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In a message dated 10/4/2003 2:44:59 PM Eastern Daylight Time,

MSO4MEDIC1@... writes:

> Hello my name is Misty. I have a question maybe someone can help me

> out. I have looked in the Texas Health and Safety Code Chapter 773

> and the Texas Administration 157.00 and I can not find the

> requirments for the duty to act.My real question is if you are

> contracted to work an event say at a Motor Speedway and a spectator

> comes to your ambulance and requests service do you have a duty to

> act? Morally yes, but were is it located in the Texas Law? Anyone

> with any views or comments please help. Thank you for your time.

>

> Misty EMT-P

>

The Nature of the Beast.

HI Misty: I hear you loud and clear. " Morality v. Law " Two different things,

that sometimes comes down to an individual decision where you are damned if

you do, and damned if you don't...and what may seem " right " at the moment in

retrospect becomes wrong, and vise versa. In your profession, you are place

among

things that can slip from under you in a hurry.

I can't quote you the law; and if you look at the Texas statues and then go

over and look at the case law based on precedence the legal issues become very

tricky and muddy.

I will give you one example, and it's not all that extraordinary. I was with

a firm back in the 1970s that had the ambulance contract with a city. Of

course, a feature of that contract was that we would have " x " number of

ambulances

available to the citizens of that city. Specifically, by contract, we were

forbidden to answer any emergency ambulance call outside of the corporate city

limits. On the edge of the city limits was an old drag strip that was once in

the city limits but had recently, at that time, been dis-annexed back into the

county. The county provided no emergency ambulance services.

It was the responsibility for the owners of the track to hire a standby

ambulance for scheduled events. There was no legal obligation on the part of any

ambulance company to respond to calls to that location. The track owners did not

hire a standby crew. When there was an accident or illness they would begin

calling around, and eventually they would find someone who would respond.

Usually a private company who handled transfer calls from a larger adjoining

city.

Against the rules and contract, I would on occasion, if we had the cars

available, send an ambulance when the track called. The police would not go with

us

because the track was outside their jurisdiction. Our dispatcher would call

the Sheriff's Department, and sometime they would make it out there, but most

of the time not. You know how hysterical a race track crowd can get.

I sent a crew and the crowd turned the ambulance over. That did it, no more.

Besides, by sending the crew I was fostering in the track owners their own

irresponsibility in not providing a standby ambulance. Even though I said " No

more, " the track would call and exaggerate the situation to the dispatcher, and

I

would authorize another call. There would be " bodies all over the place " and

when the crew arrived, it would turn out to be a stomach ache or broken toe.

Finally, we set our foot down and definitely said, " NO MORE. "

A call came in from the track one Sunday, and the call sounded like all of

the others calls, " Horrible accident, dead people everywhere. " I instructed the

dispatcher to tell the caller, " No way. " He told the owner that we were not

allowed to respond to calls from the track. The track called back several times

demanding an ambulance. We stood our ground this time and said, " No. " We

were within out legal rights to refuse. History had shown us that we had been

talked into responding previously because they would exaggerate the situation,

and in doing so, each time I had violated our contract with the city we served,

and had deprived the tax payers of that city the availability of an ambulance

they were paying for; they had even destroyed one of our ambulances in the

past and placed the crew in danger. This time we were not going to go. We had

decided to stay our ground.

The following morning, I walked out to get the newspaper, and there it was,

all over the front page, " Ambulance Company Refused To Send Ambulance: Four

People Die, Two In Critical Condition. " Two of the victims were children; a race

car had left the track and run through a crowd of people. And yes, there was

my name all through the article, painting me as an evil person who allowed

these people to die. News people were calling me on the phone, and trying to

find

me. The case was to be assigned to a grand jury. (That never happened.)

A major fire department ambulance crew(s) finally responded to their call,

but not before the call had been passed around their ranks. This department also

did not want to respond to a call outside their own city. They did respond 90

minutes after they were called, after an administrator with the authority

made the decision. The Sheriff Department responded but arrived after the fire

department. The children who died, did so hours later, and they may have been

saved if my firm had responded. We could have been on the scene in about ten

minutes.

