Athletic Trainer Availability for Health-Related Issues

With more schools than ever employing an athletic trainer, it is important for athletic administrators to understand what the athletic trainer can and should do, and when and where the athletic trainer should be with regard to conflicting events on the athletic schedule.

While the athletic administrator needs to ensure that all teams, coaches and athletes are taken care of, the administrator should also realize that due to having more simultaneous contests/ practices than the number of athletic trainers on staff, the number of athletic trainers employed for the district will, at times, not be adequate.

The athletic trainer cannot be in more than one place at a time, so the following should be considered in order that the district is not legally liable while still giving the athletic trainer some semblance of work-life balance that is so important in today’s day and time. The days of coaches being the ones to tape ankles, determining whether an athlete has been concussed, tending to what were once considered “run of the mill” health and safety concerns and issues of the athletes they coach, are in the past. While all coaches should be first aid and CPR certified, when a school does employ an athletic trainer, it is critical that person is the initial point of contact for a student with a medical issue.

Although the current norm is that the athletic trainer should be at selected contests and practices, there are practical limitations of their availability. Also, there are several types of employment models for athletic trainers.

The most common is that the athletic trainer is hired and paid by the school/school district. Another common approach is that the athletic trainer is contracted by the school/district and is hired and paid by a third party (e.g., a local hospital that serves the community.) Regardless of how the person is paid, the athletic trainer typically provides service to all athletes at practices and games as those athletes are on-site and can be seen by the athletic trainer on duty. This is where most interactions occur as practice makes up most of the physical activities, and contests only make up some of the activity.

As the following questions touch on potential liability regarding athletic trainer availability, a short review of liability and negligence is in order.

A legal duty is a legal obligation to act in such a way as to enhance safety of person/property. When there is an allegation that a harm resulted from a breach of a legal duty, that is called negligence.

Negligence can arise from affirmative actions that are determined to be unreasonable under the circumstances, or failure to act in a reasonable manner in the execution of legally required duties. Negligence is the failure to exercise reasonable care in the execution of one or more specific aspects of an interscholastic athletics program.

Generally, negligence allegations cite commission of a hazardous act or omission of reasonable act or duty (failure to act) in the performance of supervisory responsibility. In either case, acts of omission or commission may serve as both the actual cause and the proximate cause of an injury.

The Four Elements of a Claim of Negligence Are:

1. Duty – The defendant (school/district/athletic trainer) owed a specific duty, an obligation of reasonable care under all circumstances to ensure (not guarantee) that the participants in an activity (including spectators) are as reasonably safe as they can be during the activity;
2. Breach – That the defendant (school/district/athletic trainer) breached the duty of reasonable care;
3. Causation – The breach of the duty was both the actual and proximate cause of damage, and
4. Damage – That the breach was foreseeable and actually caused PROVABLE compensable personal and/or property injury/damage.

The 14 Duties Are –

1. Duty to Plan
2. Duty to Supervise
3. Duty to Select, Train and Supervise Coaches
4. Duty to Provide Proper Technique Instruction
5. Duty to Provide Warnings
6. Duty to Provide a Safe Playing Environment
7. Duty to Provide Protective Athletic Equipment
8. Duty to Evaluate the Conditioning of Athletes
9. Duty to Evaluate for Injuries and Incapacities
10. Duty to Match and Equate Athletes
11. Duty to Provide Immediate Medical Assistance
12. Duty to Develop an Emergency Medical Response Plan
13. Duty to Provide Safe Transportation
14. Duty to Disclose Insurance Coverage and Other Information

Reminders:
Reminder 1 – The law of negligence is not a guarantee that nothing bad happens – the law exists so that if something does happen that was foreseeable under very specific circumstances, the injured party can seek relief. The athletic trainer relationship with the school/district is frequently one of agency – the athletic trainer is the agent of the school/district as it relates to many of the 14 duties. That means in many aspects, the school/district is only as good as the athletic trainer conduct under the circumstances of dispute.

