Applewhite v. Accuhealth, Inc., 20 N.Y.3d 412 (2013)
When a municipality provides ambulance service through EMTs responding to a 911 call, it performs a governmental function and can only be liable if it owed a “special duty” to the injured party.
Summary
This case addresses whether a municipality is liable for negligence when its EMTs respond to a 911 call. Tiffany Applewhite suffered anaphylactic shock, and her mother called 911. EMTs arrived but were not paramedics with advanced life support (ALS) capabilities. Tiffany’s mother allegedly requested the EMTs take her to a nearby hospital, but they waited for an ALS ambulance. Tiffany suffered brain damage. The New York Court of Appeals held that providing ambulance service is a governmental function, requiring a “special duty” for liability. The Court found triable issues of fact as to whether the EMTs assumed a special duty to Tiffany, precluding summary judgment for the City.
Facts
In 1998, Tiffany Applewhite experienced anaphylactic shock after a nurse administered medication. Her mother called 911 when Tiffany’s breathing worsened. Two EMTs from the New York City Fire Department arrived in a basic life support ambulance because no ALS ambulance was available. One EMT performed CPR while the other called for an ALS ambulance. Tiffany’s mother allegedly asked the EMTs to transport Tiffany to a nearby hospital. Paramedics from a private hospital arrived in an ALS ambulance, administered epinephrine, intubated her, gave her oxygen, and transported her to Montefiore Hospital. Tiffany survived but suffered serious brain damage.
Procedural History
Tiffany and her mother sued the nurse, her employer (Accuhealth), and the City of New York. The claims against Accuhealth and the nurse were resolved. The City moved for summary judgment, arguing governmental immunity and lack of proximate cause. Supreme Court granted the City’s motion. The Appellate Division reversed, finding triable issues on special duty and proximate cause. The Court of Appeals affirmed the Appellate Division.
Issue(s)
Whether the City was exercising a governmental or proprietary function when the EMTs initiated emergency care.
Whether the City voluntarily assumed a “special relationship” with the plaintiffs beyond the duty owed to the general public.
Holding
Yes, the City was exercising a governmental function because providing ambulance service by EMTs responding to a 911 call is a core governmental responsibility.
Yes, because the allegations raised a question of fact as to whether the EMTs assumed an affirmative duty and whether the mother justifiably relied on their actions, precluding summary judgment.
Court’s Reasoning
The Court reasoned that police and fire protection are quintessential governmental functions. Emergency medical services are a critical government duty. The court distinguished this case from medical services provided in hospital settings, which are akin to private, proprietary conduct. The Court stated that emergency medical services are “undertaken for the protection and safety of the public pursuant to the general police powers.” The court stated that “publicly-employed, front-line EMTs and other first responders, who routinely place their own safety and lives in peril in order to rescue others, surely fulfill a government function…because they exist ‘for the protection and safety of the public’ and not as a ‘substitute for…private enterprises’.”
To establish a special duty, the plaintiff must prove: ” ‘(1) an assumption by the municipality, through promises or actions, of an affirmative duty to act on behalf of the party who was injured; (2) knowledge on the part of the municipality’s agents that inaction could lead to harm; (3) some form of direct contact between the municipality’s agents and the injured party; and (4) that party’s justifiable reliance on the municipality’s affirmative undertaking.’ ”
The Court found a question of fact as to whether the EMTs assumed an affirmative duty by deciding to await ALS paramedics rather than transport Tiffany to the nearby hospital, after being asked to take her to the hospital by her mother. The court also found a question of fact concerning justifiable reliance. The Court stated, “Plaintiffs are therefore entitled to show how the EMTs’ statements or “conduct deprived [plaintiffs] of assistance that reasonably could have been expected from another source”.
The court also cited public policy concerns. The cost of tort recoveries would be excessive for taxpayers, and liability could dissuade municipalities from maintaining emergency services.