Nursing Degrees, LPN-RN, RN-BSN, RN-MSN, Associate, Bachelors, Masters and more!

---

Nursing Topics, A to Z, Search Our Site or The Internet: Free Nursing E-mail, Check Your Mail

---

---

Nursefriendly.com (homepage) About Us Add URL Contact Us Gifts For Nurses Linking Policy Privacy Policy Search Our Sites Top Nursing Topics: A to Z Nursing Topics About Nursing: Certified Nursing Assistants, CNAs Disabled Nurses Impaired Nurses LPNs, LVNs Registered Nurses Advanced Practice Nurses Clinical Nurse Specialists Nurse Practitioners Ask The Nurse Associations (Nursing) Authors (Nursing) Boards of Nursing Burnout (Nursing) Businesses (Nurse-Owned) Brainteasers Care Plans (Nursing) Careers In Nursing Case Studies (Malpractice) CEUs (Nursing) Commonly Used Drugs Chat (Nursing) Clothes (Nursing) Colleges (Nursing) Consultants, Nursing Current Events, Nursing News Degrees in Nursing Discussions (Nursing) Drugs (Commonly Used) Education (Nursing) Employment (Nursing) Entrepreneurs (Nurse) Equipment (Medical) Forensic Nursing Gifts For Nurses Going Shopping Health & Wellness Health Insurance Healthcare Unions, Nursing Unions, Organized Labor History of Nursing Hospitals, Medical Centers Informatics Nurses Intravenous (IV) & Infusion Therapy Jobs in Nursing Jokes (Nursing) Journals (Nursing) Legal Nursing Consultants, LNCs Long Term Care, Nursing Homes Male Nurses Malpractice Cases Medical Centers, Hospitals Medical Equipment Medical Humor, Nursing Jokes Men in Nursing Nurse Training Nurse Entrepreneurs Nursing Associations Nursing Authors Nursing Burnout Nursing Care Plans Nursing Careers Nursing (CEUs) Nursing Boards Nursing Clothes, Scrubs, Uniforms Nursing Colleges, Schools Nursing Consultants Nursing Degrees Nursing Discussions Nursing Education Nursing Employment Nursing Entrepreneurs Nursing Gifts Nursing Homes, Long Term Care Nursing Informatics Nursing Jobs Nursing Jokes, Medical Humor Nursing Journals Nursing History Nursing Malpractice Cases Nursing News Nursing Pay Nursing Programs Nursing Refresher Courses Nursing Research Nursing Resumes Nursing Salaries Nursing Scholarships Nursing Schools, Colleges Nursing Scrubs, Uniforms Nursing Shoes Nursing Shortage Nursing Stories Nursing Students Nursing Uniforms Nursing Unions, Organized Labor, Healthcare Unions Nursing Wages Paychecks (Nursing) Prescription Drug Indexes Puzzles, Quizzes Relocation Resources Refresher Courses Research (Nursing) Resumes (Nursing) Salaries (Nursing) Scholarships (Nursing) Schools of Nursing Scrubs, Nursing Uniforms Shoes (Nursing) Shopping (Going) on the Internet Shortage (Nursing) State Nursing Boards Student (Nursing) Training (Nursing) Traveling Nurses Uniforms, Scrubs, Nursing Unions (Nursing), Organized Labor, Healthcare Unions Wages (Nursing) Work At Home Opportunities

