Good Maryland Samaritan Act Malpractice Opinion

The Maryland Court of Appeals issued an opinion in TransCare v. Murray last week. It is an opinion you should read if you are handling tort cases – or litigating anything – in Maryland.

This medical malpractice involves the transportation of the minor Plaintiff by helicopter from the Emergency Department at Easton Memorial Hospital in Talbot County, Maryland to the Pediatric Intensive Care Unit at the University of Maryland Medical System in Baltimore City.

The Venue Battle

The first battle in Transcare v. Murray was venue. Plaintiff sued in Baltimore. Plaintiff argued that TransCare Maryland has its resident agent in Baltimore City, (2) the patient’s medical records show that the doctors at Easton called the University of Maryland ExpressCare, which is located in UMMS in Baltimore City to effectuate a transfer from Easton to Baltimore City, and (3) air transport went to the University of Maryland to pick up a team of health care providers and then transported those people to Easton.

Plaintiff’s lawyers also make another argument that we have tried to make as well (and also failed). If you need air transport during a serious medical emergency, this affects everyone in Maryland, including Baltimore City residents, equally. This never seems to work.

Judge Cox’s Venue Ruling

Judge Sylvester S. Cox, sitting as Motions Judge in the Circuit Court for Baltimore City, found that while venue was proper in Baltimore City, Talbot County was the more appropriate venue. Tough blow. Almost any personal injury case has a greater value in Baltimore City than it does in Talbot County.

What Were the Facts of TransCare v. Murray?

Let’s get to the facts. Plaintiff had trouble breathing because of congestion and was rushed to Eastern Memorial where he was fitted with an endotracheal breathing tube. However, because the hospital was not equipped to handle intubated children, the hospital arranged for a helicopter to transport the plaintiff to a pediatric intensive care unit at another medical center. Onboard the chopper was an employee of the defendant, a commercial ambulance company under contract to provide ground ambulance services between the medical center and area hospitals. Shortly after take-off, the plaintiff’s endotracheal tube became dislodged, which blocked his airway and led to a drop in his heart rate and oxygen blood level. Members of the flight team scrambled to find an air mask, but could not locate it. The helicopter then made an emergency landing, where the crew located the mask and re-intubated the plaintiff. The plaintiff’s cardiac activity returned to normal, and the helicopter completed its trip to the medical center.

Trial Court Dismisses Case

The plaintiff sued alleging medical malpractice. According to the plaintiff, the employee of the defendant failed to provide the requisite standard of care, and that the defendant was liable under respondeat superior. The plaintiff also claimed that he was left blind, deaf, and mentally disabled because of hypoxic brain injury from the incident. The defendant moved for summary judgment, arguing immunity arising from the Good Samaritan Act and the Fire and Rescue Act. Judge Sidney S. Campen denied the motion but then reversed himself and granted the defendant’s Motion for Reconsideration of their Motion for Summary Judgment. How often does that happen? Plaintiff appealed and the Maryland Court of Special Appeals reversed, ignoring the venue issue – a dead loser on appeal anyway – but finding that defendants could not use the Good Samaritan Act as a shield. Defendants then appealed to the Maryland high court.

How Did the Court of Appeals Rule in TransCare v. Murray?

First, the Maryland Court of Appeals examined the Good Samaritan Act. Under common law, there is no duty to help someone in danger. We are not our brother’s keeper under Maryland law; I guess. However, under tort law, someone who voluntarily helps another owes that person a duty of care, so the helper may be held legally liable if he or she cannot exercise that care. I think we should all be responsible to take care of each other instead of just the good people who step forward.

Anyway, Good Samaritan laws were enacted to encourage medical professionals to provide emergency assistance without having to worry about legal liability for ordinary negligence. Here, the Maryland Good Samaritan Act “provides immunity to specified individuals and entities from liability for ordinary negligence that occurs in connection with assistance or medical care rendered without fee or other compensation at the scene of an emergency or in transit to a medical facility.”

Is there CJ §5-603(b)(3) immunity as a volunteer fire department?

The defendant first claimed that it had immunity under CJ §5-603(b)(3) as a “volunteer fire department or ambulance and rescue squad.” The question was whether “volunteer” modifies only “fire department” or also “ambulance.” It seems like a crazy thing to be arguing about. But the defendant, a for-profit ambulance company, would not have immunity under the latter interpretation.

After investigating the legislative history of the statute, the court concluded that “volunteer” applies to both the “fire department” and “ambulance and rescue squad.” As a result, the defendant did not have immunity under the Maryland Good Samaritan Act, CJ §5-603.

Is the company immune because the employee is immune?

Second, the defendant argued that its employee was immune under the statute, and therefore the company could not be held vicariously liable. The court rejected this argument, stating that unless an independent source of immunity exists for the employer, a claim under vicarious liability can still be brought even if the employee is immune.

The court then moved on to the second statute, the Fire and Rescue Act, CJ §5-604. The statute provides immunity from civil liability for ordinary negligence by a fire company or rescue company and its personnel acting in the course of their duties, with an exception for negligent operation of motor vehicles. In this case, the defendant argued that they were a rescue company, and because of immune under the statute. Again, examining the legislative history of the act, the court concluded that the act was designed to confer governmental-like immunity on volunteer fire departments and entities performing similar functions, including privatized emergency services or commercial entities. Next, the court turned to the primary question of whether the defendant was a rescue company, and whether commercial ambulance companies (“CAC”) can be rescue companies. The court first noted that CACs are licensed and regulated in the state of Maryland, whereas rescue companies are not required to be. In addition, the same regulation governing CACs also exempts ambulance services run by the government or volunteer fire and rescue companies. In addition, CACs are required to purchase general liability insurance to provide payment for bodily injuries, death, and property damage “resulting from any cause for which the commercial ambulance service is liable.” The court remarked that if CACs enjoyed immunity under the statute, there would be no point in having liability insurance. Finally, the court addressed the defendant’s argument that CACs may provide emergency medical services, and therefore qualify as rescue companies. Rejecting this argument, the court stated that it was unwilling to grant broad immunity to the defendant for normal commercial activities. The court did not believe that the legislative intent was to grant immunity to commercial enterprises.

But a CAC Can Be a Rescue in Some Cases

However, the court explained that CACs might qualify as rescue companies in particular circumstances. In such cases, the company must show that it performs the function of a rescue company, which the court said: “presumably engaged in activities that alleviate a crisis or emergency.” In particular, the court pointed to a case where a rescue squad provided “rescue, ambulance, fire-fighting support, and emergency medical services.” The court also mentioned that parts of the Maryland Code suggest that the phrases “rescue company” and “rescue squad” could refer to private entities providing public services in responding to crises or emergencies, although they would not normally include commercial ambulance companies. Although the court did not ultimately provide a detailed breakdown of what a company must show to be classified as a “rescue company,” the opinion sheds some light on the issue.

The court decided that the defendant did not qualify for immunity under the Good Samaritan Act and that it had not shown its function as a “rescue company” entitled to immunity under the Fire and Rescue Act. As a result, the defendant was not entitled to summary judgment.

The full opinion can be found here along with the text of the two statutes.