In December 2013, the Illinois Appellate Court decision in Abruzzo v. City of Park Ridge illustrates the significant financial exposure local governments face when first responders (in this case paramedics) fail to follow proper protocol when responding to calls that may appear routine.  Previously, the Illinois Supreme Court had ruled that the limited immunity contained in the Emergency Medical Services System Act (“EMS Act”) as set forth in 210 ILCS 50/1 et seq. applied instead of the absolute immunity for failure to evaluate, diagnose, or prescribe treatment for an illness or physical condition as set forth in the Local Governmental and Governmental Employees Tort Immunity Act.  In light of this earlier ruling by the Illinois Supreme Court, the City was entitled to only a qualified immunity which recognized liability where a plaintiff establishes wilful and wanton conduct on the part of first responders for failure to evaluate, diagnose, or prescribe treatment.

The facts in Abruzzo were that a father called 911 because his sleeping son, with a history of breathing problems, was not responding to his father trying to wake him.  By the time the paramedics arrived, the son had awakened and did not exhibit any visible signs of illness or other adverse condition.  Based solely on their visual observation of the son, the paramedics failed to follow the standard operating procedures (“SOP”) of the Saint Francis EMS system which required a general patient assessment. They left without administering any tests or treatment.  Later that night, the son again became unresponsive, the father again called 911, which dispatched paramedics who happened to be different paramedics from the first call.  The son did not regain consciousness this time, and the paramedics transported the son to the hospital where he was later pronounced brain dead and removed from respirators.  After trial, the jury found that the first set of paramedics acted wilfully and wantonly, and returned a verdict in favor of the Plaintiff and against the City in the amount of $5,187,500.

The published opinion provides a detailed summary of the trial testimony and highlights the fact that the paramedics who responded to the first call were impeached on several occasions; including that they had been told of the son’s history of breathing problems and asthma.  Here, knowledge of the history of breathing problems or asthma would have required the paramedics to follow the SOPs of the St. Francis EMS system.  Additionally, the opinion described the testimony of the father that after his son told him that the pills he was taking made him tired, one of the paramedics who heard the statement “kind of rolled his eyes like with an attitude, like why would you bother calling us, like he was put out.”

An important takeaway is that when responding to calls that may appear routine, a responder’s inattention to a condition, illness and the relevant protocol can constitute wilful and wanton conduct resulting in significant financial exposure to the municipality.

One of the City’s theories advanced at trial is that the paramedics “did not have a patient” to treat because of their observation of the son apparently being awake, alert and responsive when they arrived at the house.  The City also argued that the paramedics were not told of the son’s history of breathing problems and asthma.  The jury obviously resolved the issues of witness credibility in favor of the plaintiff and ultimately decided that the paramedics exhibited a “conscious disregard” of the son’s medical condition and the required protocol based on their knowledge of his history of breathing problems and asthma when it found for the Plaintiff and issued the nearly $5.2 million verdict.

Practice Points:  While first responders routinely face challenging situations, tend to be overworked, and see people at their worst, the appellate court’s affirming of the above verdict should send a strong message to local government responders to never take apparently routine situations for granted.  Paramedics and all first responders should follow the required protocols despite the fact that the situation may appear not to require the protocol.  Additionally, paramedics and other first responders must remember to act professionally in all stages of their duty, whether dealing with the public, following the proper protocol, or when preparing for and testifying at depositions and trials so their credibility as witnesses will be without question. Finally, this opinion demonstrates that what appears to be carelessness by first responders can result in significant financial exposure, as a $5.2 million judgment can be devastating to a self-insured small municipal government’s budget for many years.

Anthony J. Sassan

Author: Anthony J. Sassan