Objectives Describe the goals of Good Samaritan Laws Define the criteria that must be met for Good Samaritan Laws to be applicable Recognize how location is relevant to the utilization of Good Samaritan Laws ID: 926924
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Slide1
Good Samaritan Laws
Jennifer Li, MD
Slide2Objectives
Describe the goals of Good Samaritan Laws
Define the criteria that must be met for Good Samaritan Laws to be applicable
Recognize how location is relevant to the utilization of Good Samaritan Laws
Identify when you are legally obligated to help
Discuss the obligations and protections in place for in-flight emergencies
Slide3Pretest
Slide4Question: True or False?
All 50 states and the District of Columbia have some form of the Good Samaritan law.
Slide5Answer
True
Slide6Question: True
or False?
Good Samaritan laws protect providers from having to go to court.
Slide7Answer
False
Good Samaritan laws do not protect providers from being named in a lawsuit. Providers may still need to go to court and assert themselves.
Slide8Question: True
or False?
Emergency Medicine physicians are required to respond to medical emergencies on a plane.
Slide9Answer
False
Slide10Question: True
or False?
In all 50 states, there is no legal obligation to provide Good Samaritan care.
Slide11Answer
False
Rhode Island, Minnesota, and Vermont have laws that make it a crime if Good Samaritan care is not provided.
This is the expectation for both professional healthcare providers and laypersons.
Slide12Question: True
or False?
Licensed physicians acting as Good Samaritans are covered anywhere in the United States, regardless of the state(s) in which they have a medical license.
Slide13Answer
False
Exception: Kentucky
All states except Kentucky provide legal coverage for any licensed physician providing Good Samaritan emergency care in that state, regardless of the state(s) in which the physician has a medical license.
Kentucky provides legal coverage only to physicians licensed in Kentucky.
Slide14Question for Discussion
If a flight attendant was to ask if there was a doctor on board to assist another passenger, raise your hand if you would volunteer to help.
Why or why not?
Slide15Good Samaritan Laws
Goals
:
To encourage healthcare providers to provide potentially life-saving care to those in need when the providers have no duty to do so
To protect healthcare providers from civil liability for any acts, omissions, or injuries occurred when delivering emergency care to victims
Slide16For Good Samaritan Laws to be Applicable…
The situation must be an
emergency
The services rendered must be
voluntary
The victim receiving care must be accepting of it - obtain
consent
whenever possible
The care provided must be rendered
free of charge
The care performed must be done “
in good faith
” to help
The care provided
cannot be considered as gross negligence or willful misconduct
Slide17Negligence
Ordinary negligence
: The person providing aid did not perform as a reasonable health care provider would under similar circumstances.
In general, Good Samaritan Laws provide immunity from civil damages for injuries or death that are due to ordinary negligence
Gross negligence
: The person did not follow the accepted standard of care. A “conscious, voluntary act or omission in reckless disregard of a legal duty and of the consequences to another party.” Their actions were “willful, wanton, or even malicious.”
Good Samaritan Laws typically do not protect against allegations of gross negligence
Slide18What Type of Negligence?
Scenario
: You witness an individual go into cardiac arrest while at a party. You perform CPR by yourself the best that you can, alternating compressions and rescue breaths at a ratio of 15:2. However, the individual does not survive. When EMS personnel arrive, they note that the compressions and rescue breaths should have been performed at a ratio of 30:2.
Is this ordinary or gross negligence?
Slide19Answer
Ordinary negligence
Slide20What Type of Negligence?
Scenario
: You witness an individual go into cardiac arrest while
at a party. You start to perform CPR but then suddenly stop when someone tells you the individual is a known gang member.
Is
this ordinary or gross negligence?
Slide21Answer
Gross negligence
Slide22Good Samaritan Laws do
not
protect physicians who have a pre-existing duty to provide care for a patient.
Examples of
Pre-existing Duty
:
If the victim is the provider’s current patient
If the physician has a contractual obligation to provide care to the victim
If there is an on-call agreement for which the physician is required to provide services.
Duty
Slide23Do You Have Good Samaritan Protection?
Scenario
: You volunteer to provide first-aid at a high school soccer game, without pay, and a player develops a severe asthma attack and is in respiratory distress.
Slide24Do You Have Good Samaritan Protection?
