A paramedic held a patient's face and threatened her

The tribunal called the restraint unnecessary. It lasted twelve minutes, and he wrote nothing about it.

What happened

On 6 January 2019 two emergency medical technicians were called to Patient A, who was reported to have tried to end her life by taking alcohol and medication. She was intoxicated, verbally abusive, and would not go to hospital. Control sent a second crew: a paramedic with the Welsh Ambulance Services NHS Trust since January 2014, and a newly qualified paramedic on her fourth shift.

The paramedic was on scene for about twelve minutes. The crew wheeled Patient A out over a step and down a short slope to the ambulance. Once in the wheelchair she tried to get out and flailed her arms. The paramedic, standing behind the chair, held down her arm and put his hand across her face and mouth, pulling her face to one side. He told her: “Do that again and I will break your fucking arm.”

He had not used an appropriate technique to move her from the floor into the wheelchair. He made no entry on her patient clinical record.

The outcome

A conduct and competence committee of the Health and Care Professions Tribunal Service sat from 6 to 10 December 2021. It found the particulars proved, found misconduct, and found him impaired. On 10 December 2021 it made a suspension order, holding that striking off would be disproportionate at that stage.

At the mandatory review on 19 December 2023 the panel substituted a striking-off order. It found limited insight and no evidence of remediation. No criminal proceedings are recorded.

What went wrong

The panel’s central sentence is short: “the restraint applied by the Registrant was unnecessary.”

Three colleagues gave evidence, and all said they had seen nothing like it from him before or since. One demonstrated the hand across the face and described it as aggressive and forceful. The paramedic said he had put his hand over her forehead and parried blows, and that she had punched and spat at him. The panel preferred the colleagues.

Two further failures sat alongside it. He did not use a taught technique for the transfer, and did not record his own involvement, so the clinical record said nothing about what had been done to her, or why.

What it teaches

Physical intervention is judged on necessity and technique, not on intent. A clinician who is spat at still has to move, hold and record a patient to a taught standard. The provocation is real. It is not a defence.

The missing record matters as much as the hand. A patient who cannot describe her own transfer depends on the notes. When the only clinician who used force writes nothing, the next crew and any later investigation have no account at all.

Questions for the room

The panel called the restraint unnecessary. What in those twelve minutes made it feel necessary at the time?
You are the senior clinician and a patient spits at you. What do you do in the next five seconds, and what do you write?
Three colleagues reported it within two days. What would make that easier in your service?

Evidence and limits

Confidence: probable. The two tribunal decisions are one source family, and no independent press report was found.

Both were read, with one limit. The 2021 decision stops mid-sentence in its sanctions section, so the reasoning behind the suspension rests on the later review panel’s account rather than the original wording.

Patient A is not named here. She had attempted to end her life. Proceedings concluded on 19 December 2023.

Our vulnerable and volatile persons training covers de-escalation, and what to do when a patient is abusive towards you.

Sources

Reviewed 20 October 2026.

A paramedic held a patient’s face during a transfer and threatened her