The opinion
SURVIVAL & WRONGFUL DEATH ACTION — SUMMARY JUDGMENT —
GROSS NEGLIGENCE — SUFFICIENT EVIDENCE
Pursuant to Maryland Rule 2-501(f), a “court shall enter judgment in favor of or against
the moving party if the motion and response show that there is no genuine dispute as to
any material fact and that the party … is entitled to judgment as a matter of law.”
Recognizing that a claim for gross negligence “sets the evidentiary hurdle at a higher
elevation[]” than a claim for negligence, the Court explained that in order to claim that a
party has acted with gross negligence, it must be pled that the party acted with wanton
and reckless disregard for the rights of others. Beall v. Holloway-Johnson, 446 Md. 48,
64 (2016). It is more than the failure to perform a duty, but “an intentional failure to
perform a manifest duty in reckless disregard of the consequences ….” Barbre v. Pope,
402 Md. 157, 187 (2007).
GOOD SAMARITAN ACT — FIRE & RESCUE COMPANIES ACT —
IMMUNITY — WILLFUL OR GROSSLY NEGLIGENT CONDUCT
Pursuant to Maryland Code, Courts & Judicial Proceedings Article, § 5-603 (“Good
Samaritan Act”) and § 5-604 (“Fire & Rescue Companies Act”), in the absence of willful
or grossly negligent conduct, emergency responders covered under the Good Samaritan
Act and/or the Fire & Rescue Companies Act are immune from civil liability for any acts
or omissions in providing assistance or in the performance of their duties.
The Court concluded that there was insufficient evidence support Paramedic Nappi and
EMT Jackson’s pre-arrival and post-arrival conduct as being willful or grossly negligent.
And, because they were employees of the Baltimore County Fire Department, the Court
determined that both Paramedic Nappi and EMT Jackson were entitled to immunity for
the claims against them under the Good Samaritan Act and the Fire & Rescue Companies
Act.
NEGLIGENCE — CONDUCT OF EMPLOYEES — DIRECT CLAIMS AGAINST
COUNTIES
The Local Government Tort Claims Act (LGTCA) of the Courts & Judicial Proceedings
Article, §§ 5-301, et seq., governs claims and lawsuits against local governments.
Appellants asserted direct claims against Baltimore County for the conduct of its
employees and for its failure to have policies in place, requiring the emergency
responders to notify dispatch of any delay in responding.
The Court found that there was insufficient evidence that there was a delayed response by
Paramedic Nappi and EMT Jackson or that the existence of a delayed-response policy
would have resulted in a different outcome. It concluded that there was no legal or
factual basis for a direct claim of liability against Baltimore County for its failure to have
a delayed-response policy in place. As a result, it was entitled to governmental immunity
under the LGTCA.
Circuit Court for Baltimore County
Case No. 03-C-18-001391
REPORTED
IN THE COURT OF SPECIAL APPEALS
OF MARYLAND
No. 318
September Term, 2019
______________________________________
OCTAVIA T. COIT, ET AL.
v.
NICOLE NAPPI, ET AL.
______________________________________
Nazarian,
Arthur,
Sharer, J. Frederick
(Senior Judge, Specially Assigned),
JJ.
______________________________________
Opinion by Sharer, J.
______________________________________
Filed: October 1, 2020
Pursuant to Maryland Uniform Electronic Legal
Materials Act
(§§ 10-1601 et seq. of the State Government Article) this document is authentic.
2020-10-01 11:08-04:00
Suzanne C. Johnson, Clerk
Ceontay Coit died on December 11, 2015, at the age of 21 as a result of cardiac
arrest following an acute asthma attack. Appellants, Octavia T. Coit and Jan Michael
Pinkney, his parents, and the Estate of Ceontay Coit, filed suit in the Circuit Court for
Baltimore County asserting wrongful death and related claims. Appellees, defendants
below, are Nicole Nappi and Traci Jackson, and their employer, Baltimore County. Ms.
Nappi was a paramedic at the time and Ms. Jackson was an emergency medical
technician (EMT) at the time who responded to a 911 call to attend to Mr. Coit and
transported him to a hospital, where he died. It is the timing and propriety of their
response that led to this litigation.
After the completion of discovery, appellees moved for summary judgment, which
was heard by Hon. Dennis M. Robinson, Jr. on March 15, 2019. By order of March 26,
2019, the court granted the motion and entered judgment for all appellees.
