The mobile intensive care unit staffed by an EMT and nurse was called to the home of Loretta and her daughter, Erin. The daughter had a seizure at home. The ambulance driver encouraged Loretta to come along in the ambulance to the hospital. Loretta said, “I’m feeling faint. I don’t really want to go,” but the ambulance attendants said, “You need to come with us and be with your daughter.”
Loretta got in the front of the ambulance in the seat next to the driver. They went to the hospital, unloaded Erin’s stretcher and took Erin into the emergency department. When Loretta got into the hospital, she felt faint. She fell and fractured her hip in the emergency department.
Is there emergency medical services’ liability?
Does this case meet the 4 elements of medical malpractice?
- Duty
- Breach of duty
- Proximate cause
- Damages
As a legal nurse consultant, you know the plaintiff has to prove 4 things: duty, breach of duty, proximate cause and injuries. The case of Loretta raises an interesting question: Did the squad members have a duty to Loretta? Who was the patient?
The plaintiff attorney came to me before filing suit to ask me about the emergency medical services’ liability? Did the mobile intensive care unit staff had a duty to prevent Loretta’s fall. The attorney representing Loretta wondered if the ambulance attendants had a duty to help her get safely out of the rig and into the hospital.
Who was the patient of the rescue squad? Loretta or Erin?
Were the squad members responsible for what happened to Loretta? Who was the patient in that ambulance?
Did the emergency medical services have liability?
Erin was the patient.
Erin’s seizure was the reason the squad came to the house. Loretta was not the patient and was in the ambulance because of her relationship with her daughter and the need to provide information about her when they arrived at the hospital.
Loretta got out of the ambulance uninjured. She became a patient when she fell on the hospital property. She was no longer under the supervision of the EMT and nurse at the time she fell. Therefore the emergency medical services’ liability was non-existent. They were not responsible for the injury.
Did the attendants have a duty to Loretta? You might say common courtesy would mean that the squad members would help Loretta get out of the rig, but she was able to get out of the rig on her own. She fell in the Emergency Department. There was no duty between the attendant and the mother in that situation.
Did the emergency department environment contribute to the fall?
What caused Loretta to fall in the Emergency Department? Was the ED staff negligent in causing her injuries? Loretta told the plaintiff attorney she suddenly felt faint as she walked into the ED. This type of reaction could not be anticipated and occurred without warning. However, if the emergency department was cluttered, had wet floors, or in some way contributed to creating a dangerous environment, they could have been liable for her injuries.
In one case in which I was involved as an expert witness, a woman in an advanced stage of pregnancy tripped over a wheelchair that was positioned in the path of people walking through a hallway.
Someone positioned the wheelchair at right angles to the wall and left it with the foot pedals sticking out into the hallway. The pregnant woman did not see the pedals and tripped over the wheelchair. She landed on her knee and had to have surgery for her injuries.
The jury concluded the emergency department staff had a duty to her, as a visitor in the emergency department, to maintain a safe environment. They breached their duty, and their actions were the proximate cause of her injuries. They were negligent for creating a hazardous condition.
In Loretta’s situation, she fell because she felt faint. There was no evidence that she tripped over a hazard or slipped on water. There was no duty of the rescue squad because there was no patient relationship with her. She was not the patient. There was no liability on the part of the emergency department. The outcome of this case was that the plaintiff’s attorney decided to not file the claim against the rescue squad even though there were a lot of injuries to Loretta.
Remember, just because there are injuries does not mean there is emergency medical services liability.
Pat Iyer MSN RN LNCC is a past president of the American Association of Legal Nurse Consultants.
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