IN THE SUPREME COURT OF THE STATE OF WASHINGTON
MICHAEL J. LANG, individually, and as ) Personal Representative of the ESTATE OF ) FRANK E. COSTA, on behalf of the Estate ) and all statutory beneficiaries, )
)
Respondents, )
)
No. 104498-4 En Banc
Filed: October 29, 2026
v. )
)
PLATINUM NINE HOLDINGS, LLC, a )
)
)
)
Washington Limited Liability Corporation, doing business as NORTHWEST
AMBULANCE, a company,
)
Petitioners, )
)
and )
)
NORTHWEST AMBULANCE CRITICAL )
CARE TRANSPORT, a company; and XYZ, ) a fictitious entity or company; RUBATINO )
REFUSE REMOVAL, INC., RUBATINO )
REFUSE REMOVAL, LLC, a Washington ) Limited Liability Corporation; RUBATINO ) REFUSE, LLC, a Washington Limited ) Liability Corporation; RUBATINO REFUSE ) REMOVAL HOLDINGS, LLC, a )
Washington Limited Liability Corporation; )
RUBATINO LITTER SOLUTIONS, INC., )
FILE
IN CLERK'S OFFICE
SUPREME COURT, STATE OF WASHINGTON
OCTOBER 29, 2026
THIS OPINION WAS FILED
FOR RECORD AT 8 A.M. ON
OCTOBER 29, 2026
SARAH R. PENDLETON
SUPREME COURT CLERK
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a Washington Corporation; RUBATINO ) HOLDING COMPANY, INC., a Washington ) Corporation; and RUBATINO ) ENGINEERING, LLC, a Washington ) Limited Liability Corporation; and XYZ ) Corporation, )
)
Defendants. )
)
MUNGIA, J.—The legislature granted emergency medical technicians (EMTs) immunity from civil liability if they negligently provide emergency medical treatment to a patient. In other words, if an EMT's treatment of a patient falls below the standard of care expected of a reasonably careful EMT under the same or similar circumstances, the legislature enacted a statute that prevents an injured patient from being compensated for that negligent treatment. However, in that statute, the legislature immunized only acts of medical expertise. It did not immunize an EMT's acts that did not involve their medical expertise, such as driving an ambulance. Henry Shaw, an EMT, drove an ambulance into a highway divider while taking Frank Costa to the hospital. Northwest Ambulance,1Mr. Shaw's employer, admitted that Mr. Shaw was negligent and that his negligence caused the accident. The Northwest Ambulance crew also failed to secure Mr. Costa to the ambulance gurney
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with shoulder restraints. Northwest Ambulance admitted that the crew's failure to secure Mr. Costa with shoulder restraints was negligent. Northwest Ambulance argues that RCW 18.71.210(1) immunizes it from the negligent acts of its ambulance crew because they were transporting Mr. Costa to the hospital. The statute provides immunity to licensed ambulance services for any act or omission done in good faith by an EMT rendering emergency medical services while transporting a patient to a medical facility. However, RCW 18.71.210(2) limits the scope of that immunity. The immunity applies only "in the performance of the actual emergency medical procedures" and affords immunity only for acts or omissions that are within the EMT's field of medical expertise. RCW 18.71.210(2). Both parties moved for summary judgment as to whether RCW 18.71.210(1)'s immunity applies to this situation. The trial court ruled in favor of Michael Lang, the personal representative of Mr. Costa's estate (Estate), finding no immunity. The Court of Appeals affirmed the trial court's ruling.
We affirm the Court of Appeals' holding that an EMT's negligent driving is not within the scope of rendering emergency medical services as contemplated by the legislature. As discussed below, we do not reach whether failing to secure Mr. Costa with shoulder restraints is within the scope of rendering emergency medical services. We do not need to reach this issue because Northwest Ambulance did not propose a special jury verdict form distinguishing between the two negligent acts. The negligent
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driving alone is sufficient to uphold the verdict. Accordingly, we hold that Northwest Ambulance is not entitled to qualified immunity in this case.
I
FACTUAL AND PROCEDURAL HISTORY
A. Factual History
Frank Costa, a patient, was transported by a Northwest Ambulance crew to a medical facility. The Northwest Ambulance crew consisted of three people: (1) EMT Jack Wilson, (2) EMT Henry Shaw, and (3) EMT trainee Katelyn Averill.2 Mr. Wilson and Mr. Shaw secured Mr. Costa on a gurney using guardrails and two lap belts positioned over his waist and knees. The EMTs did not use shoulder restraints. Northwest Ambulance's policy required the use of shoulder restraints. There is no dispute that the EMTs violated the policy by not securing Mr. Costa with the shoulder straps.
After Mr. Costa was secured, Mr. Wilson and Ms. Averill remained in the back of the ambulance to monitor Mr. Costa while Mr. Shaw drove. On the way to the hospital, Mr. Wilson believed that Mr. Costa's heartbeat was becoming irregular. Mr. Wilson called an emergency code. An emergency code allows the driver certain privileges not accorded to other drivers but with the restriction that the driver must
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always drive with due regard for the safety of others. The rules for driving emergency code are set out in RCW 46.61.035:
(1) The driver of an authorized emergency vehicle, when responding to an emergency call or when in the pursuit of an actual or suspected violator of the law or when responding to but not upon returning from a fire alarm, may exercise the privileges set forth in this section, but subject to the conditions herein stated.
