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Duty of Care Owed by Ambulance to Those Being Transported

Does an ambulance owe a duty to care to those it transports and does that duty require those being transported while on psychiatric hold to be restrained?  That was what was taken up in (T.L. v. City Ambulance of Eureka, Inc. (Sep. 29, 2022, No. A162508) ___Cal.App.5th___ [2022 Cal. App. LEXIS 829, at *1-2].)

While plaintiff was being transported by ambulance from a crisis stabilization unit to an inpatient psychiatric facility, she suddenly unbuckled the two belts strapping her to the semi-reclined gurney and stepped out of the back of the moving ambulance, sustaining serious injuries. She sued the ambulance company and the paramedic and EMT staffing the ambulance.

Indeed, the ambulance company had a specific policy pertaining to the use of restraints. It stated:

Restraints are to be used only when necessary, in situations where the patient is potentially violent and is exhibiting behavior that is potentially dangerous to self and/or others, and:

  1. the patient is under arrest and the law enforcement officer permits restraints, or
  2. the patient is under a 5150 hold and 5150 documentation is transported with the patient, or
  3. Unablerather than unwilling to follow directions.-i.e. confused, delirious, disoriented, or extremely restless. They may be grabbing, pulling or tugging tubes, line or other therapeutic devices.“

At the stabilization unit, plaintiff had been placed on a “section 5585” 72-hour mental health hold.  However, she was calm and cooperative while at the unit, was never diagnosed as being a danger to herself, and was transported by ambulance to and from a local hospital for a medical clearance, without incident. Her attending psychiatrist determined she was also stable for transport to the in-patient facility, where she could receive a higher level of care than was available locally.  As a result, the ambulance personnel chose not to restrain the plaintiff and simply had her sit on a gurney with two seatbelts buckled.

Defendants moved for summary judgment on the sole ground they owed no duty “to prevent plaintiff from engaging in impulsive, reckless, irrational and self-harming conduct,” relying on Hernandez v. KWPH Enterprises (2004) 116 Cal.App.4th 170 (Hernandez). Concluding Hernandez was dispositive, the trial court granted the motion.

The Plaintiff appealed, claiming Hernandez is distinguishable and defendants owed her a general duty to act with due care.

The First District Court of Appeal agreed with plaintiff and reversed, holding:

Defendants, a paramedic and an emergency medical technician, owed plaintiff a general duty to act with due care while transporting plaintiff by ambulance from a crisis stabilization unit to an inpatient psychiatric facility. The court thought it likely enough that negligence in securing a patient for transport may result in injury to the patient, including because of the patient’s own physical movement. This case did not involve criminal conduct by a third party. Nor did plaintiff seek to require defendants to make highly burdensome expenditures that, given the efforts of a determined criminal, would be of dubious efficacy. The court therefore could not conclude that allowing the possibility of liability in cases such as this one would result in such significant social burdens that the law should not recognize such claims.

The court was careful to recognize, and state, that it was not making a ruling that EVERYONE being transported 5150 (5885 for minors) need be restrained.  The Court explained:

“…contrary to plaintiff’s apparent view, the professional standard of care does not, as a matter of law, require the use of restraints during the transport of any patient subject to a 5150 or 5585 hold (including a hold based on reported acts indicating [*45]  a generalized risk of harm to others or self), regardless of all the other circumstances, including the attending physician’s assessment of the patient’s readiness for transport and decision not to order the use of restraints. In short, as plaintiff has argued the case on appeal, and in light of the record on appeal, the only claims plaintiff has advanced that have any conceivable traction are that the gurney should have had shoulder harnesses which should have been used, and the rear door of the ambulance should have been locked. As we have observed, whether these claims have any merit was not addressed by the summary judgment motion.”

(T.L. v. City Ambulance of Eureka, Inc. (Sep. 29, 2022, No. A162508) ___Cal.App.5th___ [2022 Cal. App. LEXIS 829, at *44-45].)
Thus, on remand, the plaintiff may pursue her claims that shoulder harnesses should have been used and that the rear door should have been locked.

At Heiting & Irwin, we have decades of experience handling negligence and medical negligence cases.  If you or a loved one has been injured due to the negligence of another, call us today for a free consultation at (951) 682-6400 or visit us online at


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