The laws in Maryland regarding assaulting an EMS clinician or other public safety professional make it difficult to immediately charge and have an offender arrested on the scene unless there are significant criteria that is met.
One Maryland paramedic plans to press charges after being assaulted in the back of an ambulance during a transport because she believes the offender will strike again.
Video: Gordon Graham on violence prevention
An unprovoked attack
Just before 7 p.m., the in-station alert at Hagerstown鈥檚 Community Rescue Service activated for a reported man down. The paramedic crew responded, and found local city police already on the scene. The call presented like many routine calls handled by CRS, the busiest EMS operation in Washington County, Maryland. CRS handles over 20,000 calls for assistance from four stations annually.
During the transport, the call quickly turned violent.
I spoke with the paramedic involved. 鈥淚 was precepting a new hire EMT and we were following standard patient care protocols,鈥� she told me. The transport from Hagerstown鈥檚 downtown district to Meritus Medical Center is relatively short. 鈥淭he patient suddenly began yelling. I had the new hire move to the captain鈥檚 seat ... a safer location,鈥� she said.
鈥淭he patient stopped yelling, looked me right in the eye and he threw a punch,鈥� the paramedic said. 鈥淚 said, 鈥榟e is hitting me鈥� and dropped the mic.鈥�
The patient reportedly struck the paramedic in the hand.
鈥淚 have never been afraid. But I was fearful,鈥� the paramedic said. She moved to a safer location as the patient continued to be aggressive. The crew was met in the ambulance bay by security.
After care was transferred to the emergency department personnel, the paramedic notified her duty officer and the local police. She requested to file a report. Officers told her that they wouldn鈥檛 be able to press charges because they didn鈥檛 witness the assault, she had no marks on her body and there wasn鈥檛 significant bodily injury.
鈥淚 just broke down. I was crying,鈥� she recalled. 鈥淚 couldn鈥檛 believe that there was nothing that could be done. The patient will get discharged and do this again to another clinician one day. People that assault EMS professionals need to be held accountable for their actions.鈥�
鈥淗e wanted to intentionally hurt me,鈥� she added. 鈥淭his wasn鈥檛 a combative patient, and someone got caught by a flailing extremity.鈥�
Increasing assaults
The trend for increasing assaults on public safety, specifically EMS professionals was identified over 20 years ago.
A 2002 report, outlines that on average, an EMS professional is violently killed on duty in the U.S. each year.
A 2017 CDC report, noted 2,000 EMS professionals are injured each year in a violence-related incident. This rate of violence-related injuries results in lost workdays for EMS professionals (22 times higher for EMS providers compared to the national average). More than half of EMS professionals assault injuries result in lost work time.
also published in 2017, reports female EMS professionals may have a disproportionately greater risk of violence-related injury.
The law regarding EMS assaults
鈥淯nder Maryland law, for a person who commits an assault against a first responder in the performance of their duties, the grading would be a felony second-degree assault,鈥� Frederick Police Department Chief of Police Jason Lando told me. 鈥淗owever, there is a caveat. There must be a physical injury beyond that which would be considered minor. If a paramedic gets punched and there is no significant injury as a result, it would be classified as a misdemeanor second-degree assault.鈥�
Lando added that this does not mean charges cannot be filed, but a misdemeanor assault would not result in an on-scene/physical arrest ... unless the officer was there to witness it happen.
鈥淩ather, the case could be brought to court by way of a summons to appear. The victim could file charges if the suspect was identified or the investigating officer could file the charges on the victim鈥檚 behalf,鈥� Lando said.
Chief Lando emphasized that people may confuse the lack of a physical arrest on scene with charges not being filed. In both cases (summons versus physical arrest), the case goes to court. More and more, however, states are steering away from taking people to jail in many cases and opting to file charges by way of a summons.
The CRS paramedic intends to file charges in Washington County District Court because she believes the act was intentional.
鈥淗e will continue to be an offender until someone gets shot, stabbed or killed,鈥� she said, adding, that the next victim could be a police officer, firefighter, EMT, paramedic or hospital professional.
鈥淎t times, the laws that address assaulting a first responder can be broad and not clearly defined,鈥� Washington County Division of Emergency Services Director R. David Hays said. 鈥淭he Division of Emergency Services will fully support any first responder that is assaulted, using all means possible within the judicial process.鈥�
Preventing assaults against EMTs, paramedics
鈥淎ssaulting a firefighter, EMT or paramedic is not taken lightly, and we strive to make incident scenes and transports as safe as possible utilizing the most appropriate resources at our disposal,鈥� Hays said.
The optimal scenario is to be able to prevent the violence against EMS professionals by identifying scenes early.
鈥淲hen an emergency communications specialist interrogates a 911 caller, there are a series of questions built into the script that ask questions related to 鈥榓re there any weapons?,鈥� 鈥榠s the patient violent?鈥� If the call is an assault as example, the question would involve asking if the assailant is still on scene,鈥� Hays continued.
In Washington County, after a call is dispatched where the scene is not secure 鈥� meaning a weapon may be present, the patient or family member may be violent, or there are too many concerns for EMS to enter safety 鈥� law enforcement is dispatched first. Additionally, dispatchers add 鈥渟cene is not secure鈥� to the end of the dispatch.
鈥淭his announcement creates an awareness of circumstances that are potentially harmful to the patient and, most importantly, the responders. Hearing this phrase institutes a standing protocol for responders鈥� actions related to response,鈥� Hays said.
Hays added that in some situations, the scene can deteriorate after EMS and fire units arrive. He says that crews should first try to remove themselves from the immediate area and request law enforcement. If crews cannot self-extricate or are involved in protecting themselves, they should activate their EAB on their portable radio and state their unit, location and situation if possible. By doing this, it will alert the communication center that there is a problem on the scene so law enforcement can be started.
After action
According to Hays, Washington County offers several resources to clinicians that may have been assaulted including:
- CISM available through the Department of Emergency Services
- A chaplain group through the Washington County Volunteer Fire and Rescue Association
鈥淎nytime a clinician is assaulted, whether it be by a patient or another individual involved in the incident, law enforcement should immediately be notified, and a report filed,鈥� Hays said.
鈥淲ith the ever-changing dynamics of society, we must remain vigilant and always maintain situational awareness, not only for our safety, but for the safety of our patient and others around us,鈥� Hays said.
This article was originally posted June 14, 2023. It has been updated.
