Good Samaritan Laws

Monday, December 22nd, 2008

I’m not sure this is the “lawsuits gone wild” case some people are making it out to be. Seems like a much tougher call to me.

Proving that no good deed goes unpunished, the state’s high court on Thursday said a would-be Good Samaritan accused of rendering her friend paraplegic by pulling her from a wrecked car “like a rag doll” can be sued.

[…]

Alexandra Van Horn was in the front passenger seat of a car that slammed into a light pole at 45 mph on Nov. 1, 2004, according to her negligence lawsuit.

Torti was a passenger in a car that was following behind the vehicle and stopped after the crash. Torti said when she came across the wreck she feared the car was going to explode and pulled Van Horn out. Van Horn testified that Torti pulled her out of the wreckage “like a rag doll.” Van Horn blamed her friend for her paralysis.

Whether Torti is ultimately liable is still to be determined, but Van Horn’s lawsuit can go forward, the Supreme Court ruled.

For the sake of argument, let’s assume Torti’s actions caused Van Horn’s paralysis, and that the car wasn’t actually on fire (meaning there was no imminent threat to Van Horn’s life). Should Torti’s obviously good intent allow her to duck liability? We want to encourage good Samaritans, but do we want to encourage reckless good Samaritans.

I’m really not sure, here. What say you, Agitator readers?

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94 Responses to “Good Samaritan Laws”

  1. #1 |  bobzbob | 

    The original injury to the SPINE was caused by the accident, but as in most cases like this the damage to the SPINAL CORD was probably caused by the twisting and bending of the body as the edges of the damaged spine are moved against the fragile spinal cord. It is highly likely that the damage was caused by the movement, and this was probably demonstrated by medical examination after the fact.

    Cars rarely burst into flames after and accident, except for movies, good intentions based on ignorance are not good intentions. If “good intentions” were a legal defense then virtually any behaviour would be excusable. I’m sure Madoff didn’t intend to defraud anyone, its just that the economy fell apart exposing his ponzi scheme. The administration had “good intentions” when they unlawfully detained and tortured “terror suspects” does this make the behaviour OK? Police departments have “good intentions” when they bust down the wrong door, does this make it right? A good intentions defense is a recipe for disaster.

    Why would any libertarian want to interfere in the process by which a free society assigns responsibility for actions, the courts?

  2. #2 |  Spleen | 

    I blame television. Cars always explode on TV.

    Even horses explode on TV.

  3. #3 |  ClubMedSux | 

    I think the question here is not whether it will open a flood of lawsuits but rather what kind of effect it will have on Good Samaritans and other first responders. Personally, I’m thinking that for every one case like this where somebody gets hurt, there are one hundred where the Good Samaritan saves the day. I’d look into the statistics and if the numbers back me up, I think you keep the Good Samaritan law. The bottom line is revoking Good Samaritan laws will lead to a decrease of people helping those in need, so it’s a simple risk-benefit analysis to determine whether the laws should remain in place. The number of lawsuits filed doesn’t even factor into the equation for me. (Full disclosure: I am a civil defense lawyer, though not an insurance defense lawyer.)

  4. #4 |  ClubMedSux | 

    Oh, and in response to David @ #49:

    I don’t blame the plaintiff’s lawyers here, I blame the defendant companies that force things to litigation when the liability is clear but playing hardball might scare away a claimant.

    Both sides play hardball. Trust me.

  5. #5 |  bobzbob | 

    “Is it realistic to expect someone in that situation to accurately assess the damage to the car, and the injuries to their friend? ”

    Not moving a person with a suspect spinal injury (anyone who has been in a violent accident) is among the first thing you will learn in any first aid course – which are readily available to the public at low cost from several organizations at low cost. It would be unreasonable for the friend to know how to perform spinal surgery, but NOT unreasonable for her to be appraised of the basics of first responder care. This is the kind of thing that we should expect all citizens to know and not excuse them for ignorance of these basics.