The answer for this scenario is ambiguous. You may not necessarily have protection because of the duty implied in your agreement to serve in the role to provide first-aid.
Slide25Let’s Look at A Real Life Case…
Slide26Boccasile
v
Cajun Music Limited
Rhode Island - 1989
Aline Champoux, RN, and Dr. Sara John volunteered to staff a first-aid station at the Cajun Music Festival
They were informed that “there was a man having a problem on the hill” during the event
Dr. John and members of the first aid crew went to provide emergency care. Nurse Champoux stayed at the first aid tent.
Dr. John discovered that the patient, Ralph Boccasile was experiencing an allergic reaction to seafood gumbo. Dr. John stayed with Boccasile while others went back to the tent to get medication and to call an ambulance.
Slide27Within a few minutes, someone returned with an
EpiPen
. Dr. John injected it into the patient’s thigh. Nurse
Campoux
joined Dr. John.
Boccasile
lost consciousness.
Dr. John began resuscitative efforts and continued until EMS arrived.
Boccasile never regained consciousness and died the next day.
Boccasile’s widow sued Dr. John and Nurse Champoux, alleging that they were negligent by failing to bring the medical equipment to the scene. She also claimed that Dr. John and Nurse Champoux were not protected by the Good Samaritan law because they had volunteered their services at the music festival, thereby establishing a pre-existing duty.
Dr. John and Nurse Champoux felt that because they were volunteers and were not paid for their services, they were covered by the Good Samaritan law.
The case was dismissed in favor of Dr. John and Nurse
Campoux
based on Good Samaritan law.
Boccasile
v
Cajun Music Limited
Slide28Location Matters
Most Good Samaritan laws apply solely to care provided outside the hospital, clinic, or doctor’s office
However, in some states such as Colorado, Good Samaritan laws protect physicians who provide Good Samaritan care in a hospital
E
xample: If a physician is rounding on their patients and responds to an urgent request by staff to attend to another physician’s patient who becomes acutely unstable
Contingent upon it being outside the normal scope of the physician’s responsibilities, the physician has no duty to respond, and there is no additional pay
Slide29Real-Life Case in Texas from 1998
Good Samaritan Law covered physician responding to in-hospital emergency.
Dr. Douglas McIntyre, an OB/GYN, happened to be visiting a patient on the labor and delivery floor when he heard a page for “Dr. Stork,” which signals that a physician’s assistance is immediately needed for a patient in labor.
The patient, Ms. Ramirez’s labor had progressed rapidly and her own OB physician was not present.
By the time Dr. McIntyre arrived to the room, the baby’s head had been delivered but there was shoulder dystocia. The baby was eventually delivered vaginally, but sustained neurologic damage and paralysis to the right shoulder and arm.
Ramirez sued Dr. McIntyre for negligence.
The Texas Supreme Court ruled in favor of Dr. McIntyre, stating that it was
outside the normal scope of the physician’s
responsibilities and there was no
additional pay
.
Slide30Another
P
hysician
W
as Not so Lucky…
Real-life case in New Jersey from 2002
Dr. Teresa Jiminez was the OB/GYN of the patient, Germane Velasquez
Ms. Velasquez’s vaginal delivery was c/b shoulder dystocia
After delivering the head, Dr. Jiminez called for help
Dr. Angela Ranzini, an OB/GYN physician assigned to the maternal fetal care unit, responded. Dr. Ranzini had no affiliation with Ms. Velasquez, and the patient was not on the maternal fetal unit.
After attempts to delivery the baby vaginally were unsuccessful, the two OB/GYN physicians performed a C-section
The baby was born with severe brain damage and died of pneumonia at age 2 years old
Slide31The Velasquez family sued the medical center, Dr. Jiminez, and Dr. Ranzini for
negligence
Dr. Ranzini claimed she was immune from liability by the state’s Good Samaritan law because she had no duty to respond
However, the New Jersey Supreme Court felt that Dr. Ranzini was not
someone who came upon the emergency "by
chance.” They ruled that the state’s Good Samaritan law is not applicable to physicians working within a hospital.
Another
P
hysician
W
as Not so Lucky…
Slide32Emergency Medicine practice groups that have a contract to provide coverage on the hospital floors for emergencies and procedures are not protected by the Good Samaritan laws, because they have already accepted reimbursement for the response beforehand
Slide33Are you Legally Obligated to Help?
