In a case of first impression in New Jersey, the Supreme Court held that while the Emergency Medical Services Act (EMS Act) and Good Samaritan Act provide immunity to officers and members of a rescue squad for civil damages, the plain language of those statutes does not provide immunity to a rescue squad as an entity. Murray v. Plainfield Rescue Squad, 210 N.J. 581 (2012). Thus, a rescue squad may be subject to liability for negligence even though its members may be immune from liability. Although the court’s holding may appear to have broad implications for rescue squads, the court recognized that the New Jersey Legislature has conferred immunity upon EMS entities providing advanced life support (ALS) services and “volunteer” rescue squads.

In Murray, the patient was shot in the chest by his younger brother, outside their home in Plainfield. Approximately four minutes later, a Plainfield Rescue Squad ambulance arrived on the scene. The ambulance was staffed by two emergency medical technician-basics and one member in training. An ALS unit operating out of John F. Kennedy Medical Center was also dispatched, but the testimony was disputed as to whether the ALS unit actually arrived on the scene.

According to the rescue squad members, the patient did not have a pulse, so they began administering CPR. They also applied a defibrillator, but it registered “no shock advised[,]” meaning the defibrillator did not detect a cardiac rhythm that could be successfully shocked. The rescue squad members continued CPR and called for a Medevac helicopter for transport of the patient to the hospital, but the helicopter was cancelled because transport of a patient in cardiac arrest is against protocol.

After spending more than 30 minutes on scene, the Plainfield Rescue Squad transported the patient to Muhlenberg Regional Medical Center, which was only a few minutes away. Upon arrival at the emergency department, hospital personnel intubated the patient and attempted to insert an intravenous line. At that time, the patient was still alive and had an active blood pressure, although the bullet had perforated his aorta and severed his spinal cord. The patient later died.

The patient’s parents filed suit against the Plainfield Rescue Squad and JFK Medical Center, claiming that their negligence proximately caused the death of their son. Specifically, the complaint alleged that the rescue squad’s members failed to provide critical emergency medical treatment to the patient and to transport him promptly to the hospital. The complaint also alleged that the ALS unit operating out of JFK Medical Center was negligent.

The trial court granted JFK Medical Center’s motion for summary judgment, finding that the hospital was protected by the immunity provision contained within the EMS Act, N.J.S.A. 26:2K-14, which provides immunity to mobile intensive care paramedics (MICPs) from liability for acts or omissions while rendering ALS services in good faith. The trial court also granted summary judgment in favor of the Plainfield Rescue Squad on the basis of immunity under both the Good Samaritan and EMS Acts. On appeal, the Appellate Division affirmed the dismissal. Murray v. Plainfield Rescue Squad, 418 N.J. Super. 574 (App. Div. 2011). The Supreme Court granted certification, limited to the issue of whether the EMS Act afforded immunity to the rescue squad. The court reversed the award of summary judgment, holding that the EMS Act does not provide immunity to a rescue squad as an entity.

Applicable Immunity Statutes

The Supreme Court’s ruling, which was based upon its interpretation of the various applicable statutes, provides a roadmap for when immunity may or may not apply. As set forth in more detail below, while individuals are generally protected for good-faith actions, the immunity analysis may have differing results depending upon the type of entity seeking immunity.

• Individual Immunity

Individual EMS providers may be immune from liability for negligence under the Good Samaritan Act, N.J.S.A. 2A:62A-1. Under that statute, individuals who in good faith render emergency care “shall not be liable for any civil damages as a result of any acts or omissions by such person rendering the emergency care.” Similarly, the EMS Act states that “[n]o EMT-intermediate … 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 omission of an act committed while in training for or in the rendering of intermediate life support services in good faith[.]” N.J.S.A. 26:2K-29. While courts have upheld immunity with respect to patient care, see Frields v. St. Joseph’s Hosp. & Med. Ctr., 305 N.J. Super. 244 (App. Div. 1997), other courts have taken a more restrictive approach. See De Tarquino v. City of Jersey City, 352 N.J. Super. 450 (App. Div. 2002). Thus, the Good Samaritan and EMS Acts generally protect EMS providers from civil liability where the EMS provider acts in good faith in rendering patient care.

