Saturday, December 20, 2008

One Good Deed equals one Good Lawsuit


In California, four coworkers were driving home and ended up in a bad accident. One of the cowokers pulled another from the car fearing that she would be burned when the car exploded. The woman that was saved has paraplegia from the accident but has chosed to sue the person who pulled her from the car. The California Supreme Court is letting the suit go forward. The plaintiff claims that even though she had a broken neck from the accident, it is the person who removed her from the car that caused the paralysis. (I can only imagine the chase for who has the big pockets)

This case is sending waves throughout the medical community and the people in California. There is nothing like the threat of a lawsuit to further push people away from helping in a crisis. In medicine where fear of lawsuits is the norm, there is great confusion about what the "Good Samaritan Laws" actually mean. Most of my collegues are afraid to stop at the scene of an accident and render aid for fear of being sued. The Good Samaritan Law is supposed to prevent this fear of suits but no one seems to believe that it will offer any protection. I have tried to find cases where physicians and nurses have been sued for helping at accidents or sporting events and so far have not found them. Not that they haven't occured. When I ask other physicians, everyone seems to have heard of a doc being sued but nobody has any first hand experience. I personally always try to stop and help and for the most part there is not much that I can do except hold pressure and wait for EMS but I have had to help them intubate and performed CPR.

I think it is sad enough that people would rather go their own way and not help in an emergency without the courts now opening the door to suing those that are trying to save your life.

16 comments:

SnowLite said...
This comment has been removed by the author.
Jeffrey said...

Does the law protect a physician or nurse acting outside of their area of expertise? What about a radiologist or a school nurse? What if your ACLS training is expired? With this ruling, unless you are a trauma surgeon, emergency medicine physician or nurse (with recent level one experience), or off-duty EMT, I would recommend you just drive on by.

Throckmorton said...

Jeffery:

I think you hit the nail on the head. I have no idea of what or if "Good Samaritan Law" covers and unfortunately, I cant help that most people believe that no matter what, trial attorneys will find a way through it as they are on California!

Throckmorton said...

Jeffery:

I think you hit the nail on the head. I have no idea of what or if "Good Samaritan Law" covers and unfortunately, I cant help that most people believe that no matter what, trial attorneys will find a way through it as they are on California!

SeaSpray said...

I shouldn't even be over here now Throckmorton, but wondered if you posted. 40,000 things to do! I need some of Santa's elves! :)

This post is upsetting/disturbing and I hate the possible outcome. Damned if you do and damned if you don't.

Can you imagine living with the thought that someone burned alive in a car... that you could've saved??? It would rip me apart.

I also could not live with myself if I sued someone who tried to help me. Ugh!

I'll come back to this.

Jeffrey said...

Perhaps the California Medical Association should issue a public statement explaining that the court has gutted the good Samaritan law. They should advise physicians that unless they are a trauma specialist and ATLS/ACLS current they are possibly unprotected at an accident scene. Maybe that would get the attention of the public and the legislature. By the way, would my med mal insurance cover me in that situation, again, acting outside the scope of my practice?

BladeDoc said...

I AM a trauma specialist. I have no training however in pre-hospital EMS, how to correctly extract someone from a burning vehicle, sitting spine immobilization, etc. etc. My professional liability insurance is unlikely to cover me in the event I provide medical care out in the street and outside my training (as prehospital care would be). If I see an accident I'll drive to the hospital and see you when you're wheeled in by EMS. My family's future in regards to my personal assets are too important to me to "go bare" and uncovered by good Sam laws.

Rogue Medic said...

The court was split 4:3 on whether the Good Samaritan law covers only medical care and only at medical emergencies because it appears in the EMS Act. Fortunately, 3 of the justices did not see it that way.

As far as this case of an apparently drunk and stoned person pulling someone out of a car? Why leave the person right next to the car, if it is going to blow up? There was no reason to believe the car would blow up. The defendant apparently recognized this, otherwise she would have done something to try to get the person farther from the car.

