Empowered bureaucratic bullies. We can, and certainly should, do better.
Ramblings of an Emergency Physician in Texas
Empowered bureaucratic bullies. We can, and certainly should, do better.
Here’s the actual text of California’s Good Samaritan Law:
California Health And Safety Code Section 1799.102No person who in good faith, and not for compensation, renders emergency care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.
I have to tell you, that seems pretty straightforward to me. You help (not for profit), you’re covered.
Now, for the problem: the decision is here (.pdf file), and it exemplifies why normal people don’t trust lawyers.
Here’s the crux of their reasoning (page 2 of the ruling):
We hold that the Legislature intended for section 1799.102 to immunize from liability for civil damages any person who renders emergency medical care. Torti does not contend that she rendered emergency medical care and she may not, therefore, claim the immunity in section 1799.102. Accordingly, we affirm the judgment of the Court of Appeal.
Why do they believe that to be the correct reasoning?
One can infer from the location of section 1799.102 in the Emergency Medical Services division, as well as from the title of the act of which it is a part, that the Legislature intended for section 1799.102 to immunize the provision of emergency medical care at the scene of a medical emergency.
This is remarkably obtuse; where does health and safety legislation go, except into H&S legislation. Thank goodness it wasn’t in a farm bill, else it’d only apply on farms.
To say I disagree with this interpretation (as a non-lawyer) is a bit of an understatement. Read the whole decision to see the tortured logic involved.
I find myself in agreement with the dissent by Baxter J (at the bottom of the decision). He’s supposedly a liberal activist judge, but no matter, he’s right on here.
Health and Safety Code section 1799.1021 states that “[n]o person who in good faith, and not for compensation, renders emergency care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission.” (Italics added.) Nothing in this clear statement limits or qualifies the kind of emergency aid — medical or nonmedical — that an uncompensated lay volunteer may provide without fear of legal reprisal from the person he or she tried to help.
He goes on to point out the absurdity of the majority decision:
Thus, in the majority’s view, a passerby who, at the risk of his or her own life, saves someone about to perish in a burning building can be sued for incidental injury caused in the rescue, but would be immune for harming the victim during the administration of cardiopulmonary resuscitation out on the sidewalk. A hiker can be sued if, far from other help, he or she causes a broken bone while lifting a fallen comrade up the face of a cliff to safety, but would be immune if, after waiting for another member of the party to effect the rescue, he or she set the broken bone incorrectly. One who dives into swirling waters to retrieve a drowning swimmer can be sued for incidental injury he or she causes while bringing the victim to shore, but is immune for harm he or she produces while thereafter trying to revive the victim.
The legislature wrote what it meant, in plain language. The California Supreme Court says the plain language isn’t correct, that their intent was clearly different than that written.
Nothing good will come of this. I can only hope the California Legislature doesn’t go broke before they can clarify their very plain language so even lawyers can understand it.
(The defendant is going to go to trial over whether her actions were negligent, which is pretty much unavoidable. I’m told that she’ll probably win, as juries are made of more reasonable people than lawyers. That doesn’t change the problem this decision will make for all society.)
I cannot believe this is happening in a civilized society (even California):
The ruling stems from a case in which a woman pulled a crash victim from a car ‘like a rag doll,’ allegedly aggravating a vertebrae injury.
By Carol J. Williams
December 19, 2008
Being a good Samaritan in California just got a little riskier.
The California Supreme Court ruled Thursday that a young woman who pulled a co-worker from a crashed vehicle isn’t immune from civil liability because the care she rendered wasn’t medical.
The divided high court appeared to signal that rescue efforts are the responsibility of trained professionals. It was also thought to be the first ruling by the court that someone who intervened in an accident in good faith could be sued.
This will have a chilling effect on all Good Samaritans, and not just in California.
In case you didn’t get the message, here’s a Professor of Constitutional and Bioethics Law at USC:
Noting that he would be reluctant himself to step in to aid a crash victim with potential spinal injuries, Shapiro said the court’s message was that emergency care "should be left to medical professionals."
