Good Samaritan law shields California doctor from liability

In an era when physicians' fear of liability lawsuits sometimes changes the way they practice medicine, there's one area where courts consistently tell doctors that they shouldn't be afraid to jump in -- as Good Samaritans.

Traditionally, lawmakers and the courts have encouraged physicians to lend their skills in emergency situations they encounter outside the exam room, by making doctors and others immune from medical liability in those situations.

A recent California appellate court decision continues that custom.

The scenario at the heart of the case before the California Court of Appeal, Fourth Appellate District, Division One in San Diego isn't quite as clear cut as when a physician acting as a Good Samaritan is driving down the road and comes across a car crash.

Here's what happened.

Bruce Adams, DDS, put patient Orlando Reynoso under general anesthesia so that he could perform oral surgery. According to court records, the San Diego County dentist administered anesthesia because Reynoso has been mentally retarded since birth and cannot sit calmly through a dental procedure.

Shortly after Reynoso went to the recovery room, Dr. Adams noticed that Reynoso's oxygen saturation levels were low. They fluctuated between the mid-80s and 90s.

Dr. Adams had anesthesiologist William K. Lo, MD, monitor Reynoso, court records show. The patient spit up blood, and his SATs fluctuated irregularly. Dr. Lo recommended that Reynoso be sent to the hospital to treat possible aspiration of blood.

Dr. Adams called friend and family physician Jeffrey L. Newman, MD, for a second opinion. Dr. Newman, who has privileges at the nearest hospital, arrived "shortly after" Dr. Adams called. He agreed that Reynoso should go to the hospital, according to court records.

Initially, the office tried to arrange a nonemergency ambulance transfer, but when none was available they called 911, and Reynoso was taken to the hospital.

A year later, Reynoso sued Dr. Newman and the others. He claimed that the doctors were negligent for not recognizing an emergency and getting him to the hospital sooner. Reynoso claimed that the delay deprived him of oxygen, exacerbating his existing mental retardation and behavioral problems.

Dr. Newman asked the court to throw out the lawsuit against him, arguing that he should be shielded from the suit because he responded as a Good Samaritan.

But Reynoso says that the law shouldn't protect Dr. Newman.

Court weighs in

The court was asked to look at the semantics of the California statute.

The law reads that "no licensee, who in good faith upon the request of another person so licensed, renders emergency medical care to a person for medical complication arising from prior care by another person so licensed, shall be liable for any civil damages as a result of any acts or omissions by such licensed person in rendering such emergency medical care."

Reynoso's attorney argued that the law requires a physician to believe they are responding to an emergency situation to be exempt under the state's Good Samaritan law.

He told the court that wasn't the case with Dr. Newman.

Reynoso's attorney pointed to a deposition that Dr. Newman gave:

Lawyer's question: "Do you have any recollection as to whether you received the impression that it was an urgent request?"

Dr. Newman: "I don't recall."

Question: "And you don't have any recollection of what it was you were asked to come and help with. Is that correct?"

Answer: "I have no recollection."

Reynoso's attorney also pointed to statements in the dentist's deposition indicating that he couldn't recall if he had said anything to Dr. Newman that would suggest an emergency existed.

The appellate court sided with the physician. It ruled that, based on the premise of the medical malpractice claims, it's clear that an emergency existed. The court further said that it didn't matter whether Dr. Newman believed he was on his way to an emergency.

"Because there is no dispute that Dr. Newman was a volunteer who rendered Orlando emergency care, his subjective belief as to the existence of a medical emergency when Dr. Adams contacted him and while he was on the way to the surgery center is irrelevant," the court said.

Reynoso's attorney did not return calls or an e-mail requesting comment.

But John Morris, the California attorney who represented Dr. Newman in Reynoso v. Newman, said the court's finding wasn't surprising. Still, he said, doctors should feel good about it. "The court got it right."

What doctors need to know

Good Samaritan laws vary from state to state, but the message in most is that doctors shouldn't be afraid to help in an emergency situation.

Although legal experts said doctors should familiarize themselves with the nuances of their own state laws, there are a few general rules physicians can follow if they are questioning whether the Good Samaritan act may apply. For example:

• Is the case an emergency?
• Does the incident take place outside of the traditional health care setting?
• Is there any previous patient-physician relationship?
• Is there compensation involved?

If the answer is yes to the first two questions and no to the last two questions, most physicians should feel fairly comfortable that the Good Samaritan laws apply.

"There is a tendency to grant physicians immunity who gratuitously respond to an emergency," said Vernellia R. Randall, a University of Dayton law professor.

Physicians "should not be afraid to lend a helping hand, at least in Florida, because the courts have protected doctors by strictly interpreting the law," said Scott J. Weiselberg, a lawyer with Taylor, Hodkin, Kopelowitz & Ostrow in Fort Lauderdale, Fla., who represents plaintiffs in medical liability cases.

But there are situations in which Good Samaritan laws may not apply.

In general, care that is provided within an institutional structure -- even if the physician doesn't bill the patient -- means that the Good Samaritan law isn't applicable.

Weiselberg cautioned that, at least in Florida, the law shields doctors only when they are treating the injury that is part of the emergency and when they don't go beyond what is necessary to deal with the emergency at hand. For example, if a physician stops at a car crash and the person's leg is broken, Florida law would protect the doctor for splinting the injury, but not for any damage that might occur if the physician tried to set the broken bone at the scene.

"They could open themselves up to liability," Weiselberg said.

Billing someone for whom the doctor provided care outside of the health care institution also would open up a physician to liability, Randall said.

She added that willful and wanton misconduct or overt acts that harm the person in need of help also could take away the Good Samaritan laws' immunity. "You drive by an accident. You stop, and you're drunk. You know you don't have the capacity to provide care," Randall said. "In that case, you may not be protected."

But in general, legal experts agree that this is one area where the courts have tried to strictly interpret laws and encourage physicians to lend their skills in an emergency without the fear of being sued -- the California case being one of the latest examples of that.

"Doctors don't have to form a subjective belief that they are responding to an emergency [in California]," Morris said. "If they're called to help, they should drop what they are doing and help."