Bottom line up front (BLUF): Eric Yeager, Esq., warns that while criminal prosecutions of EMS clinicians remain rare, the threshold for charging has shifted in ways that materially affect how EMS must operate.
The emerging risk is no longer intentional wrongdoing, but alleged criminal negligence, care delivered so poorly that it is framed as a crime, often driven by body-worn camera footage, post, George Floyd accountability pressures, and medical examiner rulings of homicide.
Video evidence now shapes charging decisions, credibility and even how protocols are weaponized in court, exposing gaps between documentation and observable actions. For EMS leaders, the takeaway is stark: assume you are always on camera, design protocols that allow clinical judgment, train providers to articulate and document care clearly, and recognize that credibility, behavior and system design now carry criminal, not just civil consequences.
| MORE: Gathering of legals — Fads, trends and clinical standards of care. The jury may start after the sirens have stopped.
Editor’s note: This year’s National Association of EMS Physicians (NAEMSP) annual meeting hosted a remarkable array of presentations on clinical issues, as well as one very well-attended track containing a set of well-received sessions delivered by leading EMS lawyers.
This three-part series brings together a tightly connected set of conversations that define the current legal reality facing EMS leaders, medical directors and clinicians. From how standards of care are judged, to the daily operational risks of refusals, to the once-unthinkable rise of criminal charges against EMS providers, these sessions collectively explore how decisions made on scene are later interpreted in courtrooms, regulatory hearings and the court of public opinion.
In “Fads, trends and clinical standards of care,” Douglas Wolfberg, Esq., dismantled the assumption that protocols, guidelines or consensus statements are the standard of care, instead explaining how standards are determined retrospectively based on reasonableness, evidence and expert testimony.
That legal framing sets the stage for “Getting past ‘no’ when the patient needs to go,” in which Samantha Johnson, Esq.; and Lekshmi Kumar examine refusals as a systems issue — one shaped by culture, training, access to medical control and defensible capacity assessment — rather than isolated provider judgment.
The series then closes with “‘Guilty’ criminal charges against EMS providers: What does it mean?” in which Eric Jaeger, Esq., confronts the uncomfortable reality that criminal prosecution is now part of the EMS risk landscape, driven by video evidence, shifting prosecutorial norms and heightened scrutiny of clinical decision-making.
Together, these sessions form a coherent narrative: EMS law is no longer a theoretical concern reserved for rare lawsuits. It is a daily operational reality shaped by protocols, documentation, behavior and leadership choices. This series is intended to help EMS leaders understand not just what the risks are, but where they originate — and how deliberate system design remains the strongest defense.
Every action has a consequence
Eric Yeager’s session landed like a cold splash of water: criminal prosecution of EMS clinicians is still relatively rare, but it is no longer unthinkable, and the trend line matters. The cases he focused on were not the traditional EMS crimes — diversion, theft, assault — where intent is obvious and the moral line is clear. These newer prosecutions are different. They are built on the theory that a provider did not intend harm, but performed so far below acceptable practice that the conduct rises to criminal negligence.
Yeager framed the consequences in human terms before he got to policy.
- Civil litigation is painful, but it is structurally designed to compensate with money and is often buffered by agencies and insurance.
- Criminal charges are a different universe. The moment a medic is charged, employability evaporates, reputation is shredded in public and even an eventual acquittal years later doesn’t rewind the damage.
His point was not to scare the room, it was to force a realistic discussion about what this new enforcement posture will do to EMS practice, training, leadership expectations and protocol design.
Cameras have changed the game
He argued that we are seeing criminal charging decisions more often for three main reasons.
- First, cameras have changed the game. It is no longer just a patient care report and a police narrative; it is body-worn camera footage, ring doorbells, street cameras and bystander phones. Video doesn’t just document actions, it captures tone, demeanor, impatience, indifference and the “vibe” of the encounter, which can powerfully influence how prosecutors and juries interpret the same clinical decisions. Yeager used the Earl Moore Jr. case to illustrate the point: video showed the patient placed prone on a stretcher with straps tightened across his back, paired with visible frustration and inappropriate behavior on scene. He argued bluntly that without that footage; first-degree murder charges would be far less likely.
