To stop or not to stop?

Posted by Patrick Lickiss on Jun 16, 2010 in General, Legal | 2 comments

So today I’d like to change things up a little bit.  Rather than tackling a specifically clinical issue, I’d like to present a moral/ethical/legal conundrum.  This issue came to mind the other day when, on my way home from work (off-duty and clocked out), I approached the scene of an MVA on the freeway.  I tend not to stop at these types of incidents, but as soon as I saw the scene (rolled over vehicle with possible entrapment with no responders on scene) I was on the phone to our dispatch center to see if they had a unit en route.  Since the accident was news to them, I requested they send resources and told them I would call back with an update.  After pulling over, I performed an initial assessment and, finding the patient remarkably uninjured but still pinned in the vehicle, waited until further resources arrived.

After driving away from the scene of the accident, I marveled that in my tenure in EMS this was only the third accident I had ever stopped at while off duty.  All three of those incidents were fairly serious looking and had happened recently with no one on scene.  I remembered briefly hearing about recent changes to the California “Good Samaritan” law which had closed some legal loopholes so I started researching when I arrived at home.  It turns out that in August of 2009, the Governor (the Terminator himself for those of you from out of the state) signed AB 83 which closed a loophole in the existing law withholding protection from those who stop and render “non-medical” aid to those in need (1).  Nice to know that if I were to stop and help someone change a flat tire I would be as protected as if I were rendering medical care.  A quick search of the California EMSA website revealed that Chapter 9 of Division 2.5 of the California Health and Safety Code addresses directly the limitation of civil liability.  I’ll save you from the legal ramblings, but I would like to quote one section which sums up the protection afforded to off-duty EMS workers:

1799.102. (a) No person who in good faith, and not for compensation, renders emergency care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered. This subdivision applies only to the medical, law enforcement, and emergency personnel specified in this chapter. [Amended by AB 83 (CH 77) 2009.]

The rest of the chapter goes on to speak to more specific situations, but the take-home lesson is this:  as long as care is rendered “in good faith” and is not grossly negligent, the responder rendering the care is protected from civil damages.  This is certainly reassuring.  A quick review of medical legal terms shows that for negligence to be proven, four things have to occur:

• There is a duty to act
• There is a breach of that duty
• The breach causes an affect
• Damage has been inflicted to another (2)

Now as I understand it, at least in California, providers do not have a duty to act unless they are being paid or are volunteering in an official capacity.  Since this is the case, stopping at an accident scene off-duty is entirely voluntary.  Once you contact a patient, of course, you have a duty to continue to render aid until providers arrive.

So from a purely legal standpoint, it seems that we are protected (assuming you live in California) when we stop and help at on-view accident scenes.  Stopping at said scenes is also entirely voluntary and we assume no legal liability for just driving on by.

Another interesting issue surrounds the equipment available.  In most cases, the best thing for the scene of an accident is a pair of gloves and something to write with; triage and assessment are going to be the most helpful for later-arriving responders; but what about more advanced equipment?  At least when I used to work there, Sacramento County had a provision in the protocols allowing off-duty paramedics to carry intubation equipment for establishing advanced airways.  Needless to say (for those who know me) I did not exercise that right.

Now comes the part where I would love some input.  Do you stop at accidents when you are off-duty?  How do the legal issues differ in your area?  What do you carry in your vehicle in the way of supplies?  Does your LEMSA allow the use of ALS equipment off-duty?  What is your view when coming onto a scene with bystanders rendering aid while on-duty?  Do we have a moral obligation to stop more often to render aid not just when it “looks serious”?  I’m interested to hear your opinions.

NOTE: The opinions expressed here are those of the author alone and do not represent the views of any company or organization.  Use common sense and check with your local accrediting agency before making treatment decisions based on anything written here.  This article is not a substitute for protocols or policy and procedure manuals.  Additionally, I am not attorney and nothing stated in this article should be interpreted as legal advice.

CITED RESOURCES
1. http://democrats.assembly.ca.gov/members/a42/newsroom/20090806AD42PR02.htm

2.  http://www.ems1.com/ems-products/consulting-management-&-legal-services/articles/311436-Negligence-and-the-EMS-Professional/