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View Full Version : moral obligation vs. lawsuit mentality



calicojack
06-20-12, 17:28
so today at work some of the medics and I were having a discussion about treating patients when they/we are off the clock. I was SHOCKED to hear what i was told, to an extent.

As everyone knows we, in the EMS field, work under medical control and a specific dr's license.

Apparently, in my state, If a paramedic performs a non-"basic" intervention (ie: needle decompression) that medic can a) loose their license b) open themselves up to a lawsuit (which wouldn't be covered by malpractice insurance) and c) open themselves up to possible criminal charges if things go south. which opens a whole nother can o' worms for the untrained civilian who carries an ifak around with them.

The general consensus at my service is that the medics will keep on riding/moving if they see anything go south, if they can, and not intervene.

this bothers me. For me, i got in this field to help people, all the time, not just when i'm on the truck. to me, shit happens. as trained professionals we have a moral obligation to intervene as medically needed.

Kchen986
06-20-12, 19:02
There's usually a good amount of legal defenses that will arise if you act during an exigent circumstance.

tremiles
06-20-12, 19:14
In many states, untrained civilians are protected by "Good Samaritan" laws that do not apply to professional emergency response individuals. It's the main reason I got out of the lifeguard business in my early 20's. Especially considering the amount of trim a beach lifeguard gets despite being slow witted and not particularly attractive by any definition, it was a tough life choice.

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glocktogo
06-20-12, 23:19
The Hippocratic Oath is subordinate to tort law. Welcome to America. :(

Kchen986
06-21-12, 06:18
In many states, untrained civilians are protected by "Good Samaritan" laws that do not apply to professional emergency response individuals. It's the main reason I got out of the lifeguard business in my early 20's. Especially considering the amount of trim a beach lifeguard gets despite being slow witted and not particularly attractive by any definition, it was a tough life choice.

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Actually, it depends on the state. Usually, instead of a simple negligence standard for liability, the standard rises to gross negligence/recklessness, even for a trained professional. I'm not sure which state you live in, but I would suggest reading the actual statute before arriving at a conclusion.

Further, you will have defenses of necessity and causation, if you decide to stick someone suffering from tension pneumothorax.

Caduceus
06-21-12, 06:33
In many states, untrained civilians are protected by "Good Samaritan" laws that do not apply to professional emergency response individuals. It's the main reason I got out of the lifeguard business in my early 20's. Especially considering the amount of trim a beach lifeguard gets despite being slow witted and not particularly attractive by any definition, it was a tough life choice.

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California is similar to this - Good Sam laws don't cover trained professionals. But, yes, states vary. In general, anything over Red Cross basic first aid is essentially opening yourself up to problems, IMO. If you can argue that every Boy and Girl Scout would be able to do the same thing, you really negate the argument that you screwed up.

That being said, you don't have a Duty to Act if you're not identified as a health care provider. In other words, you don't have to stop unless you have some huge glaring star of life on your car or something that screams EMS provider.

As an EMT-B I've stopped at several MVAs (MVC's, TA's, TC's, whatever you call them). As a physician, hell no.

ST911
06-21-12, 10:23
I was SHOCKED to hear what i was told, to an extent.

I'm not. The reality of the modern legal environment has made things much more complicated, expensive, and risky than they should be.

I had a much longer post for you, but it comes down to this: Do your own cost:benefit, and act according to what you feel obligated to do and what you're willing to pay.

Texas42
06-21-12, 17:37
In Texas, the Good Samaritan laws cover professionals when they don't have a professional duty to respond. There are some stipulations (Don't take payment, no gross negligence ect) I'd really be supprised if most states didn't have similar laws. . . . but Texas is probably the safest place (in terms of liability) to practice medicine.

I wouldn't do anything you were not trained to do or weren't comfortable doing.

Talk to a Medical defense lawyer. Most medical schools have some kind of jurisprudence course for their graduating seniors. You might try and see if you could tag along. (just an idea)

WARPIG [USMC]
06-21-12, 18:01
And that's a sad thing to see...our nation becoming filled with more and more greedy people, just out looking to "get theirs" by whatever means possible...even if someones intentions were to save sometimes life, if something beyond their control went South, they'd open themselves up to an onslaught of lawyers and BS. Truly sad. People have good intentions but they are afraid to use them, "just in case" something can come back and bite them in the ass.

Hizzie
06-21-12, 19:27
Even when I was LE I kinda stuck to the cell phone as my "action". To many variables and too many lawyers.

mallowpufft
06-21-12, 21:33
A few weeks ago I would have been shocked at this but I just finished up the class to get certified to get certified to teach ski patrolling stuff (yes, I had to pass a class to see if I could teach adult learners before being allowed to get trained to actually teach the classes) and this was gone over. Here in VA ski patrollers have sovereign immunity as long as they are volunteering. I'm hosed for the winter as I'm paid. During the summer anything I do, as long as I stick go NSP levels of care, I'm good to go.

