Liability of an EMT acting strictly as a driver.

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jordanfstop

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In my town there is an ambulance service you may all be aware of (Hatzolah [a VAS ran by Orthodox Jews.]) On Shabbos (the Sabbath) they pay non-Jewish drivers to drive their ambulances (I don't want to get into a debate of why they can drive their cars to the scene, but not the ambulance.) Basically the role of them (driver) is to wait around for a call, drive their car to the station, pick up the rig and take it to the scene where the EMTs will already be there in their POVs. The driver basically sits in the rig waiting for them to move the patient out of the house, opens any doors (that may involve using electricity) for them, drives the patient to the hospital, writes the PCR at the hospital, and drives the rig back to the station. The driver has minimal-to-no patient contact (and they mostly are speaking Yiddish to each other only.)

Now to the question, does the driver have any liability if pt tx goes against state protocol and the call gets called to court?
 
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ffemt8978

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In my town there is an ambulance service you may all be aware of (Hatzolah [a VAS ran by Orthodox Jews.]) On Shabbos (the Sabbath) they pay non-Jewish drivers to drive their ambulances (I don't want to get into a debate of why they can drive their cars to the scene, but not the ambulance.) Basically the role of them (driver) is to wait around for a call, drive their car to the station, pick up the rig and take it to the scene where the EMTs will already be there in their POVs. The driver basically sits in the rig waiting for them to move the patient out of the house, opens any doors (that may involve using electricity) for them, drives the patient to the hospital, writes the PCR at the hospital, and drives the rig back to the station. The driver has minimal-to-no patient contact (and they mostly are speaking Yiddish to each other only.)

Now to the question, does the driver have any liability if pt tx goes against state protocol and the call gets called to court?

The driver, who has minimal patient contact, is the one who writes the PCR?!?!:blink:
 

MAC4NH

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I'm not a lawyer or a NY EMT, but to me, if he's signing the PCR, he's probably got liability. If he doesn't do the PCR and he can prove that he does not have significant pt contact, maybe he can make a case. However, since he's an EMT and on scene with the truck, it might not hold water.

I don't know NY regs, but many NJ volly squads have non-EMT drivers. Since they don't really do patient care, they're really only liable for driving matters.
 

medicdan

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In my town there is an ambulance service you may all be aware of (Hatzolah [a VAS ran by Orthodox Jews.]) On Shabbos (the Sabbath) they pay non-Jewish drivers to drive their ambulances (I don't want to get into a debate of why they can drive their cars to the scene, but not the ambulance.) Basically the role of them (driver) is to wait around for a call, drive their car to the station, pick up the rig and take it to the scene where the EMTs will already be there in their POVs. The driver basically sits in the rig waiting for them to move the patient out of the house, opens any doors (that may involve using electricity) for them, drives the patient to the hospital, writes the PCR at the hospital, and drives the rig back to the station. The driver has minimal-to-no patient contact (and they mostly are speaking Yiddish to each other only.) Now to the question, does the driver have any liability if pt tx goes against state protocol and the call gets called to court?

Here is my understanding of liability. Please correct me if I am wrong. In MA, in order for an ambulance to “roll” there need to be two providers trained at the level of the ambulance (or care), that is, two EMT-Bs for a BLS and two medics (or P/B) for an ALS unit. In that case, no matter who is in the back, both parties share equal responsibility for patient care and the safety of the unit on the road.
In the case that there is a third party (FF/FR driver), and both “techs” are in the back, the driver has no liability for patient care, but the techs are still responsible for the safety of the unit (not getting lost or in an accident).
In the case that there is ONE EMT and a driver, that may change. I would assume that the driver shares
From my limited understanding of Hatzolah (and my buddies who volunteer for them), most often there are two EMTs at a given scene, and they both “tech” the call—leaving minimum liability for the driver. At the same time, I understand that the drivers often have little or no medical training, which is not a good thing. Whatever the situation, the driver should not be sitting in the rig until the EMTs come out—they should be coming into the residence and helping…. But that’s a different topic.
My last comment, going along with ffemt is that if the “Driver” is writing the PCR, they are signing it, and are thus responsible for it in court. I really understand little about Hatzolah, but know enough not to get involved in arguing about their policies (politics). I wish you well on your conquest to learn more. Please fill us in on anything you find out.
 

firecoins

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In my town there is an ambulance service you may all be aware of (Hatzolah [a VAS ran by Orthodox Jews.]) On Shabbos (the Sabbath) they pay non-Jewish drivers to drive their ambulances (I don't want to get into a debate of why they can drive their cars to the scene, but not the ambulance.) Basically the role of them (driver) is to wait around for a call, drive their car to the station, pick up the rig and take it to the scene where the EMTs will already be there in their POVs. The driver basically sits in the rig waiting for them to move the patient out of the house, opens any doors (that may involve using electricity) for them, drives the patient to the hospital, writes the PCR at the hospital, and drives the rig back to the station. The driver has minimal-to-no patient contact (and they mostly are speaking Yiddish to each other only.)

