Paramedic Appeals Ruling in Chapel Hill Football Player Wrongful Death Suit
There has been another development in a heartbreaking case from Orange County, North Carolina that has raised several important EMS questions. Atlas Fraley was a 17 year old Chapel Hill High School student who died on August 12, 2008 following a pre-season football scrimmage.
After the scrimmage, the 260 pound Fraley went home complaining of a headache and severe muscle cramps. His parents were at work, so he called 911. Paramedic James Griffin from Orange County Emergency Medical Services responded.
Fraley told Griffin he thought he was dehydrated, and specifically requested an IV. He advised Griffin that a previous dehydration experience from the previous summer was resolved quickly with an IV. Griffin refused to give him an IV, but told him instead to keep drinking fluids. When Griffin was unable to reach Fraley’s parents by phone, he allowed the minor to decline aid. The age of consent in North Carolina is 18.
When Fraley’s parents returned home, their son was dead. While the autopsy was inconclusive, the parents filed a wrongful death suit alleging negligence by Orange County EMS and Griffin. The focus of their case has been to raise two major questions:
- Should 17 year old Atlas Fraley have been transported to the hospital by EMS, rather than being left at home alone, after EMS responded to this young man's 911 plea for help; and
- If Atlas had been transported to the hospital, rather than left at home alone, would he more likely than not, have survived?
After an initial court ruling that found Orange County to have immunity protection, the parents dismissed Orange County and Orange County EMS from the suit, and have been proceeding against paramedic James Griffin individually. Last November Superior Court Judge Carl Fox ruled that the immunity law that protected the county did not extend to Griffin personally. According to the parent’s attorney, Donald Strictland, Griffin is covered by the county's insurance policy, so a finding of liability on his part will trigger policy coverage.
The latest news is that Griffin has opted to appeal Fox’s ruling now rather than wait until after trial. The North Carolina Court of Appeals is expected to hear the case later this year.
The case raises several important issues including: the ability of a 17 year old to decline aid in a state that says the age of consent is 18 (some states allow 14 year olds to consent for themselves); the capacity of someone suffering from heat related emergency (or any judgment impairing condition) to decline aid; the issue of abandonment; and the liability exposure of paramedics (as well as EMTs and firefighters) where statues only provide protection to public agencies.
This is a sad case based on the outcome but the deeper issue is the paramedic making a medical decision unilaterally and without apparent medical control direction. The other issue as presented is allowing a minor to sign a release document. This patient was not afforded the best possible care to create a favorable outcome. The minor asked for the right short term intervention (an IV) which was denied. The second course of possible treatment was a request for transport to a hospital based on his last experience with dehydration. Unknown if this was an option. The paramedic made the wrong decision and now will suffer the consequences. There are many good examples of great outcomes if the paramedic only practices within the limitation of their training. Here there is an appearance that the paramedic was practicing medicine outside of their scope of practice and allowing a minor to sign a document (AMA, Decline Treatment or other release document) was improper. A kid dies and the system is thrown into chaos paramedic sued. This is a sad but valuable lesson in the scope of practice issues.