See also: Medical, Legal Nurse Consultants, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety: To receive each case and supporting resources by E-mail weekly, please click here. Subscriptions to the Case of the Week are Free. Summary:  "Off-duty" healthcare professionals rendering Emergency aid are in most cases "covered" by the Good Samaritan Acts.  These are laws enacted in each state that provide some degree of immunity from liability for good faith efforts in giving emergency care.  In this case, a nurse and physician were sued for providing assistance in a volunteer function at a "first-aid" station. Good Samaritan "immunity" was not recognized by the courts. A nurse, physician and several others volunteered to help out with a first-aid station at a food festival being held locally.  During the festivities one attendee would suffer an anaphylactic attack. The man had a known allergy to fish and helped himself to a "gumbo" mix that contained the allergen.  He proceeded to experience an anaphylactic allergic reaction.  The event "first aid squad" was notified only of a "problem" and the person's location. "Anaphylactic Shock is the most severe form of allergy which is a medical emergency, is a type I reaction in Gell And Coombs Classification .An often severe and sometimes fatal systemic reaction in a susceptible individual upon exposure to a specific antigen (as wasp venom or penicillin) after previous sensitization that is characterized especially by respiratory symptoms, fainting, itching, urticaria, swelling of the throat or other mucous membranes and a sudden decline in blood pressure."2 Of those present, all but a nurse remained at the station.  With the physician and others on the way to assist the victim, clearly someone had to stay at the station in case there were other emergencies.  The question would arise of whether or not their actions were covered under existing Good Samaritan Laws.  A key consideration is whether or not a legal "duty to assist" the victim was created when the responsibility to "volunteer" was accepted. "Flynn v. United States, 681 F. Supp. 1500, 1506 (D. Utah 1988), modified in part, 902 F.2d 1524 (10th Cir. 1990). Good Samaritan laws responded to the common law rule that made one liable for negligently rendering voluntary emergency assistance by extending immunity from suit, thereby encouraging humanitarian acts by licensed medical providers."3 Arriving on the scene, not knowing what to expect, they found the person symptomatic, still conscious and standing on his own. He indicated that he'd had a reaction and was in need of "a shot." "Symptoms of anaphylactic shock include dizziness, loss of consiousness, labored breathing, swelling of the tongue and breathing tubes, blueness of the skin, low blood pressure, and death bronchospasm"1 The physician recognizing the anaphylactic nature of the situation requested one of the others obtain "epinephrine," while she stayed with the patient. When the other member of the squad returned with a single "Epi pen."  The physician administered a dose.  The patient claimed to not have obtained any relief.  A second shot was requested.  The pen was a single dose unit only.  Having already used the available dose, the physician explained it would be nearly empty.  There was no other immediate source of epinephrine available at the time.  Unable to offer an alternative, the physician gave the patient a second shot with the same injector hoping it might still contain "some" medication. Again the patient did not obtain relief.  With symptoms persisting, the patient's condition deteriorated.  At this point an ambulance was on the way, the nurse had been relieved at the station and came up to assist, still unaware of what the problem had been. When she came upon the patient, the best she could do was stay with him until the emergency medical personnel arrived.  The patient would complain of increasing shortness of breath.  En route to the hospital, he would slip into a coma.  He would die the next day. A lawsuit was filed naming both the physician and the nurse alleging a "wrongful death."  Both the nurse and physician fought this in court.  In the initial trial, the complaint was dismissed. They argued for protection under the Good Samaritan Acts of the state.   This legislation was enacted to encourage health professionals to render aid at the roadside.  Previously, professionals had and still do hesitate to assist for fear of being sued by the injured party. "Because of the pervasive myth of liability in the medical professions, most states have enacted some form of Good Samaritan law prohibiting a patient from suing a physician or other health care professional for injuries from a Good Samaritan act. To trigger the protection of such an act, two conditions must be satisfied: it must be a volunteer act, and the actions must be a good-faith effort to help. Displacing a neck fracture in an effort to do rescue breathing might be malpractice in the Emergency Room, but it is not bad faith on the roadside."4 While a Good Samaritan Act may protect you in state-specific circumstances from being found and held liable, it will not protect you (nor will an employer's malpractice insurance policy) from being sued in the first place. In most states there is no obligation for a bystander to render aid or legislation to penalize those that do not decide to get involved. Minnesota, Vermont and Wisconsin are exceptions to this rule. Minnesota statutes follow: "A person at the scene of an emergency who knows that another person is exposed to or has suffered grave physical harm shall, to the extent that the person can do so without danger or peril to self or others, give reasonable assistance to the exposed person. Reasonable assistance may include obtaining or attempting to obtain aid from law enforcement or medical personnel. A person who violates this subdivision is guilty of a petty misdemeanor. "5 A common thread in each of the Good Samaritan laws is that no immunity will be afforded for specific exceptions. "The most commonly stated exception to immunity