When a Car Crash Case Can Also Be a Medical Malpractice Case –And When Not

By randall SorrelS and JeSSica rodriguez-wahlquiSt

In 2020, the National Safety Council reported 180 deaths in crashes involving emergency vehicles.1 A significant portion involved ambulances. If the victim’s injuries are life-altering, falling within the claws and caps of the Texas Medical Liability Act (“TMLA”) can be devastating. Fortunately, there are exemptions—some more distinguishable than others—that may allow for a more just and righteous recovery.

For a claim to be deemed a healthcare liability claim in a lawsuit, these three elements must be satisfied: (1) a physician or healthcare provider must be a defendant; (2) the claims at issue must concern treatment, lack of treatment, or a departure from accepted standards of medical care, or healthcare, or safety or professional or administrative services directly related to healthcare; and (3) the defendant’s act or omission complained of must proximately cause the injury to the claimant.2 The second element is usually the disputed and deciding element as to whether a claim resulting from an ambulance wreck is a healthcare liability claim.3

Let’s Start With The obvious

To decide if a claim is a healthcare liability claim, courts focus on the “nature of the acts or omissions causing the victim’s injuries and whether the events are within the ambit of the legislated scope of the TMLA.”4 The pivotal issue becomes the nexus between the duty of care and whether the breach of the duty is one implicated to the defendant’s duties as a healthcare provider, including patient safety.5 Intrinsically, simply because an ambulance is involved in a wreck does not automatically morph an otherwise regular negligence claim into a healthcare liability claim.6

Driver or Passenger Of another Vehicle

Claims brought by drivers or passengers of other vehicles are not healthcare liability claims. When the occupants of another vehicle impacted by an ambulance bring a claim against the ambulance, the ambulance is not seen as an instrumentality used in the provision of healthcare, regardless of whether they were providing medical care to someone onboard. Why? Because those victims are not patients of the ambulance: their alleged injuries occurred outside the ambulance and not in a place where they were receiving medical care as they were either the driver or the passenger of another vehicle.7 That is, the ambulance driver is considered to have failed to follow the rules of the road by negligently operating a vehicle—legal duties that apply to any common driver and are not unique to a healthcare provider.8

a Pedestrian

The same could be said about pedestrians. However, be careful and do not assume. If the injured pedestrian is, for example, the nurse in charge of the patient’s transfer from hospital to ambulance, the claim will be deemed a healthcare liability claim. However, if the injured pedestrian is simply a civilian, then her claim is not one within the reach of the TMLA. To determine whether the TMLA does reach the pedestrian’s claims, courts will analyze the facts through what are called the Ross standards (titled after the Texas Supreme Court case where these standards are articulated, Ross v. St. Luke’s Episcopal Hosp., 462 S.W.3d 496, 505 (Tex. 2015)). The Ross standard asks: (1) whether the alleged negligence occurred in the course of the defendant’s performance of tasks with the purpose of protecting patients from harm; (2) whether the alleged injuries occurred in a place where patients were receiving care, so that the obligation of the provider to protect persons who require medical care was implicated; (3) whether the claimant was seeking or receiving healthcare when the alleged injuries occurred; (4) whether the claimant was providing or assisting in providing healthcare when the injuries occurred; (5) whether the alleged negligence arises from safety standards that are part of the professional duties owed by the healthcare provider; (6) if an instrumentality was involved in the defendant’s alleged negligence, whether it was a type used in providing healthcare; and (7) whether the alleged negligence implicates safety-related requirements set for healthcare providers by governmental or accrediting agencies.9

a Passenger non-Patient

Generally, claims brought by a non-EMS/ non-patient passenger traveling inside an ambulance are not considered healthcare liability claims. While the injuries may occur in the healthcare setting of an ambulance, mere location of an injury does not bring a claim within the TMLA when a passenger is simply accompanying a patient along the ride.10 As with a pedestrian, courts will also analyze the facts surrounding the passenger through the Ross Standards, specifically focusing on factors three and four, whether the claimant was seeking, receiving, assisting, or providing healthcare when the injuries occurred.

Watch out for The TTca

Do not let your guard down. Remember there are city-owned ambulances. While in the instances mentioned above the TMLA may not apply, the Texas Torts Claims Act could limit recovery. Ambulances are considered emergency vehicles, which will trigger the limitations of the TTCA under certain circumstances. In turn, the plaintiff will bear the burden to establish that the emergency response exception does not apply.11

Conclusion

The review of a potential case involving an emergency transportation vehicle must be done with careful diligence. Mistakes made if the case involves a Chapter 74 medical liability case12 can be consequential and case determinative. “Better safe than sorry” definitely applies in these cases.

Randall Sorrels is double board certified in personal injury trial law and civil trial law. He is a past president of the Houston Bar Association and State Bar of Texas. Randy is a founding partner at Sorrels Law. Jessica Rodriguez-Wahlquist is a personal injury and medical malpractice attorney at Sorrels Law. She is proud to be an out LGBTQ+ lawyer, bilingual, and an immigrant, who is dedicated to helping those in her community. Jessica is recognized as a Super Lawyers Rising Star amongst many other accolades.

Endnotes

1. Emergency Vehicles, NATIONAL SAFETY COUNCIL INJURY FACTS, https://injuryfacts.nsc.org/ motor-vehicle/road-users/emergency-vehicles/ (last visited Jan. 6, 2023).

2. Psychiatric Sols., Inc. v. Palit, 414 S.W.3d 724, 725 (Tex. 2013) (quoting Tex. W. Oaks Hosp., LP v. Williams, 371 S.W.3d 171, 179–80 (Tex. 2012)).

3. See, e.g., Taton v. Taylor, No. 02-18-00373-CV, Tex. App. LEXIS 5422, at *10 (Tex. App.—Fort Worth June 27, 2019, no pet.) (mem. op.) (analyzing second element only because plaintiff did not dispute that defendants (an ambulance company and its employee) were health care providers or that a causal nexus existed between defendants’ conduct and plaintiff’s injury).

4. Coci v. Dower, 585 S.W.3d 652, 655 (Tex. App.— Eastland 2019, pet. denied).

5. Ross v. St. Luke’s Episcopal Hosp., 462 S.W.3d 496, 505 (Tex. 2015).

6. Coci, 585 S.W.3d at 656.

7. See Canter v. Toca, No. 10-22-00166-CV, 2022 Tex. App. LEXIS 6713, at *1 (Tex. App.—Waco Aug. 31, 2022, pet. filed) (mem. op.).

8. See id

9. Ross v. St. Luke’s Episcopal Hosp., 462 S.W.3d 496, 505 (Tex. 2015).

10. Id. at 504–05.

11. Quested v. City of Houston, 440 S.W.3d 275, 284 (Tex. App.—Houston [14th Dist.] 2014, no pet.)

12. TEX. CIV. PRAC. & REM. CODE Ch. 74