In the end, it was determined that we had done the right " legal thing. " The

track owners were responsible, and we were in the clear.

Nearly 30 years later, I still think about those two children, ages 8 and 12.

I can't offer advice, I am certain that someone here could do a much better

job than I could. I would say that you should try to do your job within the

policy and guildlines of the firm or departement you work for.

Respectfully.

Rocco-Rusk

Funeral Director.

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In a message dated 10/4/03 4:19:33 PM Central Daylight Time,

jwservices@... writes:

Reply-To:

Date: Sat, 04 Oct 2003 18:44:22 -0000

>Hello my name is Misty. I have a question maybe someone can help me

>out. I have looked in the Texas Health and Safety Code Chapter 773

>and the Texas Administration 157.00 and I can not find the

>requirments for the duty to act.My real question is if you are

>contracted to work an event say at a Motor Speedway and a spectator

>comes to your ambulance and requests service do you have a duty to

>act? Morally yes, but were is it located in the Texas Law? Anyone

>with any views or comments please help. Thank you for your time.

>

>Misty EMT-P

Misty--I believe you do have a duty to act unless like someone said before

you have other arrangements made for anyone that walks up to your unit (i.e.

another provider on standby etc.)

I know some of our football games cannot be played without an ambulance

standing by at the game with a full crew. I believe that is UIL rules though.

What I suggest is what everyone else has said--go with your heart and think

of that person as one of your family members. What would you want the medic to

do if they walked up and were hurt or sick?

I also would do a search on the Texas Health and Saftey codes website and

find it for yourself if you want the exact law. OR Wes Olgive might be able to

tell ya exactly what law it is.

I hope some of this will be of help to you

Dana Garrett EMT-I 427

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Hi Misty. I cannot quote law or section but I can answer your question.

Because you are contracted to be at the special event then you are duty

bound to be there to provide care at that location. Unless it is directly

stated in the contract that you cannot treat spectators then your duty

covers the spectators as well. If it is not, you can provide care for the

spectator untill a second EMS unit can arrive to treat/transport as needed.

Of course there are exemptions to this. i.e life or death cases must be

treated.

I am basing my oppion on the fact that I have worked several special

events and have asked that very question befoe and that was the answer I

have been given. Perhaps I am wrong , and if so I greatfully hope someone

will correct my misunderstanding on this issue.

Lawrence Verrett EMT-P

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In a message dated 10/4/2003 5:19:26 PM Eastern Daylight Time,

jwservices@... writes:

> Hi Misty,

>

> Let me put it plane and simple: If one of your family members needed help,

> how would you like for the medics to respond?

> Do what you think is right in your heart--don't second guess--you'll be

> fine !!!!!

>

Yeah, I too have always been an adherent to the " May be your mother " concept.

Rocco-Rusk

Funeral Director

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Hi Misty,

Let me put it plane and simple: If one of your family members needed help,

how would you like for the medics to respond?

Do what you think is right in your heart--don't second guess--you'll be fine

!!!!!

---------- Original Message ----------------------------------

Reply-To:

Date: Sat, 04 Oct 2003 18:44:22 -0000

>Hello my name is Misty. I have a question maybe someone can help me

>out. I have looked in the Texas Health and Safety Code Chapter 773

>and the Texas Administration 157.00 and I can not find the

>requirments for the duty to act.My real question is if you are

>contracted to work an event say at a Motor Speedway and a spectator

>comes to your ambulance and requests service do you have a duty to

>act? Morally yes, but were is it located in the Texas Law? Anyone

>with any views or comments please help. Thank you for your time.

>

>Misty EMT-P

>Rendon Fire Department

>

>

>

>

>

>

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In a message dated 10/4/2003 11:22:26 PM Eastern Daylight Time,

rsdrn@... writes:

> I was with a firm back in the 1970s that had the ambulance contract with

>

> >a city. <snip> I sent a crew and the crowd turned the ambulance over.

>

>

> AHA!! I knew your name was familiar! Now there's a blast from the

> past! I too think of that call constantly. I have told that story to

> every rookie I ever worked with.

>

> Rob

>

I sometimes think about it also Rob. It was a weird deal.

