When does doing nothing become negligence?

In this gripping episode of The Standard of Care Podcast, hosts Samantha Johnson and Nick Adams explore two real-world legal cases in which EMS providers were sued—not for what they did but for what they didn’t do. The central issue is the failure to forcibly enter a residence during a medical alert activation and its devastating consequences.

This conversation explores pre-hospital providers' legal, ethical, and practical responsibilities when responding to calls that may require forced entry. From Life Alert activations to one-ring 911 calls and silent apartments with growing stacks of mail, this episode examines the critical decisions providers face when balancing patient care, property damage, and personal liability.

You’ll walk away with actionable insights, fundamental policy considerations, and a deeper understanding of your “duty to act” when the door stays closed.

Key Takeaways

• For providers with advanced responsibilities: Legal precedent is shifting—standing outside the door and “erring on the side of caution” may no longer protect you in court. If your system doesn’t give you the tools or authority to act decisively, it’s time to start the policy conversation.
• For providers early in their practice: Knowing how and when to involve law enforcement or fire services during a potential forced entry call is critical. Policies are not just guidelines—they’re your legal armor.
• For those just beginning in EMS: Just because the lights are off and no one answers the door doesn’t mean no one is home—or in danger. Learning when to escalate, who to call, and how to document your decision could be the essential skill you acquire early in your career.

References

https://f001.backblazeb2.com/file/Standard-Of-Care/Handout_ch37.pdf

https://f001.backblazeb2.com/file/Standard-Of-Care/Handout_ch38.pdf
 

https://www.firelawblog.com/2011/06/16/duty-to-act-right-to-enter-their-well-being-our-well-being/

https://www.nbcphiladelphia.com/news/local/lawsuit-philadelphia-geneva-mackrides-death-senior-living-facility/4127192/

https://www.nbcphiladelphia.com/news/local/family-lawsuit-claims-north-philly-man-died-emts-left/4138474/

https://6abc.com/post/another-lawsuit-filed-city-philadelphia-ems-response/16045833/

https://www.ems1.com/legal/philadelphia-family-files-lawsuit-over-ems-failing-to-aid-father-after-unanswered-knock

What happens when a determination of death GOES WRONG?

In this episode of the Standard of Care Podcast, hosts Samantha Johnson and Nick Adams break down a real and heartbreaking case where EMS medics declared a 14-year-old patient deceased—only for him to be resuscitated at the hospital nearly an hour later. The fallout? A legal battle that made its way to the Supreme Court, and a patient left with devastating consequences.

With legal nuance and clinical insight, Samantha and Nick walk through the case from street to courtroom. They explore the intersection of qualified immunity, the complexities of assessing patients with conditions like cerebral palsy, and the chilling legal and ethical risks that come with the determination of death in the field. This episode will change the way you view determination of death—and might just save your career someday.

Listen now on your favorite podcast platform or directly at https://flightbridgeed.com/standard-of-care/. While you’re there, explore our award-winning and nationally recognized courses that are helping thousands of providers stay sharp, safe, and legally sound.

Key Takeaways

• Don’t shortcut your assessment. "Cold to the touch" and single-lead asystole aren’t enough—especially in patients with neurological conditions that can present atypically.
• Qualified immunity protects government providers—until it doesn’t. It's not a license to cut corners.
• Thorough documentation and a second-by-second account of your decision-making process can be your legal lifeline.
• Cross-agency coordination and quality assurance are essential. What one crew misses, another might catch—but how that’s handled matters.
• EMT and paramedic education rarely prepares you for the weight of calling a death. Clinical training must evolve to meet that responsibility.
• When in doubt, initiate resuscitation. Let the ER be the place of final determination—not the living room.

• Stacy Williams, on behalf of her minor grandson, J.J. v. Andrew Williams and Joe Spradlin, United States District Court, Southern District of Texas, Houston Division, Civil Action File No. 4:23-cv-289 (January 26, 2023), available at https://bencrump.com/wp-content/uploads/2023/02/Doc.-1.-Plaintiffs-Original-Complaint.pdf
• FOX 26 Digital. (2023, February 2). Lawsuit Filed Against Houston Paramedics Who Refused Emergency Care to Disabled Teen. FOX 26 Houston. https://www.fox26houston.com/news/lawsuit-filed-against-paramedics-who-refused-emergency-care-to-disabled-teen
•  Wallace, R. (2025, January 10). US Supreme Court Declines Case of 2 Houston Paramedics Who Mistakenly Declared Teen Dead. FOX 26 Houston. https://www.fox26houston.com/news/us-supreme-court-declines-case-2-houston-paramedics-who-mistakenly-declared-teen-dead

In this episode of The Standard of Care Podcast, Samantha Johnson and Nick Adams tackle a harrowing real-life EMS case involving a catastrophic ambulance fire in Honolulu, Hawaii. A routine oxygen tank switch turned deadly, sparking conversations around scene safety, equipment maintenance, and the legal standards EMS providers face. Explore the chilling details, from the moment the fire erupted to the ensuing lawsuit against EMS providers and manufacturers. This case shines a spotlight on the intersection of clinical practice and legal implications, offering critical insights for providers at every level.