In their appeal, appellants ask this Court to consider:
1. Whether the trial court erred, as a matter of law, in granting [appellees’]
motion for summary judgment where [there] existed genuine issues of
[material] facts between the parties[.]
2. Whether the trial court erred in holding, as a matter of law, that
[appellants] required expert testimony to establish the proximate cause
of death of Ceontay Coit despite the record demonstrating a fact witness
unambiguously revealed [that] the deceased was still alive at the time
[appellees] Jackson and Nappi abandoned him.
We review a trial court’s grant of summary judgment for legal error, i.e., was the
court correct in its legal determination that there existed no genuine dispute of material
fact and that the prevailing party was entitled to judgment as a matter of law. See Powell
v. Breslin, 195 Md. App. 340, 345–46 (2010); ABC Imaging of Wash., Inc. v. Travelers
Indem. Co. of Am., 150 Md. App. 390, 394 (2003) (quoting Tyma v. Montgomery County,
369 Md. 497, 503–04 (2002)). In our review of a trial court’s grant of summary
judgment, we examine “‘the same information from the record and determine the same
issues of law as the trial court.’” Cent. Truck Ctr., Inc. v. Cent. GMC, Inc., 194 Md. App.
375, 387 (2010) (quoting La Belle Epoque, LLC v. Old Europe Antique Manor, 406 Md.
194, 209 (2008)). In so doing, “[w]e look only to the evidence submitted in opposition
to, and in support of, the motion for summary judgment in reviewing the trial court’s
decision to grant the motion.” Id.
Having reviewed the record developed in the circuit court, including discovery, as
did the motions court, we are satisfied that it committed neither error nor abuse of
discretion in the order granting summary judgment. The court’s extensive and thorough
Decision and Order clearly, and in detail, considered the relevant facts. Its application of
the law to those facts is clearly and carefully stated and, in our view, could not be
improved upon by a writing of this Court. Hence, we adopt the motions court’s findings
and rulings as the opinion of this Court. We transpose into, with minor non-substantive
edits, alterations where necessary, and incorporate into this opinion, the Decision and
Order of the Circuit Court for Baltimore County, entered on March 26, 2019, as the
opinion of this Court.1
The circuit court wrote:
1
Because we affirm the court’s grant of summary judgment, we need not consider
appellants’ second issue, even though it was likewise fully considered by the trial court.
2
DECISION & ORDER – [APPELLEES’] MOTION FOR SUMMARY
JUDGMENT
This case arises out of the untimely death of Ceontay Coit. He died
on December 11, 2015 when he was twenty-one years old, after having
difficulty breathing while at his friend’s house. [Appellants] Octavia Coit,
Jan Michael Pinkney and the Estate of Ceontay Coit filed a lawsuit against
the Paramedic and Emergency Medical Technician who responded to a 911
call for service for Mr. Coit and against Baltimore County. Octavia Coit is
Mr. Coit’s mother. Mr. Pinkney is Mr. Coit’s father. Paramedic Nicole
Nappi and EMT Traci Jackson are the emergency medical service providers
who responded first to the 911 call for Mr. Coit’s medical emergency.
Bruce Watkins is Mr. Coit’s friend who was with him when he started
experiencing the symptoms that prompted the 911 call. Mr. Watkins and
Mr. Coit were at Mr. Watkins’ home.
[Appellants] asserted three claims: 1) a survival action based on
alleged gross negligence (Claim I - Count I), 2) a claim for funeral
expenses (Claim I - Count II) and 3) a wrongful death claim based on
several theories of recovery (Claim II - Count I). Discovery is complete.
Paramedic Nappi, EMT Jackson and Baltimore County filed a motion for
summary judgment. Ms. Coit, Mr. Pinkney and the Estate of Mr. Coit filed
an opposition. The Court held a hearing regarding the motion for summary
judgment on March 15, 2019. For the reasons stated below, the Court is
granting [appellees’] motion for summary judgment and entering judgment
in favor of Paramedic Nappi, EMT Jackson and Baltimore County.
SUMMARY JUDGMENT STANDARD
Motions for summary judgment are governed by Maryland Rule 2-
501, which provides that “[a]ny party may file a written motion for
summary judgment on all or part of an action on the ground that there is no
genuine dispute as to any material fact and that the party is entitled to
judgment as a matter of law.” The standard for a motion for summary
judgment is a familiar one:
A summary judgment motion is not a substitute for trial.
