The rules changed

[micsaver]

OK I realize for some of you it would seem that this issue has been beat with a stick, but after searching the threads I still have the same question.

It's my understanding that in MA there is no "duty to act" if you are off-duty. That if you do respond to assist a person with an injury or medical issue that you act at your level of certification. If your an EMT-B you would provide care at that level. Anything less could be considered negligent even with the good samaritan laws.

This is a bit confusing though... if I am off duty and I find a woman that was holding an icepack to her head because she tripped and hit her head... She has no AMS, Pupils = round and reactive, she is pink-warm & dry. No loss of consciousness w/ Slight nausea and dizziness that went away after sitting for a bit. BUT I didn't put her in a collar with a back board (because I was off duty at my non-emt job) and just recommended that she go to the hospital or see her doctor ASAP. She didn't want an ambulance and it didn't seem she needed one. She was picked up and taken to her doctor.

So would that be negligent? Should you really not get involved unless it is major trauma, because then you would call an ambulance anyway? My initial reaction is to help when I see someone fall, hand out a band-aid for a minor cut, or even stop when I come upon a car accident with moderate-major damage (if the scene is safe). Reading all the threads is making me second guess my natural response. It makes me feel like I should hesitate to help in minor situations. It leaves me feeling extremely guilty that I haven't helped out when it seemed like no big deal. I became an EMT so that I would have better knowledge and training to help people, even when off duty. God, now I feel like helping people when I'm not on duty isn't a good idea. I hate that the rules have change.

 

[VentMedic]

I have a few different licenses which include many skills. When I am off duty I carry a cell phone. I may have more knowledge to be a little more insistent about the pt seeing a doctor or calling 911 or PD.

I can do only what any first aider can as far as equipment...and that is all I care to do off duty. That is all any state can legally expect of you unless you are on the clock as call back and compensated.

You can still be there to help by keeping others and yourself safe. You can still be with the patient, make the call to 911 if needed and keep everyone calm while providing basic first aid. However, don't try to be a hero without the necessary protective equipment that many endanger you or leave your family unattended in a car that might put them or others in harms way.

 

[csly27]

When your off duty do you normally carry a collar and backboard with you while off duty? probably not. The fact that you stopped and were willing to help and stayed with the her untill someone came to pick her up was great I think. If you provided the care that she needed with what you had to work with, had she needed a collar and things then you would have called 9-11 and to make sure her airway was maintained you would still be coverd by good sam laws.
Remember I am still a student.

 

[KEVD18]

in mass, you practice under the authority grandted to you by your services medical director. off duty, you are not authorized to practice outside of basic first responder skill.

its a tight line in this state. your best bet is to call an ambulance and provide basic aid until they arrive. allow the people covered by their insurance and medical direction to handle it. only they can properly document a refusal.

 

[JPINFV]

Let's look at this from a practical standpoint. Are you going to give out your full name and such to a patient? How about to a police officer unless explicitly asked? Contact information? If acting as an off duty first responder and yielding to any on duty EMS crew, do you even really need to say you're an EMT-B? The assessment you mentioned in your scenario can be done by observation and talking to the patient without letting the patient know about your level of training. If the patient doesn't know who you are past John Doe, GS (Good Samaritan) (or at most <nickname or first name>, GS), can you really be sued?

 

[flhtci01]

It's my understanding that in MA there is no "duty to act" if you are off-duty. That if you do respond to assist a person with an injury or medical issue that you act at your level of certification. If your an EMT-B you would provide care at that level. Anything less could be considered negligent even with the good samaritan laws.

Most areas once you begin to assist, you have a duty to act, but it is either at First Responder or Basic level. For example, if I am off-duty and stop to assist someone, I can only act at the Basic level and call 911. If I am in my service area, once the crew is paged out, I can do advanced skills. If I am not in my service area, I stay at a Basic level.

If the patient doesn't know who you are past John Doe, GS (Good Samaritan) (or at most <nickname or first name>, GS), can you really be sued?

I think it could be a possibility if they can identify you, such as a license plate.

 

[KEVD18]

from a legal stand point, his identity would be fairly easy to ascertain.

the op stated that he was working at his off duty job. not tto hard for a lawyer to come up later and say "who was the employee that offered medical aid to such and such a peron on such date".

unfortunatley this is massachusetts where every single decision you make every day has to be weighed against whether or not your going to get sued.

 

[BossyCow]

I don't know of a single system that will mandate you act when it is unsafe to do so. If you have no gloves or other PPE, no information regarding the safety of the scene (was her head injury from her S.O. hitting her with something heavy and is he still around?) you can't be made to enter that scene. Bare minimum, call dispatch and have them send EMS.

