Washington EMT Immunity Protects Emergency Medical Care, Not Negligent Ambulance Driving

1. Introduction

The Washington Supreme Court held that statutory immunity for emergency medical technicians does not extend to negligent ambulance driving. Under RCW 18.71.210, immunity protects qualifying emergency medical treatment within a provider’s medical expertise; it does not protect every activity undertaken during an emergency response.

Michael J. Lang, individually and as personal representative of Frank Costa’s estate, pursued wrongful death and survival claims against Platinum Nine Holdings, LLC, doing business as Northwest Ambulance. During Costa’s transport to a hospital, an ambulance driven by EMT Henry Shaw struck a highway divider. Costa, whose shoulder restraints had not been secured, was thrown from his stretcher, injured, and died later that day.

Northwest Ambulance admitted negligence but argued that RCW 18.71.210 barred liability. The central issue was whether ambulance transportation itself constitutes protected emergency medical service. A related issue concerned the failure to use shoulder restraints, but the Supreme Court expressly declined to decide that question.

2. Facts and Procedural Background

The transport and collision

Northwest Ambulance assigned two EMTs, Jack Wilson and Henry Shaw, and an EMT trainee, Katelyn Averill, to transport Costa. Wilson and Shaw secured him to a gurney with guardrails and belts across his waist and knees. They did not use shoulder restraints, contrary to company policy.

Wilson and Averill remained with Costa while Shaw drove. When Wilson detected a possible irregular heartbeat, he instructed Shaw to “drive code,” activating emergency driving privileges. Those privileges permit specified departures from ordinary traffic rules but remain subject to the duty to drive with due regard for others’ safety.

While accelerating to pass a garbage truck, Shaw encountered a situation in which he believed he could not stop without striking the truck. He swerved right and hit a highway divider. Costa was ejected from the stretcher into the ambulance wall, suffering injuries to his head, neck, and arm.

The litigation

The Estate alleged that negligent driving and inadequate restraints proximately caused Costa’s death. Northwest Ambulance asserted statutory qualified immunity. The parties filed cross motions for summary judgment: the Estate sought to eliminate the immunity defense, while Northwest Ambulance sought dismissal.

The trial court rejected immunity for driving because driving an ambulance was not an emergency medical service within the statute. Northwest Ambulance subsequently conceded ordinary negligence in failing to avoid the collision and failing to secure Costa fully, while maintaining its immunity defense.

A jury returned a general verdict for the Estate. Its verdict did not distinguish between negligent driving and negligent restraint. Northwest Ambulance neither requested a special verdict separating those theories nor obtained separate findings. The Court of Appeals affirmed, and the Supreme Court granted review of the immunity ruling.

The garbage-truck operator was also named as a defendant, but its liability was not before the Supreme Court.

3. Summary of the Decision

The Supreme Court affirmed the Court of Appeals and left the Estate’s judgment undisturbed. Its principal conclusions were:

• Immunity is activity-specific. EMT certification and employment by a licensed ambulance service do not immunize every act performed during transport.
• Driving is not medical treatment. RCW 18.71.210 protects qualifying emergency medical procedures within the provider’s medical expertise, not negligent vehicle operation.
• Emergency driving privileges preserve a duty of care. RCW 46.61.035 does not eliminate an ambulance driver’s obligation to drive with due regard for safety.
• The restraint question remains open. The court did not decide whether securing a patient with shoulder restraints falls within protected emergency medical services.
• The general verdict was sufficient here. Negligent driving independently supported the verdict, and Northwest Ambulance had not preserved a demand for differentiated jury findings.

The decision therefore establishes a rule about negligent ambulance driving, not a categorical rule excluding all transportation-related patient handling from immunity.

4. Analysis of the Court’s Legal Reasoning

A. The statutory protection depends on the nature of the act

RCW 18.71.210(1) protects specified providers and entities against liability for qualifying acts or omissions undertaken in good faith while rendering emergency medical service. Subsection (2), however, limits that protection to conduct occurring in the performance of “actual emergency medical procedures” and excludes conduct outside the provider’s “field of medical expertise.”

The majority treated subsection (2) as a substantive boundary on subsection (1). Northwest Ambulance’s status as a licensed service and the EMTs’ undisputed good faith did not answer whether driving was a protected activity. Those conditions could not extend immunity beyond the statutory category of medical conduct.

This approach rejects Northwest Ambulance’s proposed blanket protection from the Estate’s claims. The relevant inquiry is not simply whether an EMT was working during an emergency, but whether the particular allegedly negligent act falls within the immunity statute.

B. “While transporting” identifies when treatment occurs

RCW 18.73.030(11) defines emergency medical service as:

“medical treatment and care which may be rendered at the scene of any medical emergency or while transporting any patient in an ambulance to an appropriate medical facility, including ambulance transportation between medical facilities.”

