Non-emergency medical transport crashes are often unnecessary causes of death and severe injury in Georgia. In a recent incident in Newnan, a Coweta EMS ambulance operated by American Medical Response employees, rolled over while transporting a chest pain patient to Piedmont Newnan Hospital. According to witnesses, the ambulance drove off the left side of the road, causing it to roll over. The patient, Tracy Thomas, 45, did not survive.
Failure of non-emergency medical transport personnel to follow safety rules has been the subject of serious claims in Georgia in recent years. Right next door to Coweta County, in 2013 a jury in very conservative Troup County awarded $2.5 million for the death of a profoundly disabled woman who was killed after non-emergency medical transport personnel failed to strap her in as required.
During my lifetime, emergency medical transportation has evolved from the “meat wagon” often operated by a local funeral home and driven by a high school kid who scooped up wreck victims and took them to either the funeral home or the hospital. One of my high school friends had that part-time job which involved a great deal more drama than my job sacking groceries. You can imagine how a minimally trained teenager operating a vehicle with flashing lights and siren would get into situations that made for exciting stories in homeroom on Monday. Fortunately, he survived, married well, and is now mayor of his town.
Starting in 1965 and accelerating after the Vietnam War, we have seen dramatic improvements with trained EMS and EMT personnel equipped with a great deal of life-saving technology.
With greater capacity has come higher expectations. Medical transport, either emergency or non-emergency, involves risks. Part of the risk arises from lack of use of seatbelts by EMS workers; failure to properly restrain patients and equipment; unpadded or intrusive equipment that can cause serious head-impact injuries; an structural deficiencies in ambulance design. Safety concerns have led to development of safety standards from the National Fire Protection Association and National Highway Traffic Safety Administration.
Georgia law has long provided that ambulance is a common carrier so long as it undertakes to carry sick, injured, or disabled persons indiscriminately, and as such is held to a standard of extraordinary diligence. With regard to personal injuries to passengers, an ambulance operator as a common carrier has absolute liability for even the unauthorized and willful acts of its employees, although the ambulance company may not be liable for an employee’s theft of a patient’s jewelry. See, e.g., Bricks v. Metro Ambulance Service, Inc., 177 Ga.App. 62, 338 S.E.2d 438 (1985).
In Georgia, both emergency and non-emergency medical transport services are governed by the Emergency Medical Services Prehospital Clinical Operating Guidelines. The primary focus of these guidelines is appropriately on medical triage decisions to save lives. However, there is also coverage of emergency vehicle operations, incorporating the provisions of O.C.G.A § 40-6-6. The key points are:
- “The driver of any authorized emergency vehicle must always drive with due regard for the safety of all persons, including the patient being transported, the transport crew, and the public.”
- In responding to an emergency call, and only when the ambulance is making use of an audible signal and use of a flashing or revolving red light visible under normal atmospheric conditions from a distance of 500 feet to the front of such vehicle, the ambulance driver may:
- Proceed past a red or stop signal or stop sign, but only after slowing down as may be necessary for safe operation;
- Exceed the maximum speed limits so long as he or she does not endanger life or property; and
- Disregard regulations governing direction of movement or turning in specified directions.
- However, this does “not relieve the driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons.”
- When operating a vehicle as “an authorized emergency vehicle”, both the warning lights and audible signal must be in use. Operating a vehicle with only one of these warning devices in use, even in a bona fide emergency, does not relieve the ambulance driver from compliance with traffic laws.
- Certain medical conditions may require the rapid transport of the patient, without use of an audible warning device due to the patient’s condition (e.g. acute MI, preeclampsia). In circumstances where lights only are used for transport, the vehicle cannot proceed as “an authorized emergency vehicle” and must proceed in complete compliance with traffic laws, including red lights, stop signs, speed limits, etc.
- Pediatric patients must be restrained in accordance with the National Highway and Traffic Safety Administration’s “Best Practice Recommendations for Safe Transport of Children.” A key point is that, “No child or infant should ever be held in the arms or lap of parent, caregiver, or medic during transport.”
- Guidelines for transport of patients with special health care needs include, “When moving a special needs patient, use slow, careful transfer. . . . Do not use excessive force to straighten or manipulate contracted extremities, as this may cause injury or pain to the patient. . . . Transfer the patient if possible to their medical “home” hospital. This may involve bypassing the closest facility.”
Other publications on ambulance safety state the common sense standards such as:
- All patients on the stretcher must be secured at all times when the vehicle is in motion or the stretcher is being carried or moved.
- Any child transported to the hospital should be in the child’s own protective restraining device – child safety seat – when available. He/she should be placed in the device and the device should be belted to an ambulance seat. If the child actually is the patient, he/she should be secured onto the stretcher and if appropriate, kept in the child safety seat.
Ken Shigley is an Atlanta-based trial attorney practicing statewide in Georgia. A former president of the State Bar of Georgia, he is lead author of Georgia Law of Torts: Trial Preparation and Practice, a board certified civil trial attorney of the National Board of Trial Advocacy, and chair-elect of the American Association for Justice Motor Vehicle Collision, Highway & Premises Liability Section.