(Also, fires should only be fought by Firemen, so be sure and let your neighbor’s house burn down; don’t keep the mugger from beating the old lady, law enforcement is for the Police only, etc).
Did this Professor of Law not think about the lives saved by CPR every year, and how this will be interpreted by them? Bystander CPR, and the heroic actions of many a Good Samaritan, are endangered by decisions like this. That trust in your fellow man, and a belief that government is run by reasonable people, is perishable. This kind of ruling will kill it, for good. Horrible.
Prepare to burn to death in your car as people drive by, unwilling to be victimized by a legal class without scruples and a society without morals
I sincerely hope there’s an appeal, to benefit at least good sense if not human decency.
Update: HotAir got the same message:
The court has sent a signal to the people of California: don’t get involved. If someone’s drowning, don’t jump in the lake and save them. If someone’s trapped in a car that’s about to explode, sit there and watch the show. Just make a phone call, and who cares that it might be several minutes before an EMS team can make it to the scene? If you sit on your hands, no one can sue you for all you’re worth.
Predictably, their post is better than mine, making the same points and others, so make sure you read it all.
Dr. Glauser at EMNews vents his spleen a bit about a general feeling that Primary Care needs more funding:
Say what? Fund physicians to promote primary care? Why throw good money after bad? If ever there was a group that has failed in providing care, it is our primary care system. To fund such a venture for groups that are singularly inept at performing anything of value to society is pure folly and a waste of precious health care dollars.
This did not pass unnoticed by an excellent primary care blogger, Dr. Rob at Musings of a Distractible Mind:
This guy is not arguing, he is ranting. Why? My suspicion is that he sees the fact that increased reimbursement for primary care physicians means potentially decreased reimbursement for emergency physicians. That does not mean you shouldn’t trust his arguments – he could use the same against me.
Read them both, and join the argument. I’m for paying primary care better, because they need some more flexibility (though I have my concerns, too).
BBC NEWS | Asia-Pacific | Chinese girl gets ‘kiss of deaf’
“While kissing is normally very safe, doctors advise people to proceed with caution,” wrote the China Daily.
Another reason normal people think docs are stupid. Look at that quote. Dumb.
via Medgadget I was made aware of the PalmPistol, a single-shot 9mm weapon apparently intended for contact-wound distance self defense. One of their marketing focuses is for the disabled, with amputations, arthritis, etc.
Images from the PalmPistol website.
The trigger is on the top and is thumb-activated, and I’ve got to assume the buttons in the front have to be depressed as a safety, which seems like it’d be hard to use unless you’ve got a decent grip, a thumb and at least two fingers. How that’d make it easier to use for people with hand problems I don’t know. I think a derringer type pistol would do the same thing, but Medicare won’t pay for a Derringer (and I sincerely hope they don’t start paying for this).
I also don’t know of any other firearm that’s been approved as a medical device (but I don’t follow that, either). It is ATF recognized as a firearm, so it’s got the same restrictions on ownership, transportation and prohibited facilities as any other firearm.
There is a market for this sort of thing. I would bet the disabled and frail are targeted by our permanent criminal class, and they should be able to use any legal means of self-defense available. If the look of a conventional firearm drives them away, maybe this will help.
I won’t be writing any prescriptions for one, however. When used the prescriber is going to get a brush with an attorney (especially if used in a suicide); doctor, did you screen the patient formally for homicidal or suicidal tendencies? Did you make sure they knew how to use it properly? Fill in your second-guessing here.
So, interesting marketing. Best of luck with it.
Political post, feel free to skip.
The CEO’s of the Big 3 automakers went hat in hand before Congress to plead for unearned taxpayer dollars to continue their operations. Apparently their plan was ‘give us 25Bn and we’ll see that it’s spent properly’. As a business proposition that seems lacking, and thy were sent away empty handed. Good.
But there was a bit of hypocritical theater by some goofy congressman, a ‘show of hands of those that came here on a biz jet’ or somesuch. Of course, these CEO’s all make a heck of a lot of money and haven’t flown commercial since they were Senior VP’s. This is common in the world of the Big Money CEO’s, and was a spectacularly tone-deaf thing to do when pleading for other peoples’ money as a handout.
