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Paramedic Immunity: Coit v. Nappi 1
The Baltimore Medical Malpractice Lawyer Blog features Maryland appellate opinions in medical malpractice cases. This post addresses the legal standard for claims against Paramedics and EMTs and also the paramedic immunity that results for failing to meet the standard. Specifically, I will discuss the reported opinion in the case of Coit v. Nappi, 248 Md. App. 44 (2020).
Factual Background
The 21 year old patient died of a cardiac arrest following an asthma attack. Afterward, his parents and estate filed a wrongful death claim in the Circuit Court for Baltimore County. The defendants were a paramedic and EMT. They responded to the 911 call for the patient. An additional defendant was their employer, Baltimore County. The circuit court subsequently granted the defense motion for summary judgment, and the plaintiffs filed an appeal. (Op. at 1).
The paramedic & EMT argued that they were to receive paramedic immunity under CJP 5-603 (the Good Samaritan Act) and CJP 5-604 (Fire & Rescue Companies Act). In addition, Baltimore County argued it was to receive governmental immunity under CJP 5-301. The defendants further claimed contributory negligence by the patient and insufficient evidence of negligence. (Id. at 4).
The plaintiffs then responded that there was sufficient evidence of gross negligence and the defendants’ policies and customs kept them from receiving immunity. (Id.).
Appellate Court on Paramedic Immunity
The Court of Special Appeals adopted the opinion of the circuit court. (Id. at 2). The circuit court noted the Maryland definition of gross negligence is:
[G]ross negligence is an intentional failure to perform a manifest duty in reckless disregard of the consequences as affecting the life or property of another and also implies a thoughtless disregard of the consequences without the exertion of any effort to avoid them. (Id. at 6).
The plaintiffs asserted that the defendants were willful and grossly negligent in their pre-arrival and post-arrival and were not entitled to paramedic immunity. In the pre-arrival, the plaintiffs focused on the delayed response time, incorrect information to dispatch, and lack of urgency on arrival. The post-arrival allegations center on the assessment and treatment. (Id. at 8).
Evidence
The courts found that the evidence did not establish willful or grossly negligent pre-arrival conduct. The ambulance arrived less than seven minutes after the call for service. The responders’ failure to run from the ambulance to the patient was not negligent; it was specifically for the safety of the responders. (Id. at 9-10).
The courts also found that the evidence did not establish willful or grossly negligent conduct post-arrival, and paramedic immunity applied. The responders promptly assessed and treated the patient:
“They checked for a pulse, observed agonal respirations, placed an oxygen mask on Mr. Coit, prepared an intravenous line and began administering fluids, began transcutaneous cardiac pacing to address Mr. Coit’s heart rate, administered Narcan, and administered Atropine. Treatment and assessment of Mr. Coit’s condition continued after Mr. Coit was removed from the house and taken to the medic unit for transport to Northwest Hospital. He was intubated with an endotracheal intubation tube. Further assessment resulted in noting the absence of mechanical capture with transcutaneous pacing and agonal electrical rate without a pulse. Emergency medical service providers began administering CPR and administered Epinephrine during transport to Northwest Hospital. Upon arrival at Northwest Hospital, Paramedic Nappi reported to emergency department personnel regarding what treatment had been provided and the status of Mr. Coit’s condition.” (Id. at 10).
The plaintiffs claimed Narcan not needed because there was no indication that the patient was experiencing an opioid overdose. However, Narcan causes no harm. (Id. at 11).
As a result, the responders were to receive paramedic immunity based on the Good Samaritan Act and the Fire & Rescue Companies Act and to judgment as a matter of law (Id.).
Commentary by the Baltimore Medical Malpractice Lawyer on Paramedic Immunity
Past Maryland cases demonstrate how difficult it is to meet the willful conduct and gross negligence standard in cases against ambulance crews. You can read more generally about this in this Blog’s post on the case of Stracke v. Butler.
This Coit case does not come close to meeting the evidentiary standard to avoid paramedic immunity. The plaintiffs’ case seems to be based mostly on their perception and belief that the responders were not hurrying in their response and treatment of the patient. The case also included a complaint of unnecessary Narcan that caused no harm. Consequently, the defense’s summary judgment was predictable.
In part 2 of the post, I will address the issue of causation that the courts discussed.
Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.