EMS and LEGALESE
Aside from learning all about hopefully life-saving treatments of their patients, New York’s EMS providers also must know how to avoid potential claims of malpractice or negligence. While New York State laws tend to protect providers from malpractice accusations made by patients and their families, there are certain acts which can land a provider in the proverbial “hot water.”
If you are responding on a rig, are on-duty, or even if you are off duty and you introduce yourself as a medical professional and begin care, you cannot walk away from the patient. There are times when ending patient care, or not beginning it, is okay. On or off duty, if the scene is unsafe, or the patient refuses your care – you are PROBABLY off the hook. If the patient that is refusing is intoxicated or otherwise unable to think straight, then let a police officer or family member make the decision; the parents, police or caregiver must make any decisions for care or not if the patient is a minor. But document the reason for the decision, have the adult patient sign and if they refuse, ask a police officer to witness (and sign) that the patient is refusing care.
In New York State, even if you are a certified EMT or Paramedic, if you are OFF duty, you are not obligated to begin care… BUT ONCE YOU DO BEGIN, you must continue until either there is a patient refusal (remember to document it) or an on-duty crew (preferably with equal or higher certification) arrives on scene to take over patient care. Always make note of the circumstances and times if you do leave the scene. Local laws may protect you from liability for trying to help someone in need, but your training also plays a big role in that level of protection. Neglecting your duty or being careless with procedures may cause you to be legally liable for abandonment, injury, or death of the patient.
There are a few NYS EMS agencies which utilize the use of “body-worn-cameras” (BWC); however, the use and purpose of these cameras are extremely strict - BWCs must protect a patient’s privacy as per HIPPA laws and patients must consent to their use. The cameras can be used to record treatment, films cannot be made public, and so long as patient identities are “blurred,” may (in controlled cases) be used for training purposes. Recordings are helpful when a patient refuses care or transport, but still refuses to sign (if possible, still get the signature of a police officer or family member for documentation). The footage can be used in a court of law if there are accusations of malpractice. Training should always be given to providers about the proper use of BWCs.
Agencies and certified providers can be held liable for malpractice if their rigs are not Part 800 compliant, if Oxygen was withheld from a patient who needed, or if a patient who was not deemed of “sound mind” was allowed to refuse medical care. The NYS Bureau of EMS has oversight of agencies’ preparedness, response times, and any failures to comply with Part 800 requirements.
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