Paramedics who failed to thoroughly read a man’s advance directive have immunity from the wrongful death suit filed by his sister, the Supreme Court of Virginia has ruled, upholding a decision from Smyth County.
The trial court found the paramedics were “clearly negligent, and probably grossly negligent” but they had absolute immunity from liability under Virginia’s Good Samaritan statute. They rendered emergency care in good faith and were not compensated for the care they provided within the meaning of the statute, and there was no evidence they had “bad intent or dishonest motives” in their failure to treat the man or that they bore him any ill will.
“Thus, while it is undisputed that the Paramedics committed a grave mistake in failing to evaluate the Advance Directive more thoroughly, that mistake, without more, cannot rise to the level of bad faith,” Justice Cleo E. Powell wrote for the court.
The decision is Stoots v. Marion Life Saving Crew, Inc., et al. (VLW 021-6-082).
Marion Life Saving Crew, or MLSC, is a nonprofit emergency medical response agency with a single salaried employee and a group of volunteers. It provides organized lifesaving and first aid services for Smyth County.
Volunteers can get paid under a membership incentive program, or MIP, after they work three volunteer shifts each month; a monthly time sheet is marked with which shifts are paid and which are volunteer.
After 43-year-old Calvin Stoots had difficulty breathing and became unresponsive, his sister, Rebecca Ann Stoots called 911. She believed Calvin was suffering from ketoacidosis associated with his diabetes. Paramedics James Thompson and Zachary Powell responded, and concluded Calvin was still breathing with a normal resting heart rate.
Rebecca asked the paramedics to take Calvin to the hospital and gave them an advance directive for health care, which named her as Calvin’s medical agent.
According to the opinion, Thompson “looked briefly” at the directive “and concluded that Calvin was ‘DNR,’ meaning that he did not want to be resuscitated by medical professionals.” Thompson later conceded that he did not have time to fully read the directive.
But Rebecca told the paramedics that Calvin was not DNR; as his medical agent, she wanted him to receive treatment. In part, Calvin had provided in the directive, “I want treatment for a period of time in the hope of some improvement in my condition. I suggest 2 days as the period of time after which such treatment should be stopped if my condition has not improved.”
Thompson and Powell drove to the hospital in a “non-emergency fashion” with no lights or sirens, and stopped to pick up Larry Chatham, an advanced EMT, to provide advanced life support services. Calvin died before they got to the hospital.
Emergency room staff were told that no attempt had been made to resuscitate Calvin because he had a DNR order. MLSC billed Calvin’s insurance for its services, and received an undisclosed amount from the insurer.
Rebecca filed suit against Powell, Thompson, Chatham and MLSC. All defendants filed a plea in bar, claiming immunity under Virginia’s Good Samaritan statute, Code § 8.01-225. Evidence showed Powell had designated the shift that involved Calvin as a volunteer shift. Thompson did not participate in the MIP, and there was no timesheet entry for Chatham because he was not scheduled to work.
The Smyth County Circuit Court found that the paramedics were absolutely immune under the statute, and that MLSC had immunity because the paramedics were immune.
Powell pointed out that this case primarily concerns subsection § 8.01- 225(A)(5), which reads, in part that any person “who … [i]s an emergency medical services provider … who in good faith renders emergency care or assistance … to any injured or ill person … or while transporting such injured or ill person … shall not be liable for any civil damages for acts or omissions resulting from the rendering of such emergency care, treatment, or assistance ….”
In claiming that the trial court misconstrued the “good faith” provision in the Good Samaritan statute, Rebecca’s principal point appeared to be that the paramedics’ alleged gross negligence proved they were not acting in good faith.
“Stated differently, Stoots takes the position that good faith and gross negligence are mutually exclusive of each other; the existence of one proves the absence of the other,” Powell explained. “While this construction may be true in some contexts, we cannot say that it applies here, as other provisions of Code § 8.01-225 indicate that good faith and gross negligence can coexist.”
Rebecca’s argument that “‘good faith’ should be judged by a standard of objective reasonableness” was rejected because it would essentially void the Good Samaritan statute.
“In light of the fact that the General Assembly has clearly signaled a move away from looking at the manner the act is performed, we hold that, with regard to Code § 8.01-225, the question of whether an individual has acted in ‘good faith’ is best answered by looking at that individual’s mindset at the time the conduct is undertaken,” Powell wrote.
There was no evidence that the paramedics had any “bad intent or dishonest motives” in their failure to provide Calvin with treatment and Rebecca was not able to identify any evidence showing they had any ill will toward her brother.
The paramedics’ serious mistake of failing to evaluate the advance directive more thoroughly alone “cannot rise to the level of bad faith,” and the trial court made the correct call.
However, trial court’s ruling that MLSC’s liability was coterminous with the paramedics’ was an error requiring reversal; liability of a principal is only coterminous with the liability of its agent “when a verdict or other finding that the [agent] was not negligent is the basis for exoneration of the [principal],” Powell explained.
“As there was no verdict in favor of the Paramedics, or finding that they were not negligent, their immunity from civil liability is not dispositive of whether Code § 8.01- 225 applies to MLSC,” Powell said.
Abingdon attorney Mary Lynn Tate, who represented Stoots, told Virginia Lawyers Weekly that she filed a petition for rehearing on Jan. 21.