Chapter 4. Limitation on Liability for Medical Care or Assistance in Emergency Situations.
§ 7–401. Limitation on liability for medical care or assistance in emergency situations.
(a) Any person who in good faith renders emergency medical care or assistance to an injured person at the scene of an accident or other emergency in the District of Columbia outside of a hospital, without the expectation of receiving or intending to seek compensation from such injured person for such service, shall not be liable in civil damages for any act or omission, not constituting gross negligence, in the course of rendering such care or assistance.
(b) In the case of a person who renders emergency medical care or assistance in circumstances described in subsection (a) of this section and who is not licensed or certified by the District of Columbia or by any state to provide medical care or assistance, the limited immunity provided in subsection (a) of this section shall apply to such persons; provided, that the person shall relinquish the direction of the care of the injured person when an appropriate person licensed or certified by the District of Columbia or by any state to provide medical care or assistance assumes responsibility for the care of the injured person.
(c) A certified emergency medical technician/paramedic or emergency medical technician/intermediate paramedic who, in good faith and pursuant to instructions either directly or via telecommunication from a licensed physician, renders advanced emergency medical care or assistance to an injured person at the scene of an accident or other emergency or in transit from the scene of an accident or emergency to a hospital shall not be liable in civil damages for any act or omission not constituting gross negligence in the course of rendering such advanced emergency medical care or assistance.
(d) A licensed physician who in good faith gives emergency medical instructions either directly or via telecommunication to a certified emergency medical technician/paramedic or emergency medical technician/intermediate paramedic for the purpose of providing advanced emergency medical care to an injured person at the scene of an accident or other emergency or in transit from the scene of an accident or emergency to a hospital shall not be liable in civil damages for any act or omission not constituting gross negligence in the course of giving such emergency medical instructions.
(d-1) If the Mayor of the District of Columbia declares a state of emergency pursuant to § 7-2304, any act or omission of an emergency medical technician/paramedic (“Paramedic”), an emergency medical technician/intermediate paramedic (“EMT/I”), or an emergency medical technician (“EMT”), performed while providing advanced or basic life support to a patient or trauma victim shall not impose liability upon the Paramedic, EMT/I, or EMT, or any employer of the Paramedic, EMT/I, or EMT; provided, that the care is provided in good faith and does not constitute gross negligence.
(e) For the purposes of this section, the terms “emergency medical technician/paramedic,” and “emergency medical technician/intermediate paramedic,” and “emergency medical technician” mean a person who has been trained in advanced emergency medical care, employed in that capacity, and certified by the appropriate governmental certifying authority in the District of Columbia or in any state to:
(1) Carry out all phases of basic life support;
(2) Administer drugs under the written or oral authorization, including via telecommunication, of a licensed physician;
(3) Administer intravenous solutions under the written or oral authorization, including via telecommunication, of a licensed physician; and
(4) Carry out, either directly or via telecommunication instructions from a licensed physician, certain other phases of advanced life support as authorized by the appropriate governmental certifying authority.
§ 7–402. Health care professional volunteer assistance protection.
(a) A licensed physician, registered nurse, certified midwife, or advanced practice registered nurse certified or practicing in the specialty of obstetrics or gynecology who in good faith provides health care or treatment at or on behalf of a free health clinic operating lawfully in the District of Columbia without the expectation of receiving or intending to receive compensation shall not be liable in civil damages for any act or omission in the course of rendering the health care or treatment, unless the act or omission is an intentional wrong or manifests a willful or wanton disregard for the health or safety of others.
(b) A licensed physician, registered nurse, certified midwife, or advanced practice registered nurse providing medical care or assistance in obstetrics or gynecology in accordance with subsection (a) of this section shall provide and shall require his or her prospective client to sign a written statement witnessed by 2 persons in which the parties agree to the rendering of the health care or treatment.
(c) The immunity provided in subsection (a) of this section shall apply to any claim, arising out of health care or treatment given under subsection (a) of this section against:
(1) District of Columbia public health clinic; and
(2) a free clinic, and the District of Columbia as an indemnifier of such a free clinic, which meets the eligibility requirements of § 1-307.21(2).
§ 7–403. Seeking health care for an overdose victim.