Scenario
: You are driving home from work when a car in front of you is T-boned by a truck. The car spins out of control and hits a tree. The driver of the car is slumped over in the seat.
Slide34Are
You Legally Obligated
to
Help
?
No, unless your state has a “duty-to-act” law
Slide35“Duty-To-Act” Laws
Rhode Island, Minnesota, Vermont
If a physician (or any person) does not provide assistance and instead leaves a scene in which an individual required emergency medical treatment, they can be in violation of the law.
Penalties for Violation of the Statute:
Rhode Island
: Petty misdemeanor. 6 month imprisonment, fine up to $500, or both.
Minnesota
: Petty misdemeanor
Vermont
: Fine of not more than $100
Slide36All
50 states and the District of Columbia have some form of the Good Samaritan
law
However, no two jurisdictions apply the same language in their
laws
Know the laws in your state
jurisdiction
If aid is provided, it only needs to be
stabilization
All states and the District of Columbia’s Good
Samaritan Laws exempt people from liability when using automated external defibrillators (AEDs) in an
emergency
Variations in State Good Samaritan Laws
Slide37Variations in State Good Samaritan Laws
Some states only provide protection for trained providers
8 states (California, Connecticut, Illinois, Indiana, Kansas, Louisiana, Missouri, Oregon) do not provide protection for individuals with no training at all
All states except Kentucky have statutory language that protect physicians licensed in any other state as well
Slide38Most states require that the emergency care provided occur at or near the scene of the accident or emergency
If a physician charges a fee for medical care provided in an emergency situation, Good Samaritan laws generally will not protect the physician
Variations in State Good Samaritan Laws
Slide39Table: Summary of Good Samaritan Laws in All 50 States and the District of Columbia
Who is protected?
Column 1
: The state’s statute protects
any person
who acts as a Good Samaritan, including physicians.
Column 2
: The state’s statute has language that protects
health-care personnel
licensed in any state.
Column 3
: The state’s statute specifically mentions that
physicians licensed in
any
state
acting as Good Samaritans are protected in that particular state.
Column 4
: The state’s statute specifically mentions that
physicians licensed within
that
state
itself have protection.
Slide40Slide41Slide42Stewart PH, Agin WS, Douglas SP. What does the law say to good samaritans?
Chest.
2013; 143(6): 1774-1783.
Slide43Do Physicians Have an Ethical Duty to Respond?
American Medical Association’s (AMA) Code of Medical Ethics
:
“A physician shall, in the provision of appropriate patient care,
except in emergencies
, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care
.”
AMA’s Council of Ethical and Judicial Affairs
:
Physicians should “respond to the best of their ability in cases of emergency where first aid treatment is essential.”
Slide44Do
Physicians Have
an
Ethical Duty
to
Respond
?
World Medical Association’s
International Code of Medical Ethics
: “A physician shall give emergency care as a humanitarian duty unless he/she is assured that others are willing and able to give such care.”
Slide45When to Hand over Patient Care…
Physicians who offer aid should not leave the scene until a provider of at least comparable capability can assume care of the patient
Otherwise, the physician can be charged with abandonment
Some possible scenarios:
Leaving the scene once experienced EMS providers have arrived
Traveling along with EMS and the patient to the hospital where patient care is handed off from one physician to another physician
Slide46What Happens in the Air…
In the United States, Canada, and United Kingdom, physicians are not legally obligated to provide assistance during in-flight emergencies
Slide47For those that do help in the air…
Aviation
Medical Assistance Act of 1998
:
Federal
statute that covers aircraft registered in the United States, even if they are outside U.S. airspace
A
medically qualified individual
have
Good Samaritan protection and “shall not be held liable for damages in any action brought in a Federal or State court arising out
of… providing
or attempting to provide assistance in the case of an in-flight medical emergency
unless the individual, while rendering such assistance, is guilty of gross negligence or willful misconduct
.”
Slide48Definition
Medically Qualified Individual
:
“Any healthcare practitioner who is “licensed, certified, or otherwise qualified to provide medical care in a
S
tate, including a physician, nurse practitioner, physician assistant, nurse, paramedic, and emergency medical technician.”
Slide49Remember that the Good Samaritan provider must receive
no
monetary compensation.
Seat upgrades, credit for travel miles, or travel vouchers do not count as monetary compensation. They should be viewed as a “token of gratitude” from the airline for the provider’s inconvenience.