Now to the question, does the driver have any liability if pt tx goes against state protocol and the call gets called to court?

Normally the person who signs the document is responsible. Howevedr this is Hatzolah we are talking about and nothing is done normally with those guys.
 

KEVD18

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well i can tell you one thing: i wouldnt sign a pcr unless i teched the call.

in ma, at leat in region 4 and 5, you can never have anything less that two certified emts on a bus. they can be any combination of basics, intermediates and medic(with appropriate waivers) but you absolutely not have one emt and a non emt driver.
 

Flight-LP

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Ditto..........If I did not provide the care, then I do not sign. Its sad that NY allows uncertified personnel to drive. Having only one medic, an EMT-B at that, on emergency calls is just poor quality of care.............................
 

ffemt8978

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daedalus

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In my town there is an ambulance service you may all be aware of (Hatzolah [a VAS ran by Orthodox Jews.]) On Shabbos (the Sabbath) they pay non-Jewish drivers to drive their ambulances (I don't want to get into a debate of why they can drive their cars to the scene, but not the ambulance.) Basically the role of them (driver) is to wait around for a call, drive their car to the station, pick up the rig and take it to the scene where the EMTs will already be there in their POVs. The driver basically sits in the rig waiting for them to move the patient out of the house, opens any doors (that may involve using electricity) for them, drives the patient to the hospital, writes the PCR at the hospital, and drives the rig back to the station. The driver has minimal-to-no patient contact (and they mostly are speaking Yiddish to each other only.)

Now to the question, does the driver have any liability if pt tx goes against state protocol and the call gets called to court?
Uh, I want to know how this is even legal. Nothing against being Jewish or Israeli, but how is a religious group allowed to operate a private EMS response system that only caters to other Jews, responds in POV, and employs the use of non-medical persons? And another thing, why do the EMTs just staff the ambulance?
 

Flight-LP

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Uh, I want to know how this is even legal. Nothing against being Jewish or Israeli, but how is a religious group allowed to operate a private EMS response system that only caters to other Jews, responds in POV, and employs the use of non-medical persons? And another thing, why do the EMTs just staff the ambulance?

There is nothing illegal about a private group making its own rules. As they are not a public or goevernmental entity, they have every right to operate this way. No contesting that!

Unfortunately, NY has the belief that one medical provider is sufficient on an ambulance. It's not right, it is substandard, but the State says it's o.k. No contesting that either!

Don't like them, don't use 'em. Freedom of choice is great!
 

MAC4NH

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And another thing, why do the EMTs just staff the ambulance?

The original post was referring to staffing the unit during the Sabbath which is sundown Friday to sundown Saturday. The rest of the week it is staffed by Jewish volunteers who, I believe, are generally EMTs. During the Sabbath, Orthodox Jews are not supposed to do anything resembling work. There are a number of different groups and the definition of work varies from group to group. Apparently, in the group manning Hatzolah rendering aid is not work but driving the vehicle is. I would love a post from someone involved with Hatzolah to clarify the situation because we have to deal with them occasionally here too.
 

medicdan

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I would love a post from someone involved with Hatzolah to clarify the situation because we have to deal with them occasionally here too.

A quick background, from someone who has watched Hatzolah from the background in several different settings. Again, please correct me if you find I am wrong. Hatzolah is an all volunteer ambulance service that is tasked with serving Orthodox Jewish communities. They have "chapters" all over NJ, NY, CA, Waterbury, CT, and Baltimore, MD, as well as Canada, Mexico, England, Israel, South Africa, Russia, Australia, etc.

H exists as a "third-service" soliciting only emergency calls using a private dispatch number from members of the community and dispatching members from wherever they are. In principal, H can call in "mutual aid", that is the ambulance service naturally set up to cover the area, but as I understand it, they do very infrequently.

Hatzolah claims that because of their volunteer-in-the-community model, they have excellent response times (they do!), and provide a higher (and more respectful) level of care to the orthodox Jews then would be provided elsewhere. During the week, they operate just like any other ambulance service, but their operations change on Shabbat (Friday night to Saturday night). On the Sabbath, Observant Jews are prohibited from performing any work, defined as lighting a fire (or using electricity, or driving for that matter), writing, carrying items from one domain to another, etc, except in the case of needing to save a life.