• ALS Immunity

MICPs and entities providing ALS services are generally entitled to immunity under the EMS Act. That law states that no MICP “first aid, ambulance or rescue squad, or officers or members of a rescue squad shall be liable for any civil damages as a result of an act or the omission of an act committed while in training for or in the rendering of advanced life support services in good faith[.]” N.J.S.A. 26:2K-14. As recognized by the court in Murray, the Legislature specifically intended to shield MICPs and entities rendering ALS services who act in good faith from civil liability for negligence.

• Intermediate Life Support Immunity

Although the EMS Act specifically provides immunity to ALS entities, the section applicable to intermediate life support entities does not confer such specific immunity. That provision states that “[n]o EMT-intermediate … 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 omission of an act committed while in training for or in the rendering of intermediate life support services in good faith[.]” N.J.S.A. 26:2K-29. Thus, the EMS Act does not immunize the entity itself. Therefore, as interpreted by the Supreme Court, “ [t]he Legislature evidently intended to shield rescue squads rendering advanced life support services, and not rescue squads rendering intermediate life support services.”

Issues Applicable to Volunteer Rescue Squads

On its face, it appears that while ALS entities are afforded immunity from liability, intermediate entities are not. However, the Legislature has specifically conferred immunity upon “volunteer” EMS agencies and their individual volunteers. New Jersey law expressly provides immunity to an incorporated or unincorporated “volunteer first aid, rescue or emergency squad” that provides for “emergency public first aid and rescue services” and acts in good faith. N.J.S.A. 2A:53A-13.1. Additionally, immunity is afforded to an “authorized active volunteer first aid or rescue squad worker” who renders services in good faith. N.J.S.A. 2A:53A-13. However, such immunity from liability does not extend to the operation of any motor vehicle in connection with the rendering of any such services. See N.J.S.A. 2A:53A-13 and -13.1.

In Murray, the Plainfield Rescue Squad argued that it should be afforded immunity because it was a volunteer rescue squad, but the plaintiffs argued that immunity should not apply because the rescue squad was a for-profit entity. The court did not resolve that dispute and did not analyze whether the rescue squad was a “volunteer” entity. Thus, the court did not provide insight into facts it may consider when determining whether a squad qualifies as a “volunteer” entity.

The statute does not define the phrase “volunteer first aid, rescue or emergency squad,” so it is necessary to look to other New Jersey statutes for guidance. The New Jersey Highway Traffic Safety Act of 1987 defines a volunteer squad as “a first aid, rescue and ambulance squad which provides emergency medical services without receiving payment for those services.” N.J.S.A. 27:5F-20(f). A “[n]onvolunteer first aid, rescue and ambulance squad” is defined as “a first aid, rescue and ambulance squad which provides emergency medical services on a paid basis.” N.J.S.A. 27:5F-20(g). Moreover, New Jersey regulation specifies that “whether the individual members of a squad provide their services for free or are compensated by the squad is irrelevant to a squad’s volunteer status.” N.J.A.C. 8:40A-1.3. Consequently, plaintiffs seeking to recover damages for negligence claims against rescue squads may seek to avoid dismissal of their lawsuit by arguing that the squad is not a “volunteer” entity. Issues such as whether a squad engages in third-party billing may be raised to argue that a squad is not a “volunteer” entity and thus not entitled to immunity, as such issues remain open after Murray.

Rescue squads should encourage their members to follow all procedures and protocols to better protect against negligence lawsuits. If faced with a negligence lawsuit, rescue squads should be aware of the various immunity laws. Because such laws are located in a variety of statutes, it is important that squads engage in discussions with counsel to determine which immunity laws may apply. •