Rocco-Rusk

Funeral Director

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Sounds like " Yellow Belly Drag Strip " ???

Re: The Duty to Act

> In a message dated 10/4/2003 2:44:59 PM Eastern Daylight Time,

> MSO4MEDIC1@... writes:

>

> > Hello my name is Misty. I have a question maybe someone can help me

> > out. I have looked in the Texas Health and Safety Code Chapter 773

> > and the Texas Administration 157.00 and I can not find the

> > requirments for the duty to act.My real question is if you are

> > contracted to work an event say at a Motor Speedway and a spectator

> > comes to your ambulance and requests service do you have a duty to

> > act? Morally yes, but were is it located in the Texas Law? Anyone

> > with any views or comments please help. Thank you for your time.

> >

> > Misty EMT-P

> >

>

> The Nature of the Beast.

>

> HI Misty: I hear you loud and clear. " Morality v. Law " Two different

things,

> that sometimes comes down to an individual decision where you are damned

if

> you do, and damned if you don't...and what may seem " right " at the moment

in

> retrospect becomes wrong, and vise versa. In your profession, you are

place among

> things that can slip from under you in a hurry.

>

> I can't quote you the law; and if you look at the Texas statues and then

go

> over and look at the case law based on precedence the legal issues become

very

> tricky and muddy.

>

> I will give you one example, and it's not all that extraordinary. I was

with

> a firm back in the 1970s that had the ambulance contract with a city. Of

> course, a feature of that contract was that we would have " x " number of

ambulances

> available to the citizens of that city. Specifically, by contract, we were

> forbidden to answer any emergency ambulance call outside of the corporate

city

> limits. On the edge of the city limits was an old drag strip that was once

in

> the city limits but had recently, at that time, been dis-annexed back into

the

> county. The county provided no emergency ambulance services.

>

> It was the responsibility for the owners of the track to hire a standby

> ambulance for scheduled events. There was no legal obligation on the part

of any

> ambulance company to respond to calls to that location. The track owners

did not

> hire a standby crew. When there was an accident or illness they would

begin

> calling around, and eventually they would find someone who would respond.

> Usually a private company who handled transfer calls from a larger

adjoining city.

>

> Against the rules and contract, I would on occasion, if we had the cars

> available, send an ambulance when the track called. The police would not

go with us

> because the track was outside their jurisdiction. Our dispatcher would

call

> the Sheriff's Department, and sometime they would make it out there, but

most

> of the time not. You know how hysterical a race track crowd can get.

>

> I sent a crew and the crowd turned the ambulance over. That did it, no

more.

> Besides, by sending the crew I was fostering in the track owners their own

> irresponsibility in not providing a standby ambulance. Even though I said

" No

> more, " the track would call and exaggerate the situation to the

dispatcher, and I

> would authorize another call. There would be " bodies all over the place "

and

> when the crew arrived, it would turn out to be a stomach ache or broken

toe.

> Finally, we set our foot down and definitely said, " NO MORE. "

>

> A call came in from the track one Sunday, and the call sounded like all of

> the others calls, " Horrible accident, dead people everywhere. " I

instructed the

> dispatcher to tell the caller, " No way. " He told the owner that we were

not

> allowed to respond to calls from the track. The track called back several

times

> demanding an ambulance. We stood our ground this time and said, " No. " We

> were within out legal rights to refuse. History had shown us that we had

been

> talked into responding previously because they would exaggerate the

situation,

> and in doing so, each time I had violated our contract with the city we

served,

> and had deprived the tax payers of that city the availability of an

ambulance

> they were paying for; they had even destroyed one of our ambulances in the

> past and placed the crew in danger. This time we were not going to go. We

had

> decided to stay our ground.

>

> The following morning, I walked out to get the newspaper, and there it

was,

> all over the front page, " Ambulance Company Refused To Send Ambulance:

Four

> People Die, Two In Critical Condition. " Two of the victims were children;

a race

> car had left the track and run through a crowd of people. And yes, there

was

> my name all through the article, painting me as an evil person who allowed

> these people to die. News people were calling me on the phone, and trying

to find

> me. The case was to be assigned to a grand jury. (That never happened.)