  6. #6 |  Ron | 

    @salvo:

    re: “Ummm…no. There is no duty to help. One of the most basic rules in torts. If Michael Phelps were to see a baby drowning in 6 inches of water, legally speaking, he could stand there and laugh and incur no liability. That’s one of those things you hear in your torts class and say “wait, what? Seriously?” and then much discussion ensues on why this is the case. Now, there might be some sort of criminal penalty incurred depending on your jurisdiction ”

    translation: “Ummm No, but also ummm yes”. Very lawyerly of you, and thus adds nothing to the discussion.

  7. #7 |  Sean | 

    In our society, no matter the situation, it is better to let someone die than to try to help them. This case is the exact reason for that statement.

  8. #8 |  Bob | 

    “Nobody has questioned the cause of the crash, which resulted in everything that followed.
    Was Van Horn responsible for the crash? As a driver, is she not required to keep her vehicle under control?”

    Van Horn was not driving.

    Two cars:

    First car is driven by Anthony Watson, with Alexandra Van Horn in the passenger seat and Jonelle Freed riding in the back seat.

    Second car is driven by Dion Ofoegbu with Lisa Torti in the passenger seat.

    For reasons not explained, Watson steered his car into a light pole at 45 mph.

    The fact that it was 1:30 am on halloween night and all 5 were out partying could have been a factor, though.

    My theory, which is based not on facts in the case in any way, but the fact that I don’t like sue happy people and I don’t think Watson’s car drove itself off the road… is that Van Horn was giving him a blow job, thus positioning herself to receive the maximum spinal injury in an accident where everyone else walked away.

    Personally? After reading all the details I can about the case, I don’t see where Torti is guilty of anything. It was perfectly reasonable for her to try to get Van Horn out of the car, that was what everyone else was doing, and under duress it probably seemed like the best course of action…. it was just her bad luck that Van Horn not only had a spinal column injury, but was a sue happy bitch.

    Tragically. The lesson here is if you come across an accident. Let them die before attempting to render aid.

  9. #9 |  Frank N | 

    Note to self: Cover portion of license plate with mud and install “Keep on truckin'” bumper sticker on dashboard.

  10. #10 |  Ron | 

    OK, cars don’t usually *explode* but when gas is leaking all over the place there is a real risk of *fire*. I have seen my share of vehicle fires, and many times they get bad fast. All it takes is one sliced fuel line, a spark, and then all the plastics in the engine compartment and in the passenger compartment can get going pretty good. It is likely that by “explosion” the Samaritan in this case was concerned about any kind of conflagration, not just an explosion like the ones you see in movies. The idea being, if that car lights up more than likely the disabled occupant is toast. That is a real risk that must be assessed in a situation like this. Wait until you see actual flames and it could well be too late.

  11. #11 |  Bob | 

    “For the sake of argument, let’s assume Torti’s actions caused Van Horn’s paralysis, and that the car wasn’t actually on fire (meaning there was no imminent threat to Van Horn’s life). Should Torti’s obviously good intent allow her to duck liability? We want to encourage good Samaritans, but do we want to encourage reckless good Samaritans.”

    Heh… one last shot at this. using Radley’s ‘Instructions to the jury’ as a sounding board.

    “Should Torti’s obviously good intent allow her to duck liability?”

    No. They should not. What should allow here to duck liability is the fact that she was under duress and did not act in malice or with gross negligence.

    “Duress” is shown by the stress of coming up to an accident scene that just occurred. Very few of us have the ‘Right Stuff’ to be calm and collected in a situation like that.

    “Acting in malice” should be self explanatory. There is no reason to believe she intended to injure.

    “Gross Negligence” would be something like pulling her from the car, but then dropping her down an embankment to the rocks below.

    The question of “Why did she even TRY to get her out of the car? Doesn’t she know about spinal injuries and not moving accident victims?”

    When she got there, under duress, the driving thrust of all the people there was to ‘get them out of the car’. Watson got out on his own, Ofoegbu was helping Freed. She probably just latched onto “Get them out of the car!” as a course of action without executing much thought. If they were all jumping off a cliff, she probably would have done that too.

