California Appeal Court Upholds Judgment for Defendant Ambulance Services When Plaintiff Failed to Show Evidence that Alleged Delay in Transportation to Hospital Caused Resulting Injury

The California Appeal Court, Fifth District, addressed the issue of causation in a personal injury action based on the alleged negligence of the ambulance crew in assessing and transporting the plaintiff to a hospital.  The plaintiff had suffered a head injury while playing a high school football game, and the standby paramedic and the emambulanceergency medical technician (EMT) examined him.  After the EMT completed an assessment, the plaintiff was transported to the hospital and diagnosed with a right-sided subdural hematoma.  He underwent surgery to relieve a brain hemorrhage, and at some point, he suffered a stroke.

The plaintiff sued Kern County Emergency Medical Transportation Corporation (the defendant) and others for injuries.  He alleged that the defendant was grossly negligent, which is the standard of care that applies to paramedics and EMTs under the Health and Safety Code.  The plaintiff contended that in assessing him, the defendant did not recognize that he had sustained a traumatic brain injury, requiring immediate transport to a trauma center.

At the trial court, the defendant had moved for summary judgment and argued that there was no evidence of gross negligence or causation of damages.  The defendant made clear that the EMT conducting the assessment had used the Kern County criteria for activating the trauma system, and since the plaintiff did not meet the criteria, he was not immediately transported.  The delay lasted two and a half minutes, which, according to the defendant, did not harm the plaintiff.

In opposition to the summary judgment motion, the plaintiff submitted the expert declaration of a neurological surgeon. The surgeon opined that if the plaintiff had been immediately transported, there would have been decreased brain swelling.

The trial court granted the defendant’s motion for summary judgment and found that the plaintiff had not offered substantial evidence demonstrating the element of causation of injury. The plaintiff appealed.

On appeal, the court stated that providers of emergency services, including EMTs and paramedics, may be liable for damages when they have been grossly negligent in their actions or omissions.  Gross negligence is a lack of scant care or an extreme departure from ordinary conduct.   A plaintiff alleging negligence in the medical context must show that the defendant breached a duty to the plaintiff, and the breach caused the plaintiff’s injury.

First, the appeals court addressed whether the trial court should have sustained some of the evidentiary objections to parts of the plaintiff’s neurological surgeon’s expert declaration.  The court stated that certain assumptions set forth by the surgeon were not supported by the facts.  For example, when the surgeon delivered his opinion that the plaintiff’s condition was worsened by the delay in transporting the plaintiff, he ignored the fact that a paramedic responding to an emergency situation must conduct a survey of the patient to determine his condition.

After reviewing the evidence, the appellate court held that the surgeon’s opinion that the plaintiff should have been immediately sent to the hospital was not supported by the facts.  Not only did a primary assessment need to occur before transporting the plaintiff, but also the crew needed to undertake personal precautions.  Here, the court stated, the plaintiff’s expert assumed facts contrary to the undisputed facts of the case.

In this case, the court stated, the defense experts challenged the plaintiff’s neurosurgeon’s opinions, showing that the assumptions on which he based his opinions were not valid, as demonstrated in the medical literature.  The plaintiff’s expert did not show otherwise, nor did the plaintiff refute the showing that their expert’s opinions had been based on facts without support.  Instead of reviewing the analysis of the defendant’s experts or the medical literature set forth by the defendant’s experts, the plaintiff’s expert asserted that the delay in transporting the plaintiff, from the EMT’s first contact to the departure of the ambulance, was an unnecessary delay and wrongful conduct.

The court also held that the plaintiff’s expert failed to provide a reasoned explanation based on fact for his conclusion that the stroke was caused by the delay in transport.  The court stated that since the surgeon had not reviewed the declaration of the defendant’s expert, he did not address the evidence that there is not a current scientific strategy to determine when a stroke takes place.  In short, the court stated that the plaintiff’s expert had not shown his opinion regarding causation was based on matters upon which experts reasonably rely.

Turning to whether summary judgment had been appropriate, the court stated that causation is an essential element of a negligence or gross negligence cause of action. The plaintiff must show that the defendant’s negligence was a substantial factor in causing harm to the plaintiff.  In this case, the plaintiff sought compensation from the defendant for the alleged aggravation of his condition due to the gross negligence of the defendant as he treated the plaintiff following his football injury.

The defendant, when moving for summary judgment, attempted to show that the plaintiff could not demonstrate either gross negligence or causation.  According to the trial court, the plaintiff had not raised a triable issue of material fact regarding causation.  The plaintiff had not presented evidence that countered the defendant’s contention that if there had been a delay in transport to the hospital, it did not worsen the plaintiff’s condition.

Specifically, there had been no admissible evidence that the plaintiff should have been transported immediately to the hospital.  Additionally, there had been evidence that the stroke may have occurred after surgery, and the appellate court stated that any delay in transport would not have affected the onset or severity of the stroke.

The plaintiff maintained that he met his burden of showing a triable issue of fact.  But the court of appeal stated that his reliance on excluded portions of a declaration (the plaintiff’s neurological surgeon) did not raise a triable issue of material fact.  The court held that the plaintiff could not rely on excluded portions of the surgeon’s declaration.

The court held there was no reversible error in the judgment in favor of the defendant.

If you or someone close to you has suffered serious harm due to the negligence of others, the Los Angeles injury attorneys at Sharifi Firm can help you seek compensation for your harm. We provide personalized legal service and skilled advocacy. Call our office today for a free consultation at 866-422-7222 or complete our online form.

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