(a) Notwithstanding any other law, the offenses listed in subsection (b) of this section shall not be considered crimes and shall not serve as the sole basis for revoking or modifying a person’s supervision status:
(1) For a person who:
(A) Reasonably believes that he or she is experiencing a drug or alcohol-related overdose and in good faith seeks health care for or administers an opioid antagonist to himself or herself;
(B) Reasonably believes that another person is experiencing a drug or alcohol-related overdose and in good faith seeks healthcare for or administers an opioid antagonist to that person;
(C) Is reasonably believed to be experiencing a drug or alcohol- related overdose and for whom health care is sought or to whom an opioid antagonist is administered; or
(D) Is a bystander to a situation described in subparagraph (A), (B), or (C) of this paragraph; and
(2) The offense listed in subsection (b) of this section arises from the same circumstances as the seeking of health care under paragraph (1) of this subsection.
(b) The following offenses apply to subsection (a) of this section:
(1) Unlawful possession of a controlled substance prohibited by § 48-904.01(d);
(2) Unlawful use or possession with intent to use drug paraphernalia as prohibited by § 48-1103(a);
(3) Repealed.
(4) Possession of alcohol by persons under 21 years of age as prohibited by § 25-1002; and
(5) Provided that the minor is at least 16 years of age and the provider is 25 years of age or younger:
(A) Purchasing an alcoholic beverage for the purpose of delivering it to a person under 21 years of age as prohibited by § 25-785(a);
(B) Contributing to the delinquency of a minor with regard to possessing or consuming alcohol or, without a prescription, a controlled substance as prohibited by § 22-811(a)(2) and subject to the penalties provided in § 22-811(b)(1); and
(C) The sale or delivery of an alcoholic beverage to a person under 21 years of age as prohibited by § 25-781(a)(1).
(c) The seeking of health care or administration of an opioid antagonist under subsection (a) of this section, whether or not presented by the parties, may be considered by the court as a mitigating factor in any criminal prosecution or sentencing for an offense that is not listed in subsection (b) of this section.
(d) This section does not prohibit a person from being arrested, charged, or prosecuted, or from having his or her supervision status modified or revoked, based on an offense other than an offense listed in subsection (b) of this section, whether or not the offense arises from the same circumstances as the seeking of health care.
(e) A law enforcement officer who arrests an individual for an offense listed in subsection (b) of this section shall not be subject to criminal prosecution, or civil liability for false arrest or false imprisonment, if the officer made the arrest based on probable cause.
(f) Notwithstanding any other law, it shall not be considered a crime for a person to possess or administer an opioid antagonist, nor shall such person be subject to civil liability in the absence of gross negligence, if he or she administers the opioid antagonist:
(1) In good faith to treat a person who he or she reasonably believes is experiencing an overdose;
(2) Outside of a hospital or medical office; and
(3) Without the expectation of receiving or intending to seek compensation for such service and acts.
(g) The Mayor shall compile and review overdose data to identify changes in the causes and rates of fatal and non-fatal overdoses in the District of Columbia and report the findings to the Council annually. The report may be part of existing mortality reports issued by the Office of the Chief Medical Examiner, and shall include enhanced data collection to measure the effect of this section. The report may include data on the following:
(1) Overdose deaths, including data separated by age, gender, ethnicity, and geographic location;
(2) Utilization of emergency rooms for the treatment of overdose;
(3) Utilization of pre-hospital services for the treatment of overdose;
(4) Utilization of opioid antagonists for preventing opioid overdose deaths;
(5) Utilization of 911 and other emergency service hotlines to seek and obtain health care for an individual experiencing an overdose; and
(6) Police arrests made in response to seeking health care for a person experiencing an overdose.
(h) The Department of Health shall educate the public on:
(1) The risk and frequency of overdose deaths;
(2) The prevention of overdoses and overdose deaths;
(3) The importance of seeking health care for individuals who are experiencing an overdose; and
(4) The provisions of this section, with a special emphasis on the education of subpopulations that may be at greater risk of experiencing or witnessing an overdose.
(i) For the purposes of this section, the term:
(1) “Good faith” under subsection (a) of this section does not include the seeking of health care as a result of using drugs or alcohol in connection with the execution of an arrest warrant or search warrant or a lawful arrest or search.
(2) “Opioid antagonist” means a drug, such as Naloxone, that binds to the opioid receptors with higher affinity than agonists but does not activate the receptors, effectively blocking the receptor, preventing the human body from making use of opiates and endorphins.
(3) “Overdose” means an acute condition of physical illness, coma, mania, hysteria, seizure, cardiac arrest, cessation of breathing, or death, which is or reasonably appears to be the result of consumption or use of drugs or alcohol and relates to an adverse reaction to or the quantity ingested of the drugs or alcohol, or to a substance with which the drugs or alcohol was combined.
(4) “Supervision status” means probation or release pending trial, sentencing, appeal, or completion of sentence, for a violation of District law.