Rather it is used to dispose of cases when there is no genuine
dispute of material fact and the moving party is entitled to
judgment as a matter of law. The standard for appellate
review of a trial court’s grant of summary judgment is
whether the trial judge was legally correct in his or her
rulings. In granting a motion for summary judgment, the trial
3
judge may not resolve factual disputes, but instead is limited
to ruling on matters of law. Summary judgment is generally
inappropriate when matters such as knowledge, intent, and
motive are at issue. If any inferences may be drawn from the
well-plead facts, the trial court must construe those inferences
in the light most favorable to the non-moving party. The
existence of a dispute as to some non-material fact will not
defeat an otherwise properly supported motion for summary
judgment, but if there is evidence upon which the jury could
reasonably find for the non-moving party or material facts in
dispute, the grant of summary judgment is improper.
Okwa v. Harper, 360 Md. 161, 178 (2000) (internal citations omitted).
Although a court must resolve all inferences in favor of the party opposing
summary judgment, those inferences must be reasonable. Beatty v.
Trailmaster Products, Inc., 330 Md. 726, 739 (1993).
SUMMARY OF THE PARTIES’ RESPECTIVE POSITIONS
Paramedic Nappi and EMT Jackson argue that they are entitled to
immunity pursuant to Md. Code Ann., Cts. & Jud. Proc. § 5-603 (“Good
Samaritan Act”) and Md. Code Ann., Cts. & Jud. Proc. § 5-604 (“Fire &
Rescue Companies Act”). Baltimore County argues that it is entitled to
governmental immunity under Md. Code Ann., Cts. & Jud. Proc. §§ 5-301,
et seq. (“LGTCA”). [Appellees] also argue that they are entitled to
summary judgment because Mr. Coit was contributorily negligent and
because there is insufficient evidence to support a negligence claim against
Paramedic Nappi and EMT Jackson.
[Appellants] argue that there is sufficient evidence of gross
negligence on the part of Paramedic Nappi and EMT Jackson to preclude
them from receiving the immunity provided by the Good Samaritan Act
and the Fire & Rescue Companies Act. They argue that Baltimore County
is not entitled to governmental immunity under the LGTCA because the
claims are based on the County’s policies and customs. [Appellants] also
argue that the evidence does not support a finding of contributory
negligence on the part of Mr. Coit, and that there is sufficient evidence to
support the claims against [appellees]. According to [appellants], there are
several factual disputes that preclude entry of summary judgment in favor
of [appellees]:
1) the parties’ respective interpretations on [appellees]
Jackson and Nappi’s response time; 2) the effect of
4
abandoning Mr. Coit and rendering no useful aid upon
arrival; 3) whether [appellees] followed response protocol
when there is an actual delay to their response time and
refusing to update dispatch on said delay while having full
knowledge that all communications to dispatch are relayed to
the patient for the patient’s health and safety; 4) whether
injecting Coit with Narcan with no evidence of Opioid use,
then lying on his medical records to cover up their further
malfeasance, in stating that, “patient was found with a rubber
band around arm” to justify use of Narcan which they
themselves purport has no helpful effects on persons not
suffering from Opioid overdose such as Mr. Coit; 5) whether
[appellees] actually began any “treatment” for Mr. Coit after
their uneventful arrival at Mr. Watkins’ home; 6) whether
[appellees] provided any assessment for Mr. Coit, at all, in a
time frame that would actually serve to benefit Mr. Coit; 7)
whether the use of [the] CAD report to document response
and event time throughout this emergency given [appellees]
Nappi and Jackson admit to providing misinformation to
dispatch on the critical question of when they were “in route”
and driving to Mr. Coit; 8) who upgraded the call and
requested a “medical box” respond to Mr. Coit, dispatch or
[appellees] Nappi and Jackson; and 9) the wrongful assertion
that Mr. Coit had done something wrong to cause or
contribute to his own death.
Pls.’ Opp[.] at 12-13.
