Deny Patients a Ride In the Ambulance - What Laws?

[spenac]

OK I keep hearing that you can not legally deny transport to anyone that requests it. OK show me the laws. I know that many have protocols that say no but that is not a law, that is the choice of your medical director. So my request is show me the state laws that say you must transport all callers that request transport. Show me where by state law that you can not say no to someone that just wants a ride but has no health problems. I am not saying they do not exist but no one has ever backed up their claims. Thank you for your help in educating all of us. It would be nice to have a list of all states with laws that show one way or the other.

[Chief1C]

If Pennsylvania does have a protocol that states we can deny transport, then I'm unfamiliar with it. I have no problem telling people, we're not a taxi, we'll take you the nearest hospital.. Not your doctor, shopping, to another community, to a hospital farther away for an appointment, etc.. But I wouldn't tell them we won't take you anywhere. I'll take an ill or injured person where they need to go, hospital wise.

[hr:aaf93ab475]

[hr:aaf93ab475]

[spenac]

But is there a law that says you can not deny transport?

I will take any patient that could suffer further injury or even death if transported by any means other than ambulance. At what is now my part time job we will treat minor injurys then send them on their way to the hospital pov. We will not take our ambulance out of service for somebody just wanting a ride.

So does anyone know of any state law that specifically requires you to take all callers to the hospital?

[spenac]

North Dakota law allows the ambulance crew to refuse to transport an individual for which a transport is not medically necessary (N.D.C.C. § 23-27-04(2)). To deny transport of an individual that wishes to be transported the following must be complied with:

· The EMS provider must believe that the individual does not need immediate medical attention or ambulance transport.

· The EMS provider must contact medical control for a physician’s order of concurrence of denying transport. If the EMS providers are unable to contact medical control and/or obtain an order to deny transport, the individual must be transported to the nearest appropriate facility.

· Recommend an alternate mode of transport to the individual; taxi, relative, or other means.

· The EMS provider must fully document the event and notify the medical director as soon as practical.

http://64.233.167.104/search?q=cache:pMyK_...;cd=1&gl=us

[Chief1C]

Guess I'm not familiar with any Commonwealth Laws or Codes, that in affect, would allow an ambulance to refuse transport.

[spenac]

So are there any laws that state that you must transport all callers?

[crotchitymedic1986]

I am not aware of any law, but I am aware of:

1. If you are hospital owned, you fall under JCAHO. I am not aware if it was every clearly clarified if the hospital owned ambulance being called is the same as coming to hospital property. Meaning you can not refuse "care" - defined as stabilization - not transport. I have seen inerpretations of that rule in both directions.

2. While there may not be a law, I think it is a bad practice to refuse transport of someone who is REALLY ill or injured, as there is no defense for your actions in a court of law if you are wrong and the patient has a negative outcome. Just open up the checkbook and be prepared to write a big check. Ambulance crew refuses to take patient to the hospital, never sounds good on the 6pm news.

3. I knew of a 911 service that implemented a no transport for DNR patients, which was disasterous. Grandma dying, ambulance comes, refuses to take grandma -- family and nursing homes are upset.

[spenac]

I am not aware of any law, but I am aware of:

1. If you are hospital owned, you fall under JCAHO. I am not aware if it was every clearly clarified if the hospital owned ambulance being called is the same as coming to hospital property. Meaning you can not refuse "care" - defined as stabilization - not transport. I have seen inerpretations of that rule in both directions.

2. While there may not be a law, I think it is a bad practice to refuse transport of someone who is REALLY ill or injured, as there is no defense for your actions in a court of law if you are wrong and the patient has a negative outcome. Just open up the checkbook and be prepared to write a big check. Ambulance crew refuses to take patient to the hospital, never sounds good on the 6pm news.

3. I knew of a 911 service that implemented a no transport for DNR patients, which was disasterous. Grandma dying, ambulance comes, refuses to take grandma -- family and nursing homes are upset.

OK on your points:

1. ER only has to stabilize, which often when nothing life threatening is tell them this is not an emergency follow up with your doctor, I have seen that many times. The same can be done on scene, we can make examination and if no life threatening illnesses or injuries send them POV to the ER or to follow up with their doctor.

2. Never said deny transport to those with a life threatening illness or injury. But patient calls about wanting a ride to the hospital for a cheap lunch, sorry we should say no. The same could be said with the I sneezed last week and now at 0300 I can't sleep so I want you to drive me to get checked, sorry no way.

3. DNR does not mean no treatment so bad on them. Now some patients have no transport in their living will, so service can still not transport unless a person with power of attorney over rides patient when patient is unable to communicate.

[Arizonaffcep]

As far as I know (I've been doing a LOT of research as far as "rules" and "statutes" because we just started our own EMS academy) there is NO such ruling in Arizona. I believe, while it is a common thought, that it is more a "customer service" and an "I want all the money I can get" from private ambulance services in Arizona. If anyone can show me where, I'll change my mind. The only problem I see in refusing to transport a patient is the detrimental (or potentially detrimental) effect on a company's reputation for customer service. Here are the links for

Statutes: http://www.azdhs.gov/bems/ems_statutes.pdf

Rules: http://www.azsos.gov/public_services/Title_09/9-25.pdf

[spenac]

As far as I know (I've been doing a LOT of research as far as "rules" and "statutes" because we just started our own EMS academy) there is NO such ruling in Arizona. I believe, while it is a common thought, that it is more a "customer service" and an "I want all the money I can get" from private ambulance services in Arizona. If anyone can show me where, I'll change my mind. The only problem I see in refusing to transport a patient is the detrimental (or potentially detrimental) effect on a company's reputation for customer service. Here are the links for

Statutes: http://www.azdhs.gov/bems/ems_statutes.pdf

Rules: http://www.azsos.gov/public_services/Title_09/9-25.pdf

You do not collect from the majority of 911 callers so in theory you make more money saying no to those that do not really need an ambulance.

As to reputation head it off in advance by occasionally advertising when to call 911, and also alert the public that to be sure ambulances are available for their emergency that the Paramedics will at times say no to ambulance transport if it is determined after examination that it is not needed.

This in time should stop the number of bogus calls, and save the service money. It also would free up ambulances for real emergencys.

I know most get mad that I say we should deny transport, but when we act as taxis we encourage the abuse most systems see.