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<In an era of mass shootings, can ED staff recognize troubling signs in patients before they commit terrible acts of violence?>

Physicians Treating Shooting Victims: What Happens When Trouble Strikes Close to Home?

By Jonathan Springston, Associate Managing Editor, AHC Media

On Dec. 2, two shooters killed 14 people and wounded 21 others at a county social services building in San Bernardino, Calif.

One week after the event, physicians from the Arrowhead Regional Medical Center, a Level 2 trauma hospital in San Bernardino County that treated six of the victims, recounted the horrors of the day.

Despite being under lock down and the fact two of the victims were married to Arrowhead employees, one of California’s busiest emergency rooms continued to take in and treat patients. County officials praised Arrowhead for their determination despite the dire situation.

Mass shootings have become an all-too-frequent occurrence in the United States. More and more physicians across the country have become front-line responders to these tragedies, made even worse when physicians are related to the victims, as was the case in San Bernardino.

To prevent such tragedies, some Americans are calling for stricter gun control laws while others are calling for better recognition and treatment of individuals who may show troubling psychiatric traits that could lead them to take the lives of others.

The February 2016 issue of ED Legal Letter will be dedicated to insight on the legal risks of treating psychiatric patients. The cover story reports on how EDs can defend against allegations of inadequate psychiatric evaluation. Inside, other articles within the issue will cover the legal risks of boarding psychiatric patients for extended periods, report on malpractice suits involving frequent ED users with psychiatric complaints, and explore EMTALA requirements involving psychiatric patients.

The cover story specifically notes that if an ED treated a patient who later goes on to commit a mass shooting, the physicians could be held liable for that violent act. From the issue:

“In this era of violence and terrible mass shooting incidents, EDs are vulnerable as being a point of contact for dangerous psychiatric patients,” says Jonathan D. Rubin, JD, an attorney at Kaufman Borgeest & Ryan in New York City.

Eric J. Neiman, JD, an attorney in the Portland, OR office of Lewis Brisbois, says there is currently a “troubling” case before the Washington Supreme Court. The case involves a man who murdered his former girlfriend and one of her children. He had not indicated violent intent toward a specific victim to his psychiatrist.

“Nevertheless, the Washington Court of Appeals decided there was enough evidence to send the case to trial against the psychiatrist,” Neiman says. If the court upholds this decision, he warns, it could expand the potential liability of many mental health and medical professionals, including EPs.

“There could be a new wave of litigation around the country regarding medical professionals’ liability for violent acts of their patients,” Neiman says.