DISCUSSION
STATUTORY IMMUNITY FOR PARAMEDIC NAPPI AND EMT
JACKSON
There are two statutes that may provide a basis for immunity for
Paramedic Nappi and EMT Jackson: 1) the Good Samaritan Act, and 2) the
Fire & Rescue Companies Act. Section 5-603(a) of the Good Samaritan Act
provides that a person entitled to immunity under the statute
is not civilly liable for any act or omission in giving any
assistance or medical care, if: (1) The act or omission is not
one of gross negligence; (2) The assistance or medical care is
provided without fee or other compensation; and (3) The
assistance or medical care is provided: (i) At the scene of an
5
emergency; (ii) In transit to a medical facility; or (iii)
Through communications with personnel providing
emergency assistance.
Section 5-603(b) of the Good Samaritan Act provides that the immunity
provided in subsection (a) of the statute applies to several categories of
people, including “[a] member of any State, county, municipal, or volunteer
fire department, ambulance and rescue squad, or law enforcement agency,
the National Ski Patrol System, or a corporate fire department responding
to a call outside of its corporate premises, if the member [satisfies other
conditions.]” Section 5-604[(a)] of the Fire & Rescue Companies Act
provides: “Notwithstanding any other provision of law, except for any
willful or grossly negligent act, a fire company or rescue company, and the
personnel of a fire company or rescue company, are immune from civil
liability for any act or omission in the course of performing their duties.”
There is no dispute that Paramedic Nappi and EMT Jackson were providing
emergency medical services in their official capacities and are otherwise
entitled to the immunity protections under the Good Samaritan Act and the
Fire & Rescue Companies Act, provided that their conduct with respect to
Mr. Coit was not willful or grossly negligent.
In Barbre v. Pope, 402 Md. 157, 187 (2007), the Court of Appeals
noted the distinction between simple negligence and gross negligence. The
Court explained:
[G]ross negligence is an intentional failure to perform a
manifest duty in reckless disregard of the consequences as
affecting the life or property of another, and also implies a
thoughtless disregard of the consequences without the
exertion of any effort to avoid them.
The Court of Appeals recently explained that a claim for gross negligence
“sets the evidentiary hurdle at a higher elevation[.]” Beall v. Holloway-
Johnson, 446 Md. 48, 64 (2016). To claim that a party has acted with gross
negligence, it must be pled that the party acted with wanton and reckless
disregard for others. Id. (holding that a wrongdoer is guilty of gross
negligence or acts wantonly and willfully only when they inflict injury
intentionally or is indifferent to the rights of others, that he acts as if such
rights do not exist). The Court of Special Appeals has explained the
difference between the terms “willful” and “wanton” as follows:
Willful misconduct is performed with the actor’s actual
knowledge or with what the law deems the equivalent to
6
actual knowledge of the peril to be apprehended, coupled
with a conscious failure to avert injury. By contrast, a wanton
act is one performed with reckless indifference to its potential
injurious consequences. The term “wanton” generally denotes
“conduct that is extremely dangerous and outrageous, in
reckless disregard for the rights of others.”
Wells v. Polland, 120 Md. App. 699, 719 (1998) (citing Doehring v.
Wagner, 80 Md. App. 237, 246 (1989)).
[Appellees] rely primarily on two cases involving emergency
medical services providers and the issue of gross negligence: Tatum v.
[Gigliotti], 80 Md. App. 559 (1989), aff’d, 321 Md. 623 (1991) and McCoy
v. Hatmaker, 135 Md. App. 693 (2000). These cases are instructive and
help to calibrate this Court’s assessment regarding whether Paramedic
Nappi’s and EMT Jackson’s conduct was willful or grossly negligent.
In Tatum v. Gigliotti, 321 Md. 623 (1991), a representative of a
patient who died during an asthma attack filed a wrongful death and
survival action against EMTs and Prince George’s County. Mr. Tatum had
called 911 and informed the dispatcher that he was having a severe asthma
attack. Medics responded to the call and attempted to treat him for
hyperventilation by placing a paper bag over his face, “although that act
was in contravention of the prescribed treatment for an asthma attack.” Id.
at 625. Mr. Tatum was aided walking down twelve flights of stairs but was
not carried on a stretcher. Id. Along the way to the hospital, a paramedic
attempted to place an oxygen mask over Mr. Tatum’s face, but he resisted.