Cars almost never blow up, unless you are watching a movie/TV, in which case they always blow up - just as the hero/heroine safely dive out of the way. If something is on fire, then move people from the vehicle, but otherwise don't worry about cars blowing up.

Jeffrey,

What difference would it make if a card has expired? CPR, ACLS, ATLS, PALS, PHTLS, . . . . None of these cards authorize you to do anything to anyone to begin with. They are course completion cards, not certifications authorizing anything.

Jeffrey said...

You've never been involved in a liability lawsuit, have you? "Doctor, so it is your testimony that you administered CPR to my client even though you have not had the required training to maintain certification as required by the American Heart Association?""Doctor, prior to the event during which my client was grieveously and permanently injured, when was the last time you administered CPR?" "As a neurosurgeon, how often do you have occasion to perform CPR? ". "Doctor, isn't it true that CPR can cause serious injury if not done properly?"
Trust me - a plaintiff's attorney would get quite a bit of mileage out of your lack of current training.

rotator said...

And even if you are 100% covered
by existing law, a tort can still
occur and you can still be sued.
Eventually your lawyer, likely
paid by you, as others have pointed
out, this is almost certainly
outside the scope of normal malpractice insurance, so it could be some to incredibly expensive.
Which is why I can't volunteer to
cover at the 'free clinic' for indigents.

Rogue Medic said...

Jeffrey,

I have not been involved in a liability lawsuit. I hope to continue to be able to say that. I would hope that the state acts to prevent the abuse of the legal system.

The AHA teaches, or used to, that even properly performed CPR can cause injuries. Broken ribs, pneumothoraces, aspiration pneumonitis, . . . . That the presence of injuries does not mean that CPR was performed badly. This used to be a test question. Since I have not taught CPR for years, I do not know if they currently focus on this.

As an ACLS instructor, I start the class by explaining that the only things that have been shown to improve outcomes - real outcomes, as in leaving the hospital with a functioning brain - are good early CPR and rapid defibrillation. None of the drugs, tubes, . . . have been shown to improve outcomes. None.

For the AHA to take the position that a card is required, is counterproductive. I used to teach at some of the mass CPR training in California (ARC I think), which did provide some sort of card, but it was not the same as even a lay person CPR card. Some sort of awareness level?

While arguing law and logic together will often be counterproductive, there is no logical reason to discourage CPR. They aren't going to get better on their own.

The idea that we should discourage people from help others is wrong. I am not for requiring people to help others, but we should have some means of limiting the liability of a person who acts in good faith. Complete immunity may go too far, maybe gross negligence is where the liability should begin. I do not know. I am not a lawyer. We do need to have law be more understandable by the public, otherwise it becomes a joke. If you cannot understand the law, how can you obey it? To claim that ignorance of the law is no excuse, don't we need a law that is understandable by non-lawyers?

As I understand it, the fact that you are a neurosurgeon creates a greater liability for you, than for someone with no medical training. This completely ignores the relevance of what you do (neurosurgery) to what CPR is. The CPR you may have performed during your residency, does not remotely resemble the current practice. Still, this CPR would be better than no CPR at all.

SnowLite said...
This comment has been removed by the author.
SeaSpray said...

What he said. :)

I won't pretend I can get into this conversation but I totally agree with RM's statement "we should have some means of limiting the liability of a person who acts in good faith."

I hope to God that one of you would stop to help me or someone I care about if we needed it! That being said...I understand the reluctance and it is a sad day when one human being , particularly one who is educated and has the skills/ability to make a difference, save a life is afraid to help another in need because they have to be worried about being sued. God help us.. really!

RM also said "We do need to have law be more understandable by the public, otherwise it becomes a joke. If you cannot understand the law, how can you obey it? To claim that ignorance of the law is no excuse, don't we need a law that is understandable by non-lawyers?"

Off topic Throckmorton... but if only the insurance companies were as open with providers... all the back and forth bS could be eliminated.

SnowLite said...
This comment has been removed by the author.
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