For the majority, “medical treatment and care” supplies the controlling category. The phrase “while transporting” identifies circumstances in which treatment may occur; it does not turn transportation itself into treatment.

The concluding reference to transportation between facilities likewise ensures that qualifying care remains covered during an interfacility transfer. It does not independently immunize the driver’s operation of the ambulance.

The distinction is between care delivered during transportation and the driving that accomplishes transportation. The former may qualify for immunity; the latter does not merely because it assists an urgent medical mission.

C. Certification requirements support the medical/nonmedical distinction

The majority consulted WAC 246-976-010(33), which defines emergency medical procedures by reference to skills within certified EMS personnel’s scope of practice. Related regulations connect authorized patient care to approved instructional requirements and the Department of Health’s EMS skills and procedures list.

Ambulance driving is not part of the state’s EMT certification requirements. The majority regarded that omission as supporting the conclusion that driving is not an emergency medical procedure within an EMT’s medical expertise.

The opinions disagreed about the significance of the employees’ driving instruction. The majority emphasized Shaw’s testimony describing a brief PowerPoint presentation and noted that a more substantial emergency-driving course occurred after the collision, through another employer. The dissent emphasized classroom instruction, field experience, and the specialized demands of emergency vehicle operation.

The holding nevertheless does not depend simply on Shaw having insufficient training. The majority’s central proposition is categorical: driving does not become medical treatment merely because an EMT performs it or receives specialized driving instruction.

D. Separate crew responsibilities reinforce the distinction

The majority also relied on RCW 18.73.150, which assigns patient-care responsibilities to a nondriving EMT when two or more EMTs operate an ambulance. Here, Wilson attended Costa while Shaw drove.

That division supported the majority’s conclusion that emergency transportation can involve distinct functions: medical care and vehicle operation. Although those functions cooperate toward a common objective, their practical connection does not give them identical legal treatment.

E. Alternative destinations do not expand the protected activity

Northwest Ambulance relied on RCW 18.71.210(4), which extends the statute to qualifying conduct involving transportation to mental health facilities or chemical dependency programs under approved procedures.

The majority understood that provision as expanding permissible destinations covered by the existing immunity, not expanding immunity to driving. The 2015 legislation authorized transport to specified alternative facilities and correspondingly extended protection for emergency medical care during those transports.

Thus, subsection (4) addresses where patients may be taken, while subsection (2) continues to govern which activities are protected.

F. Related statutes confirm that transportation immunity requires clearer language

Two statutory comparisons reinforced the majority’s interpretation.

First, RCW 4.24.300(1), governing qualifying volunteer assistance, expressly refers to emergency care or transporting persons. The legislature therefore knew how to distinguish—and expressly protect—both activities. Its different wording in RCW 18.71.210 supported a different scope of protection. This comparison does not establish unlimited volunteer immunity; the volunteer statute retains its own eligibility requirements and limitations.

Second, RCW 46.61.035 permits authorized emergency drivers to exercise specified traffic privileges but expressly preserves their duty to drive with due regard for everyone’s safety. The majority considered immunity for ordinary negligent driving inconsistent with that statutory framework.

The governing standard remains sensitive to emergency driving circumstances. The decision does not require an ambulance responding to an emergency to behave exactly like an ordinary commuter; it requires reasonable care under the applicable emergency-vehicle rules.

G. The verdict form limited the issues requiring decision

The jury’s general verdict did not identify whether liability rested on negligent driving, negligent restraint, or both. Because Northwest Ambulance sought different legal treatment of those theories through its affirmative defense, it bore the responsibility to request a special verdict distinguishing them.

Having failed to do so, Northwest Ambulance could not obtain a new trial merely by challenging one possible basis for the undifferentiated verdict. The independently sufficient driving theory allowed affirmance without deciding whether restraint-related negligence was immune.

This procedural ruling is an important limit on the precedent: the court’s refusal to address restraints must not be mistaken for a substantive ruling against immunity for that conduct.

5. The Dissent: Emergency Transport as Integrated Medical Service

Justice Montoya-Lewis would have granted summary judgment to Northwest Ambulance. The dissent viewed ambulance transportation and medical care as integrated components of emergency medical service rather than separately classified activities.

A. Driving implements medical judgments

The dissent emphasized that a lead EMT assesses the patient and determines whether urgent transport is necessary. The driver then implements that medical decision through route selection, emergency equipment, speed, and maneuvering. On this understanding, code driving is part of a coordinated medical response rather than an independent nonmedical task.

The dissent also relied on statutory provisions placing a nondriving EMT in command of the ambulance and responsible for its operation and patient care. Where the majority saw differentiated responsibilities, the dissent saw an integrated service directed by medical judgment.

