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Missouri Court Denies EMS Immunity

The family of a man who died of a heart attack can sue the emergency responders who misdiagnosed him with acid reflux, the Missouri Court of Appeals has held.

The trial court had granted official immunity to the EMTs based on the Eastern District's extension of that doctrine to publicly-employed EMTs last September in a case of first impression.

But the Eastern District found that the current case did not constitute a "true emergency" and reversed summary judgment for the EMTs on the family's wrongful death action.

"This true emergency situation is a strict requirement. A true emergency is one involving rapidly-evolving circumstances where the medical personnel have limited information. The court should determine whether the situation involved a true emergency on a case-by-case basis by evaluating the totality of the circumstances," Judge Kenneth M. Romines wrote.

Time and Information

Michael Brandt, a licensed emergency medical technician, and James Loehrer, a licensed paramedic, responded to an emergency call from Anthony Thomas in July 2008.

During their 15-minute visit, they performed two surveys of Thomas, who complained of chest pains and breathing difficulty. They checked his vital signs, finally diagnosing him with acid reflux and recommending an over-the-counter medicine.

The next morning Thomas was taken by ambulance to the hospital, where he was diagnosed with cardiac arrest. He died later that day.

The appellate court pointed out that Loehrer and Brandt treated a patient who was stable, unlike the Richardson case, in which the EMTs were required to immediately insert an endotracheal tube in a patient experiencing respiratory distress.

In this case, the patient was also able to effectively communicate his symptoms to the EMTs.

"The time and information available to Respondents was more like that of a doctor treating a patient in a hospital than that of an emergency responder arriving to find a patient in critical and devolving condition. Given that Respondents were not acting in a rapidly-evolving emergency situation, the defense of official immunity is not available to them," Judge Romines wrote.

In 2009 in Richardson v. City of St. Louis, the appellate court explained that EMTs must make judgments similar to police officers when responding to an emergency. Doctors, who treat patients in a hospital setting, are not covered by official immunity.

Risks

The EMTs argued that failing to provide official immunity to all state-employed emergency personnel will cause some to hesitate, which increases the risks to patients.

But the Eastern District said the "strict emergency" requirement addresses this concern.

"Quite the opposite of causing hesitancy in their treatment, this approach encourages responders to spend more time with patients and be more thoughtful in their diagnosis - to not act rashly when time is not of the essence," the court concluded.



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