>

> A major fire department ambulance crew(s) finally responded to their call,

> but not before the call had been passed around their ranks. This

department also

> did not want to respond to a call outside their own city. They did respond

90

> minutes after they were called, after an administrator with the authority

> made the decision. The Sheriff Department responded but arrived after the

fire

> department. The children who died, did so hours later, and they may have

been

> saved if my firm had responded. We could have been on the scene in about

ten

> minutes.

>

> In the end, it was determined that we had done the right " legal thing. "

The

> track owners were responsible, and we were in the clear.

>

> Nearly 30 years later, I still think about those two children, ages 8 and

12.

>

>

> I can't offer advice, I am certain that someone here could do a much

better

> job than I could. I would say that you should try to do your job within

the

> policy and guildlines of the firm or departement you work for.

>

> Respectfully.

>

> Rocco-Rusk

> Funeral Director.

>

>

>

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dnewdeath@... wrote:

> I was with a firm back in the 1970s that had the ambulance contract with

> a city. <snip> I sent a crew and the crowd turned the ambulance over.

AHA!! I knew your name was familiar! Now there's a blast from the

past! I too think of that call constantly. I have told that story to

every rookie I ever worked with.

Rob

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I think the question was she wanted to see if any one could find a

resource which has our duty to act defined in writing. I know Misty

ran a call the other night where she found a child that had fell from

a seat at an event. The parents had taken the child to the " EMS " crew

where they was given a bottle of water and told to go call 911 if

they wanted further treatment. The parents left the track and went to

a local store and called 911 where they met EMS and Fire. I am very

interested in seeing this in writing, or do we all just believe in

the " duty to act " because years ago " for some of us " we was taught

that it was right. I do agree with your statement, and Misty is not

challenging the duty to act, she simply wants to see it in writing to

prove a point with another old-time medic.

> Hi Misty,

>

> Let me put it plane and simple: If one of your family members

needed help, how would you like for the medics to respond?

> Do what you think is right in your heart--don't second guess--

you'll be fine !!!!!

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Share on other sites

Misty,

Duty to act is a common law concept which is applied in the law of

negligence, contracts, and many other areas.

It is a more or less contractual duty although most of the time the contract

is implied rather than explicit.

You will not find a statute or regulation that speaks to duty to act. You

will, however, find case law on the subject. If you want to see some

discussions, ask Google.com to search for " negligence duty to act. " You'll get

lots of

hits.

Now, with reference to the situation you describe. You mention that you're

under contract for standby at the Motor Speedway. The terms of your contract

will define your duties.

You should read the specific language of the contract to see what it says

you're agreeing to do. When you agree in writing to perform a service, you're

bound by the terms of your contract or agreement. So if your contract says that

you are agreeing to standby ONLY for injuries to the drivers and crews, that

defines your duty. OTOH, perhaps it is the intent of the contract that you

be present to handle ANY emergencies that arise.

So read your contract. If the contract fails to spell out the precise terms,

it might need to be renegotiated and revised to spell out the intent. If

the intent is not apparent from the 4 corners of the document it is possible to

go outside the document in some cases to find out what the parties intended;

in some cases it is not. This is a rather complex and involved area of the

law.

The casebooks have been filled with cases about duty to perform a promise for

hundreds of years. Duty to perform has generated lots of controversies, and

the rules have evolved over the years.

Remember that legal duty and moral duty are entirely different things.

Ethical duty may be different still.

Also, always remember that once you begin performance, whether or not you

were required to act in the first place, you have created the duty for yourself

and then cannot terminate care until the patient can be handed off to another

crew with the appropriate level of training to handle the patient's needs.

Hope this helps.

Gene

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But, the contract can't relieve your duty to act when confronted with a

possible patient, can it? If so, to what degree?

My recommendation for stand-by events when you are there solely for the

participants of the even is to position the ambulance and yourselves in such

a place that has rapid access/egress and is not accessible from the stands

or by the public or spectators. This goes towards " preplanning " , which

should be done for any event and should simplify the mission, whatever it

is.

Schadone, NREMT-Paramedic

City of Austin

Austin/ County EMS

Medic 12 / Medic 24

@...

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