Flip side of that is my wife who is an RN is had to get malpractice insurance on top of what the hospital she works at provides, just to be safe.
I know that most EMS agencies that have paid staff have insurance of some sort to protect medics as lo g as it wasn't gross negligence.

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nubs101
06-21-12, 22:52
Even when I was LE I kinda stuck to the cell phone as my "action". To many variables and too many lawyers.+1 Even my Department says unless it is something very serious its best to use the phone.

ST911
06-22-12, 09:18
Lots of variables and nuances. Talk to a lawyer specializing in this subject area in your court of jurisdiction. Buy yourself some liability insurance. Generally accepted universal principles:

Duty to act- No good sam. Includes volunteers if they have a statutory or employment duty to act.

Skills requiring credentialing or licensure- No good sam. You likely can't do those outside of employment anyway.

Also... When stopping to help, consider announcing that you know first aid rather than you're a (insert credential here). Perform BLS/first aid interventions, then fade silently away when other help has arrived.

Weaver
06-23-12, 01:51
In New York, you have to meet a couple criteria to be able to be sued successfully (for voluntary acts without expectation of monetary compensation, performed outside a hospital):

1) Must have duty to act,
2) Must have actually caused harm, through act or omission, to the patient through gross negligence.

The only way to rise to the level of gross negligence is to act outside your training level, or to do something that a "reasonable person" with your training wouldn't do.

But so long as you do not actively cause harm through act or omission, you are good to go here.

thirteen/autumns
06-26-12, 09:32
it's really said but all I do is call 911 and give ACCURATE information if someone hasn't yet or is doing a terrible job of it... Really wish it wasn't that way but "risk vs. reward." No star of life on my vehicle or identifing myself on scene. If it's my family or close friend then by all means do what I can. Again really sucks but heard to many horror stories.

thirteen/autumns

TahoeLT
06-26-12, 13:47
This very issue has helped lead me to let my certification lapse. I don't currently work in EMS, but I like having the skills ready if needed; but I don't want to deal with the legal crap. I'll keep the skills up and handy, but as a "joe civilian" I'm more likely to be covered by the law. Sad.

Texas42
06-27-12, 08:20
This very issue has helped lead me to let my certification lapse. I don't currently work in EMS, but I like having the skills ready if needed; but I don't want to deal with the legal crap. I'll keep the skills up and handy, but as a "joe civilian" I'm more likely to be covered by the law. Sad.

Please forgive me, but how will letting your certifications lapse help protect you from civil litigation?

YVK
06-30-12, 10:16
Please forgive me, but how will letting your certifications lapse help protect you from civil litigation?

As a bystander providing CPR he is covered under a Good Samaritan law. As a certified professional he could be targeted by a litigation even if he provides it off duty. Letting cert lapse moves him from a latter category into former.
It is a sad state of things. Somebody told me of a case in Florida where a bystander CPR provided by a doc was observed by a malpractice attorney who actually counted compression to breath ratio and the doc was taken to a court...Of course, professional malpractice insurance doesn't cover bystander CPR.

Texas42
06-30-12, 20:25
You know how there is always that CCW instructor or LEO who say some complete BS. . . . and those people tell other people and it becomes accepted as fact. Often times leading people to make unwise decisions.

I believe this subject is one such example. Yes, there is lots of litigation in medicine.

Now, the rules are very different between states. I'd recommend everyone talk to a defense attourney who works in their state. I HAVE talked to a defense attorney who specialized in defending MD's. No, I'm not an expert, and I won't give legal advice (so don't take it as such).

I really doubt the Good Samaritan laws are that different in all the other 49 states in the union. I've made up my mind that if the person next to me at the supermarket, who in all likelyhood has neglected his hypertension, diabetes, and cholesterol, I'm going to do chest compressions and call for 911 and an AED. I'm not going to expose myself bodily fluids, but if they want to sue me for doing that. . . that is their moral problem, not mine. Besides, he joke is on them, I have no money.

kmrtnsn
06-30-12, 21:09
I once watched a co-worker of mine jump into the Santa Cruz River during a monsoon storm to save two drowning aliens, as the Santa Cruz flows north from Mexico. When he went to the hospital to be checked out for all of the river water he ingested (think sewage and hepatitis). The service wouldn't cover the medical bills. Same happened to another co-worker who gave mouth to mouth for 20 minutes to save another alien; "go pound sand". I have seen people I work with sued by the "victims" for not giving enough/too much aid; doesn't matter what you do in my line of work, the public is not satisfied. Hence, my philosophy is, if you aren't my partner, on my team in blue, or a loved one; vaya con Dios, I have no obligation to you. I'll make a call but beyond that, you're on your own.

