Morgan D L, Trail W R, Trompler V A
Division of Emergency Medicine, University of Texas Southwestern Medical Center at Dallas 75235-8579, USA.
Prehosp Disaster Med. 1995 Apr-Jun;10(2):82-90; discussion 90-1. doi: 10.1017/s1049023x00041777.
Although many emergency medical services (EMS) providers are concerned about liability litigation, no comprehensive, national studies of EMS appelate cases have been published. Information about these cases and the use of liability immunity (sovereign immunity, emergency medical care immunity, or Good Samaritan immunity) as a defense could be used for EMS risk management and better patient care.
To review recent EMS system civil litigation cases to determine their common characteristics and the number that used liability immunity as a legal defense.
An observational study of the WESTLAW computerized database of legal cases from all state and federal appellate courts. All legal cases that named a member of the EMS system as a defendant, involved either a patient-care incident or ambulance collision, and received an appellate court opinion from 1987 through 1992, were studied.
Eighty-six cases were identified and analyzed. Most cases (85%) were related to a patient-care incident, and 71% of the cases involved a death or significant physical injury. More than 49% of the patient cases alleged inadequate assessment or treatment, and 27% alleged delay in ambulance arrival or no ambulance arrival. There were 11 cases (15%) that alleged no transport of the patient to the hospital. Liability immunity was used as a defense in 53% of the cases. The appellate courts ruled in favor of 68% of the defendants that did not use an immunity defense and in favor of 72% of those that did use liability immunity.
There have been a large number of recent appellate cases involving EMS systems. The common characteristics of many of these cases demonstrate the need for providing rapid ambulance arrival, proper assessment and treatment, and rapid patient transportation to a hospital. Although liability immunity was used as a legal defense by most EMS system defendants, the appellate court outcome was similar regardless of its use.
尽管许多紧急医疗服务（EMS）提供者担心责任诉讼，但尚未发表关于EMS上诉案件的全面的全国性研究。有关这些案件的信息以及使用责任豁免（主权豁免、紧急医疗护理豁免或善意 Samaritan 豁免）作为抗辩手段，可用于EMS风险管理和改善患者护理。
回顾近期的EMS系统民事诉讼案件，以确定其共同特征以及使用责任豁免作为法律抗辩的案件数量。
对来自所有州和联邦上诉法院的WESTLAW计算机化法律案件数据库进行观察性研究。研究了所有将EMS系统成员列为被告、涉及患者护理事件或救护车碰撞且在1987年至1992年期间获得上诉法院意见的法律案件。
共识别并分析了86起案件。大多数案件（85%）与患者护理事件有关，71%的案件涉及死亡或严重身体伤害。超过49%的患者案件指控评估或治疗不足，27%的案件指控救护车到达延迟或未到达。有11起案件（15%）指控未将患者送往医院。53%的案件使用责任豁免作为抗辩。上诉法院对68%未使用豁免抗辩的被告做出了有利裁决，对72%使用责任豁免的被告做出了有利裁决。
近期有大量涉及EMS系统的上诉案件。其中许多案件的共同特征表明需要提供快速的救护车到达、适当的评估和治疗以及将患者快速送往医院。尽管大多数EMS系统被告使用责任豁免作为法律抗辩，但无论是否使用，上诉法院的结果相似。