§ 7–404. Prescribing authority of opioid antagonist for overdose victim and 3rd parties.
(a) For the purposes of this section, the term:
(1) "Community-based organization" means an organization that provides services, including medical care, counseling, homeless services, or drug treatment, to individuals and communities impacted by drug use. The term "community-based organization" includes all organizations currently participating in the Needle Exchange Program with the Department of Human Services under § 48-1103.01.
(2) "Health care professional" means a physician or pharmacist licensed under Chapter 12 of Title 3 practicing within the scope of practice for his or her profession.
(3) "Opioid antagonist" shall have the same meaning as provided in § 7-403(i)(2).
(4) "Overdose" shall have the same meaning as provided in § 7-403(i)(3).
(5) "Standing order" means a prescriptive order written by a health care professional that is not specific to and does not identify a particular patient.
(b) Except as provided in subsection (d) of this section, a health care professional acting in good faith may directly or by standing order prescribe, dispense, and distribute an opioid antagonist to the following persons:
(1) A person at risk of experiencing an opioid-related overdose;
(2) A family member, friend, or other person in a position to assist a person at risk of experiencing an opioid-related overdose; or
(3) An employee or volunteer of a community-based organization.
(b-1) An opioid antagonist issued in accordance with subsection (b) of this section shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.
(c) Except as provided in subsection (d) of this section, an employee or volunteer of a community-based organization acting in good faith and in accordance with a standing order or under a health care professional's prescriptive authority may dispense and distribute an opioid antagonist to the following persons:
(1) A person at risk of experiencing an opioid-related overdose; or
(2) A family member, friend, or other person in a position to assist a person at risk of experiencing an opioid-related overdose.
(d)(1)(A) A pharmacist may dispense or distribute, but not prescribe, an opioid antagonist pursuant to a written protocol and standing order.
(B) An employee or volunteer of a community-based organization shall not dispense or distribute an opioid antagonist under this section unless he or she completes training conducted by the Department of Health.
(2) The frequency of the training required by this subsection shall be determined by the Department of Health through rulemaking.
(3) The training required by this subsection shall include:
(A) How to screen a patient for being at risk of an opioid-related overdose;
(B) How opioid antagonists operate to stop an opioid-related overdose;
(C) When the administration of an opioid antagonist is medically indicated;
(D) How to properly administer an opioid antagonist and circumstances under which administration of an opioid antagonist is contraindicated; and
(E) Precautions, warnings, and potential adverse reactions related to the administration of an opioid antagonist.
(e) Upon prescribing, dispensing, or distributing an opioid antagonist, the health care professional or employee or volunteer of a community-based organization shall provide education and training to the recipient of an opioid antagonist. The education and training shall include:
(1) How to identify an opioid-related overdose;
(2) How to properly administer the prescribed opioid antagonist and circumstances under which administration is contraindicated;
(3) Precautions, warnings, and potential adverse reactions related to administration of the prescribed opioid antagonist;
(4) How opioid antagonists operate to stop an opioid-related overdose;
(5) The importance of seeking medical care for the person experiencing the opioid-related overdose immediately after the opioid antagonist is administered; and
(6) Information on how to access substance abuse treatment services.
(f)(1) A health care professional or an employee or volunteer of a community-based organization who prescribes, dispenses, or distributes an opioid antagonist in accordance with this section shall be immune from civil or criminal liability for the subsequent use of the opioid antagonist, unless the health care professional's actions or the actions of the employee or volunteer of a community-based organization with regard to prescribing, dispensing, or distributing the opioid antagonist constitute recklessness, gross negligence, or intentional misconduct.
(2) The immunity granted pursuant to paragraph (1) of this subsection shall apply whether or not the opioid antagonist is administered by or to the person for whom it was prescribed, dispensed, or distributed.
(f-1)(A) Nothing in this section shall be construed to require a health care professional to prescribe, dispense, or distribute an opioid antagonist to a person at risk of experiencing an opioid related overdose or a family member, or friend, or other person in a position to assist a person at risk of experiencing an opioid related overdose, or an employee or volunteer of a community based organization.
(B) A health care professional that does not prescribe, dispense, or distribute an opioid antagonist based upon his or her professional judgment shall be immune from civil or criminal liability, unless the health care professional's decision not to prescribe, dispense, or distribute an opioid antagonist constitutes recklessness, gross negligence, or intentional misconduct.
(f-2) Nothing in this section shall be construed to expand the scope of practice of a health care professional.
(g) Within 180 days after April 11, 2019, the Mayor, pursuant to subchapter I of Chapter 5 of Title 2, shall issue rules to implement the provisions of this section.