Id. At some point during the ride, Mr. Tatum fell out of the seat and was
lying face down on the floor. Id. 625-26. Upon arrival at the hospital, the
ambulance report prepared by one of the EMTs indicated that Mr. Tatum
arrived at the hospital in stable condition. Id. at 626. The emergency room
nurse testified otherwise, stating that Mr. Tatum was in complete
respiratory and cardiac arrest when he arrived. Id. The hospital staff was
unable to revive Mr. Tatum and he died due to oxygen deprivation. Id. In
Tatum, the Court of Special Appeals rejected the argument that the EMTs’
failure to administer oxygen and falsification of the ambulance report rose
to gross negligence, reasoning that “[t]he evidence...indicated that although
the [EMTs’] actions […] may have amounted to negligence, they do not
satisfy the threshold of gross negligence.” Tatum, 80 Md. App. at 569
(1989).[2]
[2]
The Court of Appeals granted a writ of certiorari in Tatum to address
whether the immunity provided by the Good Samaritan Act applied to a
7
In McCoy v. Hatmaker, 135 Md. App. 693 (2000), Mr. McCoy
collapsed while driving himself and a co-worker to work. [Id. at 699.] After
the car came to a stop, Mr. McCoy was unresponsive and making a
gargling noise. [Id. at 700]. His co-worker flagged down a passing police
officer who stopped and took Mr. McCoy’s pulse. [Id.] The officer
conveyed to the co-worker that McCoy had a weak pulse. [Id.] When an
ambulance arrived, the officer advised EMTs that Mr. McCoy was in full
cardiac arrest. [Id. at 701.] The EMT ran to the vehicle and took no
resuscitation efforts due to his observation that Mr. McCoy had no pulse,
dilated and fixed pupils, expelled bodily fluids, and a decreased body
temperature. [Id.] In that case, McCoy’s estate alleged that the EMT was
grossly negligent in failing to render appropriate aid to the decedent and
that the EMT failed to follow emergency medical protocols related to the
treatment of deceased patients. [Id. at 701-02.] The Court of Special
Appeals concluded that the decisions made under emergency circumstances
did not amount to a deliberate choice not to render medical care to a patient
and found the EMT was not grossly negligent. [Id. at 713-14.] In McCoy,
the Court of Special Appeals also characterized the circumstances of Tatum
as “highly egregious facts showing misdiagnosis of a patient, treatment
bordering [upon] cruelty, and falsification of records” and explained that
the Court “nevertheless upheld the trial court’s grant of summary judgment
in favor of [the EMT] in Tatum.” Id. at 707.
According to [appellants], there are two distinct time periods during
which Paramedic Nappi’s and EMT Jackson’s conduct was willful or
grossly negligent. First, [appellants] claim that their delayed response time,
alleged incorrect information to dispatch before their arrival and perceived
lack of urgency upon arrival constitute willful conduct or gross negligence
(pre-arrival conduct). Second, [appellants] claim that Paramedic Nappi and
EMT Jackson engaged in willful conduct or were grossly negligent in their
assessment and treatment of Mr. Coit on the scene (post-arrival conduct).
Given that there are separate and distinct factual allegations related to the
salaried emergency medical technician and whether the Court of Special
Appeals and trial court correctly applied the gross negligence standard to
analyze the conduct at issue with respect [to] the issue of immunity. The
Court of Appeals held “that the gross negligence standard of the Good
Samaritan statute was the proper standard to be applied by the courts
below.” Tatum, 321 Md. at 630. This Court also cited the Court of Special
Appeals[’] decision because it analyzed the issue of whether the conduct at
issue was grossly negligent, which is a central issue in this case.
8
pre-arrival conduct and the post-arrival conduct, the Court will address
them separately.
There is insufficient evidence to support [appellants’] claim that
Paramedic Nappi’s and EMT Jackson’s pre-arrival conduct was willful or
grossly negligent. The [appellants] do not dispute that the call for service to
M19, the unit Paramedic Nappi and EMT Jackson were operating, was
dispatched at 5:08:46 a.m. on December 11, 2015, as reflected in a
computer-aided dispatch (CAD) report that is part of the evidentiary record.
