ems liability
TRANSCRIPT
Harmonized
Emergency
Forensic Medicine
นพ. เอนก ยมจินดา
Emergency
Medical Services
( EMS )
Liability
นพ. เอนก ยมจินดา
Defensive Medicine Practiced among ER. Staffs Fearing Lawsuits
11 pm Tuesday , EMS responds to a private home to find elderly man cardiac arrest
Rx. Defib & ALS , patient dies in ER.
children are moved to quiet room ,
where doctor informs their father has died
days follow , Family questions
proper paramedic care ?
Finally , son calls EMS provider to describe his concerns
the procedures performed
Supervisor shows
great reluctance to
discuss the provided
care
Not sympathetic
EMS provider,
missing opportunity to Defend & Educate ,
Forces family
to seek
other lines of communication
“ The Attorney ! ”
Lack of Compassion
Communication
Customer Service Skills
Not Clinical Errors
RISK MANAGEMENT
StrengtheningEMS System
Risk Management relatively New to EMS
EMS Risk Management Strategies
Full-Time Risk Manager
Proactive
Pre-Loss RM Strategies
( How To Prevent a Lawsuit )
Reactive
Post-Loss RM Strategies ( How To Survive a Lawsuit )
Pre-Loss RM Strategies
Taken One Step Further
Proactive Risk Management
How To Prevent a Lawsuit
Nature of ER.
1. limited relationship
2. Patient’s Expectations
3. Overcrowded
Elephant in the room
Documentation
Documentation
1. lack of documentation
2. Adds & Changes 3. Review of other records
4. Discharge Instructions
Differential Diagnosis
Common misdiagnoses
Continuity of Care
Patient of Unknown Origin
Admission & Discharge
Consultations in ER.
Labs & Radiological Studies
4 Distinct Elements Necessary to Prove Medical Negligence :
1. Duty /Standard of Care
2. Non-Conformity 3. link NC to the injury
4. Damages
Begins & Ends
Duty, Begins
before physical
contact patient
when call for
assistance comes into the center
Duty, Ends
generally ends with Transfer of Care To The Receiving Facility
9-1-1 center do not provide
pre-arrival instructions or
response-mode recommendations
Because of Fear of Litigation
Duty, Begins with The Call to 9-1-1
Standard of Care
Degree of care / Reasonable care
Defined by Organization' Policies/ Procedures
Become Standard of Care
Standard
EMS Systems
Standard
Providers Practice
Standard Equipments
Insurance
Protocols
Triage / Mass Casualty Protocol
Continuing Education Programs /CQI.
EMS Risk Management Strategies
Full-Time Risk Manager
Proactive
Pre-Loss RM Strategies
( How To Prevent a Lawsuit )
Reactive
Post-Loss RM Strategies ( How To Survive a Lawsuit )
Litigation is the legal retrospective form of
Quality Assurance ; To Correct EMS system Defects
Post-Loss RM Strategies
Taken One Step Further
Reactive Risk Management
How To Survive a Lawsuit
Notice of Suit & Suit
Mediate don’t Litigate
Trial Preparation & Testimony