B. Subsection (2) limits qualifications, not the service category

The dissent interpreted the reference to medical expertise primarily as a credentialing restriction. Different providers may perform different procedures, and immunity should protect only services within their qualifications. It rejected using subsection (2) to narrow the broader statutory concept of emergency medical service to medical procedures alone.

C. A duty of care can coexist with immunity

The dissent distinguished the obligation to exercise ordinary care from the availability of damages for breaching that obligation. In its view, RCW 46.61.035 establishes the driving duty, while RCW 18.71.210 can immunize an ordinary negligent breach without eliminating the duty itself.

That distinction exposes a significant point of disagreement: the majority treated the emergency-driving statute as supporting civil accountability, while the dissent considered it compatible with a separate statutory defense.

D. Policy concerns and restraints

The dissent warned that excluding driving could discourage decisive emergency responses and burden rural emergency services. It also would have treated securing a patient as protected medical service because that task involves training and patient-care knowledge.

These positions did not become the court’s holding. Nor did the majority resolve whether the conduct constituted gross negligence. RCW 18.71.210(5) excludes gross negligence and willful or wanton misconduct from immunity, but the majority decided this case on the antecedent question whether driving fell within the statute at all.

6. Precedents Cited and Their Influence

The cited decisions principally supply procedural rules and interpretive methods. The opinion does not identify an earlier case directly establishing immunity for negligent ambulance driving.

A. Authorities supporting the majority’s approach

Gerlach v. Cove Apts., LLC, 196 Wn.2d 111, 135, 471 P.3d 181 (2020)

This precedent determines the significance of the undifferentiated verdict. A party attacking one theory supporting a general verdict must have objected to that verdict form and proposed a special verdict clarifying the findings to obtain a new trial on that basis. Its application allowed the court to uphold the judgment without deciding the restraint-immunity question.

Keck v. Collins, 184 Wn.2d 358, 370, 357 P.3d 1080 (2015)

This case supplies de novo review of summary judgment and the requirement that no genuine issue of material fact remain before judgment may be entered as a matter of law. Because the parties’ immunity dispute was legal rather than factual, the court independently interpreted the statute.

Dep't of Ecology v. Campbell & Gwinn, LLC, 146 Wn.2d 1, 9–11, 43 P.3d 4 (2002)

Both opinions rely on this foundational statutory-interpretation authority. Legislative intent is derived from statutory language considered alongside related provisions and the statutory scheme. The majority used it to read the immunity, definitions, certification rules, and driving provisions together. The dissent invoked the same contextual method but drew a broader understanding of emergency medical service.

State v. Roberts, 117 Wn.2d 576, 586, 817 P.2d 855 (1991)

This decision supports treating different statutory wording as evidence of different legislative intent. It strengthened the majority’s comparison between the volunteer statute’s express transportation protection and the EMT statute’s medical-care language.

B. Authorities supporting the dissent’s interpretive objections

Associated Gen. Contractors of Wash. v. State, 2 Wn.3d 846, 863, 544 P.3d 486 (2024)

The dissent cited this decision for reading each provision in relation to others and harmonizing them where possible. It argued that subsection (2) should regulate providers’ qualifications without undermining subsection (1)’s broader protection.

In re Est. of Kerr, 134 Wn.2d 328, 355, 949 P.2d 810 (1998)

Cited through the preceding decision, this case provides the quoted harmonization principle. Its role is methodological: apparent tension between provisions should be reconciled within the overall statute.

Quadrant Corp. v. Cent. Puget Sound Growth Mgmt. Hr'gs Bd., 154 Wn.2d 224, 238–39, 110 P.3d 1132 (2005)

This authority reinforces whole-statute interpretation. The dissent used it to argue against separating transportation from the broader ambulance-service framework established by related provisions.

Wash. State Ass'n of Counties v. State, 199 Wn.2d 1, 12–13, 502 P.3d 825 (2022)

This decision states that statutory language should not be rendered meaningless or superfluous. The dissent argued that restricting immunity to medical procedures deprived the broader phrase “emergency medical service” of independent significance.

State v. J.P., 149 Wn.2d 444, 450, 69 P.3d 318 (2003)

Quoted through the preceding authority, this case supplies the anti-surplusage principle. It supports the dissent’s insistence that the statute’s broader service terminology must do meaningful work.

Spokane County v. Dep't of Fish & Wildlife, 192 Wn.2d 453, 458, 430 P.3d 655 (2018)

The dissent invoked the presumption against absurd results. It regarded the legal separation of coordinated emergency driving and treatment as inconsistent with how ambulance care actually functions.

Ralph v. Dep't of Nat. Res., 182 Wn.2d 242, 248, 343 P.3d 342 (2014)

This case supports reading a statute so that no clause, sentence, or word becomes insignificant. It reinforced the dissent’s objection that the majority narrowed subsection (1) excessively.

