Liability issues with ride alongs
The decision to have ride-alongs requires due diligence that considers the risks and benefits of such activities. The processes by which risks are recognized, evaluated, and minimized or transferred should be documented via policies and procedures. The results of this risk analysis should be used in consultation with a licensed attorney in the development, evaluation and implementation of any release, waiver or assumption of risk document. It is important to recognize that any such document must address the issues that were discovered during the due diligence process. The document should also show that the person who signed it has the legal authority to do so, has been informed of the risks of riding in an ambulance, understands the risks, and has given evidence of said understanding.
Each passenger in an ambulance is a source of liability for the ambulance and any legal entities of which the ambulance service is a part. This liability exists, because every passenger in the ambulance is at risk. The greater the number of passengers: the greater the magnitude of potential cumulative liability. Naturally, there are common risks to all riders. The risk of injury as the result of vehicle collisions during both emergency and non-emergency responses is well documented.
Necessity may dictate that one family member rides in the ambulance during patient transport. Each service should establish written policies that indicate when this is allowed. The extra passenger should ride in the front of the ambulance secured properly.
Some requests for ride-alongs may come from individuals or training centers whose goal is to achieve experience with patients. This may be required for the completion of a certification process. All laws and regulations pertinent to the authorities who control training and certification should be reviewed to clearly determine the obligations of the service, its personnel, the academic training facility which sponsors the training and the student.
There are also those persons who wish to ride-along in a purely observational capacity. They may be independent or part of an academic entity or social organization. If they belong to an organization, establishing a written agreement may be appropriate. It is important to ascertain if the potential passenger has reached the age of majority. Legal counsel must address consent issues pertinent to minors. It should be noted that even passengers whose sole function is to “observe” are subject to the risks described below.
Risk common to all riders include, but are not limited to vehicle crashes, non-crash vehicle motion capable of producing injury, exposure to the elements (heat, cold, rain, snow, ice, flooding, tornadoes, electric storms, etc.), dangerous work environments, such as, accident sites, fire scenes, explosions, crime scenes, weapons of mass destruction events, hazardous material events; exposure to violence from criminals, psychiatric patients, intoxicated patients, substance abuse patients, civil unrest, and body substance isolation issues (blood-borne pathogens, i.e., hepatitis, HIV, AIDS, air-borne pathogens, miscellaneous and currently unknown pathogens and toxins). As the ride-along interacts with patients, proximity to the patient increases the likelihood of patient based problems. Patient handling creates a huge potential for musculoskeletal injuries. It should also be noted that all ride-along participants may be exposed to situations that put them at risk for acute/chronic stress reactions, post- traumatic stress disorder (PTSD), or other psychological difficulties.
HIPAA compliance may be an issue. Protected Health Information (PHI) in the ambulance arena requires the same level of policies, procedures, training, enforcement, and monitoring as in the hospital. Although non-employees are not subject to OSHA, it makes sense that any non-patient, non-employee who rides in your ambulance is formally made aware of your safety policies and procedures, are required to adhere to them, and is removed if policies are not followed.
Although common, ride-alongs are not without risk. They should be handled in a thoughtful manner with adequate input from local counsel.
The purpose of this article is to raise issues that will help identify risks associated with ride-alongs particular to your circumstances. It is not intended to be all inclusive or prohibitive.
Wolfberg S, Wirth J, “Do Ride-Along Programs Violate Patient Privacy?” JEMS, January 2006, Volume 31, Issue 1.