 

[Hastings]

Honestly, just don't stop when you're off duty.

This is the kind of thing you open yourself up to. If there's question in your mind whether you're covered, you're not. And you will likely be sued regardless of treatment or outcome.

 

[cuvtixo]

Maybe get a new lucrative career at a law firm?

Anyone who tried to help could get sued.
This isn't a problem specific to emergency responders.
Chances of being successfully sued for helping are probably low, but sometimes strange things happen in court. But don't blame your training! If anything, you're position has given you a chance to think about this issue which you would be a possible target anyways. But relax, as an EMT, (at your second job no less) you're not exactly a prime target for gold-diggers or scam artists. I think I can safely assume no one is getting rich from suing you. (No offense! no one is going to get much from me for sure!) Final word is that it may be safer to not identify yourself as any sort of medical professional, and not to identify yourself at all!

But please put this in perspective.

 

[Hastings]

Anyone who tried to help could get sued.
This isn't a problem specific to emergency responders.
Chances of being successfully sued for helping are probably low, but sometimes strange things happen in court. But don't blame your training! If anything, you're position has given you a chance to think about this issue which you would be a possible target anyways. But relax, as an EMT, (at your second job no less) you're not exactly a prime target for gold-diggers or scam artists. I think I can safely assume no one is getting rich from suing you. (No offense! no one is going to get much from me for sure!) Final word is that it may be safer to not identify yourself as any sort of medical professional, and not to identify yourself at all!

But please put this in perspective.

A few problems here. Yes, it is a problem pretty specific to emergency responders. Yes, there are people out there wanting to actually scam you. No, changes of successfully being sued as an emergency responder in a civilian situation are actually quite high; courts usually side with the "victim". Yes, as an EMT, you are ESPECIALLY the target of scammers; possibly only second to cops. No, you're not safe to assume that; people often get rich off suing medical personnel. Lastly, you're damned if you identify yourself, and you're damned if you don't. Avoid it all together. Don't stop when it's not your job.

 

[micsaver]

Well thanks everyone for clearing it up a bit. I guess it will always be a bit of a gray area. I can fully understand why some people would say "don't stop unless it's your job", as in - you're on duty. But doesn't that just suck. We wonder why someone can be struck by a car in front of people on a Hartford CT street and the people just keep walking...the cars just drive around the body. No one even stops the already minimal traffic to see if the man is alive. The bystandard effect is a crappy thing and we make it worse when we live in a society where those that are trained to help, want to help, but will choose not to because of the sue crazy world we live in.

 

[Hastings]

Well thanks everyone for clearing it up a bit. I guess it will always be a bit of a gray area. I can fully understand why some people would say "don't stop unless it's your job", as in - you're on duty. But doesn't that just suck. We wonder why someone can be struck by a car in front of people on a Hartford CT street and the people just keep walking...the cars just drive around the body. No one even stops the already minimal traffic to see if the man is alive. The bystandard effect is a crappy thing and we make it worse when we live in a society where those that are trained to help, want to help, but will choose not to because of the sue crazy world we live in.

The safest thing you can do for for yourself and THE PATIENT - any injured person in the road - is call for appropriate help. You are putting yourself and, more importantly, the patient in danger by stopping and giving care.

The only case where I would even CONSIDER doing something is someone that goes into cardiac arrest in front of me at the mall or something. I would probably do CPR and use the AED after calling 911, however, I've seen a medic get sued over just doing that.

But road injuries? NEVER EVER. Don't do it. Call 911 and go about your business.



P.S. More than once, a patient has been paralyzed when a bystander stopped and moved that victim.

 

[KEVD18]

it has very little to do with the overall outcome of of the case.

if your on duty, the companies attorney will represent you. if your off duty, you either pay for your own attorney or take the public defender.

if your up on charges that could end your career, do you want an attorney that specializes in heathcare law or a guy thats been out of law school for 6 days and this is his first time in a court room cause its entirely possible that thats what your going to get.

 

[cuvtixo]

Damned if you do...

MASSACHUSETTS has a duty-to-rescue statute, as does Vermont, Minnesota, and Rhode Island and four other states. I think the last episode of Seinfield revolved around the crew getting jailed for neglecting to help someone, and its based on a real law.
You are open to lawsuits if you do not help, especially as a medical person!

 

[Hastings]

MASSACHUSETTS has a duty-to-rescue statute, as does Vermont, Minnesota, and Rhode Island and four other states. I think the last episode of Seinfield revolved around the crew getting jailed for neglecting to help someone, and its based on a real law.
You are open to lawsuits if you do not help, especially as a medical person!