is for conduct that is willful and wanton. Many jurisdictions also exclude other categories of conduct, such as conduct that is grossly negligent, reckless, malicious, in bad faith, fraudulent, or intentionally tortious or that is a knowing violation of law. A few even included ordinary negligence, which arguably negates the protection afforded."6 In the state of Rhode Island, in which this event occurred, there are no specific laws requiring that a bystander give assistance. Interestingly, immunity by the state laws is granted in the following which do not specify volunteer medical and first aid activities. "Rhode Island law also grants immunity from civil damages to: (1) Persons rendering service as, or assisting, a manager, coach, instructor, umpire, referee or official in certain interscholastic or intramural sports programs; (2) Any uncompensated person voluntarily serving as or assisting a manager, coach, instructor, umpire, referee or official in a youth sports program organized and conducted by or under the auspices of a nonprofit corporation; or (3) Directors, officers, trustees or employees of any nonprofit organization, authorized to do business in the state, that organizes, conducts or sponsors a youth sports program.208"6 It is debatable whether the initial trial led to a dismissal on grounds of protection under existing Good Samaritan laws, or simply a lack of evidence to prove negligence.  Of these, the latter is more likely. With the complaint initially dismissed, the patient's estate appealed. Questions to be answered. 1. In rendering care to the patient in a state of anaphylaxis, did both the nurse and physician perform to the best of their abilities with the resources available to them. 2. In rendering emergency aid to the patient, were they covered by the state's existing "Good Samaritan" laws. The plaintiff's attorneys would argue that negligence had been a factor in the patient's death.  They accused the physician and nurse of arriving on the scene "unprepared" to deal with the situation. Interestingly, the plaintiff could offer no expert witness testimony to support this. In deciding the second question, the court explicitly stated that "it assumed the defendants were not covered under Good Samaritan Laws." This is alarming in that if the plaintiff had been able to produce sufficient expert testimony to prove negligence, the nurse and physician may well have been held liable. In light of these circumstances,  the ruling of the lower court was affirmed. It sends a frightening message to nurses, medical and health care personnel who chose to "volunteer" their expertise in times of need. Some state laws do require action in specific circumstances: It is unclear whether this opinion was offered because the assistance was "organized."  Is an exception made to the Good Samaritan Acts for First Aid Squads and Organized Emergency Medical Personnel regardless of whether or not they charge the patient for their services? Troubling questions for the individual when deciding whether or not to render aid.  The answers and exceptions are defined in individual state laws that vary widely. Many nurses rely on malpractice insurance provided by their employers to cover them at work.  It is highly unlikely that such a policy would cover them while performing volunteer duties. If you accept responsibility to perform expected duties either on a paid or volunteer basis, for a profit or non-profit organization, you may not be covered under otherwise applicable Good Samaritan Statutes. If you chose to protect yourself by carrying malpractice insurance policy, it would be wise to make sure this coverage is specifically included. Related link Sections: Direct Patient Care Links http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm Emergency Department Nurses on the Nurse Friendly: http://www.nursefriendly.com/nursing/directory/spec/ed.html Good Samaritan Laws & Acts: http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/good.samaritan.laws.acts.htm Ethics: http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm Medical Legal Consulting Nurse Entrepreneurs: http://www.nursefriendly.com/nursing/ymedlegal.htm Sources: 1. 38 RRNL 4 (September 1997) 2. Health on The Net Foundation. July 2, 1998.  HON Allergy Glossary Anaphylactic Shock. Retrieved July 18, 1999 from the World Wide Web:  http://wolfgang.hcuge.ch/Library/Theme/Allergy/Glossary/shock.html 3. Utah State Courts. Filed November 14, 1997.  Hirpa v. IHC Hospitals, Inc., No. 960180.  Retrieved July 18, 1999 from the World Wide Web:  http://courtlink.utcourts.gov/opinions/supopin/hirpa.htm 4. Law and the Physician Homepage.  No Date Given.  Good Samaritan Laws. Retrieved July 18, 1999 from the World Wide Web:   http://plague.law.umkc.edu/Xfiles/x894.htm 5. LawGuide.  1998.  Minnesota Good Samaritan Law.  Retrieved July 18, 1999 from the World Wide Web:  http://www.lawstreet.com/lawguide/sigsgomn.HTML 6. Carter-Yamauchi, Charlotte A. 1996.  Volunteerism - A Risky Business? Retrieved July 18, 1999 from the World Wide Web:  http://www.hawaii.gov/lrb/vol/volchp3.html   The Uniform Resource Locator (URL) or Internet Street Address of this page is http://www.nursefriendly.com/nursing/clinical.cases/071899.htm Send comments and mail to Andrew Lopez, RN Created on July 14, 1999 Last updated by Andrew Lopez, RN on Monday, January 25, 2010

This Page is Part of The Nursefriendly National Nursing A To Z & Consumer Health Directories

We are Incorporated in The State of New Jersey, under the name:
Nursefriendly, Inc.
38 Tattersall Drive, Mantua, New Jersey (NJ) 08051
Our Phone #: 856-415-9617, E-mail, ICQ#6116137 (www.icq.com)

We are a proud member of The National Nurses in Business Association, http://www.nnba.net

This website Is © Copyright 1997 - 2010, Andrew Lopez, RN, Nursefriendly, Inc. Please contact us for permission to reproduce.

Other products and companies referred to herein are trademarks or registered trademarks of their respective companies or mark holders, and are not owned or affiliated with Nursefriendly, Inc. or any of it's affiliated companies.