[Appellants] dispute that Paramedic Nappi and EMT Jackson were “en
route” as of 5:11:12 a.m., as reflected in the CAD report. That dispute is
based on an attempt to parlay Paramedic Nappi’s and EMT Jackson’s
inability to recall details at a deposition on October [23, 2018], nearly three
years after the date of the call for service related to Mr. Coit, into
allegations that they falsely reported when they were en route. Regardless
of whether the dispute regarding the dispatch time is genuine, it is not
disputed that Paramedic Nappi and EMT Jackson arrived on the scene at
5:15:30 a.m., which was 6 minutes and 44 seconds after the call was
dispatched. Paramedic Nappi and EMT Jackson’s arrival time is further
corroborated by the CAD report and other evidence reflecting their arrival
time. There is undisputed evidence in the CAD report that units, EMS5 and
E19 arrived at the scene after Paramedic Nappi and EMT Jackson, at
5:16:57 a.m. and 5:22:24 a.m.[,] respectively. Based on the CAD report,
EMS5 arrived 1 minute and 27 seconds after Paramedic Nappi and EMT
Jackson, and E19 arrived 6 minutes and 54 seconds after Paramedic Nappi
and EMT Jackson. Although [appellants] attempt to call into question the
entire CAD report based on Paramedic Nappi’s and [EMT] Jackson
inabilities to recall details nearly three years after the incident and even go
so far as to suggest that the report was falsified, there is no evidentiary
basis for that. Although, in the context of a motion for summary judgment,
non-moving parties are entitled to have the Court draw all reasonable
inferences in their favor, non-moving parties are not entitled to all
conceivable inferences. There are no genuine disputes regarding material
facts related to the timing of Paramedic Nappi and EMT Jackson’s arrival
at Mr. Watkins’ home.
[Appellants] also claim that Paramedic Nappi and EMT Jackson
were “lackadaisical” when they arrived at Mr. Watkins’ residence.
[Appellants] characterize their conduct as “abandoning” Mr. Coit. There is
no evidentiary basis for that. [Appellants] also attempt to highlight a
snippet of Paramedic Nappi’s deposition testimony, in which she stated,
“We don’t run.”[] [Appellants’] reliance on that statement to attempt to
generate evidence of willful conduct or gross negligence ignores the
9
context for that statement. Paramedic Nappi explained that not running to
calls for service is a matter of safety for emergency medical service
providers, and is intended to maximize their effectiveness as first
responders. Essentially, emergency medical service providers are not able
to render aid if they become injured or incapacitated while responding. The
evidence in the record demonstrates that Paramedic Nappi and EMT
Jackson arrived at the scene of an emergency in response to a call in the
early morning hours less than 7 minutes after receiving the call from a
dispatcher. There is no genuine dispute regarding that evidence.
[Appellants’] reference at the hearing to a policy-based expectation of a 90-
second “turn-out time” for emergency medical service providers does not
provide a basis for gross negligence. Even if Paramedic Nappi and EMT
Jackson were, in some way, negligent in their response to the call for
service, which the Court is not suggesting, there is not sufficient evidence
that their pre-arrival conduct was willful or grossly negligent.
There is also insufficient evidence that Paramedic Nappi’s and EMT
Jackson’s post-arrival conduct was willful or grossly negligent. Although
the Court recognizes that seconds may seem like minutes during an
emergency, the evidence demonstrates that, upon entering the basement of
Mr. Watkins’ home, Paramedic Nappi and EMT Jackson promptly assessed
and treated Mr. Coit. They checked for a pulse, observed agonal
respirations, placed an oxygen mask on Mr. Coit, prepared an intravenous
line and began administering fluids, began transcutaneous cardiac pacing to
address Mr. Coit’s heart rate, administered Narcan, and administered
Atropine. Treatment and assessment of Mr. Coit’s condition continued after
Mr. Coit was removed from the house and taken to the medic unit for
transport to Northwest Hospital. He was intubated with an endotracheal
intubation tube. Further assessment resulted in noting the absence of
mechanical capture with transcutaneous pacing and agonal electrical rate
without a pulse. Emergency medical service providers began administering
CPR and administered Epinephrine during transport to Northwest Hospital.
Upon arrival at Northwest Hospital, Paramedic Nappi reported to
emergency department personnel regarding what treatment had been
provided and the status of Mr. Coit’s condition.
[Appellants] contend that the administration of Narcan was
unnecessary because there was no specific indication that Mr. Coit was
experiencing an opioid overdose. The Court understands and appreciates
Mr. Coit’s family’s concern over a misperception that he was using drugs.
