On Tuesday, the New Jersey Supreme Court handed down a decision paving the way for a jury to decide whether personnel assigned to the Plainfield Rescue Squad were negligent in not immediately transporting a shooting victim, as opposed to performing CPR for 30 minutes on scene.

Here are the facts in the court’s own words:

Shortly after 5:00 a.m. on August 4, 2004, twenty-five-year-old Odis P. Murray was shot in the chest by his younger brother outside their home at 418 Parkside Road in Plainfield. Their parents, Geraldine and Odis E. Murray, who were already awake, were alerted by “loud noises” and went outside to investigate. They found their son, Odis, lying in the street behind his car with a gunshot wound in his chest. He was conscious and able to speak and identified his brother as the shooter. Mrs. Murray—a critical-care nurse by profession—immediately returned to her home and called 9–1–1. The time was approximately 5:12 a.m. Three minutes later, a Plainfield police officer appeared on the scene. At 5:16 a.m., a Plainfield Rescue Squad (Rescue Squad or Squad) ambulance—staffed by two Emergency Medical Technicians-basics (EMT-basics) and one volunteer in-training—arrived. A mobile intensive care unit, known as Mercy 9, was dispatched from defendant John F. Kennedy Medical Center in Edison at 5:13 a.m.1 Mr. and Mrs. Murray averred in certifications and deposition testimony that Mercy 9 never came to the scene.

Given their status as EMT-basics, the two Rescue Squad members had authority, among other things, to assess vital signs; administer oxygen; manage cardiac, respiratory, and diabetic shock emergencies; perform pulmonary and cardiopulmonary resuscitation (CPR); and provide emergency treatment for bleeding and “chest-abdominal-pelvic injuries.”…

According to the Squad members, the patient did not have a pulse and was “unconscious and not responding to verbal stimuli or painful stimuli.” They began giving him CPR and oxygen through “a bag valve mask,” and then “hooked him to a defibrillator,” which registered “ ‘no shock advised.’ “ They then continued performing CPR and ventilation. During this process, Mrs. Murray asked the Squad members why they were not transporting her son to the hospital or intubating him—that is, placing a tube down his larynx to secure an airway. When Mrs. Murray asked those questions, in her opinion, the Squad members “looked at [her] like a deer in headlights.” Muhlenberg Regional Medical Center—the nearest hospital—was only minutes away.

Approximately fifteen minutes after their arrival, the Squad members called for a Medevac helicopter to transport the patient to a hospital. That request was canceled because protocol did not allow for such a transport when a patient is in cardiac arrest. Eventually, Odis—who weighed between 260 and 270 pounds—was secured on a board and placed in the ambulance. Not until 5:47 a.m.—more than thirty minutes after first appearing at the scene—did the Rescue Squad members take the patient to Muhlenberg hospital. On their arrival there, hospital personnel intubated the patient and attempted to insert an intravenous line. Odis, still alive, had an active blood pressure. The bullet had perforated his aorta and severed his spinal cord. By 6:10 a.m., he was pronounced dead. The autopsy report declared the cause of death as “[p]enetrating gunshot wound to the chest.”

The Murrays retained as an expert Assistant Burlington County Medical Examiner Dr. William L. Manion, who expressed the following opinions in his report. The Rescue Squad members “wasted over 30 minutes at the scene” while performing ineffective CPR, thus depriving the patient of “any chance of surviving his injury.” He needed an immediate transport “to Muhlenberg Regional Medical Center Emergency Room where a surgical trauma team could have opened his chest, stopped blood loss and taken him to the [operating room] for surgical repair.” Although “mortality from injuries to the thoracic aorta is high,” despite the “tremendous delay in transporting” Odis to the hospital, he still “demonstrated a blood pressure of 66/47 and EKG activity in the emergency room.” “Had [the patient] been transported promptly ․ he would have had a high degree of probability of surviving the bullet injury.”4 “He essentially died without the benefit of ․ surgical and emergency services provided by a professional trauma center only two minutes away.” Dr. Manion concluded that the members of the Squad engaged in “significant deviations from usual standards of rescue squad practice [that] were significant contributing factors to [Odis's] death.”…

Plaintiffs Geraldine and Odis E. Murray … filed a wrongful-death/survival action against defendants Plainfield Rescue Squad and John F. Kennedy Medical Center, claiming that defendants’ negligence proximately caused the death of their son. The complaint alleged that the Rescue Squad’s members failed both to provide critical emergency-medical treatments to Odis and to transport him promptly to Muhlenberg Regional Medical Center for life-saving medical intervention. The complaint also alleged that the Mercy 9 paramedics operating out of JFK Medical Center never arrived at the scene or, alternatively, if they did, failed to take necessary life-saving measures, such as starting an intravenous line, intubating the patient, monitoring the patient’s cardiac condition, and giving emergency medications. Plaintiffs sought compensatory and punitive damages against defendants….

The suit did not name any of the individual members of the rescue squad or Mercy 9, but instead sought to hold the rescue squad and the hospital liable for the actions of their employees. The trial court ruled that the hospital had statutory immunity, and that the rescue squad was similarly immune plus had protection under the state’s Good Samaritan Act.

The plaintiffs appealed initially to the Appellate Division of New Jersey Superior Court, where the Good Samaritan Act was found not to apply to an emergency to which a rescue squad was dispatched. However, the squad was held to be immune under N.J.S.A. 26:2K–29.  The Plaintiffs appealed that ruling and the issue before the New Jersey Supreme Court was a limited one: whether the rescue squad had statutory immunity under N.J.S.A. 26:2K–29.

N.J.S.A. 26:2K–29 states:

“[n]o EMT-intermediate, licensed physician, hospital or its board of trustees, officers and members of the medical staff, nurses or other employees of the hospital, or officers and members of a first aid, ambulance or rescue squad shall be liable for any civil damages as the result of an act or the omission of an act committed while in training for or in the rendering of intermediate life support services in good faith and in accordance with this act.”

In deciding the case, the NJ Supreme Court concluded that N.J.S.A. 26:2K–29 provides immunity protection to individual members but not to the emergency organization for which the individual members work. The court was quite blunt in its reasoning: “The Legislature knows how to write an immunity statute covering both an entity and its individual members.”

The court rejected the logic that “ if a Squad member is not liable under the immunity provision of N.J.S.A. 26:2K–29, then the Squad cannot be liable”, pointing to other immunity statutes that grant protection to both individual members and the organization.

“The Legislature chose to provide immunity to volunteer rescue squads, N.J.S.A. 2A:53A–13.1, and to rescue squads rendering advanced life support services, N.J.S.A. 26:2K–14. By the clear language of N.J.S.A . 26:2K–29, the Legislature chose not to provide immunity to rescue squads, as entities, rendering intermediate life support services. If the failure to provide immunity to such rescue squads was an oversight, any corrective measure must be taken by the Legislature.” It should be pointed out that the Plainfield Rescue Squad was not a volunteer rescue squad, nor was it an ALS unit. This it could not take advantage of the immunity protection afforded to either of those entities.

Here is a copy of the decision. Murray v Plainfield Rescue Squad

The big take away from this case is that the court did not find the EMTs to be negligent, nor the Plainfield Rescue Squad to have been liable. Rather, the court concluded that the Murrays have the right to have their case heard by a jury.

News coverage of the decision.