Slide50Aviation Medical Assistance
Act
Also protects airline companies registered in the U.S. from liability sustained in “obtaining or attempting to obtain the assistance of a passenger in an in-flight emergency, or out of the acts or omissions of the acts of the passenger rendering the assistance…if the carrier
in good faith
believes that the passenger (that provides aid) is a medically qualified individual.”
“In good faith” requirement met when airline employees ask if the person who volunteers assistance is a health care provider. Flight crew may ask for some proof of licensure or documentation of medical credentials.
Slide51Resources Available on Planes
Federal Aviation Administration (FAA) requires any plane weighing 7,500 pounds or more and carrying at least 1 flight attendant must have an automated external defibrillator (AED)
FAA also requires emergency medical kit (with IV supplies, medications, syringes) be available
Basic first aid supplies oftentimes stored separately
Most U.S. airlines have 24/7 access to emergency physicians who can be consulted if necessary
Slide52Laws on International Flights
The laws of the country in which the airline is based are applied
Example: On a flight from New York to Australia on Qantas Airlines, Australian law (which says you have a duty to act) would be in effect
Some countries such as
Australia, France,
and Germany
legally mandate
that physicians provide aid. If not, the physician can be fined or imprisoned.
Slide53To Land or Not to Land the Plane…
Do not take the responsibility of deciding whether or not a plan gets diverted due to a medical emergency. Leave that decision to the pilot or captain. Instead, provide your medical opinion about the patient’s condition.
Slide54Post-test
Slide55Question: True or False?
All 50 states and the District of Columbia have some form of the Good Samaritan law.
Slide56Answer
True
Slide57Question: True
or False?
Good Samaritan laws protect providers from having to go to court.
Slide58Answer
False
Good Samaritan laws do not protect providers from being named in a lawsuit. Providers may still need to go to court and assert themselves.
Slide59Question: True
or False?
Emergency Medicine physicians are required to respond to medical emergencies on a plane.
Slide60Answer
False
Slide61Question for Discussion
If a flight attendant was to ask if there was a doctor on board to assist another passenger, raise your hand if you would volunteer to help.
Why or why not?
Slide62Question: True
or False?
In all 50 states, there is no legal obligation to provide Good Samaritan care.
Slide63Answer
False
Rhode Island, Minnesota, and Vermont have laws that make it a crime if Good Samaritan care is not provided.
This is the expectation for both professional healthcare providers and laypersons.
Slide64Question: True
or False?
Licensed physicians acting as Good Samaritans are covered anywhere in the United States, regardless of the state(s) in which they have a medical license.
Slide65Answer
False
Exception: Kentucky
All states except Kentucky provide legal coverage for any licensed physician providing Good Samaritan emergency care in that state, regardless of the state(s) in which the physician has a medical license.
Kentucky provides legal coverage only to physicians licensed in Kentucky.
Slide66Summary
For Good Samaritan Laws to be applicable:
The situation must be an
emergency
The services rendered must be
voluntary
The victim receiving care must be accepting of
it Obtain
consent
whenever
possible
The care provided must be rendered
free of
charge
The care performed must be done “
in good faith
” to
help
The care provided
cannot be considered as gross negligence or willful
misconduct
Know the laws in your state
jurisdiction
Slide67References
Boccasile v Cajun Music
Limited et al, Rhode Island
694 A2d
686, 1997.
Brown
SM. Good samaritan laws: protections and limits.
RN Legally Speaking.
1999; 62(11): 65-68
.
Dachs RJ, Elias JM. What you need to know when called upon to be a good samaritan.
Family Practice Management.
2008; 4: 37-40.
Isakov A. Management of inflight medical events on commercial airlines. In: UpToDate, Waltham, MA, 2018
.
Matt SB. Good samaritan laws: will I be protected if I help?
The nurse practitioner.
2018; 43(3): 52-54.
McGrane K, Moore GP, Cookman L. Special report: Good samaritan law and the emergency physician: where are you covered?
Relias Media.
2009; 1-7.
McIntyre v. Ramirez, Texas No. 01-1203, June 26, 2003
.
Stewart PH, Agin WS, Douglas SP. What does the law say to good samaritans?
Chest.
2013; 143(6): 1774-1783.
Velasquez v. Jiminez, New Jersey No. A-105-00, May 29, 2002.