# Realistic Liabilities



## medicdan (Apr 17, 2007)

I just came home from my EMT-B class, and I have been thinking a lot about what was lectured. Essentially I now understand that by becoming an EMT, I open my self up to huge liabilities, and I never realized how much danger there is in a refusal of care.
I now understand that even if a pt. of legal age and mental status signs a Refusal of Care Form, we tell them that if things change to call us back, they decompensate, don't call us, and sue us, it is our butts on the line, despite the fact we have paperwork that states otherwise.

Even if legally we are in the right, they can take the case to Civil Court, and in front of a jury of their peers look like a damsel in distress, and essentially say, "I was sick, and this EMT did nothing to help me!", and we are defenseless.

How realistic is this situation? Does this really happen? What is the real purpose of refusal of care forms? Was the moral of that story, that, without committing kidnapping not to let patients go?
I also learned theoretically what needs to be proven in order to be prosecuted for negligence, but now understand that often prosecutors get by proving much less. Does this happen?
I am interesting in EMS for other reasons then being  sued all the time. I have read little about this side of the job from here, or anywhere else, but it still seems daunting.

Thanks a lot for your comments...
DES


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## MMiz (Apr 18, 2007)

Legal liability *is* a big deal in EMS.  Truth be told, that ten page chapter on medical liability/law in your EMT book doesn't even scratch the surface of the issue.  My personal philosophy is to document document document, contact medical control, and then always lean towards the overly-safe side.

Picking up $100 a year EMT liability insurance is also a non-brainer.


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## FF/EMT Sam (Apr 18, 2007)

1) Document Everything
2) Document Everything
3) Document Everything
4) Be obcessive-compulsive about everything
5) Document Everything
6) Document Everything
7)Be obcessive-compulsive about everything
8) Did I mention to document everything...?


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## SwissEMT (Apr 18, 2007)

emt-student said:


> ilities, and I never realized how much danger there is in a refusal of care.
> I now understand that even if a pt. of legal age and mental status signs a Refusal of Care Form, we tell them that if things change to call us back, they decompensate, don't call us, and sue us, it is our butts on the line, despite the fact we have paperwork that states otherwise.
> DES



As long as you *adequately* document the pt's refusal, you are fine. The moment they sign that piece of paper, they waiver their right to hold you and your company liable. Note the emphasis on "adequately"


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## Flight-LP (Apr 18, 2007)

Having testified on many AMA refusal suits, I have yet to see any plantiff who was conscious, alert, and oriented at the time of call, sign a refusal of care, and successfully sue. That simple signature usually waives any and all rights to recourse, including civil liability. But as previously stated, document everything!!!

"Picking up $100 a year EMT liability insurance is also a non-brainer."

Personally I would not recomend it, any indication of having a funding source will immediately have lawyers jumping all over you. It is rare for an individual EMT / Paramedic to be listed as a sole defendent. Reason...........It is not a profitable path to pursue. The lawyers want the hospitals, the physicians, the EMS service, the town, etc...........Not the lowely 'ol $30,000 / yr. medic. 

Do your job proficiently and this should never be an issue.......................


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## Ridryder911 (Apr 18, 2007)

SwissEMT said:


> As long as you *adequately* document the pt's refusal, you are fine. The moment they sign that piece of paper, they waiver their right to hold you and your company liable. Note the emphasis on "adequately"




If you actually believe this, I have some land to sell you! 

Just think, the waiver that surgeons have you sign is more detailed than any EMS document, and they still sue all the time. The piece of paper is only valuable in the description that you informed them and they signed it. They can still sue you and you will have to pay for attorney fees, off work time, etc.. 

I fully agree that you should document to the fullest to paint a picture that displays that you fully informed and they were aware. This presents a better defense and the possibility that it would not justify going to court. 

R/r 911


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## MMiz (Apr 18, 2007)

Flight-LP said:


> Having testified on many AMA refusal suits, I have yet to see any plantiff who was conscious, alert, and oriented at the time of call, sign a refusal of care, and successfully sue. That simple signature usually waives any and all rights to recourse, including civil liability. But as previously stated, document everything!!!
> 
> "Picking up $100 a year EMT liability insurance is also a non-brainer."
> 
> ...


I hear many EMTs and Paramedics say this, but it is my understanding after consulting actual lawyers that this is only anecdotal and isn't true.

Second, the insurance not only helps you in a civil suit ($), but just as important, it will help pay for your legal expenses in a criminal suit.  Having an understanding of the management side of health care, and being privy to their legal conversations during networking meetings, I can only say that they'll drop you in a second in order to protect their butt.

It's an individual choice as to whether one carries insurance, but I personally wouldn't work in EMS without it.


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## medicdan (Apr 19, 2007)

Thanks alot to everyone who responded. I think that this is not a black and white issue, and that there is a lot of ambiguity. I think I am going to get insurance (when I finish my course), but of course will be very careful about documentation. 

