.”
Berry outlines a professional protocol to help correctly respond to potentially fraudulent complaints, which he finds especially prevalent among inmates whose only real illness is that they are sick of being behind bars and would like even a short vacation from the custody of the justice system. His tips include:
- Repeatedly ask questions and document inconsistencies, but don’t point out discrepancies, which could allow the patient to redefine their symptoms
- Observe patient’s behavior when healthcare providers are not present
- Document subjective data from before and after the onset of the patient’s purported condition
- Keep in mind that the situation might be the real thing, so always perform a full objective medical assessment at the outset