Commercial Ambulance: TransCare v. Murray

The Baltimore Medical Malpractice Lawyer Blog discusses issues in Maryland medical malpractice cases. In this post, I examine whether the immunity that applies to municipal EMTs applies to commercial ambulance services. The case is TransCare, MD, v. Murray, 413 Md. 225 (2013). The Court of Appeals of Maryland (now the Supreme Court of Maryland) decided the case.

When a medical crisis occurs during transit, who bears the legal liability? The Maryland Court of Appeals tackled this crucial question in a major medical malpractice decision. The court examined whether a private, for-profit ambulance firm could claim statutory immunity for alleged negligence during a medical transfer.

The court ruled that private commercial companies cannot shield themselves using statutes designed for volunteer responders and public agencies. This decision clarifies the reach of statutory protections in transport cases.

Factual Background

A young child suffered severe breathing difficulties and congestion in late 2007. A local hospital in Talbot County evaluated the minor and also inserted an endotracheal breathing tube. Because the facility lacked the specialized equipment to treat intubated pediatric patients, doctors arranged an emergency air transfer. Accordingly, they planned to transport the patient to the pediatric intensive care unit at a major medical center in Baltimore.

A specialized flight team managed the helicopter transport. The team included a pediatric intensive care nurse, a flight paramedic, and a flight nurse. A licensed paramedic employed by a commercial transport company also joined the flight for orientation purposes. The employer operated ground transport under a contract with the medical center.

Shortly after takeoff, the patient experienced a life-threatening emergency. The patient’s heart rate and blood oxygen levels then dropped rapidly. The legal complaint alleged that the breathing tube dislodged and then blocked the airway. The flight crew searched for a pediatric air mask to restore breathing, but they could not find one on board.

The helicopter made an emergency landing at a nearby airport. The flight paramedic retrieved a mask from a storage compartment and reintubated the patient. The child survived the flight, but the lack of oxygen caused severe, permanent hypoxic brain damage. The injury left the child blind, deaf, and disabled.

Parties’ Arguments

The plaintiff filed a medical malpractice lawsuit alleging negligence. The lawsuit targeted the private transport company, asserting vicarious liability for the actions of its paramedic.

The defendant requested summary judgment based on two statutory defenses:

• The Good Samaritan Act (CJ § 5-603): The company claimed status as an “ambulance squad.” It also argued that an employer cannot be held liable if its employee holds personal immunity.
• The Fire and Rescue Act (CJ § 5-604): The company argued that it functioned as a private “rescue company.” It claimed broad protection from liability for acts performed during official duties.

The plaintiff countered that these immunity statutes protect public and volunteer entities, not commercial enterprises. The plaintiff noted that the employer could not hide behind employee protections without an independent legal basis.

Court’s Ruling on Commercial Ambulance Immunity

The trial court originally granted summary judgment to the commercial entity. The intermediate appellate court reversed that ruling, and the state’s highest court affirmed the reversal.

Summary of Key Holdings:

• Good Samaritan Act Scope: The court held that CJ § 5-603(b)(3) applies only to volunteer squads, not for-profit ambulance entities.
• Vicarious Immunity: The court ruled that an employee’s personal immunity does not automatically shield the employer under common law agency principles. The employer must establish an independent shield.
• Fire & Rescue Act Scope: The court determined that CJ § 5-604 excludes commercial companies by default unless the firm proves it functioned as a public first responder in that specific context.

The court evaluated the plain language and legislative history of both statutes. It determined that the Good Samaritan Act protects individual care providers and volunteer squads. The word “volunteer” modifies ambulance squads in the statute. Therefore, for-profit ambulance businesses cannot claim this defense.

The court also rejected the vicarious immunity argument. Under agency law, an agent’s personal immunity does not automatically transfer to the principal. The employer must show an independent legal basis for protection.

Finally, the court reviewed the Fire and Rescue Act. The court noted that this statute mimics sovereign immunity for public first responders. Commercial ambulance services operate for profit and also must maintain liability insurance by law. They cannot claim broad municipal immunity unless they prove they acted as a public first responder.

Commentary by Baltimore Medical Malpractice Lawyer Mark Kopec on Commercial Ambulance Immunity

This decision was a major victory for patient safety and accountability. The court correctly limited public immunity defenses to their intended recipients. Allowing commercial entities to exploit statutes meant for municipal responders would have injured patients.

The decision is sound for several reasons:

1. Preserving Legislative Intent

The legislature created the Good Samaritan Act to encourage bystander aid and support volunteer fire and rescue groups. It created the Fire and Rescue Act to grant sovereign-like protection to public responders. Lawmakers never intended these statutes to shield private businesses from ordinary negligence.

2. Profit and Public Duty

For-profit transport firms choose to enter the healthcare market to make a profit. They calculate business risks, charge fees, and carry liability insurance. The law requires these companies to maintain commercial coverage precisely because they face ordinary civil liability. Shielding them under volunteer statutes would grant an unfair financial windfall at the expense of injured patients.

3. Accountable Care Standards

Commercial responders must maintain a high standard of care. Patients in transport are vulnerable and rely completely on the technical skills of the crew. Holding private companies liable for negligence ensures proper training and complete equipment checks before takeoff.

Why Commercial Firms Cannot Claim Municipal Immunity

Private companies cannot claim municipal responder immunity because municipal immunity originates from public sovereignty. State and local governments perform essential public duties funded by taxpayers. Municipal responders act for the public good rather than financial gain.

In contrast, private ambulance companies operate under private contracts. They can accept or refuse business, set prices, and manage risks through commercial insurance. Allowing a commercial enterprise to hide behind municipal immunity would then create an unfair imbalance. The company would gain private profits while avoiding standard legal liability.

This decision ensures that commercial medical transport providers remain accountable to their patients. When a private transport company fails to meet professional standards, vulnerable patients retain the legal right to seek fair compensation.

You can read other Blog posts on issues involving immunity, including:

• County Immunity: Coit v. Nappi 3
• Paramedic Immunity: Coit v. Nappi 1
• Suing Ambulance EMTs: Stracke v. Butler

Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.