Thanks again,
DES


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## Ridryder911 (Apr 19, 2007)

Liability insurance for basics is pretty cheap, since they are not held as responsible and perform any advanced skills. As a Paramedic I would recommend it since, ironically my Paramedic insurance is higher than my nursing and even student nurse practitioner insurance. 

R/r 911


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## HorseHauler (Apr 19, 2007)

just out of curiousity, what is the payment on medic insurance?


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## Ridryder911 (Apr 19, 2007)

I am not sure for individual, but altogether for RN and Paramedic I pay about $140 yr. They informed me that the Paramedic was the highest liability. 

p.s... it is tax deductible as a business expense..

R/r 911


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## HorseHauler (Apr 19, 2007)

interesting, thanks for the info, I will look into this. What company are you with?


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## Artique (Apr 19, 2007)

this is very interesting and nice to know. It may sound weird but the fact that this inner drama that I know exisit in life will exisit in my carrer is kinda interesting. Like its something more serious then the allure of it can be. I dont know if that makes sense but long Idea short, Its nice to know that we have to think before we act instead of just going in like magical saviors.


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## Glorified (Apr 19, 2007)

I just see it as a risk of the job. For example I am working my way through school as a kitchen hand.  Someone gets food poisoning at the restaurant,or an anaphylactic, reaction that person may or may not sue for medical bills and the management will be held liable.  

All  jobs have risks. The risks associated with providing emergency medical care (or not providing care)  are just greater than many other professions.


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## Stevo (Apr 20, 2007)

i just finished up a lengthy discussion in a legal forum with many lawyers on malpractice/malfesiance suits.  _(and believe me, i was in the minority doing so)_

many of these folks come across as insisting thier efforts police the medical field, creating a better medical enviroment for us all

my stance was (and still is) that they need to prove that , to be able to present themselves in such a fashion

i won't bore you here with the onslaught of available data but...

the final tally is, they only help the individual, at the expense of us all, yet continue to obscure that fact as their sales pitch


~S~


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## firecoins (Apr 20, 2007)

are there statistics available on how many EMTs or Paramedics get sued annually?  I would like to see how often EMTs and Medics actually get sued.


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## BossyCow (Apr 20, 2007)

firecoins said:


> are there statistics available on how many EMTs or Paramedics get sued annually?  I would like to see how often EMTs and Medics actually get sued.



How often they get sued or how often it actually goes anywhere.  My husband a ff/emtP has had to testify multiple times from people trying to sue the city where he works over a call he was on.. "They weren't there fast enough, they didn't do enough, ..." Part of the grieving process is to look to assign blame, those with lawyers on speed dial will do that through the courts.  

I don't think a single judgement has been awarded to any of the multitude that has attempted to sue his agency.    

On another note .... if you don't have some fear of the repercussions of your actions on a call, you aren't paying attention.  Fear is a good thing if it motivates us to obey our protocols, operate our vehicles safely, be aware of what we say or do not say on scenes, and document, document, document, document.


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## firecoins (Apr 20, 2007)

BossyCow said:


> How often they get sued or how often it actually goes anywhere.  My husband a ff/emtP has had to testify multiple times from people trying to sue the city where he works over a call he was on.. "They weren't there fast enough, they didn't do enough, ..." Part of the grieving process is to look to assign blame, those with lawyers on speed dial will do that through the courts.
> 
> I don't think a single judgement has been awarded to any of the multitude that has attempted to sue his agency.
> 
> On another note .... if you don't have some fear of the repercussions of your actions on a call, you aren't paying attention.  Fear is a good thing if it motivates us to obey our protocols, operate our vehicles safely, be aware of what we say or do not say on scenes, and document, document, document, document.



Making decisions based on fear of repurcussions is not a good idea. In fact I think its a horrible idea personally.  

I am asking for all statisitics of all lawsuits. The best way to win a lawsuit is not be sued to begin with so knowing what people are likely to sue with is important.  On top of that knowing which lawsuits are successful is even more important.  Seeing how other EMTs mess up or leave them open to lawsuits helps to prevent them.


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## VentMedic (Apr 20, 2007)

Statistics for EMT:
http://www.wrongdiagnosis.com/medical-malpractice/emt_and_medical_malpractice.htm

Working for a governmental entity helps since there is are sovereign immunity statutes for courts to prove gross negligence in order for the lawsuit to continue.

http://www.jems.com/jems/23-3/13201


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## Ridryder911 (Apr 21, 2007)

Remember as well majority are settled out of court, so there is no record of a suit. Although, there is still exchange of money. 

R/r 911


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## Mercy4Angels (Apr 22, 2007)

push hard...three copies.....done...


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## firecoins (Apr 22, 2007)

Ridryder911 said:


> Remember as well majority are settled out of court, so there is no record of a suit. Although, there is still exchange of money.
> 
> R/r 911



Insurance companies still foot the bills and usually push out of court settlements even on cases they would win.  They calculate this stuff into the insurance premiums.


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