A lawsuit alleging that a Florida car crash victim might have survived if a helicopter had been sent instead of an ambulance may be the first legal challenge of its kind in the nation.
Sharon Hanlon, the attorney representing family members of the deceased woman, Diana Lopez, said Collier County emergency personnel were lax when they allegedly declined to provide air transport because of her weight, which reportedly exceeded 300 pounds. That negligence occurred due to “failure to clarify the rules/procedures regarding heavy-set patients who are trauma alert patients,” she said.
“Ms. Lopez was in her mid-30s, was a business owner of a trucking company, recently underwent gastric bypass surgery, and had lost 94 pounds. She was in good health and looking forward to life,” Ms. Hanlon asserted.
The defense countered that the “sole proximate cause of the plaintiff's damages was the decedent's own negligence and actions, or omissions,” including, but not limited to, failing to wear a seatbelt. County officials appear confident that neither Collier County nor its Emergency Medical Services will be held liable. “We believe that the county has many viable defenses to this action,” said Assistant County Attorney William Mountford, who filed Collier County's legal reply to the wrongful death suit.
The suit appears to be the first to test the merits of precluding air transport on the basis of safety considerations related to patient weight. If it goes to trial, it also may ignite further debate over whether public health agencies and governments can be held liable for sending transportation that results in slower delivery of emergency care.
The lawyers on each side submitted a long list of disputed points, but the basic facts do not seem to be in conflict. Ms. Lopez was thrown from her car after a tire blew out along an interstate highway more than 30 miles from Naples. By the time she reached the hospital, she could not be revived.
Her attorneys contend that in addition to the lack of clarity on weight limits, Ms. Lopez's health was jeopardized by several other preventable factors: failure to immediately transport her to a trauma center; failure to arrange for evacuation by flight instead of ambulance from “all and available nearby sources;” and failure to have “fully operational ground transport” — the first ambulance had mechanical problems, meaning Ms. Lopez had to wait for a second one.
In addition to raising patient weight restrictions as a point of litigation, the suit also looks at how much responsibility can be attributed to the patient for actions that result in serious injury or demise. This brewing legal battle arrives at a time when American obesity is at an all-time high and when some personal injury law firms are beginning to focus on, if not specialize in, factors that may influence urgent patient care within the “golden hour.”
One law firm with offices in different parts of the country, for example, introduces a page of its web site with an article stating that ambulance crashes are one of the “many hazards” faced by EMS personnel. The text apparently comes from a report by the Centers for Disease Control and Prevention, which highlights how use of restraints might help prevent injury in these collisions. (MMWR 2003;52:154.)
As the April 26, 2000, St. Petersburg Times found in an investigation seven years ago, medical helicopters crash with apparent regularity, too. The newspaper's report of incidents dating to 1991 showed an average of one crash or more a year. In most cases, these crashes caused multiple deaths.
In fact, helicopter crashes have incited as much, if not more, academic attention as their ground-transport counterparts. Last year, in an article in the Annals of Emergency Medicine, “EMS Helicopter Crashes: What Influences Fatal Outcome,” Susan Baker, MPH, and her colleagues at the Johns Hopkins University Bloomberg School of Public Health published findings showing that these crashes have increased in recent years. The overwhelming majority are fatal. (Ann Emerg Med 2006;47:351.)
They found that darkness and bad weather were most often associated with crashes. Asked if patient weight had been looked at in a systematic way, Ms. Baker, a professor at Johns Hopkins, said she was unaware of a study or a court challenge involving patient weight limits. She declined to speculate on how a morbidly obese patient might affect the safety of helicopter flight. “It is a tough call,” she said. “An overloaded helicopter is less safe.”
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