  12. #12 |  Brandon Bowers | 

    @47: “Alexandra Van Horn was in the front passenger seat of a car that slammed into a light pole at 45 mph on Nov. 1, 2004.”

    And for those who say it’s the insurance companies, it’s not. This is one ungrateful c*** suing a friend for trying to help her after an accident. “Beverly Hills lawyer Robert Hutchinson, who represented Van Horn, said he’s pleased with the ruling.” He’s a Beverly Hills ambulance chaser, not an insurance company lawyer.

    I think basing a legal precedent on this case is ridiculous. First of all, people in California are friggin’ morons, with the notable exception of Cynical in Ca, and I agree that cases like this should be decided individually. Any “precedent” set by this will inevitably give the government more power by allowing them to say “don’t help each other, just stand back and let us take care of it institutionally.” Or possibly “If you’re going to help someone who’s been in an accident, you have to get a permit first.” Either way, they will take more of our money to fund the administration of this new statute and more of our rights to allow their agents to maintain control of situations.

  13. #13 |  Scott | 

    “Not moving a person with a suspect spinal injury (anyone who has been in a violent accident) is among the first thing you will learn in any first aid course – which are readily available to the public at low cost from several organizations at low cost.”

    Great. So one more aspect of my personal life in which I have to incur an expense just to be in compliance with the law. I’ll add that to the list of other “compliance expenses”, which includes tax preparation fees, vehicle emissions testing, etc.

  14. #14 |  Steve Verdon | 

    This is the type of situation best left to a jury, I think. Lets see what a consensus of citizens thinks when presented with the factual scenario and given an opportunity to hash it out.

    Maybe, but once lawyers it is almost always a bad thing…so from now on, I wont stop.

    First of all, people in California are friggin’ morons, the notable exception of Cynical in Ca

    Hey!

  15. #15 |  SusanK | 

    This has to be insurance companies suing each other. Anyone who doesn’t understand that can re-read David Chesler’s comment (#49). The Plaintiff’s attorney may not be an insurance company, and Torti could have been added in as a defendant by the driver’s insurance company. Knowing nothing about the facts (or the insurance in the case), my guess is this:
    Plaintiff sued driver who wrecked car, saying “you crashed the car and it paralyzed me.”
    Driver’s insurance adds Torti in as a defendant, saying “Crash didn’t paralyze plaintiff, it was Torti’s actions that did”.
    Whether Torti has insurance or deep pockets is unknown. She may have been added in simply to muddle the cause of the injury to the jury.
    Given the facts that we have, I think Torti should be liable. She undertook a course of action she was not qualified/trained to take and mishandled it. I base my decision on the plaintiff characterizing the pulling “like a rag doll” – makes it sound like she did it to further injury, not in a caring manner.

  16. #16 |  nobahdi | 

    #29 | Marty |
    are you serious? car [explosions] are very rare, but gasoline doesn’t need ‘open flames’ to ignite- an electrical spark, mechanical sparks from friction, etc can ignite gasoline. Cars also have batteries which are explosive risks. There’s also the risk of explosive cargo- gas cans, propane tanks, etc.

    Gasoline also needs to be vaporized in order to catch fire, which basically means it needs to be exposed to air. So unless the gas tank is leaking (spraying), the gas won’t ignite. The other “explosive risks” you mention would need to be on fire (open flames) to explode.

  17. #17 |  chance | 

    In every first aid class I’ve ever taken it has been drilled into us that we have NO duty to provide assistance, and that while state laws may differ (I think some give a very limited immunity) a samaritan may be held liable for negligence. In 99 cases out of a hundred, you’re almost certainly better off waiting until the EMTs arrive.

  18. #18 |  Leonson | 

    I’d think that the jackass driving the car would be a better target for the lawsuit than the friend that pulled her out.

    But maybe he/she is dead/poor/uninsured.