Through enormously complicated discussions (that I simply don’t understand), each community has come to its own consensus about how things are done. In some communities, members can drive the ambulance TO the call (expecting to save a life), but then when they realize it isn’t threatening need to call in a non-Jew to drive to the hosp, others, the members will drive the ambulance to the hospital patient loaded, but then cannot drive the ambulance back to base or restock (because life is not at stake any more).
Nevertheless, Jews are never a group to keep things simple or easy, and in many communities clash with local authorities often. There were a set of articles in the newspaper about a year ago about a Hatzolah chapter in NJ who was issued $1500 in parking tickets by the LEOs in a 2-week period, for parking their ambulance around the corner from their station (I don’t want to get into the details…). If the chapters call for mutual aid, there are often disagreements between crews, although I hope patient care is never compromised.

In Israel, Hatzolah exists slightly differently. MDA (Magen David Adom) provides all the ambulance service (First Response, transport, etc.), but in areas of high concentrations of Orthodox, Hatzolah supplements them. All Hatzolah members are trained, certified, monitored, etc. by MDA, and supplement them on scenes, either by arriving before the ambulance, augmenting MCI crews, or driving when both “techs” need to be in the back. Hatzolah supplies QRS motorcycles, supplies, equipment, etc to the communities to facilitate the quick response. In fact, some EMT/drivers for MDA are “on call” for Hatzolah when not at work, take an ambulance home with them at night, and take it to calls as a QRS before the on-call unit can get there (as well, to decrease the response time if there were to be an MCI). It’s a neat little system, but for the record, not without internal politics and strife.

Hatzolah is generally looked at as a positive force in the EMS world. Non-Jewish ambulance services don’t need to get involved in these tight knit communities, don’t have to deal with the politics, etc. and the communities can usually fend for themselves. When called, Hatzolah ambulances do respond outside their service area (mutual aid), do provide quality patient care, and as I understand it, several Hatzolah chapters sent crews to WTC on 9/11/01.

Sorry for the long post, please correct me if you find anything incorrect, and shoot me a PM if you have any questions.
 

daedalus

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There is nothing illegal about a private group making its own rules. As they are not a public or goevernmental entity, they have every right to operate this way. No contesting that!

Unfortunately, NY has the belief that one medical provider is sufficient on an ambulance. It's not right, it is substandard, but the State says it's o.k. No contesting that either!

Don't like them, don't use 'em. Freedom of choice is great!

Not in my minds eye do they have that right. Not when it comes to responding to emergencies. Being a paramedic, driving an emergency vehicle, responding to calls for assistance, etc, all are GOVERNMENT functions (or government contracted functions). Its also a matter of homeland security. If we let anyone operate their own public safety departments, whats to stop an extremist group from claiming a "right" to operate its own services and than drive code 3 past airport security and wreak havoc? Im sorry, wayyyyy to sketchy to me.
 

daedalus

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The original post was referring to staffing the unit during the Sabbath which is sundown Friday to sundown Saturday. The rest of the week it is staffed by Jewish volunteers who, I believe, are generally EMTs. During the Sabbath, Orthodox Jews are not supposed to do anything resembling work. There are a number of different groups and the definition of work varies from group to group. Apparently, in the group manning Hatzolah rendering aid is not work but driving the vehicle is. I would love a post from someone involved with Hatzolah to clarify the situation because we have to deal with them occasionally here too.

Anyone refusing to "work" because of personal beliefs should not be operating an EMS system. The nature of public safety is 24hr/365 days.
 

MMiz

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I think many of you later posters are missing the point. This ambulance service provides exceptional response times and care, but has adapted to ensure they can provide service that is congruent with their religious beliefs. They provide service 24/7/365.

Their volunteers are trained to the EMT-Basic level, if not higher. I really see no problem with a "driver" as long as their are two EMT-Basics on the rig. Many volunteer and paid services across the nation have drivers who aren't even trained as EMT-Basics.

Lets be honest, how many of your patients could be transported in a wheelchair van? At the BLS level I'd venture to say that most of our non-emergency patients could use the service instead of a BLS ambulance. Most wheelchair van drivers only have CPR/AED/O2 training.

I'm all for any private community-based service that lessens the burden on EMS. The Hatzolah philosophy, at least what I can tell from reading a few websites, seems to work. Community providers are providing competent medical care to sick and injured patients. This does not replace 911, but compliments it.

I can't understand how having someone else sign your PCR is legal, but that's a whole separate issue.
 

MAC4NH

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Not in my minds eye do they have that right.

