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Home > Topics > EMS Management
August 23, 2011
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The Legal Guardian
by David Givot

Avoiding disaster-kit disasters

Medics may be inclined to keep a stash of medical supplies at home in case of disaster, but doing so can lead to big legal problems

By David Givot

Between you and me, we have all heard that 50cc of D50 and 1,000cc of saline is the best hangover cure in the world — of course we have no first-hand knowledge.

And we know that home "disaster" or "emergency" kits comprised of materials appropriated from the supply closet at the station or hospital (or both) are not uncommon. Nevertheless, I have another cautionary tale for you, which, like many others, begins with: I have a client...

Some time ago, I received a call from a distressed paramedic who explained that he was in some serious trouble. He said the State (of California) EMS Authority had begun an investigation and was looking to revoke his paramedic license.

It seems that my client had assembled a "disaster" kit that he kept at home just in case there was a major disaster or critical event; if absolutely necessary, he would be able to care for his family in such an emergency. The kit contained the usual variety of relatively benign first-aid supplies; bandages, gauze, tape, splints, etc...

The kit also contained several bags of IV solution (normal saline) and the requisite administration tools, such as tubing, catheters, needles, and syringes.

He had also included a few emergency drugs; Epinephrine, Lidocaine, Atropine, Narcan, Benadryl, and so on. On the whole, it was a pretty respectable kit...for disasters only, of course.

One day, the client's girlfriend was at his home sick with flu-like symptoms. She was vomiting, had diarrhea, fever, chills — the works. The OTC remedies were ineffective. My client decided that 1,000cc of normal saline might alleviate the resultant dehydration and make her feel some better. He established the IV and ran the fluid in at a responsible rate. Although she did notice some improvement, the nausea persisted. My client's answer to the nausea was 25mg of Benadryl IV. Lo and behold, the treatment worked. The nausea subsided enough to allow her to fall asleep.

A while later, while she lay sleeping comfortably in bed, she experienced a seizure. My client called 911 and paramedics responded. In the interim, he had removed the IV line and disposed of the assorted packaging and leftovers. It's worth mentioning that the responding agency was the same agency for which my client also worked as a paramedic.

When the paramedics arrived, my client gave a full report that included the treatments he had provided and the patient was transported to a local hospital. For the record: The seizure was completely organic and entirely unrelated to anything my client had done.

Naturally, the transporting paramedics offered up a full report to the receiving facility; a report that included my client's treatment. The receiving facility, being a mandated reporter, reported the treatment to the local EMS Agency who, in turn, reported it to the State EMS Authority... and here we are.

The State EMS Authority completed their investigation and concluded that he had willfully and knowingly acted beyond the scope of medical control and outside his scope of practice. They recommended complete license revocation; my client would never again be a licensed paramedic in California. After lengthy negotiations with the legal counsel for the State EMS Authority and extensive research, the case resolved with only a brief suspension of his license and probation.

As much as I would like to believe that it was my unparalleled lawyering skills that saved his license, I think luck played a much larger part; luck and a compassionate EMS Authority

While this case should be a lesson to all EMS providers about understanding, respecting, and operating within boundaries, there is a much bigger picture here. My client's exposure was far greater than simply having his license revoked — and so is YOURS!

Acquiring the sundry first-aid and medical supplies constitutes theft. Given the value of many of those items, it could be Grand Theft: A Felony. If you enter the building intending to gather the items, it could be Burglary: A Felony. When the items are in your possession for use in furtherance of agency business, and you take them instead for your own use, it could be Embezzlement: A Felony. If IV drugs are among the items appropriated, there is Possession of a Controlled Substance: A Felony. When you place them in your vehicle and drive away, there is Transportation of a Controlled Substance: A Felony. If you intend that the items be used for someone other than you, there is Possession (and Transportation) of a Controlled Substance with the Intent to Distribute: Felony, Felony. When you actually administer the drugs IV - saline included - there is Distribution of a Controlled Substance: A Felony. And let's not forget Practicing Medicine Without a License: F-E-L-O-N-Y!

I know as well as anyone that assembling and maintaining a full "emergency" kit - for the most noble of purposes - is tempting. Being prepared for the big one is part of our DNA as EMS Providers. Unfortunately, anything beyond BLS supplies that you acquire properly is illegal, and I mean the "State Prison for Many Years" kind of illegal. And you will be of no (emergency medical) use to anyone behind bars.

About the author

David Givot, Esq., graduated from the UCLA Center for Prehospital Care (formerly DFH) in June 1989 and spent most of the next decade working as a Paramedic responding to 911 in Glendale, CA, with the (then BLS only) fire department. By the end of 1998, he was traveling around the country working with distressed EMS agencies teaching improved field provider performance through better communication and leadership practices. David then moved into the position of director of operations for the largest ambulance provider in the Maryland. Now, back in Los Angeles, he has earned his law degree and is a practicing Defense Attorney still looking to the future of EMS. In addition to defending EMS Providers, both on the job and off, he has created TheLegalGuardian.com as a vital step toward improving the state of EMS through information and education designed to protect EMS professionals - and agencies - nationwide. David can be contacted via e-mail at david.givot@ems1.com.
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