  19. #19 |  Michael | 

    My father was an EMT and fireman and I have heard lots of stories where he was in the car with gasoline all over the place. He has never been in a fire in such a situation. (He was, in fact, criticized by bystanders for not getting a gasoline soaked victim out of one vehicle, immediately! His answer was, “Where did they think I was? I was concerned about fire too! But, there was none”) But, he also knows that gasoline, usually takes a spark or flame to ignite and even a cigarette is not hot enough, except when you are taking a drag, to usually light the gasoline.

    But, I would never expect a young girl, with, who knows what, training to have that knowledge to work with. She should not be held accountable for her IGNORANCE. Don’t make too many assumptions about a bystander’s knowledge. I am not impressed with the medical knowledge of the average person!

    And, bobzbob, to try to make a point that the spinal cord was not likely injured from that crash, but by the removal of the victim, seems to be very unlikely, as well. If the girl was paralyzed and unable to get out, the damage was, more likely than not, already caused by the accident. A force, strong enough to disrupt the bones and ligaments in the back, would also be strong enough to transect the spinal cord. (it is very soft) It would be impossible for even a trauma doctor or neurosurgeon to tell the difference, after the fact!

    And, even being the field, I have never heard of too many people that walk after broken backs with spinal cord damage. It happens, but is not real common. Compression fractures are a completely different story, and usually result in no spinal cord damage.

  20. #20 |  Saladman | 

    I think on balance good samaritan laws are important enough they should be upheld, rather than weakened for everybody because of a singular event. This may be an instance of a bad case making bad law.

    A more useful and direct response to the problem (if less renumerative) would be to organize a public information campaign about not moving accident victims. This is something a lot of people don’t know, and its unfortunately a natural impulse for people without first aid training. But it is often the wrong thing to do.

  21. #21 |  Jet | 

    Of course the move is being characterized as “like a ragdoll” by the plaintiff, whomever the original plaintiff is. They can’t very well sue Torti for liability if they say that Torti took all possible care, can they?

    I think something that hasn’t been pointed out, except tangentially, is that everyone else walked away from this accident. Why should Torti have had any suspicion that Van Horn had suffered a spinal injury? Unless there was something visibly and clearly wrong, moving Van Horn from the immediate scene seems pretty reasonable to me, especially if Torti had concerns about fire.

    So, to answer the original question, I think each case needs to be looked at on its merits. Which, apparently, a lower court judge already did. I’m not at all as familiar with the legal system as I should be. Why is it that in a criminal case, a verdict of not guilty is the end of it, but in civil cases it seems a plaintiff can continually re-word their complaint until they manage to get something that sticks?

  22. #22 |  Cynical In CA | 

    #44 | Dave Krueger | December 22nd, 2008 at 1:11 pm
    “I blame television. Cars always explode on TV.”

    For a wonderfully entertaining website, please visit http://www.intuitor.com and read the “insultingly stupid movie physics” as well as the movie reviews. I apologize in advance for wasting an entire day of your life, but it will be well spent.

  23. #23 |  Cynical In CA | 

    #62 | Brandon Bowers | December 22nd, 2008 at 2:33 pm

    “I think basing a legal precedent on this case is ridiculous. First of all, people in California are friggin’ morons, with the notable exception of Cynical in Ca, and I agree that cases like this should be decided individually.”

    I am flattered. Brandon, you demonstrate a cogent awareness of Californians in general. It is raining today — nothing demonstrates you point more aptly than watching [Southern] Californians drive in the rain.

    FWIW, I believe that “stare decisis” is among the worst attributes of the legal system, with pleabargaining nipping at its heels. Every single case on its own merits heard by a jury or nothing. Preferably nothing.

  24. #24 |  Cynical In CA | 

    Steve, in fairness to Brandon, I don’t think he knows you hail from Chino, am I right? So that makes two of us exceptions to the CA moron rule.

