Medical Liability
Legal liability concerns for neonatal-pediatric transport providers involve malpractice liability, in addition to regulatory actions, licensure concerns, and the possibility of criminal charges in the most extreme cases.
Transport providers may primarily be concerned with malpractice risk issues in legal discussions of liability, but the interactions of all types must be considered. In fact, violations of regulatory or licensure standards may be the basis for a malpractice allegation.Criminal
Unlicensed or substandard operations are the most likely to result in criminal charges. Issues of unlicensed operation may occur when transport units cross state lines to pick up or deliver patients.
It is essential that transport teams have a clear understanding of neighboring state laws and licensure clearance before responding across a state line. Reciprocal agreements or multistate licensure may be required to ensure that medical care may be legally performed in a neighboring jurisdiction. In the case of rotor- and fixed-wing aircraft services, the issue may extend to an even greater radius of potential service. Responses into some states, whether by rotor- or fixed-wing aircraft, may be prohibited by state or local law except in cases of disaster. It is the responsibility of the transport service's legal counsel to determine the types of clearance needed in each potential destination state and to obtain the appropriate permissions, licenses, and/or waivers needed and educate the teams on the requirements. In addition, the service should ensure that its malpractice and liability policies are in effect when traveling to other states.
Licensure
Failure to meet or maintain the standards and requirements for licensure can result in actions against the service and individual personnel. These actions can result in fines, probationary status, suspension, or revocation of licenses. It is imperative that any licensed transport clinician who potentially will be dispatched to another state check with neighboring states for rules governing practice while in another state. Most states allow a licensed clinician working for their team to aide with stabilization and transport of a patient back to his or her own facility. If a specific team routinely performs third- party transports or telemedicine consults to facilities in another state, it is recommended that their staff be licensed in those specific states being served. Similar rules apply for administering drugs and controlled substances while on transport.