Listen now on your favorite podcast platform or at FlightBridgeED.com. While you’re there, explore our award-winning courses designed to elevate your practice and recertification goals.

Key Takeaways
Advanced Insight: The importance of maintaining oxygen equipment, understanding contamination risks (e.g., oil or grease in oxygen regulators), and mitigating dangers in oxygen-rich environments.

Practical Tip: Always ensure proper protocol when switching oxygen tanks, such as turning off regulators during transitions and verifying equipment cleanliness.

Foundational Learning: Scene safety remains paramount—never compromise personal safety when responding to emergencies, regardless of perceived public expectations.

In this episode of The Standard of Care podcast, hosts Samantha Johnson and Nick Adams delve into the complex legal framework of patient consent in EMS. What happens when a patient refuses care, even in life-threatening situations? How should EMS professionals navigate the fine line between consent, implied consent, and refusal, all while staying within the legal boundaries? Samantha quizzes Nick on real-world scenarios, offering practical insights on handling refusals, informed consent, and what EMS providers need to know about patient capacity.

Whether you're a seasoned paramedic, new to the field, or just brushing up for the National Registry exam, this episode offers valuable knowledge on critical issues you may face. Get actionable advice, hear relatable examples, and understand the nuances that could impact your next decision. Tune in now to explore this important topic—and remember, you can find The Standard of Care wherever you listen to podcasts or on our website at flightbridgeed.com/explore. While you’re there, check out our award-winning courses designed to enhance your professional skills and knowledge.

Key Takeaways:

• Understanding patient capacity is critical in determining whether you can proceed with care, even if consent is initially given. If a patient has capacity, their refusal must be respected, even in life-threatening situations.
• Implied consent allows EMS providers to intervene in emergencies when a patient is unconscious or unable to give explicit consent, but only within the necessary scope of care.
• Informed refusals are equally important as informed consent. EMS professionals must ensure patients fully understand the risks of refusing care and document everything thoroughly.

In this episode of The Standard of Care Podcast, Samantha Johnson and Nick Adams recount their journey from attending conferences to becoming conference speakers on critical medical-legal topics in EMS. They reflect on how these pivotal experiences shaped their current work. The episode dives into highlights from recent EMS conferences, such as South Carolina EMS, Metro Atlanta EMS, and FAST24, where they engaged with street-level medics and addressed critical topics in the ever-evolving landscape of EMS law. Whether you're a seasoned provider or just starting, this episode offers valuable takeaways on the value of EMS conferences, the evolution of the Standard of Care Podcast, and the importance of staying informed and involved in industry developments.

Links:

National Association of EMS Physicians

https://naemsp.org/

2025 Annual Meeting
January 6-11, 2025
https://naemsp.org/annual-meeting/

South Carolina EMS Association

https://scemsa.org/

2025 SCEMSA Symposium
March 5-7, 2025
https://scemsa.org/ems-symposium

Metro Atlanta EMS Conference

2025 Metro Atlanta EMS Conference January 30-31, 2025

https://www.maemsc.org/

Prisma Health Swamp Rabbit Prehospital Medicine Conference

2025 Swamp Rabbit Conference June 17-19, 2025
https://www.facebook.com/ghsemsconference/

FAST25
(FlightBridgeED Air and Surface Transport Symposium 2025)

Lexington, KY | May 19-21, 2025
https://fbefast.com

FTFC/Gathering of Eagles
2025 FTFC/Gathering of Eagles June 9-13, 2025

https://firsttherefirstcare.com/

It’s back-to-school time for the kids and for paramedics and EMTs, too!  Nick is planning to renew his certification.  But we know there will be a set of medical-legal questions on the National Registry exam, and he will be sure he’s prepared.  In this series, Nick and Samantha dive deeper into the medical-legal concepts commonly tested on the National Registry and help our listeners prepare to take on these questions.  Please like and subscribe! You can get this and other podcasts anywhere you get your podcasts or from the FlightBridgeED website at https://flightbridgeed.com/standard-of-care/

Key Takeaways
• Understand the Difference: Criminal actions are prosecuted by the state and aim to punish and deter, while torts are civil cases seeking compensation for wrongs.
• Evidentiary Standards Matter: The burden of proof is much higher in criminal cases (beyond a reasonable doubt) compared to civil cases (preponderance of the evidence).
• Negligence Requires Four Elements: To prove negligence, you must demonstrate duty, breach, causation, and damages. All four must be present for a successful claim.
• Know Your Legal Responsibilities: As an EMS provider, it’s crucial to act with due regard for public safety, especially in high-stakes situations like driving with lights and sirens.
• Be Prepared for Legal Complexity: Cases can involve both criminal and civil aspects, and understanding how these interact is vital for protecting yourself and your practice.