  25. #25 |  Vlad | 

    I’m not sure how many people here have ever actually been in a life-and-death situation, where they have to decide whether to step in as a Samaritan or not. I’ve done it twice: Once as a kid where I jumped into a pool to grab a toddler who couldn’t swim, and once a couple of years ago when I gave the Heimlich to a lady at work who was choking on a bagel. When you’re in a situation like that, there isn’t any conscious rational thought as to whether you should do this thing or that thing or the other thing. You’re in an absolute blind panic, operating on a combination of training (if you have any) and instinct. I was lucky enough to know what to do in both cases without really having to think about it, but I’d have a hard time blaming a Samaritan for anything but the most egregious stupidity in an emergency situation.

  26. #26 |  angulimala | 

    1. I’m no EMT and I’ve been taught that, if you are not an EMT, you DO NOT move a person in an accident unless there is IMMINENT and PRESSING danger justifying it.

    If they can’t move under their own power, it is usually because they have injuries that can only be made worse by yanking on their bodies.

    I learned this crap in Middle School Health class – not some special course. Maybe it isn’t common knowledge, but I think it is and it definitely should be.

    2. Considering how easily cars blow up on TV – a single pistol shot often being enough to blow one up – it doesn’t surprise me that ignorant people would rush to assume that a car is going to blow based on what looks like bad damage.

  27. #27 |  Marty | 

    well said, Vlad!

    these are ‘true emergencies’- people have to make immediate decisions, to the best of their abilities. you obviously made the right decisions- congratulations!

  28. #28 |  Jason | 

    This is a really tough one. It’s hard to imagine that the friend would have gone through the trouble to pull the victim out of the care with anything other than noble intentions. You’d really have to know the details of the case to decide.
    http://rightklik.blogspot.com/

  29. #29 |  Brandon Bowers | 

    Sorry Steve, I’ve seen some of your posts, so I naturally assumed you weren’t from California.

  30. #30 |  edintally | 

    Radley, you are freaking me out! My 1L friend and I just had this conversation about this very topic today: Duty to Rescue

    Salvo,

    I agree with what you are saying BUT (there is always a but), eight states (I think: can’t find citations) do have laws about a Duty to Rescue. My google-fu has been weak on this topic. Apparently, Florida has something on the books but I’m still trying to get the specifics.

    Opinion: While I generally agree that someone does not have a duty of care, I don’t think it is unreasonable to consider the possibility that in some rare (very if you like) cases, a person should be held liable for not rendering ANY aid.

    This case: The facts of the case should be assessed in the courtroom. However well intentioned this girl was, she may very well have been negligent. Or not. In any case, I doubt it would have much impact on how people respond to others in an emergency.

  31. #31 |  Nick T | 

    For those clowns posting here about how cars can’t explode…. Well, then how do you explain this!!

    http://www.youtube.com/watch?v=AScxr4nJvMc

    ;)

  32. #32 |  Helmut O' Hooligan | 

    “If, however, a person elects to come to someone’s aid, he or she has a duty to exercise due care,” he wrote.

    I’m not so sure about that. If Torti is not a licensed EMT/paramedic, nurse, physician, or a first responder such as a police officer or firefighter, how can the court expect her to understand proper protocol for removing a MVA victim from a car when she felt (rightly or wrongly) that exigent circumstances existed. Did the court expect a regular citizen in extraordinary circumstances to know precisely how to immobilize the c-spine during an emergency move? Vlad (#75) is absolutely right about how people react in these situations. No, Torti probably should not have moved the victim, but I think her actions clearly in good faith.

    This is unfortunate, and it could give people pause when they see someone that needs a hand. It may also embolden those that think we have to rely solely on government agencies or “experts” during emergency situations. Voluntary action is important. You and your neighbors are the first line of defense. Police, Firefighters, EMT’s and others in protective services are the second line of defense. Poor decision, in my opinion.

  33. #33 |  andyinsdca | 

    Something has occurred to me reading these. The thoughts aren’t totally coalesced, but here goes:

    The government doesn’t want us helping ourselves. AT ALL. They don’t want us protecting ourselves and they don’t want us helping our neighbors in emergency situations. That’s what THEY are for. To protect us from all of the harm that can come. YOU are too stupid to do it on your own.

