One day a man was in a car wreck, and lay inside his car. The engine was ominously smoking, suggesting it might burst into flame.

A doctor passed by, thinking: I have no experience in emergency care, I have no medicine with me, and if I remove him from the car I could be sued, since my liability insurance won’t cover me.

A nurse stopped, pulled out her cellphone, and called the Ambulance, but did nothing more to help; she too was worried about a lawsuit if she interfered; she ignored the smoke, hoping the Ambulance would arrive in time to prevent a horrible death from fire.

But then a lowly Samaritan coming home from a bar stopped, saw the smoke and thought: WTF, that car’s going to explode, I’d better get him the F*** out of that car. So he opened the car door, took the limp guy from her seat, and saved the guy’s life…but since he lived in California, the good Samaritan ended up getting sued…

Like most parables, this one is not true, it is meant to teach us a lesson.  And the lesson is that something is very screwy in California.

From the LATIMES:

The California Supreme Court ruled Thursday that a young woman who pulled a co-worker from a crashed vehicle isn’t immune from civil liability because the care she rendered wasn’t medical. The divided high court appeared to signal that rescue efforts are the responsibility of trained professionals. It was also thought to be the first ruling by the court that someone who intervened in an accident in good faith could be sued.

Law varies from place to place, but common law presumes lay people will try to help an accident victim, but legally no one is legally mandated to help, especially if the aid places their own life at risk.

Many states have “Good Samaritan” laws to prevent lawsuits against those who assist accident victims. A lot of these laws were passed to protect physicians and nurses from aggressive lawyers who sue anyone and everyone after accidents, and often such care is not covered by one’s professional liability insurance.

Essentially this court case, if left standing, says that bystanders should not assist anyone in distress, but that they should wait and let the experts help. If the bystander helps, they could be sued for damages.

Of course, in rural areas, it might be 30 to 60 minutes until the ambulance arrives, and by then, the person could be dead, but never mind.

Indeed, the dissenting judges mention that problem in their dissent:

Justice Marvin R. Baxter said the ruling was “illogical” because it recognizes legal immunity for nonprofessionals administering medical care while denying it for potentially life-saving actions like saving a person from drowning or carrying an injured hiker to safety.

“One who dives into swirling waters to retrieve a drowning swimmer can be sued for incidental injury he or she causes while bringing the victim to shore, but is immune for harm he or she produces while thereafter trying to revive the victim,” Baxter wrote for the dissenters. “Here, the result is that defendant Torti has no immunity for her bravery in pulling her injured friend from a crashed vehicle, even if she reasonably believed it might be about to explode.”

Of course, some of you might notice that doctors or nurses would be exempt from suit even under this law, right?

But actually, the way this case was interpreted, if I as a doctor pulled a limp patient out of a smoking car, I too could be sued, for two reasons:

One, I was not rendering “medical care”, just moving someone.

Two: I would be guilty of malpractice, since as a doctor, removing a limp person from a car without stabilizing the patient’s neck with proper equipment is malpractice (limpness could mean paralysis from a neck injury).

The “good Samaritan” laws don’t cover doctors if they make a “medical mistake”. Since few doctors treat acute trauma emergencies, a lot of doctors (e.g. psychiatrists, obstetricians, pediatricians) would hesitate to render aid, for fear of lawsuit.

So, have I stopped at accidents? Yes, if no one else was there to help. Luckily, usually others already were there helping when we passed an accident, and they usually decline our help.

But would I have the courage to lift a patient from a smouldering car that might explode? I wonder…even if I stabilized the fracture with a towel or newspaper, it takes two people: One to keep the neck straight, one to move the body….so I don’t know what I would do…and I have fear of fire…

GruntDoc Blog has the best comment on this farce:

The legislature wrote what it meant, in plain language.  The California Supreme Court says the plain language isn’t correct, that their intent was clearly different than that written.

Nothing good will come of this.  I can only hope the California Legislature doesn’t go broke before they can clarify their very plain language so even lawyers can understand it.

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Nancy Reyes is a retired physician living in the rural Philippines. Her blog is Finest Kind Clinic and Fishmarket, and she writes medical essays at HeyDoc Xanga Blog.