Yet, the hypocrisy award goes to a congress which yearly racks up Trillion dollar deficits hectoring business owners for flying corporate jets. I’d have given a lot of money to have one of the Big 3 CEOs ask “Congressmen, I’d like to see a show of hands of those who rode the bus to work, given the terrific job you’ve done of generating massive budget deficits”.
I can dream.
Life’s been good to me, and today I wanted to upgrade two of my regular DirecTV boxes to HD boxes. So, a call to customer service to get a couple.
(I had tried to do this online, but stopped when it wanted to charge me for an HD installation, which I already had: that should have told me the legendary DirecTV customer service was slipping).
The phone call started fine, through the phone tree that has very good voice recognition, and within a few minutes I was talking to a nice rep who knew her stuff. She was unfailingly polite and professional throughout; this isn’t about an individuals’ poor service, it’s about a company that’s setting policies designed to drive away customers.
me: I’d like to upgrade two of my DirecTV receivers to HD, please
dtv: I’d be glad to help you with that. Oh, I see you ordered an HD receiver last December, so I can only give you one.
me: Why’s that?
dtv: You can only order 2 in a year.
me: Why would that be? I’ve never heard of a company that didn’t want business…odd.
dtv: It’s just the policy. (appropriately business-polite expression of sorrow).
dtv: I can have an installer come out (second week of November) to do an installation.
me: Installation? We’re swapping boxes. I’m going to unplug one and plug in the replacement. I really don’t need an installation.
dtv: It’s a no-charge installation.
me: It’s not about the charge, it about waiting two weeks for someone to swap a set-top box.
dtv: Your account isn’t able to have a drop-ship. (Apologies again).
me: Well, let’s cancel this order while I decide whether to keep this service.
dtv: (in that ‘let me see if I can fix this’ voice’) Hang on just a second.
three minutes on hold here…
me: What are we waiting on?
dtv: I’m canceling your order.
me: You need me to stay on the phone to cancel my order?
dtv: Yes. If you hang up your account information goes off my screen.
me: You’re kidding?
dtv: No sir.
I’d like to reiterate this isn’t the phone-persons’ doing (unless she really really misunderstands several policies, which I doubt), it’s about a company that has made some really bad choices about equipment, and set up some terrible customer service interaction software for their personnel.
I’ve got an email out the the good people at Weaknees for the same boxes (whom I should have turned to first anyway), so we’ll see.
Update: Weaknees sold me two, and assures me by email (after hours) that they’ll be activated without a problem. I suspect that’s the case. (They hadn’t heard of a limit on receiver numbers, either).
The Happy Hospitalist: What Kind Of Patient Are You?
So I ask the question, what type of patient are you? Are you contributing to the demise of the third party model so ingrained in our current culture. A third party model whose cost structure has risen exponentially due to rapidly rising costs on the few. A third party model who must pass on to others the costs of a few. The following is my breakdown of America’s patients, as seen from the door of the hospital room. What kind of patient are you?
Happy’s on a roll. Excellent summation.
We’re All Dead … « WhiteCoat Rants
If you believe Michael Cannon’s article “Universal Coverage Kills” at the National Review Online.
It amuses me when people possessing little knowledge of the inner workings of the practice of medicine write articles as if they are “in the know.” Mr. Cannon’s article is one such work.
Nice rant, on point and on target.
Dear UPS makers,
Thank you for making some really excellent products. My home has products of varying sizes made by several of your manufacturing colleagues, and they generally do a terrific job of protecting my sensitive electronics from the occasional power flicker.
I write, however, to ask you very nicely to QUIT with the dang BEEPING NOISES in your otherwise useful devices. The power has been out in my palatial abode for nearly three hours now, and I’d get some sleep were it not for the incessant hooting from self important UPS gadgets.
Yes, we know the powers’ out. The loss of the fans, AC, and lights was quite enough a clue. No need to rub in our “lives in the stix” factor. No need for inanimate devices to keep us awake telling us “hey, the power is still off”.
Nobody wants, or needs, these alarms. They were sold to you by the Vast Alarm Conspiracy. Done alarming every single thing in the hospital they went to you: flattered, you bought into their “your products’ intended function deserves attention” mantra. You were lead astray, I tell you.