  34. #34 |  Michael | 

    Nick T,

    I did not see anyone saying that cars do not explode (or catch fire). What was said is that they do much less frequently than one would believe by watching movie or TV accidents. This fear would cause a person, who did not know better, to think that a fire was imminent and pull an injured person away from the wreckage, which is rarely needed.

    The movie example, you linked to, of such an explosion is great evidence of this. Of all the front end accidents that occur, there are not very many car fires involved. And the gas tank on the van was actually located further up the side, nearer to the front. With the low velocity and force of the accident, both vehicles would have likely been drivable, afterward, realistically, with no fire involved. But not in the movies!

    Oh, not only was my dad an EMT, we also drove wreckers for many years and we witnessed only one accident that resulted in a fire. That was when, at highway speed of 65mph, a Ford Torino lost control and spun backwards running into another car (backwards head on) in the other lane, rupturing the Ford’s gas tank. Five people were burned to death in that accident, that day. Witnesses could not get them out of the burning cars. Two adults and three kids. I was about 16 at the time. We got there after the fire was out.

  35. #35 |  Brent | 

    Everything seems to hinge on whether the samaritan can prove whether there was good reason to believe the car would catch fire. How does the parapalegic prove that her injuries were caused by being pulled from the wreckage and not from the crash itself? It’s impossible to decide accurately unless these two things are factored in. Until then, you have to leave doubt for whether the rescuer acted overzealously to earn the exalted ‘hero’ title or the rescuee is just out for a payday.

  36. #36 |  Kevin | 

    I think this is a truly stupid decision that will undoubtedly cost people’s lives. Oh, and every few years California keeps trying to create a duty to rescue.

    The US is crazy about spinal immobilization due to asshole lawyers. In the rest of the world they don’t go crazy about strapping people to backboards. And as a result they have LESS spinal injuries, because it’s not benign to strap someone to a backboard. It typically results in injuries, as the average time that are on the backboard is 90 minutes, and it is sometimes many hours. Try lying immobile on your back on a concrete floor for an hour and a half some time. Plus it greatly increases the chance of aspiration as you’ve made them unable to protect their airway.

    If you doubt this look up “Out-of-hospital Spinal Immobilization: Its Effect on Neurologic Injury. 1998” in a good library.

  37. #37 |  Helmut O' Hooligan | 

    #85 Kevin:
    Interesting point about spinal immobilization. I work in a healthcare setting, and I have also had to lay on a backboard after a minor car accident (I was rear-ended). I know for a fact that it really sucks to lay on those things for extended periods. Patients complain of discomfort regularly. The drunks really hate the neck braces too.

  38. #38 |  mattincincy | 

    Between this story and the final episode of Seinfeld I don’t know what to do. I think I’ll stay home.

    We need to stop suing each other. Period.

  39. #39 |  Justin | 

    I got bored reading comments around #30 or so, so if this has been addressed, I apologize. The thing a lot of people commenting don’t seem to take into consideration is that the two people were friends. It easy to say, “Well, I’ll never stop and help a stranger again.” Is it that easy to say that you would never help your best friend in an emergency again? Odds are that you wouldn’t expect a friend to try to sue you for saving them. It wouldn’t even be something that you wouldn’t consider at the time. Your initial reaction would most likely be “I need to save my friend!” That being said, I believe that Torti behaved in a reasonable fashion: as a human being.

  40. #40 |  Michael | 

    Talking about immobilization devices,

    If someone started vomiting on a backboard, they would have to be turned on their side. That would have been hard to do with one guy in the back of an ambulance! And the people really did complain until they got off of those things.

    I often took immobilization devices off, after doing an exam on the neck and back to see if there were signs of tenderness, thus trauma. Too many were put on as knee-jerk responses by the ambulance staff at the scene. (But, in all honesty, they did the right thing, because of their limited training) On all of the patients that I removed the cervical collar, after a meticulous exam, no fractures were ever found on the x-rays.