The evidence demonstrates, however, that, regardless of how unnecessary
the administration of Narcan may have been, there are no applicable
contraindications for someone who did not overdose on opioids, and that
10
Narcan does not otherwise harm someone to whom it is administered. Even
if Paramedic Nappi and EMT Jackson were, in some way, negligent in their
assessment and treatment of Mr. Coit, which the Court is not suggesting,
there is not sufficient evidence of gross negligence regarding their post-
arrival conduct.
If the conduct in McCoy and Tatum was not willful or grossly
negligent, then neither was the conduct in this case. The lack of evidence
that Paramedic Nappi’s and EMT Jackson’s conduct was willful or grossly
negligent entitles them to statutory immunity based on the Good Samaritan
Act and the Fire & Rescue Companies Act and to judgment as a matter of
law. There is not sufficient evidence in the record to conclude as a matter of
law that Mr. Coit was contributorily negligent, so the Court is not granting
summary judgment on that basis.
LACK OF CAUSAL CONNECTION BETWEEN ANY WRONGFUL
CONDUCT AND INJURY
Even if there was sufficient evidence of gross negligence or willful
conduct by Paramedic Nappi or EMT Jackson, [appellants] must establish
causation. For wrongful conduct to be a proximate cause of an injury, it
must be a cause in fact of the injury, i.e., there must be proof that, but for
the wrongful conduct, the injury would not have occurred. See Baltimore
Gas and Elec. Co. v. Lane, 338 Md. 34, 51 (1995). Although this is not a
medical malpractice case, it is analogous to one. To prove causation in a
medical malpractice case, a plaintiff “must establish that but for the
negligence of the defendant, the injury would not have occurred.” Jacobs v.
Flynn, 131 Md. App. 342, 354 (2000). [“]Because of the complex nature of
medical malpractice cases, expert testimony is normally required to
establish breach of [the] standard of care and causation[,”] and the expert
opinion must be established [“]within a reasonable degree of probability.[”]
Id. [Appellants] have not established causation. The issue of causation in
this case can be framed as whether Mr. Coit would still be alive today if
Paramedic Nappi’s and EMT Jackson’s pre-arrival or post-arrival conduct
was different.
[Appellees] supported their motion for summary judgment with an
affidavit of Dr. David Vitberg, a board-certified emergency medicine
specialist. According to Dr. Vitberg, Paramedic Nappi and EMT Jackson
followed all applicable protocols established by the Maryland Institute for
Emergency Medical Services Systems (MIEMSS) and otherwise satisfied
the standard of care with respect to Mr. Coit. [Appellants], on the other
hand, have not provided any expert medical testimony in support of their
11
claims. Expert medical testimony is necessary to establish gross negligence
by Paramedic Nappi and EMT Jackson. See McCoy, 135 Md. App at 720-
22; Tatum, 80 Md. App at [569-71]. There is not sufficient evidence of
causation. At the hearing, [appellants’] counsel suggested that Mr. Watkins
may provide the testimony from which a jury could conclude that Mr. Coit
would have survived if Paramedic Nappi and EMT Jackson arrived at the
house sooner and assessed and treated Mr. Coit more aggressively. Any
testimony along those lines by Mr. Watkins would not be admissible under
Maryland Rule 5-702 because, although it may be relevant to the case, there
is no evidence that Mr. Watkins “is qualified as an expert by knowledge,
skill, experience, training, or education” to offer an expert opinion
regarding causation. Even if there was sufficient evidence of willful
conduct or gross negligence, the Court would grant summary judgment
based on the lack of causation evidence.
GOVERNMENTAL IMMUNITY FOR BALTIMORE COUNTY
The LGTCA governs claims and lawsuits against local governments.
The LGTCA makes “local governments,” including charter counties like
Baltimore County, responsible for the defense and indemnity of
governmental employees relating to lawsuits against employees for tortious
conduct committed in the scope of their employment with the local
government. [Housing Authority of Baltimore City v. Bennett, 359 Md. 356,
362 (2000) (citing Courts and Judicial Proceedings Article §§ 5-301(d) and
5-302(a))]. The purpose of the LGTCA is to provide a remedy for those
injured by local government employees, while ensuring that the financial
burden of compensation is on the local government, not its employees,
unless an employee acted with malice. Ashton v. Brown, 339 Md. 70[, 107-
08] (1995). The Court of Special Appeals has explained the legislative
history of the LGTCA:
The statute requires the government to assume financial
responsibility for a judgment against its employee by
abolishing that immunity the government may have had
against responsibility for the act of its employees. The Act,
however, does not create liability on the part of the
government as a party to the suit.
