SURVIVAL & WRONGFUL DEATH ACTION

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.

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.

Suzanne C. Johnson, Clerk

2020-10-01 11:08-04:00

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.

The circuit court wrote:

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.

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

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

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

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

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).

[

]

[

]

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

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.

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

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

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

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

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

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.