    I still lost my job as an ER moonlighter, in that particular hospital, because some other goon (ER doc) did not check the patient, then sent the patient to X-ray, and the collar was removed in the x-ray department on a patient with a broken neck! The head nurse thought I was the crazy one! I hope if I get into an ER situation like this, my doctor has a lot better judgment,and does his job better, than the goon!

    I have too much time on my hands. I am commenting way too much! I will stop!

  41. #41 |  Barak A. Pearlmutter | 

    The publications below are very interesting, and may indicate that the current common “immobilize everyone on a back board at all costs until after x-ray no matter how much they want to wiggle” policy may be motivated to some extent by fear of lawyers rather than by rational calculation of tradeoffs. Would be very interesting to study how the current policies came to be.

    NOTE TO THE STUPID:

    The take home lesson from the below is *not* that you
    should flop people with spinal injuries around like rag
    dolls. DO NOT DO THAT! Regardless of the below, be
    careful not to hurt people with spinal injuries.

    NOTE TO THE STUPID: REREAD PREVIOUS PARAGRAPH!

    —————————————————————-

    Hauswald M, Ong G, Tandberg D, Omar Z. “Out-of-hospital spinal immobilization: its effect on neurologic injury”, Acad Emerg Med 5(3):214-9, Mar 1998. PMID: 9523928

    Abstract:

    OBJECTIVE: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries. METHODS: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables. RESULTS: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03-3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64-3.62; p = 0.34). CONCLUSION: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.

    —————————————————————-

    Mark Hauswald and Darren Braude. “Spinal immobilization in trauma patients: is it really necessary?” Current Opinion in Critical Care 8(6):566-70, Dec 2002. PMID: 12454543

    Abstract:

    The acute management of potential spinal injuries in trauma patients is undergoing radical reassessment. Until recently, it was mandatory that nearly all trauma patients be immobilized with a back board, hard cervical collar, head restraints, and body strapping until the spine could be cleared radiologically. This practice is still recommended by many references. It is now clear that this policy subjects most patients to expensive, painful, and potentially harmful treatment for little, if any, benefit. Low-risk patients can be safely cleared clinically, even by individuals who are not physicians. Patients at high risk for spinal instability should be removed from the hard surface to avoid tissue ischemia. Understanding the rationale for these changes requires knowledge of mechanisms of injury, physiology, and biomechanics as they apply to spinal injuries.

  42. #42 |  Brian | 

    Judging by the comments, not enough people have actually read the decision. As far as I can tell, the majority decision is whether a particular law on the books in CA protects people who provide “emergency care” really means “emergency medical care”. I’ve read the decision (which you really should do before you comment) and I disagree with the prior post that said the reasoning of the majority was weak. The court fairly meticulously lays out the logic for its decision, from the name of the act and division wherein this law is located to the legislative history of the act to the description in other sections of the same act that describe in more detail what things like “emergency” constitute. It comes down to whether you think the plain language of the statute (which would support Torti’s case) should trump what appears to be the intent of the statute. Based on the description of what happened given in the background, this seems like something that, in my opinion, should go to trial.

  43. #43 |  Daniel Quackenbush | 

    The case still goes to the jury. The jury might still find for the defendant.

    I doubt few juries would actually hold the rescuer liable for acting reasonably.

    The example that a person can’t be removed from a burning vehicle because of this ruling is absurd. When there is a fire, it would not be negligence to remove the injured person before stabilizing the spine. The injury to the plaintiff was not strict liability; negligence is still required.

    Disclosure: I once met the plaintiff (she was in a wheelchair) at the law library and spoke to her awhile about her case.

  44. #44 |  Andrew Williams | 

    If Van Horn didn’t want to be helped, she should have crashed her car in an area where there were lots of witnesses. The more people witness an accident, the less likely the victim will receive aid–first or worst.