In that case, THAT is what sucks, not the fact that it's safer not to help. I'm sorry to hear that. I only hope those states have the appropriate coverage for those that do get pulled into that unfortunate situation of being required to help.

 

[cuvtixo]

Duty to Act

Vermont Statute 12-23-519, states that a person has a duty to render reasonable assistance if they have knowledge of another person in physical danger or that is injured. There is an exemption that states that a person does not have to render any type of assistance that would place the rescuer in physical danger, or if an obligation to a third party would prevent them from acting. The statute goes on to grant civil immunity for all but gross negligence on the part of the rescuer.
A Minnesota statute differs in that it only places the duty to aid on witnesses at the scene of an emergency, whereas the Vermont statute is triggered if anyone has knowledge of another in danger. Minnesota provides civil immunity to the rescuer for anything falling short of willful and wanton or reckless conduct. In 1994, Wisconsin enacted a statute almost identical in nature to that of Minnesota and in 1996, the state of Colorado followed suit.

 

[jrm818]

MASSACHUSETTS has a duty-to-rescue statute, as does Vermont, Minnesota, and Rhode Island and four other states. I think the last episode of Seinfield revolved around the crew getting jailed for neglecting to help someone, and its based on a real law.
You are open to lawsuits if you do not help, especially as a medical person!

NOPE!...Vermont true, the rest who knows, but MA has a duty to REPORT law, NOT a duty to rescue law. All you have to do is call 911. Seinfeld was actually accurate in that regard..except i think it was a local rather than state law in those 2 episodes.....

in general, even if there is a clear good Samaritan law, the standard for negligence is higher for an EMT or medical professional than for joe the plumber. You are held to a reasonable person standard, but reasonable for an EMT is different than reasonable for an handyman. MA avoids this altogether by not having a clear law in the first place. On duty you are exempt form personal liability. Off duty...who knows. Beyond CPR personally I don't plan on doing much of anything unless I know the pt. or I'm in the town where I volunteer. Then i'll call it in and bingo - I'm on duty.

Depending on circumstances, i MIGHT call my own service from another town and request to act as an EMT providing mutual aid service to the town I'm in....but I can't really think of a scenario where I'd do that. I'm really just kind of curious what my legal status would be in this hypothetical situation.

 

[micsaver]

I found this for MA General Laws:

Chapter 111C: Section 21. EMS personnel; good faith performance of duties; limitation on personal liability

Section 21. No EMS personnel certified, accredited or otherwise approved under this chapter, and no additional personnel certified or authorized under section 9, who in the performance of their duties and in good faith render emergency first aid, cardiopulmonary resuscitation, transportation, or other EMS, to an injured person or to a person incapacitated by illness shall be personally liable as a result of rendering such aid or services or, in the case of an emergency medical technician or additional personnel, as a result of transporting such person to a hospital or other health care facility, nor shall they be liable to a hospital for its expenses if, under emergency conditions, they cause the admission of such person to said hospital.
*****
And then I did a Case law search and came across this case, as an example

Campbell v. Schwartz, No. 97-P-2105 , APPEALS COURT OF MASSACHUSETTS, April 15, 1999, Argued , July 21, 1999, Decided
OVERVIEW: Plaintiff's wrongful death claim was barred by state "Good Samaritan" statute, where defendants attempted but failed to rescue a highly-intoxicated decedent under dangerously adverse weather conditions.

12. Ksypka v. Cox, Opinion No.: 97054, Docket Number: 05-00820 , SUPERIOR COURT OF MASSACHUSETTS, AT MIDDLESEX, February 1, 2007, Decided
OVERVIEW: Because nothing in the record showed that the first aid services actually rendered at the scene were performed in a negligent manner, and because the emergency exception to the doctrine of informed consent applied, an executor's negligence and lack of informed consent claims against the emergency medical technicians were dismissed.

*****

I guess what it comes down to is if I'm off duty and I can A) accept that I may put my self in some harms way (like if I attempt to slow traffic or stop traffic for an accident or person in the road) and B) accept that I may be taken to court and either be found guilty or not guilty-but still have to deal with court costs...... Than I am good to go. OK I'm willing to, at least at the minimum, accept those odds. I am a reasonable person and wouldn't run into a full on burning building or into the middle of the highway. But for the love of God I'm not someone that could walk away when there is something I could do, within reason, beyond calling 9-1-1.

 

[sethking]

its like that in california too, if you do stop you are supposed to provide your level of certification treatment... therefore you are working in a legal emt capacity... she wasnt altered and was ano x4 so that should have been fine... thats how i think of it