Applewhite v. Accuhealth, Inc.
21 N.Y.3d 420
| NY | 2013Background
- 12-year-old Tiffany Applewhite suffered anaphylactic shock after a nurse injected prescribed medication at home; she seized and arrested before/while EMS arrived, survived with severe brain injury.
- Two FDNY basic EMTs in a BLS ambulance arrived minutes after a 911 call; they performed CPR, called for an ALS ambulance (paramedics), and did not transport immediately; ALS paramedics later arrived, administered epinephrine, intubated, and transported to hospital.
- Plaintiffs sued the City (EMS/FDNY) alleging negligent emergency care/omission; Supreme Court granted summary judgment for the City; Appellate Division reversed and reinstated claims, finding triable issues on special duty and proximate cause.
- The legal question certified: whether municipal EMT/ambulance emergency medical response is a governmental function and whether plaintiffs raised triable issues of a special duty sufficient to defeat summary judgment.
- The Court held municipal 911/EMS ambulance response (including FDNY EMTs’ pre-hospital care) is a governmental function, but plaintiffs raised triable issues that the City voluntarily assumed a special duty (special relationship), so summary judgment was improper.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Is municipal EMS/EMT pre-hospital emergency care a governmental or proprietary function? | EMT care is medical treatment (like hospital care), typically provided by private actors, so proprietary. | EMS/911 response is a core government function for public safety; EMTs are public first responders. | Held governmental: municipal EMS (including FDNY EMTs) is a classic governmental function. |
| If governmental, did the City owe a special duty to plaintiffs (special relationship)? | EMTs allegedly assumed an affirmative duty by promising/waiting for ALS and thus created reliance by mother. | No special duty was owed; any duty is owed to the public generally, not to specific individuals. | Held triable issues exist on special duty: plaintiffs adequately pleaded questions of fact on assumption of duty and justifiable reliance. |
| Was the City entitled to summary judgment on proximate cause? | EMT delay/decision not to transport proximately caused harm. | Injury was caused by the drug administered by the nurse, not EMS action. | Court did not resolve proximate cause on summary judgment; factual issues remain for trial. |
| Do public-policy concerns require treating EMS medical care as proprietary to avoid chilling public services? | (Plaintiffs/concurring justices) Government should not get preferential immunity when providing medical care like private providers. | (City) Immunity for governmental functions prevents crippling liability and preserves public emergency services. | Court acknowledged policy concerns but held EMS is governmental; nevertheless special-duty analysis preserves claim viability when facts show voluntary assumption. |
Key Cases Cited
- Matter of World Trade Ctr. Bombing Litig., 17 NY3d 428 (governmental v. proprietary function inquiry and mixed-function analysis)
- Sebastian v. State of New York, 93 NY2d 790 (distinguishing governmental and proprietary functions; private-sector analogue controls)
- Laratro v. City of New York, 8 NY3d 79 (municipal duty to provide ambulance/911 services; special-duty framework applied)
- Valdez v. City of New York, 18 NY3d 69 (special duty must be more than that owed the public generally)
- Cuffy v. City of New York, 69 NY2d 255 (four-element test for establishing a special relationship)
- Lauer v. City of New York, 95 NY2d 95 (duty is essential element; duty to public generally vs. special duty)
- Schrempf v. State of New York, 66 NY2d 289 (governmental provision of medical/psychiatric care can be proprietary)
- Metz v. State of New York, 20 NY3d 175 (special duty can arise when government takes control of a known dangerous condition)