I implore you, as a man losing sleep while ranting into an iPhone, Stop It. Stop with the alarms.
Thank you, and a quiet good night, from everyone someday,
Kevin, M.D. – Medical Weblog: The Happy Hospitalist: All for one and none for all
The Happy Hospitalist: All for one and none for all
The following is a reader take by The Happy Hospitalist.
All for one and none for all. That is the state of the current government program called Medicare. The entitlement program that threatens the financial security of our nation. On March 25, 2008 the Boards of Trustees released their Annual Report of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. In this 43rd edition, the Trustees note a government program covering just over 44 million people at an expense of $425 billion dollars during 2007. That equates to approximately $10,000 per beneficiary.
The Medicare Crisis has the potential to kill this economy, and something has to give. Read the whole article: it’s well written, it’s a good prescription to avoid the oncoming disaster train, and there’s essentially no way it’s going to happen.
Too bad. We’re all going to pay for this, literally and figuratively.
As quoted in Congressional Quarterly:
The ever-evolving blogosphere is now helping to shape the health policy debate by allowing more interaction between the public and policy makers, said Department of Health and Human Services (HHS) Secretary Michael O. Leavitt , a blogger himself.
Leavitt, who launched his blog on the HHS Web site in August 2007, said his entries follow a range of topics, from day-to-day experiences, to his thoughts and decisions surrounding health care issues and policies.
People can post comments on his blog, which Leavitt said has provided valuable information.
“There have been times when someone has made an argument to me that I found compelling that I am sure began to mold and shape my thinking,” he said during a Kaiser Family Foundation event Tuesday.
Blogging can be a “very powerful engine for public policy setting,” he added, citing a recent HHS blog established to advance a summit on pandemic flu. He said the pandemic flu blog was a “wild success” in terms of being able to communicate with active “flubies” on the issue.
Note, this appointed Bureaucrats’ evidence of the power of medical blogging is that he has a blog and that people can leave comments. That’s laughable on its face, and the hubris underlying is truly impressive.
Any evidence he’s read any other medical blog? No. None.
This is unimpressive by any standard. Emarrasing, really.
amanzimtoti: Third world aid
Third world aid
We recently had an American delegation from PEPFAR (the United States President’s emergency plan for AIDS relieve) visit our clinic. I didn’t stick around for the circus because preceding the visit a list of demands was given to the clinical manager. Now PEPFAR isn’t even one of our major sponsors – from what I understand the money they’ve given us was just enough to put up some shelves in our pharmacy. Don’t get me wrong, we’re grateful for any donations, but if you’re going to give money for a worthy cause, you should do it out of the goodness of your heart, not so you can make them jump through hoops for you.
FDA to Add Warning to Antibiotics – WSJ.com
By JARED A. FAVOLE
July 9, 2008; Page B7
WASHINGTON — The U.S. Food and Drug Administration will seek to add strong warnings about the risks of tendon rupture associated with a class of antibiotics used to treat bacterial infections.
The FDA wants to add black-box warnings, the strongest warning the agency issues, to a handful of drugs, including Bayer AG’s Cipro and Johnson & Johnson’s Levaquin. The move comes six months after the consumer group Public Citizen sued the FDA to require the agency to add black-box warnings to the drugs.
Serious reports of tendonitis and tendon rupture continue to increase with use of the drugs, prompting the FDA to ask companies to add the stronger warnings, the FDA said in a posting on its Web site Tuesday. Such ruptures most frequently involves the Achilles tendon, but also include ruptures of the shoulder, hand, biceps, and thumbs.
Black box warnings used to be for very serious, life-threatening problems in drugs. Now tendonitis and tendon rupture are life threats, or are so serious they warrant a Black Box? The elevation of known, well-documented drug side effects to Black Box status dilutes its meaning, and will ultimately require the formation of a new class of warnings.
Tendon ruptures aren’t benign. Neither are infections. Name me an antibiotic that wouldn’t rate a black box under the criteria used on the flouroquinolones, then wonder at what’s happened to the FDA.