Med: Ethics in Emergencies (Part 2: Good Samaritan Law Case Study)

March 12, 2008

For the background on this post, you should probably check out Part 1 below. Parts 3 & 4 of the “Ethics in Emergencies” series will be on a different topic entirely–the Geneva Convention & Medical Care. It’s rather interesting, but will probably not be up for a few days.

So as addressed below, the Good Samaritan law is in place to, amongst other things, protect doctors working in emergency situations from being sued for malpractice. I now want to discuss a specific case, Roberts v Myers, and use it to demonstrate just how lenient the GS law really is–more often than not, it leads to findings in favor of the doctor…sometimes surprisingly. Also keep in mind that this case is from 1977, and therefore some of the hospital protocols are QUITE different now.

Background for the case:

a) Dr. Olson, Long, & Voyevidka are the obstetricians for Doris Ray, who went into labor in October, 1977.

b) At some point, all 3 of these doctors left the hospital–while she was in labor–and left her care in the hands of residents and nurses. Note: These residents are then her doctors, and are required to provide full care–their treatment is not considered an emergency or anything like that.

So here’s how things went down–in VERY brief fashion–and also note that I’ll be skipping over certain details…but you’ll get the main idea: At some point during Ms. Ray’s labor, the nurses/residents detected deceleration of the fetal heart tones–which would qualify as an emergent situation. Panicking, they began to search for another doctor and found Dr. Myers–also an obstetrician. When he also confirmed the deceleration, he began the process of using Simpsons forceps, which our case stated as “One of the fastest ways to effect a delivery.”Ms. Ray later filed a lawsuit against Dr. Myers, claiming negligence in the context of prenatal care and delivery (Note: For some odd reason, the case did NOT actually tell us what the negative outcome was…so we worked under the assumption that for some reason the forceps caused damage. That assumption may be wrong, but that’s all we have.) The baby was delivered, but “something” must have gone wrong.

Without actually knowing the negative outcome, it’s hard to say whether or not there was even a case for malpractice–if a quick delivery was needed and the use of the Simpsons forceps was the fastest way, then it would seem that he did the right thing. Nevertheless, the case never even needed to get that far. Dr. Myers argued (successfully) that he was covered under the Physicians provision of the GS law. It was an emergency, he was acting in good faith, and did not appear to willfully/wantonly do harm.

Now, I took issue with this decision at first. To me, the intent of the law was to ensure that a doctor on the street would help in an emergency situation like a car accident–it seemed like a bit of a stretch for a doctor working IN THE SAME HOSPITAL to be covered under the GS law. I guess in my mind, anyone walking around the hospital with the title of doctor should be liable for what they do/do not do. Nevertheless, a few of my colleagues rightly pointed out the following:

Was this situation so different than a doctor coming upon the scene of a car accident? Dr. Myers was NOT her doctor–he didn’t know her, he knew nothing about her pregnancy, and the nature of the situation prevented him from being able to even read her chart. He was just jumping in “cold turkey,” so to speak. Sure, he may have been an employee at the hospital, but that doesn’t obligate him to understand all of the intricacies of patients that ARE NOT under his care.

That being said, it appears that the lawyer and/or advisers for the plantiff made a pretty huge error here. What they SHOULD have done was gone after the THREE doctors that were caring for Ms. Ray that all decided to leave the hospital while she was in labor. Or, they could have gone after the hospital for having regulations/standards that allowed the doctors to act in that way. But instead, they went after the innocent doctor that was probably eating dinner at the time he was informed of the emergency, and whom did the best that he could under the circumstances. I’m not biased enough to think that NO wrongdoing occurred here, but they surely went after the wrong guy.

Pretty interesting case, I think–I never would have expected the Good Samaritan law to cover doctors while on-duty at a hospital.

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