This article contains generic information – not legal advice. If you find yourself in a questionable or problematic situation, seek professional legal counsel.
As premed students, we are strongly advised to gain clinical experience as a way to strengthen our medical school admission package. One advantageous way of doing this is to become a volunteer emergency medical responder. Becoming an EMT-Basic is ideal for premed students since it takes less than a year of training, can be done during a semester or over summer break, and only costs between $1,000-3,000.
EMT-B premeds provide a certain level of acute care to patients while in transport via ambulance to a hospital. Although the specific scope of medical practice is regulated by state law and can vary significantly, EMTs generally provide pre-hospital care consisting of basic life support and non-invasive procedures such as assessing vital signs, administering glucose, and obtaining a patient’s medical history.
Like many premeds, I decided to pursue becoming an EMT-B and after successfully completing the psychomotor test, I am now studying to take the NREMT certification exam. The thought of becoming a medical provider for various emergencies is exciting but there is an area of concern barely touched upon in EMT education and training – malpractice liability. As a lawyer turned post-baccalaureate premed student, the issue of medical malpractice is never far from my mind. Medical malpractice is a topic that is extensively covered for practicing physicians but not as adequately addressed for EMTs.
Typically, EMTs are the first on scene and have a challenging job. The most critical treatment that a patient receives occurs minutes after an acute injury or illness and the actions or non-actions of an EMT can significantly affect a patient’s outcome. Thus, like any other healthcare provider, EMTs are vulnerable to medical malpractice suits. Since negligence is the basis for a majority of pre-hospital lawsuits, familiarization with the essential elements of a medical malpractice claim based on negligence will help EMT premeds be more self-protective and mindful during shifts.
Medical malpractice and negligence occur when a healthcare provider’s actions or inactions fall below the standard of care in the medical community and cause injury or death to a patient. There are four elements to a negligence claim: duty, breach, injury, and damages. While on the job, EMTs are obligated by law to provide care for a patient who requires and consents (i.e., expressed or implied) to it. If there is no threat to safety, the EMT must fulfill this duty to act, which continues throughout the call until the patient’s care is transferred.
While fulfilling such a role, EMTs must only perform medical interventions within their scope of practice as defined by state and regional laws. For example, in 2011, an EMT negligence lawsuit settled for $1 million when an EMT improperly determined that a miscarriage birth was “non-viable.” This caused the baby to be deprived of oxygen and delayed resuscitation for several minutes. Ultimately, the baby died at a Boston hospital NICU. The EMTs were sued for making a determination about patient viability that was beyond their scope of practice. So, knowing the extent and limitations of your job is imperative.
In addition to staying within practice parameters, EMTs must also deliver the standard level of care in their field. Gauging negligence in a case is determined by using an objective “test” which asks whether the EMT in question has provided the level of care that an EMT with similar training would be expected to give if caring for a patient under a similar set of circumstances. When an EMT does not do his or her job and delivers substandard medical care, then a breach of duty has occurred.
It’s important to note that “breach” does not consider whether an EMTs actions or inactions result in harm to someone – it only concerns behavior relative to duty. For instance, if an emergency vehicle is not operating with lights and sirens and fails to stop at a red light, there has been a breach of duty to obey traffic laws, even if no injuries occurred from running the red light. However, when an EMT breaches his or her duty by negligently acting or failing to act and that breach directly results in injury to a patient, then the EMT can be considered a cause of the harm. Generally, when determining liability the law requires that the EMT is the proximate cause or most direct cause of harm. It is possible for an EMT to cause harm amidst unforeseeable, superseding, or intervening factors that may mitigate or eliminate any legal cause of action.
The final element to a negligence claim is damages. Damages must have resulted from the breach of duty and can be physical (e.g., medical bills), financial (e.g., loss of work income), and sometimes emotional (e.g., pain and suffering). The ultimate purpose of damages is to make the injured person whole again by placing him/her in the position he/she would be prior to the negligent act. Our civil legal system accomplishes the restoration of a harmed individual through monetary settlements and jury verdict awards.
Despite the subject matter of this article, EMT premeds should have an awareness of medical malpractice but not be overly concerned. First, to protect volunteer EMTs many states have passed statutes known as governmental immunity laws. Such laws are not uniform and vary widely in substance and interpretation, but raise the threshold an injured party must meet to prove the elements of a negligence case. Second, if a negligence case lacks one or more of the four elements, no fault can be placed on the healthcare provider.
In sum, the area of medical malpractice is complex. EMT premeds will be better equipped to protect themselves against a negligence claim if they understand this simple overview and always keep the following in mind:
- Know your duties per state and regional EMS laws, regulations, and policies
- Act within your scope of practice at all times
- Treat every patient with the standard level of care
If you have any questions or topics that you really care about–regarding legal and ethical issues–we’d love to hear your feedback. Comment below!
Stay tuned for Erin’s next article!