BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  SB 1365|
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                                 THIRD READING


          Bill No:  SB 1365
          Author:   Negrete McLeod (D)
          Amended:  4/30/12
          Vote:     21

           
           SENATE JUDICIARY COMMITTEE  :  5-0, 5/8/12
          AYES: Evans, Harman, Blakeslee, Corbett, Leno


           SUBJECT  :    Emergency medical services:  immunity

           SOURCE  :     California Association of Air Medical Services


           DIGEST  :    This bill extends the civil liability immunity 
          law to registered nurses trained in emergency services.  
          This bill provides immunity to all listed professionals 
          rendering medical services during emergency ground or air 
          transport.

           ANALYSIS  :    Existing case law provides that a person has 
          no duty to come to the aid of another, but if he/she 
          decides to assist another then he/she must act with 
          reasonable care. (  Artiglio v. Corning Inc.  (1998) 18 
          Cal.4th 604;  Williams v. State of California  (1983) 34 
          Cal.3d 18.)

          Existing law provides that, in order to encourage citizens 
          to participate in emergency medical services training 
          programs and to render emergency medical services to fellow 
          citizens, no person who has completed a basic 
          cardiopulmonary resuscitation course which complies with 
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          specified standards, and who, in good faith, renders 
          emergency cardiopulmonary resuscitation at the scene of an 
          emergency shall be liable for any civil damages as a result 
          of any acts or omissions by such person rendering the 
          emergency care, except where his/her conduct constitutes 
          gross negligence or is provided in exchange for 
          compensation.  (Civ. Code Sec. 1714.2(a)-(b), (e).)  

          Existing law provides that no physician or nurse, who in 
          good faith gives emergency instructions to an EMT-II or 
          mobile intensive care paramedic at the scene of an 
          emergency, shall be liable for any civil damages as a 
          result of issuing the instructions. 

          Existing law also provides that no EMT-II or mobile 
          intensive care paramedic rendering care within the scope of 
          his/her duties who, in good faith and in a non-negligent 
          manner, follows the instructions of a physician or nurse 
          shall be liable for any civil damages as a result of 
          following such instructions.  (Health & Saf. Code Sec. 
          1799.104.)  

          Existing law provides that, in addition to the above 
          provisions, a firefighter, police officer or other law 
          enforcement officer, EMT-1, EMT-II, or EMT-P who renders 
          emergency medical services at the scene of an emergency 
          shall only be liable in civil damages for acts or omissions 
          performed in a grossly negligent manner or acts or 
          omissions not performed in good faith.  (Health & Saf. Code 
          Sec. 1799.106.)

          Existing law provides that a licensed registered nurse, as 
          specified, who in good faith renders emergency care at the 
          scene of an emergency which occurs outside both the place 
          and the course of that nurse's employment shall not be 
          liable for any civil damages as the result of acts or 
          omissions by that person in rendering the emergency car, 
          except where he/she is grossly negligent.  (Bus. & Prof. 
          Code Sec. 2727.5.)  

          This bill extends those limited liability provisions 
          currently provided to firefighters, police officers or 
          other law enforcement officers, and specified EMTs, as 
          specified above, to registered nurses, as defined.







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          This bill extends the limited liability currently provided 
          under Section 1799.106 of the Health and Safety Code for 
          these emergency service professionals to include the 
          emergency services rendered during an emergency air or 
          ground ambulance transport.  

          This bill defines "registered nurse" to mean a registered 
          nurse who is both trained in emergency services and 
          licensed pursuant to the requirements under the Business & 
          Professions Code.


          This bill makes the following legislative findings and 
          declarations: 


           That since the original enactment of Section 1799.106 of 
            the Health and Safety Code, registered nurses have become 
            more directly involved in the provision of emergency 
            medical services as crew members in both air and ground 
            ambulances.

           Registered nurses should be encouraged to provide 
            emergency medical services in air and ground ambulances 
            in the same way as firefighters, law enforcement, and 
            EMT-Is and EMT-Ps.  

          This bill adds a cross-reference to the Business and 
          Professions Code Section relating to the limited liability 
          of licensed registered nurses to this section. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No   
          Local:  No

           SUPPORT  :   (Verified  5/10/12)

          California Association of Air Medical Services (source)
          California Chapter of the American College of Emergency 
          Physicians
          California Emergency nurses Association
          CALSTAR

           ARGUMENTS IN SUPPORT  :    The author writes:







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            The current law does not include registered nurses in 
            the code section that applies the gross negligent 
            standard to emergency medical staff.  This bill seeks 
            to make the standard equitable to registered nurses 
            working at the scene of an emergency.

            When the limited liability immunity law was written in 
            1980, nurses were not typically involved with rendering 
            emergency medical services in ambulances and on care 
            flights.  Now, however, nurses are routinely used 
            during these emergency transportations.  The gap in 
            immunity for nurses was discovered this past year when 
            two cases were brought against emergency medical 
            transport nurses.  These cases were settled out of 
            court, but the immunity issue remains.  

            This gap arguably is reflected in the limited liability 
            provisions found in existing law, insofar as Health and 
            Safety Code Section 1799.104 provides that no physician 
            or nurse, who in good faith gives emergency 
            instructions to an EMT-II or mobile intensive care 
            paramedic at the scene of an emergency, shall be liable 
            for any civil damages as a result of issuing the 
            instructions.  (Health & Saf. Code Sec. 1799.104(a), 
            emphasis added.)  In contrast, Health & Safety Code 
            Section 1799.106 provides that a firefighter, police 
            officer or other law enforcement officer, or specified 
            EMT who renders emergency medical services at the scene 
            of an emergency shall only be liable in civil damages 
            for acts or omissions performed in a grossly negligent 
            manner or acts or omissions not performed in good 
            faith.  (Health & Saf. Code Sec. 1799.106, emphasis 
            added.)  Thus, nurses who provided instructions to an 
            EMT rendering emergency medical services would be 
            subjected to limited liability, as would the EMT, but a 
            nurse who directly renders the emergency medical 
            services himself or herself, would be subject to 
            ordinary liability. 

            Limiting the liability exposure of persons rendering 
            emergency medical services in order to encourage 
            assistance of persons in emergency situations must be 
            balanced against serious policy concerns for the safety 







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            of those persons being assisted and the availability of 
            a legal recourse if they are further injured by an 
            inadequately trained professional who arguably should 
            not have been providing such emergency services.


          RJG/DLW:do  5/14/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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