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Hiding in Plain Sight: Part 2

Read Hiding in Plain Sight: Part 1

More common legal exposures EMS professionals forget to remember

In my previous column, we looked from different viewpoints at some obvious situations where EMS providers are at risk for legal action. Almost every decision made before, during and after a call is potentially critical — if not for the patient, for the provider.

Six Primary Legal Exposure Areas

• En Route
• On Scene
• During Transport
• Driving the District
• In Quarters
• Long After the Call/Shift

In this column, we will examine some very common, but not-so-obvious, areas where EMS providers face legal exposure.

In my personal experience, paramedics and EMTs rarely, if ever, consider driving the district to be a potential legal hazard. Likewise, because the “Station-House” culture is so unique, little consideration is given to the legal risks that exist there. Most providers consider themselves done with the call after they transport the patient or when the shift is over. I don’t believe I have ever heard a provider express a concern that could arise again two decades later.

All of that is about to change.

Driving the District
Every vehicle on the road poses a hazard and a multi-ton ambulance or rescue squad is no exception. I’m sure that EMS providers are aware of the regular traffic dangers associated with all vehicle operation. Simple math tells us that the less time a vehicle spends on the road, the less likely that vehicle will have an accident or hit a pedestrian.

On the other hand, many providers consider meandering drives through the district as part of the job — they call it “area familiarization.” After all, some say that it is important to be familiar with the district; to know the streets and traffic patterns, etc. On Saturday nights, some will also say it is important to have first-hand knowledge of the traffic and congestion in that little strip of town where the bars and dance clubs are located. Sometimes it helps to engage the citizens in conversation about any “situations” that may be arising in the various clubs — “preemptive intelligence gathering.” Some providers may even argue that the “people” feel more comfortable knowing they are close by.

Certainly there can be no significant legal exposure here, right?

Wrong.

As I have said on countless occasions, EMS providers are held to a higher standard for a number of reasons. Not the least of which is their collective willingness and ability to face danger and save lives; to be the calming, rational voice in a time of crisis; to be the face of security in a moment of vulnerability; and to be the one thing upon which every person can depend and trust.

However, when civic duty transgresses to scoping out hot [looking] citizens and engaging them in tawdry conversation or simply expressing approval for their fitness and fashion sense — as it all too frequently does — the floodgates of legal exposure open.

Assault is generally defined as:
Intentionally placing another in immediate apprehension of receiving an unwanted, harmful or offensive touching.

Charges of harassment or tortious assault may be somewhat cumbersome to prove, but are easy to claim and, regardless of their outcome, can often tarnish otherwise exemplary records and even ruined careers.

A simple gesture, an off-color comment, or the mere perception of impropriety is all it takes to set in motion a legal nightmare for everyone involved. Moreover, because you are a representative of authority, just one — perhaps innocent — misstep becomes a news story that will follow you for a long, long, long time.

I am not saying that EMS providers should stay hidden away in the confines of the station or outpost. On the contrary, I believe that providers should be in the public eye as much as possible because their mere presence does have a comforting effect on the community. Engaging the community in intelligent and productive dialogue is very valuable. Just remember — as with anything else — that prudence, maturity and civility will carry the day.

In Quarters

I will never forget that one hot July night when, at about 2:30 a.m., my partner and I were awakened by the alarm for another emergency call. As always, I quickly stepped into my jumpsuit, zipped up my boots and headed for the ambulance. When I reached into my pocket for the keys, I got quite a surprise. I found a chicken leg. And it was not a KFC chicken leg; it was a raw, salmonella-drenched chicken leg with the claws still attached. There was one waiting for me in every pocket of my jumpsuit.

While it was disgusting, it was a good prank. The other crew in the station had gotten me fair and square. The thought of being mad or complaining, let alone suing, never entered my mind. All that was left to do was to come up with a clever plan for revenge.

I did. And it was good.

We were a Mexican, a black, a woman, and a Jew (guess which one I am) all working together, and having fun, to make our corner of the city a little safer for everyone. We were a happy dysfunctional little family — 24-hours at a time, ten days a month.

That was about 1990. Things were different then.

Station-house culture has always been something that only those who have lived it will understand. There is a spirit of camaraderie and a plane of existence that seems to transcend description. To say the least, it is an existence that would not survive in the outside world.

Station life has always been enigmatic and unique and, for the most part, shrouded in an unintentional secrecy. What happened in quarters, stayed in quarters. Not because it was bad, but because nobody else would understand that cellophane on a toilet seat, or a neatly folded uniform shirt soaked in water and left in the freezer is funny. And funny is a means of coping.

Nevertheless, times have changed. The world has become too sensitive to itself and as a result, fast settlement money has become easy to get. The Los Angeles Fire Department recently paid out millions of dollars for a firefighter — a known prankster himself — who ate a forkful of dog food after proclaiming himself “the Big Dog!”

The case in Los Angeles is just one example of many that are the result of pigeon-holing and shock media. Assuming malevolence in the inexplicable makes headlines and creates the illusion of progress toward a better world. In reality, it creates divisiveness and inflames animosity that may otherwise not exist. But it is what it is and it’s here to stay.

For better or worse, old accepted practices and behaviors are now legal exposures. Practical jokes have become neither practical nor jokes and the risks of prosecution exceed the rewards of laughter as a coping mechanism. Certain rights of passage are no more. Stalwart camaraderie is caving in to easy money and early retirement. The costs of litigation and negative publicity have grown higher than the cost of quietly settling, firing the experienced, and hiring and training the new.

Long After the Call
Finally, legal exposure does not end when the patient arrives safely at the ER.

Statutes of limitation on malfeasance can follow providers for years. In fact, where the would-be plaintiff is a minor at the time of an incident, statutes of limitation may not begin to run until they reach the age of majority — 18 years old.

The best and only real defense against a claim that may not arise until long after you have forgotten about the call is clear, complete, detailed, and accurate documentation. That’s it.

Since becoming a paramedic in 1989, I can clearly remember about a dozen calls. I — like most providers who have responded to thousands of calls — will have no recollection of a call even if I were to be shown the run report and photographs of the scene. In that case, the run report will be the only voice you or I will have.

Avoiding legal exposure is not rocket science. All that is required is some common sense and an understanding of how the things we do affect those around us.

In whatever you do, take just a moment to look at the very same action from another point of view. Ask yourself, what would this look like on the evening news?

EMS1.com columnist David Givot, a seasoned EMS employee with three years of law school under his belt, is looking to the future of EMS. He has created TheLegalGuardian.com as a first step toward improving the state of EMS through information and education designed to protect EMS professionals nationwide.
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