State ex rel. Baisden v. Preston, 151 Wash. 175, 177, 275 P. 81 (1929)

Quoted through Ralph v. Dep't of Nat. Res., this older authority supplies the same whole-statute and anti-surplusage formulation. It contributes interpretive continuity rather than an independent emergency-services rule.

United States v. Hoffman, 154 Wn.2d 730, 741, 116 P.3d 999 (2005)

This authority distinguishes legislatively defined terms from undefined terms. The dissent relied on it to prioritize the statutory definition of emergency medical service while construing “actual emergency medical procedures” through its ordinary, contextual meaning.

State v. Roggenkamp, 153 Wn.2d 614, 623, 106 P.3d 196 (2005)

This case supports interpreting undefined terms in statutory context rather than isolation. It assisted the dissent’s argument that “procedures” must be understood within the integrated emergency-services scheme.

Columbia Riverkeeper v. Port of Vancouver USA, 188 Wn.2d 421, 435, 395 P.3d 1031 (2017)

This decision likewise supports contextual ordinary-meaning analysis, with dictionary definitions available as an aid. The dissent used it to resist treating the undefined phrase “emergency medical procedures” as independently narrowing the defined service category.

C. The intermediate appellate decision

Lang v. Platinum Nine Holdings, LLC, No. 86205-7-I (Wash. Ct. App. July 28, 2025) (unpublished), is cited as the decision under review. Its significance is procedural: it affirmed the rejection of Northwest Ambulance’s immunity argument. The Supreme Court’s own reasoning establishes the controlling rule discussed here.

7. Likely Impact

Ordinary negligence claims remain available for ambulance crashes

Patients injured by negligent ambulance driving need not establish gross negligence merely to overcome RCW 18.71.210. They must still establish the ordinary elements of their claims, and defendants retain other applicable defenses. The decision removes this particular statutory immunity from negligent driving; it does not impose automatic liability whenever an ambulance crashes.

Mixed-function claims require careful classification

Future disputes may concern patient lifting, stretcher handling, restraint selection, equipment placement, or other tasks combining safety and medical considerations. The opinion suggests an activity-specific inquiry but does not resolve those categories. In particular, shoulder-restraint immunity remains undecided.

Verdict forms become strategically important

Where different negligence theories may receive different immunity treatment, parties should seek separate findings and preserve appropriate objections. Northwest Ambulance’s failure to do so materially limited the appellate issues requiring resolution.

Operational training cannot substitute for statutory coverage

Ambulance services have a stronger incentive to emphasize defensive driving, emergency-code policies, and supervision. Additional training may improve safety, but under the majority’s reasoning it does not itself transform driving into an immunized medical procedure.

Any broader transportation immunity would require legislative action

The majority’s reliance on contrasting statutory language signals that broader immunity should come from an express legislative choice. The dissent’s concerns about emergency decision-making and rural services remain relevant policy arguments, but they did not overcome the majority’s reading of the enacted text.

8. Complex Concepts Simplified

Statutory qualified immunity

A conditional protection against civil liability created by legislation. Here, it concerns emergency medical services—not the separate federal doctrine commonly associated with government officials.

Ordinary negligence

Failure to use the care a reasonably careful person performing the relevant role would use in similar circumstances.

Gross negligence

A more serious degree of negligence. The statute excludes it from immunity, but the court did not need to decide whether it occurred here because driving was outside the protected category.

Summary judgment and de novo review

Summary judgment resolves an issue without trial when material facts are not genuinely disputed and the law determines the result. De novo review means the appellate court decides that legal issue independently.

Affirmative defense

A defense that can defeat liability even when the claimant otherwise establishes a claim. Northwest Ambulance asserted immunity in this manner.

General and special verdicts

A general verdict states the overall outcome. A special verdict records answers to particular questions, allowing a reviewing court to distinguish separate liability theories.

Duty versus immunity

A duty identifies required conduct; immunity may prevent damages despite a breach. The dissent emphasized that distinction, while the majority found no transportation immunity in this statute.

Wrongful death and survival claims

Wrongful death claims address legally recognized losses resulting from death; survival claims preserve qualifying claims belonging to the deceased. The opinion did not separately resolve their damages rules.

9. Conclusion

Lang v. Platinum Nine Holdings, LLC draws a consequential boundary: emergency medical immunity follows qualifying medical conduct, not every activity performed by an EMT. Negligent ambulance driving remains subject to ordinary civil accountability under the applicable emergency-driving standard.

The decision also illustrates the importance of procedural preservation. Because Northwest Ambulance did not request a verdict distinguishing driving from restraint-related negligence, the court could affirm without deciding whether patient restraint falls within immunity. The driving rule is settled; the restraint question remains open.