Well, the founding fathers kind of disagree with you. The first line of the Bill of Rights states: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof;." I don't agree with everything Hatzolah does, but they do provide a necessary service for a community that is very insulated from the rest of society that might not otherwise have access to EMS (I have issues with that too but I refer to Bill of Rights, above).


If we let anyone operate their own public safety departments, whats to stop an extremist group from claiming a "right" to operate its own services and than drive code 3 past airport security and wreak havoc? Im sorry, wayyyyy to sketchy to me.

Talk about wayyyy sketchy
 

daedalus

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I can break it down:

1. Deception: Older Jewish folks are going to innately have immense trust and respect for a jewish/socio-cultural ambulance service. So when grandpa is having chest pain, he has his wife call up Hatzohloa, instead of the JURISDICTIONAL 911 ALS provider. Turns out he was having an AMI, but the EMTs from the jewish ambulance could only bring him to a local community hospital, without thrombolytics or a cath lab. He dies in the ICU after having to wait for a transport to a STEMI receiving hospital. An ALS ambulance could have transported him right to the STEMI center with a positive Dx from a 12 lead, and the patient could have been cathed under 90 minutes. The older jewish man is taught to trust the jewish ambulance, and he has no idea what ALS or BLS is, let alone the differences between the two. Some of you may try and argue that the EMTs might have called for an ALS mutual aid. What if his presentation was non-typical? Simple mild dyspnea with adb discomfort.

2. In a lot areas (including LA county, check protocol called "Transport and Destination" online) it is against the law for a private service to take emergency calls and dispatch a unit to a citizen's call for help (unless that service is a contracted 911 provider, and the patient is within their jurisdiction). If a private non contracted service receives a request for medical aid, they are required to tell the caller to dial 911 instead here in LA county. Even if this is not the law in your area, it is at least unethical to take private emergency calls. What if the call required heavy rescue or law enforcement? If the caller called 911 instead, the dispatcher would be able to professionally glean the information and send the appropriate response including Fire and PD. You may say the EMTs may be able to request these services from on scene, but you know that if the caller had dialed 911, all the services would have been dispatched ASAP.

3. Homeland security issues already mentioned. We as a society must regulate use of emergency vehicles.

If the Hatzolah wants to provide inter-facility wheel chair van services that treat the sick and dying jewish with respect, thats a wonderful and amazing thing. Otherwise, its just monkey business providing emergency response. Come on...
 

daedalus

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Well, the founding fathers kind of disagree with you. The first line of the Bill of Rights states: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof;." I don't agree with everything Hatzolah does, but they do provide a necessary service for a community that is very insulated from the rest of society that might not otherwise have access to EMS (I have issues with that too but I refer to Bill of Rights, above).




Talk about wayyyy sketchy

You can use google, and research case law regarding the rights of religions, and than also google legal opinions written about the subject, and find that free exercise has a very limited meaning. Imagine if my religion stated that sacrificing humans was acceptable? Does the Bill of rights cover me? Maybe thats a little extreme. Would the bill of rights cover my church if it decided to run its own police department to enforce the law in surrounding communities? Absolutely not.

Here, I did some of the work for you. I
In 1879, the Supreme Court was first called to interpret the extent of the free exercise clause in Reynolds v. United States, as related to the prosecution of polygamy under federal law. The Supreme Court upheld the conviction, deciding that to do otherwise would provide constitutional protection for a gamut of religious beliefs, including those as extreme as human sacrifice. The Court said, "Laws are made for the government of actions, and while they cannot interfere with mere religious beliefs and opinions, they may with practices."
-Hamilton, Marci A. (2005). God vs. the Gavel: Religion and the Rule of Law. Cambridge: Cambridge University Press. ISBN 0521853044.

What the supreme court said was that the first amendment applies to ideas and thoughts, not actions.
 
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firecoins

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Not in my minds eye do they have that right. Not when it comes to responding to emergencies. Being a paramedic, driving an emergency vehicle, responding to calls for assistance, etc, all are GOVERNMENT functions (or government contracted functions). Its also a matter of homeland security. If we let anyone operate their own public safety departments, whats to stop an extremist group from claiming a "right" to operate its own services and than drive code 3 past airport security and wreak havoc? Im sorry, wayyyyy to sketchy to me.

First non governmental ambulance services exist and are completly legal. They do have the right to go code 3. And no they don't blow through airport security when they do it.

2nd The 1st amendment provides religious freedom. And this is a religious organization providing services to a religious group. Its members do not call 911 and would not call 911. Although they have the opition of doing so, they choose not to.

Hatzolah has every right to exist as ambulance service for Hasidic Jews.
 
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