By Arthur Hsieh

You must know how to avoid negligence in the field and for the EMT exam. If you breach your duty to act, the patient may be able to file a lawsuit against you for negligence. To prove negligence, the patient has to be able to prove four things happened:

  1. You had a duty to act.

  2. There was a breach of that duty.

  3. There was an injury.

  4. The injury (physical, emotional, or both) was a result of the breach, or causation.

All four elements must be proven in order for a suit to be successful. For example, when you were transferring your patient to the gurney, you lost your footing and dropped her to the floor. She wasn’t injured by the fall. No negligence occurred in this case because the patient wasn’t injured and you didn’t perform above or below your level of training; you didn’t breach your duty to act.

A 35-year-old male has been shot in the chest. He is unconscious; has cold, diaphoretic, and pale skin; has a rapid carotid pulse; and is tachypneic. You apply occlusive dressings to the single open chest wound, but overlook a bleeding, open wound to the patient’s back during your assessment.

The patient survives his wounds and takes a long time to recover. The patient sues you for negligence. Overlooking the back wound would be an example of

  • (A)duty to act.

  • (B)breach of duty.

  • (C)injury.

  • (D)causation.

The best answer is Choice (B). Part of your training requires you to inspect the back for an injury, which you failed to do in this scenario. You had an obligation to respond when called, Choice (A), which is unrelated to overlooking the back wound.

The gunshot wounds are examples of an injury, Choice (C). With regard to Choice (D), if you had controlled the bleeding sooner by identifying the back wound early, you may have reduced the extent of his shock condition (as indicated by his vital signs), possibly reducing his recovery time.