Paramedic Causation: Coit v. Nappi 2
The Baltimore Medical Malpractice Lawyer Blog features Maryland appellate opinions in medical malpractice cases. This post is part 2 of the reported opinion in Coit v. Nappi, 248 Md. App. 44 (2020). It was a wrongful death case against an ambulance crew and the county. In this part 2, I address the issue of paramedic causation. In part 1, I discussed the plaintiffs’ failure to meet the evidence standard of willful or gross negligence and the resulting immunity for the paramedic and EMT.
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 an EMT. They responded to the 911 call for the patient, and their employer, Baltimore County, was also a defendant. The circuit subsequently granted the defense motion for summary judgment, and the plaintiffs filed an appeal. (Op. at 1).
The paramedic & EMT argued that they were entitled 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. (Id. at 4).
The plaintiffs then responded that there was sufficient evidence of gross negligence and that the defendants’ policies and customs, which they argued were not in line with standard emergency medical procedures, kept them from receiving immunity. (Id.).
The Court of Special Appeals adopted the opinion of the circuit court. (Id. at 2). The CSA rejected the plaintiffs’ assertion that the defendants were willful and grossly negligent in their pre-arrival and post-arrival and were not entitled to paramedic immunity. Paramedic immunity, as provided under the Good Samaritan Act and the Fire & Rescue Companies Act, protects emergency responders from liability when they are providing care in good faith. The courts found the evidence did not establish willful or grossly negligent conduct. (Id. at 9-10, 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.).
Appellate Court on Causation
The courts then turned to paramedic causation. They noted that the plaintiffs were required to establish causation even if there was evidence of willful conduct or gross negligence. To satisfy proximate cause, the conduct must be the cause in fact of injury. Cause in fact means that but for the wrongful conduct, the injury would not have occurred. (Id. at 11).
This case is analogous to a medical malpractice case, and expert testimony is crucial to establish causation. In this instance, the causation question was whether the patient would have been alive if the defendants’ conduct had differed. (Id.)
The plaintiffs did not submit any medical expert testimony to establish willful conduct, gross negligence, or causation. They sought to introduce causation testimony from the patient’s friend, who was present at the scene. However, he was not qualified to provide an expert medical opinion. As a result, the courts concluded that even if the plaintiffs had established willful conduct or gross negligence, their claims would fail for lack of causation evidence (Id. at 12).
Commentary by the Baltimore Medical Malpractice Lawyer on Paramedic Causation
Causation is among the most frequent appellate issues in medical malpractice and other personal injury cases. It is an element of negligence, and the plaintiffs’ claims here were based on negligence. The plaintiffs had to prove that the patient’s death was caused by the defendants’ willful or grossly negligent conduct.
Proof of the cause of death necessitates expert medical testimony. The cause of death is beyond the knowledge and expertise of a juror. For instance, the medical expert would have to link the death to the defendants’ conduct specifically. This would involve identifying the defendants’ conduct and how it resulted in death. It often also involves identifying what different conduct would have avoided death.
In the Coit case, the plaintiffs did not have a medical expert to testify on causation. This omission virtually guaranteed that they would lose the case on motion.
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.