Spencer and Chris bring in the big guns from the Standard of Care podcast, Samantha Johnson and Nick Adams! This episode is probably one of the most disturbing cases of neglect we've reviewed in a while, so you've been warned!

On a hot Texas summer day, Dallas Fire responded to a grass fire on the side of the road.  Their subsequent encounter with a gentleman named Kyle Vess – all caught on surveillance camera - led to an ongoing lawsuit alleging “an abuse of power and a deliberate indifference to the life and welfare of the underprivileged in Dallas”.  What is the role of paramedics when confronted with a possible suspect?  Is it ever appropriate to fight a patient?  Are certain policies and practices of the department contributing to a perception (or a reality) that marginalized individuals are being treated differently?  Nick and Sam discuss all this and more.  Please like, comment, and subscribe!   

Links:

https://youtu.be/EGrlXDYzqqk

https://youtu.be/-IbjBf88gpo

https://www.dallasobserver.com/news/lawsuit-dallas-paramedic-kicked-man-in-face-while-in-police-custody-12235286

https://www.dallasobserver.com/news/dallas-tries-withholding-evidence-in-lawsuit-regarding-former-paramedic-brad-cox-who-kicked-man-in-face-12941255

https://www.dallasobserver.com/news/kyle-vess-court-rules-lawsuit-against-city-and-former-paramedic-can-move-forward-14303422

https://www.dallasobserver.com/news/video-dallas-fire-rescue-employee-kicks-man-in-face-12455856

See omnystudio.com/listener for privacy information.

An employee commits a terrible crime – should the employer be liable?  In this episode, we explore the nuances of negligent hiring, retention, supervision, and training.  What does it mean for an employee to be “in the scope of employment” to allow their employer to be sued in the first place?  When is an EMS agency responsible for its own negligence in keeping a problematic employee on staff?  If an employee commits a terrible crime, is the agency automatically off the hook?  Please like, comment, and subscribe!   

See omnystudio.com/listener for privacy information.

Season 3 is here!

The release of the police body camera footage in the cases of Earl Moore, Jr. in Springfield, Illinois and Tyre Nichols in Memphis, Tennessee show EMS personnel at their worst.  In both cases, the providers failed to assess their patients and render proper treatment.  In Illinois, these failures resulted in first degree murder charges; in Tennessee, the firings of the personnel involved.  The results of the cases may differ based upon whether the providers have qualified immunity.  In this episode, Nick and Samantha discuss the legal concept of qualified immunity and its application in the two cases.  We take a hard look at what these cases say about EMS as a profession, and what it means to have the worst of us on public display.  Please like, comment, and subscribe!   

The Standard of Care now has an email address!  Contact us directly at [email protected]!  We want to hear from you!  Tell us about the legal issues you’ve encountered, interesting cases you’d like us to discuss, and let us know what’s on your mind.

Links:

EMS 20/20 Show – Rapid Sequence Information. (2023, January 16). Reaction: Two EMS Workers CHARGED WITH FIRST DEGREE MURDER [Video]. YouTube. https://www.youtube.com/watch?v=HCqL3DF-apE

Finton, L. (2023, January 30). Three Memphis Fire Department Personnel Fired for Not Providing Aid to Tyre Nichols. The Commercial Appeal. Retrieved February 3, 2023, from https://www.commercialappeal.com/story/news/crime/2023/01/30/three-memphis-fire-department-personnel-fired-for-not-providing-aid-to-tyre-nichols/69855376007/

JEMS Staff (2023, January 31). Memphis Fire Department Fires Three in Connection to Tyre Nichols' Death. JEMS. Retrieved February 3, 2023, from https://www.jems.com/patient-care/report-tyre-nichols-may-have-survived/#:~:text=Memphis%20Fire%20Department%20Fires%20Three%20in%20Connection%20to%20Tyre%20Nichols'%20Death,-By&text=The%20Memphis%20Fire%20Department%20has,'%20death%2C%20the%20department%20announced

Olsen, D. (2023, February 3). New Details Emerge in Case Against EMS Workers Charged with Murder. Illinois Times. Retrieved February 3, 2023, from https://www.illinoistimes.com/springfield/new-details-emerge-in-case-against-ems-workers-charged-with-murder/Content?oid=16407188

WAND Staff (2023, January 16). Police Release Body Cam Footage from Fatal EMS Incident. WAND. Retrieved February 3, 2023, from https://www.wandtv.com/news/police-release-body-cam-footage-from-fatal-ems-incident/article_60ac0d16-9118-11ed-8a09-43e4be2bb405.html

See omnystudio.com/listener for privacy information.