Can hospitals treat crash victims without ICER? CDRRMO says yes

By Rjay Zuriaga Castor

ILOILO CITY – Hospitals and other capable agencies may respond directly to victims of road crashes and other emergencies, because no standing protocol requires the Iloilo City Emergency Responders (ICER) to reach a patient first, the Iloilo City Disaster Risk Reduction and Management Office (CDRRMO) said.

Darwin Joemil Papa, chief of the CDRRMO Emergency Response Division, said no rule requires ICER to handle an injured person before that person can be brought to or treated by a hospital.

“In terms of requiring us to handle the patient first before bringing the patient to the hospital, we do not have such a rule. It is not only here [in Iloilo City] but also across the country,” Papa said Thursday, Sept. 10.

Papa issued the clarification after an Aug. 27 incident in which a private hospital in Mandurriao allegedly refused to attend to a motorcycle delivery rider who was involved in a vehicular accident just a few meters from the hospital emergency room.

Hospital staff allegedly refused to bring out a stretcher or provide first aid to the injured rider and instead instructed a witness to call ICER.

The rider died two days later, on Aug. 29, while being treated at the Western Visayas Medical Center in Mandurriao, some three to four kilometers away from the crash site and the private hospital.

The Western Visayas Medical Center is the Department of Health regional referral hospital for Western Visayas and receives most public emergency and trauma cases in Iloilo City.

The Iloilo City Council on Wednesday, Sept. 9, approved a resolution by Councilor Sedfrey Cabaluna calling for an investigation in aid of legislation into the city’s hospital emergency response protocols, with the matter referred to the Committee on Health.

Papa stressed that no standing protocol determines which agency should always respond first to a vehicular crash or other emergency.

“When we talk about responding to patients, such as in vehicular crashes or any emergency, there is no standing protocol on who should respond first or who should handle the patient,” he said.

He said the CDRRMO has its own standard operating procedures governing how its personnel respond to vehicular crashes and other incidents on the road, and that nothing prevents other agencies or medical facilities from responding to emergencies within their capabilities.

“There is actually nothing preventing agencies or facilities from accepting patients,” he said.

Papa said the CDRRMO regularly reminds barangay officials and other agencies during training that people who encounter an emergency should immediately seek help from trained emergency responders if they are not equipped to provide first aid.

“We always advocate during our training in barangays and agencies that if there is nobody trained to assist the patient, the best thing they can do is to call our emergency medical services, the CDRRMO, the Bureau of Fire Protection, or the Philippine National Police,” he said.

This allows emergency responders to assess and handle the patient properly while minimizing the risk of further injury, he said.

Legal risks, hospital capacity

Papa pointed to the absence of a Good Samaritan law in the Philippines as one possible reason some people may hesitate to assist victims during emergencies, particularly when they are not trained in emergency medical services.

A Good Samaritan law, which is common in many Western countries, generally protects people who provide reasonable assistance during emergencies from liability for unintentional mistakes.

Papa said the absence of such legal protection could contribute to hesitation among individuals or facilities that are not equipped with specialized emergency medical services.

Philippine law already imposes obligations on medical facilities themselves. Under Republic Act No. 10932, which strengthened the Anti-Hospital Deposit Law in 2017, it is unlawful for any officer, medical practitioner, or employee of a hospital or medical clinic to refuse to administer medical treatment and support as dictated by good practice of medicine to prevent death or permanent disability in emergency or serious cases.

Violators face imprisonment of six months to two years and four months, a fine of PHP 100,000 to PHP 300,000, or both, with revocation of the license to operate possible for repeat offenders.

Papa said hospital capacity can also affect how quickly patients are accommodated, particularly in public hospitals in Iloilo City that receive patients from across Western Visayas.

He said these facilities frequently operate at full capacity, which can result in delays in accommodating patients or arranging their transfer to another facility.

Papa clarified that such situations do not necessarily mean hospitals are refusing patients.

“There are instances when our hospitals are already full. That is why there are times when it may take longer to accommodate a patient or for the team to receive the patient inside the hospital,” he said.

Papa also acknowledged that some patients face difficulties being transferred to another facility because of financial constraints.

Pending national measures

Papa said responding to an emergency should not be viewed as the sole responsibility of ICER or any single government agency.

“It is not only the responsibility of ICER or any agency. It is the responsibility of everyone,” he said.

Papa also urged the public to use the Unified 911 emergency system, which connects callers with trained dispatchers who can relay information to the appropriate responding agency.

“The very fact that you informed the authorities or emergency services is already helping the patient. It is our moral obligation,” he said.

Rather than relying solely on a local ordinance, Papa said the national government should pass a Good Samaritan law to encourage bystanders to assist injured or ill people without fear of potential legal consequences.

Papa also pointed to pending measures seeking to institutionalize a nationwide Emergency Medical Services System, which would establish national standards and strengthen the coordination and delivery of emergency medical services across the country.

Versions of the measure have been filed in Congress since 2004, when Senate Bill No. 82 on emergency medical services and trauma care was introduced in the 13th Congress, and have repeatedly lapsed without becoming law.