Legal Lesson of the Month: The Christmas Delivery

EMS can be full of interesting and tricky legal scenarios. While you can’t have an attorney ride with you, it behooves providers to have at least some familiarity with the principles, precedents, and major issues of EMS law. To that end EMS World is pleased to offer the EMS Legal Lesson of the Month.

These cases are presented by prominent attorneys in the EMS field. This month’s comes from Larry Bennett, program chair for fire science and emergency management at the University of Cincinnati. Bennett’s department publishes a monthly Fire & EMS and Safety Law newsletter; subscribe to that by e-mailing Lawrence.bennett@uc.edu or read the latest edition here. Find this case and more in his section on EMS cases. 

Case: Riffle v. Physicians & Surgeons Ambulance

Decided: January 2016

Verdict: The Ohio 9th District Court of Appeals affirmed a trial court’s denial of summary judgment for the city of Akron and two paramedics, Stacy Frabotta and Todd Kelly, who did not transport a pregnant woman with significant vaginal bleeding whose baby later died. 

Link: https://ceas.uc.edu/content/dam/aero/docs/fire/Pregnant1.pdf

Facts: Around 4 a.m. on December 26, 2008, Andrea Riffle, who was less than two weeks from the due date of her first child, called 9-1-1 when she awoke to find herself bleeding. Stacy Frabotta and Todd Kelly, two paramedics employed by the city of Akron, responded. The printed run report provided to Frabotta noted “[t]here is SERIOUS bleeding” (emphasis in original). 

Frabotta and Kelly assessed Riffle in her bathroom, concluded the situation was a routine first pregnancy that did not warrant emergency transport, and turned her care over to a private ambulance service. The private ambulance transported Riffle to Akron City Hospital, where she was taken directly to the labor and delivery department. After assessment there, her daughter Tenley was delivered by emergency Caesarean. Tenley Riffle died in the hospital three days later. 

“According to the deposition testimony of Frabotta and Kelly,” the court held, “they were aware that bleeding during the third trimester of pregnancy constituted an obstetrical emergency that triggered a specific protocol for treatment by EMS providers. Both acknowledged that the appropriate protocol in that situation included emergency transport with lights and sirens rather than transportation by a private ambulance service. Frabotta agreed that paramedics have an obligation to get information from obstetrical patients regarding whether they are experiencing bleeding. She confirmed she had been provided the printed run sheet on the night in question, and that run sheet contains a notation that Mrs. Riffle was a patient in her third trimester who was experiencing ‘SERIOUS bleeding.’”

Key quote: “There are genuine issues of material fact regarding whether Frabotta and Kelly failed to exercise care in connection with Mrs. Riffle’s treatment and, although aware of the risks inherent in the situation, failed to avoid the risk with indifference to the resulting harm. The motion for summary judgment was properly denied on this basis.”  

Legal lesson: Know and follow your protocols. If in doubt, call medical control and document the guidance you receive.