Khawaja v. [Mayor & City Council, City of Rockville], 89 Md. App. 314,
325-26 (1991) (emphasis original).
… Section 5-303(b) of the LGTCA provides that immunity is
waived for certain lawsuits against employees of a local government, but
12
not as to the local government itself, and that a local government must
defend and indemnify its employees:
(b)(1) Except as provided in subsection (c) of this section, a
local government shall be liable for any judgment against its
employee for damages resulting from tortious acts or
omissions committed by the employee within the scope of
employment with the local government.
(2) A local government may not assert governmental or
sovereign immunity to avoid the duty to defend or indemnify
an employee established in this subsection.
Local governments, unlike state governments, are “persons” under
42 U.S.C. § 1983 and can be sued for money damages under § 1983 when
governmental law, policy or custom contributed to the violation of federal
constitutional or statutory rights. Monell v. Dept. of Soc. Serv. of City of
N.Y., 436 U.S. 658, 690-95 (1978). See, e.g., City of St. Louis v. Praprotnik,
485 U.S. 112 (1988); Pembaur v. City of Cincinnati, [475 U.S. 469] (1986);
De Bleecker v. Montgomery County, 292 Md. 498, 511-12 (1982).
[Appellants] are asserting a direct claim against Baltimore County based on
their position that Mr. Coit’s constitutional rights “were violated as a direct
result of Baltimore County policies and customs which contributed to the
deprivation of Mr. Coit’s federal constitutional or statutory rights to life.”
Pls.’ Opp. at 19. According to [appellants], it is the lack of a policy that
provides a basis for a direct claim against Baltimore County, specifically a
“delayed-response” policy that would require emergency medical service
providers (and presumably other first responders) to notify a dispatcher if
there will be a delay in responding to an emergency. Baltimore County
argues that it is entitled to governmental immunity under the LGTCA.
According to [appellants], a “delayed-response” policy would
require emergency medical service providers, like Paramedic Nappi and
EMT Jackson, to notify a dispatcher that their response time was delayed
and require the dispatcher to relay that information to someone seeking
emergency assistance, so that someone seeking emergency assistance can
make decisions regarding their course of action based on that information.
There is no legal or factual basis for a direct claim against Baltimore
County. As discussed above, there is not sufficient evidence of a delayed
response time by Paramedic Nappi and EMT Jackson. There is also not
sufficient evidence that having a delayed-response policy would have
resulted in a better outcome for Mr. Coit. If there was a delay in response
13
time and the dispatcher had communicated that delay to Mr. Watkins, he
and Mr. Coit would have faced the choice of waiting a few minutes, at
most, for trained emergency medical service providers to arrive or having
Mr. Watkins drive Mr. Coit to Northwest Hospital, which was several miles
away, without the prospect of any medical treatment on the way to the
hospital. There is not sufficient evidence to support the theory that Mr. Coit
would have experienced a better outcome if Baltimore County had a
delayed-response policy as [appellants] suggest and if it was followed.
There is insufficient evidence for any basis to impose direct liability on
Baltimore County. Baltimore County is entitled to summary judgment.
CONCLUSION
Everyone, of course, wishes that there was a different outcome that
resulted in Mr. Coit being alive today. It is tragic and unfortunate that he is
not. This Court is required to evaluate the evidentiary record within the
framework of the applicable law to determine if there is sufficient evidence
to support [appellants’] claims. Based on the undisputed facts in the
evidentiary record, Paramedic Nappi, EMT Jackson and Baltimore County
are entitled to judgment as a matter of law. Paramedic Nappi and EMT
Jackson are entitled to statutory immunity based on the Good Samaritan
Act and the Fire & Rescue Companies Act because their conduct was
neither willful nor grossly negligent. Baltimore County is entitled to
governmental immunity under the [LGTCA] because there is no basis for
any direct claims against it. Even if the parties were not entitled to
immunity, there is insufficient evidence to satisfy the causation
requirement.
(Cleaned up).
JUDGMENT OF THE CIRCUIT COURT
FOR BALTIMORE COUNTY AFFIRMED;
COSTS ASSESSED TO APPELLANTS.
14