Reminder 2 – Unless the athletic trainers are required to be at practices/contests by law or by school/district requirement, athletic trainer availability is gratuitous, meaning the service is offered but not required. But no matter what, if an athletic trainer is on-site to render services, the athletic trainer has a duty to exhibit reasonable conduct in the execution of his or her duties. The school-provided athletic trainer certainly links the schools to the 14 duties above – specifically Duties 9, 11 and 12.

Question 1 – A school has multiple contests being held simultaneously. If there are more events than staff athletic trainers, how should the athletic trainer/athletic administrator assign coverage?

Answer 1 – There should already be a well-established protocol of duty availability by the school/district in determining what will be covered when there are too many events to cover. Typically, there is a hierarchy of contest need – the high-risk sports (football, soccer, wrestling, etc.) will constitute the highest priority. This hierarchy should be written out and discussed with coaches and the community so that everyone is aware. Typically, home varsity contests are the first priority, followed by away varsity contests. If the visiting team will not have an athletic trainer available, it is important that information is conveyed to the home school. The home school will know that there will not be a visiting athletic trainer at the contest and can plan for the fact that they will be servicing the visitors as well.

Question 2 – Because of limited facilities, school teams may have practices that go from 6 a.m. to 9 a.m. or until 10 p.m. at night. Should the athletic trainer be available for all of them?

Answer 2 – The athletic trainer should be available for all the practices. But the definition of “available” may mean that the athletic trainer can be reached via phone and is not necessarily at the site.

Question 3 – A school hosts a spring/summer league where loosely organized teams made up of athletes from that school participate. What is the liability of the school if the athletic trainer doesn’t cover the games?

Answer 3 – If there is no law, well-established practice or a school/district rule that requires an athletic trainer to be available for such an activity, there is no duty to provide an athletic trainer. Consequently, the school/district would have no liability if it does not provide an athletic trainer. Make sure to provide information so participants are aware there will not be athletic trainer.

Question 4 – A school hosts summer strength and conditioning workouts. The athletic trainer is not on contract and does not attend. What is the liability to the school?

Answer 4 – Any liability of the school would not be because there was an absence of an athletic trainer, but would most likely arise due to other, non-athletic trainer-related reasons – lack of supervision, mishandling an injury, improper coaching, etc., the normal breach(es) of the 14 duties to which school/districts are bound.

Question 5 – What is the liability to the athletic trainer/hosting school when the visiting school sends a team without an athletic trainer. Can/should the host athletic trainer tape, evaluate or make return-to-play decisions for the student at the other school?

Answer 5 – It would be “bad practice” to be at a contest and not tape, not evaluate, not make return-to-play decisions, or otherwise render aid to visiting teams that come without an athletic trainer. The “legal” way to look at it is whether the athletic trainer, independently, or the host school/district had a duty to tape, evaluate, make return-to-play decisions, and otherwise render aid to a visiting team. Such a decision maybe could withstand legal scrutiny, but it would “look” bad, and could encourage lawsuits. Certainly, liability could extend from the host athletic trainer doing a “bad job” on the visiting athlete, and not meeting the standard of care required. It also may be that a “good Samaritan”¹ law would strongly encourage the athletic trainer to act even if not legally required to do so. But under the concept of best practices, home athletic trainers should be expected to, and should expect to, help visiting teams.

In the end, all parties want the same thing – providing both preventive and needed health care for athletes. Understanding the limitations of the availability of athletic trainers, schools/districts need be creative. A suggestion would be that league/district/other school groups adopt a league rule to create understanding of when the parties can expect the services of a visiting team’s athletic trainer. This understanding and agreement goes a long way to making sure all parties are aware of the availability of athletic trainer services at all contests.

Resource

1. Good Samaritan laws have their basis on the idea that it is good “public policy” to limit liability for those who voluntarily perform care and rescue in emergency situations. It is well known that medical emergencies outside of the umbrella “medical setting” or “clinical environment” are common. The general principle of most versions of the good Samaritan law provides protection from claims of negligence for those who provide care.

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Author: David Keech

David Keech is a retired teacher and works as a sportswriter, sports official and as an educational consultant. He has reported on amateur sports since 2011, known as 'KeechDaVoice.' David can be reached at [email protected]