- Second, Yeager placed these cases in a post-George Floyd accountability environment. Prosecutors are often elected officials, and the political appetite for charging public safety personnel has shifted. That doesn’t mean every bad outcome becomes a criminal case, but it changes the calculus around when accountability becomes a prosecutorial priority, especially when there is video and public outrage.
- Third, he highlighted a less-discussed accelerant: medical examiners and coroners. Beyond cause of death, they determine manner of death (i.e., natural, accident, suicide, undetermined or homicide). Yeager emphasized that “homicide” in this context does not mean criminal intent; it means death caused primarily by the actions of another. But once a death is classified as homicide, and especially when that decision is informed by video review, it can apply meaningful pressure on prosecutors and shape the trajectory toward criminal charges.
| MORE: ‘Don’t smile for the camera.’ The dos and don’ts of operating in an era where everyone has a camera on you
One of Yeager’s most practical contributions was showing how video can dismantle credibility in real time. He played courtroom clips from the Elijah McClain proceedings, where a patient care report described actions, like attempting a pulse check, yet video failed to show them. The clinical point was not whether that pulse was taken. The legal point was that discrepancies between documentation and video can destroy a witness’s credibility, and once credibility collapses, everything else becomes harder to defend. In that same trial context, he underscored how protocols can be weaponized by prosecutors. “Perform a full assessment” and “obtain a full set of vital signs” are not just clinical aspirations when enlarged on a courtroom screen; they become alleged prerequisites, and prosecutors may argue that if those steps weren’t met, subsequent care decisions were illegitimate.
That protocol piece led Yeager to a deceptively important recommendation: EMS agencies should review protocols with a criminal-liability lens. He contrasted prescriptive “do this” language with permissive “consider” language — do a Control-F search of your protocols to see if the treatment you give is mandated (do) or suggested (consider). His argument was not to loosen standards or excuse poor care; it was to prevent clinicians from being boxed into rigid, courtroom-friendly checklists that don’t match real-world clinical nuance. Flexibility, when thoughtfully written and well-trained, can protect both patients and providers.
He also introduced a concept he credited to Doug Wolfberg: “performative EMS.” In Yeager’s framing, this is not performative in the cynical sense; it is deliberate verbalization to ensure that what you are doing clinically is captured on camera. When the camera can’t see your hands or your assessment, narration can preserve accuracy, context and intent. He paired that with a strong emphasis on narrative documentation as the place where providers “tell the story” And explain gaps, delays, scene constraints, and safety realities that video alone may not capture.
| MORE: Welcome to the era of performative patient care. Improve your patient care and decrease your legal liability risk with conscious, deliberate practices
Body-worn cameras
Yeager ended by embracing a conclusion he admitted he once disliked: EMS body-worn cameras are coming. He predicted that within a decade, most EMS agencies will be using them, driven by the reality that police already have them and the public always has a lens. He acknowledged the barriers — state recording laws, medical record integration, privacy, storage, governance — but argued that the benefits for training, QA, and provider protection will drive adoption.
His closing message was simple and sobering:
“ Assume you are on camera 100% of the time, act accordingly, be clinically thorough, be truthful, be compassionate, and build systems — including protocols and QA — that can withstand not just peer review, but prosecutorial review. ”
If Doug Wolfberg’s talk explained how standards of care are constructed in hindsight, Yeager’s talk explained what happens when hindsight turns into handcuffs.
Memorable quotes from Eric Yeager
- “In these new cases, they don’t allege that paramedics intended to cause harm. Instead, it’s this concept of criminal negligence.”
- “Criminal charges are not the next small step. They are a massive step.”
- “The moment criminal charges are filed against one of your EMS providers, they instantaneously can’t work.”
- “Had there not been body camera footage of this incident, it’s unlikely charges would have been brought.”
- “The only safe assumption is that you are on camera 100% of the time.”
