No Immunity for Maryland Ambulance Service

The Maryland Court of Appeals (State Supreme Court) has ruled against for-profit ambulance providers claim of immunity.  The ruling is available here.

In November 2007 a paramedic employed by Transcare was riding along on a medical transport flight operated by PHI Air Medical for orientation purposes. The patient being transported, Bryson Murray, was a minor and needed to be transfered to the pediatric intensive care unit at the Medical Center of the University of Maryland Medical System.

During the flight Murray’s stats began to drop, the staff could not locate the equipment needed to reintubate and the helicopter was forced to land to retrieve the needed mask from a storage compartment. The family claims the plaintiff suffered brain damage from lack of oxygen during the delay.

The court ruled that although the individual employee may have immunity under Maryland law the vicarious liability of it’s employer, Transcare, was not subject to Good Samaritan statutes. The key point was whether the transport was being operated by a “rescue company”.

TransCare is a commercial ambulance company. According to the testimony of one of its employees, its business generally involves transporting patients from nursing homes to hospitals, from home to a dialysis center, or “wherever the patient needs to go, they take them.”43 It became involved in the transport of Bryson Murray in this case as a result of its contract with UMMS to provide ground transportation services between area hospitals for UMMS patients.

Commercial ambulance companies in Maryland are licensed and regulated by the Maryland Institute for Emergency Medical Services Systems (“MIEMSS”). Maryland Code, Education Article (“ED”), §13-515. There is no mention in the statute of a licensing requirement for “rescue companies” or “rescue squads.” Rather, specifically excepted from this regulation are ambulance services provided by, or operated under, the jurisdiction of State or local government or volunteer fire or rescue companies. ED §13-515(a)(3)(ii); COMAR 30.09.03.04.44 In parsing the jurisdiction of MIEMSS over commercial ambulance services under this regulatory regime, the Attorney General noted that “nearly all commercial ambulance transports are considered non-emergency.” 80 Opinions of the Attorney General 118, 120 (1995).

It is also notable that the statute governing commercial ambulance companies requires that each company maintain commercial general liability insurance coverage in the amount of at least $1 million – in addition to motor vehicle insurance and other insurance – to provide payment for bodily injuries, death, and property damage “resulting from any cause for which the commercial ambulance service is liable.” ED §13-515(d)(2); see also COMAR 30.09.04.06B. It is not clear why a commercial ambulance company would be required to maintain such coverage if it automatically enjoyed general immunity “from civil liability for any act or omission in the course of performing [its] duties.” TransCare asserts that, as an ambulance company that may provide emergency medical services, it necessarily qualifies as a “rescue company” and that it is therefore entitled to the broad, governmental-type immunity provided by the Fire and Rescue Act for “any act or omission in the course of performing their duties.” Under this view, TransCare and its employees would apparently enjoy this broad immunity from liability for ordinary negligence in their normal commercial activities, with a limited exception related to motor vehicles. Indeed, the breadth of its immunity would exceed that of State or local agencies, for which the Legislature has enacted limited waivers of sovereign immunity for ordinary negligence that are not restricted to automobile accidents. We are loath to infer, in the absence of a clearer statement of legislative intent, that the General Assembly meant to bestow such a benefit on a commercial enterprise generally.

This is not to say that a commercial ambulance company may not qualify as a “rescue company” in particular circumstances. Unlike the Good Samaritan Act, the Fire and Rescue Act is not limited to “volunteer” entities. For example, one might imagine a situation in which a local government has privatized emergency services or has otherwise enlisted commercial entities as first responders.

In this case, the Circuit Court held that TransCare qualified as a “rescue company” without any evidence that the company provides such emergency services in Maryland or that it was functioning as a first responder in the particular circumstances of this case.
Indeed, the evidence available to the Circuit Court indicated that TransCare’s employee was present for training purposes related to its contract to provide inter-facility transports for UMMS patients. Accordingly, it was an error to grant TransCare’s motion for summary judgment on the basis of the Fire and Rescue Act.

While we agree with the Court of Special Appeals that the Circuit Court’s decision should be reversed, unlike the intermediate appellate court,46 we do not rule out the possibility that a commercial ambulance company could establish that it performs the function of a “rescue company.” Thus, if a commercial ambulance company like TransCare could demonstrate, on the basis of undisputed facts, that it functioned as a rescue company in particular circumstances, it would be entitled to summary judgment under the Act. Of course, we express no opinion on whether TransCare will be able to do so.

For the reasons stated above, a commercial ambulance company such as TransCare does not qualify for immunity under the Good Samaritan Act, regardless of whether the company’s employee may qualify for immunity under the statute. Moreover, in the circumstances of this case, TransCare has not demonstrated it functioned as a “rescue company” that has the broad immunity from liability provided by the Fire and Rescue Act.

Accordingly, TransCare was not entitled to summary judgment on the basis of statutory immunity.

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