dog guy
06-30-12, 21:48
The original Good Samaritan laws were written specifically to protect trained professionals from being sued if they voluntarily stopped at the scene of an emergency to offer aid. I don't know how far these laws have morphed in other states but in Nevada, trained or untrained is not relevant as fas a Good Sam coverage goes. If the aid is given without payment, at the scene of an emergency (or a scene which is reasonably believed to be an emergency), the care giver is protected unless he/she commits gross negligence. I think the wording might even still be gross criminal negligence, but I'm not certain. If you exceed your level of training then you'll probably have problems, but a physician has the same protection as a basic first aider. A Paramedic ends up in a pickle because their PM interventions are only allowed when working under a physicians orders/license/protocols etc., and that authorization (in NV) only applies when the PM is on duty at an agency which provides PM care with medical control. I don't know how the interplay between Good Sam protections vs. practicing without a license would play out if a PM did a PM skill off duty.

thirteen/autumns
07-01-12, 01:14
The original Good Samaritan laws were written specifically to protect trained professionals from being sued if they voluntarily stopped at the scene of an emergency to offer aid. I don't know how far these laws have morphed in other states but in Nevada, trained or untrained is not relevant as fas a Good Sam coverage goes. If the aid is given without payment, at the scene of an emergency (or a scene which is reasonably believed to be an emergency), the care giver is protected unless he/she commits gross negligence. I think the wording might even still be gross criminal negligence, but I'm not certain. If you exceed your level of training then you'll probably have problems, but a physician has the same protection as a basic first aider. A Paramedic ends up in a pickle because their PM interventions are only allowed when working under a physicians orders/license/protocols etc., and that authorization (in NV) only applies when the PM is on duty at an agency which provides PM care with medical control. I don't know how the interplay between Good Sam protections vs. practicing without a license would play out if a PM did a PM skill off duty.


Ditto... Sucks bud doesn't it!

Ironworker46
07-01-12, 17:35
My cousin who happens to be an OB/GYN in the Rockford, IL area was sued recently for responding at an accident scene. He performed CPR on a guy that was screwed up pretty bad in a car accident. He managed to get the guy back, only to find out that the guy was suing him a few weeks later, mainly for breaking his ribs trying to get him back. Greed will be the downfall to this country.

TahoeLT
07-02-12, 15:14
That's all about the size of it, in my reasoning. Things have gotten so that it's tough to do much in life without worrying about legal repercussions; seems to me that has changed over my lifetime, where things I did as a kid would cause parents today to scream in horror (and probably speed-dial their lawyer).

I realize the scope and limitation of GS laws, and in general I think I'm better off as a "man on the street" if I ever have to intervene, than if I'm a certified medical care provider without an agency and medical direction behind me. I have to think that's part of why people stand by and do nothing (or worse, take pics/video with their phones) when witnessing a medical emergency.

Six Feet Under
07-27-12, 01:02
I'd do the best I could with what I have on me at the time.

If they want to sue me, go ahead... I have nothing in my name but my nine year old truck and about $60,000 in medical bills from when I got shot. Good luck. :D

Caduceus
07-27-12, 08:01
They may not be able to collect right away, but courts can garnish your wages til the day you die.

Six Feet Under
07-27-12, 16:44
They may not be able to collect right away, but courts can garnish your wages til the day you die.

Not if I move to Somalia and become a pirate... :D

Being sued wouldn't be the worst thing that's ever happened to me... the good guys always get shit on anyways.

CompressionIgnition
07-29-12, 02:27
My cousin who happens to be an OB/GYN in the Rockford, IL area was sued recently for responding at an accident scene. He performed CPR on a guy that was screwed up pretty bad in a car accident. He managed to get the guy back, only to find out that the guy was suing him a few weeks later, mainly for breaking his ribs trying to get him back. Greed will be the downfall to this country.

Out of curiosity, what became of the lawsuit? Seems your cousin should have been able to have it dismissed out of hand, based on 745 ILCS 49/25
(at http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2076&ChapterID=58 , use the "find on page" function in your browser to find ILCS 49/25

The text is: "Sec. 25. Physicians; exemption from civil liability for emergency care. Any person licensed under the Medical Practice Act of 1987 or any person licensed to practice the treatment of human ailments in any other state or territory of the United States who, in good faith, provides emergency care without fee to a person, shall not, as a result of his or her acts or omissions, except willful or wanton misconduct on the part of the person, in providing the care, be liable for civil damages.
(Source: P.A. 89-607, eff. 1-1-97; 90-742, eff. 8-13-98.)"

redone13
08-02-12, 16:40
He shoulda been covered by the Good Samaritan law.

Voodoo_Man
08-02-12, 16:49
Before doing anything "off duty" I would run it by your management, who would have the best answers (not stop and call them during the situation, but ask them at work one day). Many public service organizations indemnify the employee so that they can help whenever or wherever they are.