Absence of a Doctor in the Ambulance Decision of the Council of State

In the incident subject to the full text of the Council of State decision below, the absence of a doctor in the ambulance during the transfer of the person injured in a knife attack to the hospital was not considered as a service defect of the administration and the Council of State upheld the decision of the first instance court rejecting the compensation claims. In our article, we have answered the questions of whether there is a doctor in the ambulance and whether there is such an obligation with the judicial decision and the articles of the regulation.

Decision of the Council of State

15th Chamber of the Council of State, 13.06.2016, 4533/4374

Summary of Request: As a result of the lawsuit filed with the claim for compensation for the material and moral damages allegedly suffered by Y.B., the children of the plaintiffs … and …., and the brother of ….., on 13/05/2008, while he was doing his internship training at the Akçakoca Teacher’s Training Centre in Düzce Province on the grounds that he lost his life due to the defendant administration’s failure to provide adequate and timely medical intervention by committing a service defect, the Sakarya 2nd Administrative Court;

In the report dated 22/06/2011 and numbered 2020 decision issued by the 1st Specialised Board of the Forensic Medicine Institution, in summary; “When the data in the forensic and medical documents prepared about Y.B, according to the clinical and autopsy findings, the death of the person was caused by bleeding with heart and lung damage due to sharp piercing instrument injury, this injury alone was fatal, the incident occurred between 18:40 – 18:50, the ambulance arrived at the scene at 18:52, the patient was admitted at 19:00:The ambulance arrived at the scene at 52, the patient was transferred to Akçakoca State Hospital at 19:00, the general condition was poor, the patient was unconscious, the blood pressure was 80/40 mHg, the intravenous line was opened and the patient was given fluid, the patient was transferred to Düzce University at 19:07 by ambulance accompanied by a physician, the patient was considered dead when he was admitted to Düzce University at 19:When the patient was admitted to Düzce University at 19:27, the patient was considered to be dead and when considered together with the damage caused by the injury determined in the autopsy, it was concluded that ” the absence of a physician in the ambulance that arrived at the scene and the transfer to Akçakoca State Hospital by opening the intravenous line and supplementing the fluid was in accordance with the rules of medicine”, In accordance with the aforementioned report, it is requested that the decision to dismiss the case on the grounds that there was no service defect in the event that resulted in the loss of life of the plaintiffs’ relative in the event that resulted in the loss of life of the plaintiffs’ relative, is reversed on appeal, claiming that it is not in accordance with the law.

Summary of Defence: It is defended that the court decision is in accordance with the law and the appeal should be rejected.

Opinion: It is considered that the appeal should be rejected.

ON BEHALF OF THE TURKISH NATION

The Fifteenth Chamber of the Council of State, which rendered the decision, listened to the explanations of the examining judge and examined the documents in the file:

Paragraph 1 of Article 49 titled “Reversal of the Decision” of the Administrative Trial Procedure Law No. 2577 stipulates that the Council of State shall revoke the decision examined as a result of the appellate review; a) A matter outside of its jurisdiction and authority has been dealt with, b) An unlawful decision has been made, c) The procedural provisions have not been complied with.

From the examination of the documents in the file and the allegations in the appeal petition, it has been concluded that the decision subject to the appeal request is in accordance with the law and procedure, and that there is no legal reason for the decision to be reversed.

For the reasons explained; it was decided on 13/06/2016 to reject the request for appeal, to APPROVE the decision of Sakarya 2nd Administrative Court dated 20/10/2011 and numbered E:2010/22, K:2011/1084, to send the file to the Court, in accordance with paragraph 1 of Article 54 of the Law No. 2577, to be open for decision correction within fifteen days from the day following the date of notification of this decision.

Is it compulsory to have a doctor in the ambulance?

The aforementioned decision brings to mind the question of whether the presence of a doctor in the ambulance is mandatory. It is necessary to look at Article 7 of the Regulation on Ambulances and Emergency Health Vehicles and Ambulance Services:

Ambulance and emergency medical vehicle personnel
ARTICLE 7 –(Amended: OG-4/12/2007-26720)

(1) Land ambulances;

a) (Amended:RG-10/4/2012-28260) A team consisting of at least three personnel shall serve in emergency ambulances. The team includes at least one physician or one paramedic or one emergency medical technician who has completed the module trainings determined by the Ministry of Health, another health personnel and a driver. Emergency medical technician or paramedic may drive the ambulance in case of necessity. In this case, there is no driver. In emergency ambulances without a physician, at least one of the personnel working in the patient cabin to intervene in the patient during transport must be a paramedic. Emergency medical technician who will work in emergency ambulances where there is no physician or paramedic; must have successfully completed the basic module, trauma resuscitation, advanced life support in children and adult advanced life support courses and received a certificate.

b) Patient transport ambulances are staffed by two personnel, at least one health personnel and one driver. An ambulance and emergency care technician (AABT) or emergency medical technician (ATT) can be employed instead of a driver. During patient transport, at least one health personnel is present in the patient cabin.

c) (Amended:RG-10/4/2012-28260) In specially equipped ambulances, at least two personnel, a physician or a paramedic and a health personnel, shall serve. A paramedic or emergency medical technician may be employed instead of a driver. Physicians and healthcare personnel who will work in intensive care ambulances must have successfully completed the basic module, adult advanced life support and trauma resuscitation courses approved by the Ministry, and physicians and healthcare personnel who will work in ambulances to be used for the transport of neonatal patients must have successfully completed the basic module and advanced life support in children (Additional phrase: RG-20/9/2013-28771) and/or NRP course approved by the Ministry and received a certificate.

As will be seen, the regulation does not require the presence of a doctor in the ambulance, whether it is an emergency ambulance, a patient transport ambulance or a specially equipped ambulance, but regulates in detail which healthcare professionals can be present as an alternative when there is no doctor in the ambulance.

This content has been automatically translated into English from the Turkish original.