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Emergency medical service & emergency medical technician standard of care in Texas

There are three common types of EMS/EMT negligence

Emergency medical technicians (EMTs) work for emergency medical service (EMS) or ambulance providers, all of which are considered healthcare providers under Texas law. This means, of course, that most claims against them will be governed by the draconian Texas tort reform statute, which imposes an expert report requirement and non-economic damages caps, among other things.

In addition to these factors, there’s another trap to be aware of when it comes to EMTs. Many of the EMS or ambulance providers are governmental entities. Major cities, like Dallas and Harris, have their own government-run emergency medical services. Many counties have emergency services districts (ESDs) that operate government-run EMS.

Like all Texas governmental entities, government-run emergency medical services and government-employed EMTs are protected by the Texas Tort Claims Act. This law has its own damages, which applies and operates separate from the normal non-economic damages cap of tort reform.

In addition, there is a separate notice requirement that mandates a written notice of claim to be served on the governmental entity, in most situations, in a rather aggressive timeline. For state governmental entities, the deadline is six months from the date of the alleged negligence. For local governmental entities, can be even shorter.

In my experience in handling medical malpractice cases involving emergency medical services and ambulance crews, it’s common to see these three types of claims:

• Motor vehicle collisions or wrecks involving the ambulance.

• Making inaccurate statements about a patient to emergency room personnel, which creates a bias that leads to a delay in diagnosis and proper care.

• Substandard care, which can involve problems ranging from dropping a patient during transfer to failing to recognize and treat an emergency medical condition.

A recent opinion entered by Houston’s First Court of Appeals addressed procedural problems in a case involving allegations that a patient was dropped while being loaded into an ambulance. The case is styled Northwest EMS Consultants, P.A. d/b/a North Cypress EMS v. Frances Guillory, No. 01-19-00668-CV. You can read the opinion here.

To satisfy the requirements of the Texas tort reform statute governing medical malpractice claims, the plaintiff timely produced an expert report from an emergency medical technician (EMT). After reviewing his report, there’s no doubt in my mind that this witness was indeed an expert in the area. He has been a licensed EMT since 1988, has been involved in academic teaching of EMTs, and has experience in the proper handling, lifting, and transportation of patients.

The facts and allegations in this case are super simple to understand. They also demonstrate the perils of the Texas medical malpractice legal minefield. Here’s what happened.

A woman in her 40s had severe abdominal pain. Someone called 911, and an ambulance crew responded. They felt that she had gastroenteritis, placed her on a stretcher and strapped her in. As the EMTs were preparing to loader into the ambulance, the stretcher legs failed to come down and she was dropped to the ground. This caused injuries and pain in her neck and back.

Texas law requires preliminary medical malpractice expert reports to state separately the applicable standard of care and how it was violated. In this case, the EMT expert didn’t do that, but rather model them together. While I think it’s still abundantly clear what his opinions are, and certainly provides fair notice to the defendant, the Houston appellate court found the expert report to be insufficient.

Here’s what the EMT expert said: “North Cypress EMS Emergency Medical Technicians . . . Were required to properly unload [the patient] from the ambulance. The proper unloading of [the patient] included the safety provided by not dropping [the patient].” Next, the EMT expert stated that the EMTS did, in fact, drop the patient while she was strapped on a stretcher.

This language could have been easily fixed with a revision, stating:

• The standard of care requires emergency medical technicians to secure a patient onto a stretcher with straps and to load the patient into the ambulance without dropping her. The standard of care further requires the EMT crew to visualize that the stretcher legs came down and were securely in place before moving the stretcher and patient into the ambulance.

• The North Cypress EMS EMTs violated standard of care by failing to visualize that the stretcher legs came down and were securely in place before moving the stretcher and patient into the ambulance, resulting in dropping the patient to the ground rather than safely transporting her into the ambulance.

While it seems easy enough to infer what happened from the expert report, that doesn’t satisfy the requirements of Texas law. The appellate court cited well-established case law that separate statements identifying the standard of care and how it was violated are essential. Importantly, the Texas Supreme Court has explained that to radically identify the standard of care, an expert report must provide specific information about what the defendant should have done differently.

In this case, the First Court of Appeals reversed the trial court, finding that the plaintiff’s expert reports were insufficient. The court remanded it back to the trial court with the likely possibility of granting the single 30-day extension allowed by the statute to cure these deficiencies.

If you’ve been seriously injured because of poor ambulance, hospital, physician, or medical care, then contact a top-rated skilled Houston, Texas medical malpractice lawyer for help in evaluating your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.

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