(2) The driver of an authorized emergency vehicle may:
(a) Park or stand, irrespective of the provisions of this chapter;
(b) Proceed past a red or stop signal or stop sign, but only after slowing down as may be necessary for safe operation;
(c) Exceed the maximum speed limits so long as he or she does not endanger life or property;
(d) Disregard regulations governing direction of movement or turning in specified directions.
(3) The exemptions herein granted to an authorized emergency vehicle shall apply only when such vehicle is making use of visual signals meeting the requirements of RCW 46.37.190, except that: (a) An authorized emergency vehicle operated as a police vehicle need not be equipped with or display a red light visible from in front of the vehicle;
(b) authorized emergency vehicles shall use audible signals when necessary to warn others of the emergency nature of the situation but in no case shall they be required to use audible signals while parked or standing.
(4) The foregoing provisions shall not relieve the driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his or her reckless disregard for the safety of others. After Mr. Shaw began to "drive code," he noticed a garbage truck farther down the road. Mr. Shaw stayed behind the garbage truck for a while but then sped up. So, when an ambulance is going lights and sirens behind a trash truck going its regular speed[, that] is not really the speed the ambulance wants to go. So I was camping, waiting behind it for a while. And then it finally did start to—to head off and then that's when I began to overtake—accelerate to begin to overtake it.
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Clerk's Papers (CP) at 76. Mr. Shaw testified that while it looked like the truck was going to the right, it then began to go back into the lane where he was driving. At the speed Mr. Shaw was traveling, he could not brake without hitting the truck, so he swerved to the right. I hadn't begun passing, but I was accelerating in order to pass. As they got back in front of me, I was at such a distance where they got in front of me that I engaged my brakes completely.
And—and I noticed I was still traveling at such a speed that with my brakes engaged right now and at the speed I'm going, I'm going to hit this guy. I'm not—I'm not slowing down at a quick enough rate to avoid rear-ending this truck.
So I swerved to the right because there was that shoulder there. I swerved to the right to get away from hitting him. And I couldn't see it because of where the garbage truck was positioned to my—say my 2:00—was positioned and then came back in front of me at my 12:00. And there was what's called a gorder, which is those chevron dividers with like—a lots of times they have sand barrels behind them and stuff like that, that divide the exit ramp from the rest of the—the highway. And I hit that head on when I tried to go—I tried to go around him just to be able to get, slow down—have more room to slow down, maybe in the shoulder, or maybe I could commit to that ramp to start slowing down. But I just avoided him—basically slow down and then I hit that instead. I didn't see it there and I hit it head on.
CP at 74.
Mr. Costa was ejected from the stretcher into the ambulance wall, injuring his head, neck, and arm. He died later that day.
After the accident, Northwest Ambulance terminated Mr. Shaw's and Mr. Wilson's employment. In the termination letter, Northwest Ambulance set forth the bases for the termination.
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This notice of dismissal is issued to you for violation of company policies and Snohomish county code policies which has led up to the decision to end employment at once effective today, November 24, 2020. The impact your behavior created is unacceptable behavior and dismissal for not adhering to the policies.
Policies and Transport documentation:
1) Insubordination of company policy in transporting patients with proper restrains, [sic] calling code when essential and lack of defensive driving which caused a preventable accident.
2) Excessive speed while driving code and above our policy limit of 10 miles over posted speed limit. Per policy, "Any speeding that exceeds . . . (10 mph code) over the posted speed limit will be considered a violation of our policy".
3) Insubordination of the company Code of Conduct and expectations.
4) Insubordination of policy; Drivers must conform to all traffic laws and make allowances for adverse weather and traffic conditions.
CP at 132.
B. Procedural History
1. The Estate's Wrongful Death Case Against Northwest Ambulance The Estate brought wrongful death and survival actions against Northwest Ambulance.3The complaint alleged that the EMTs' failure to properly secure Mr. Costa to the gurney and failure to avoid the collision were the proximate causes of Mr. Costa's death. In its answer, Northwest Ambulance raised an affirmative defense
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of statutory qualified immunity under RCW 18.71.210, arguing it was completely immune from the Estate's claims. Licensed ambulance providers are subject to qualified immunity for an EMT's acts or omissions while rendering emergency medical services in good faith during transport. RCW 18.71.210(1); RCW
18.73.030(11).
2. Summary Judgment Proceedings Both parties subsequently filed cross motions for summary judgment. The Estate's motion for partial summary judgment sought to strike Northwest Ambulance's qualified immunity defense. The Estate argued that Northwest Ambulance was not subject to qualified immunity because the EMTs were not rendering emergency medical services under RCW 18.71.210 when driving the ambulance and securing the patient. The Estate asserted that those acts were not part of any "ʻactual emergency medical proceduresʼ" within the EMTs' field of medical expertise, as is required for the immunity to apply. CP at 36 (quoting RCW
18.71.210(2)).
In Northwest Ambulance's cross motion for summary judgment, it argued that it should be dismissed from the suit because it was subject to qualified immunity. Northwest Ambulance argued that RCW 18.71.210 completely immunized it from suit, not simply from liability for certain negligence claims.
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The trial court denied Northwest Ambulance's motion and granted the Estate's motion in part. The court concluded as a matter of law that Northwest Ambulance was not immune from suit because "driving an ambulance is not emergency medical service." CP at 318.
Northwest Ambulance later conceded that its employees acted outside the scope of ordinary care by failing to fully secure Mr. Costa to the gurney and by failing to avoid the collision. However, Northwest Ambulance denied any claims of gross negligence and corporate negligence, reasserting that it was immune from all liability under RCW 18.71.210.
3. Judgment and Appeal Before trial, Northwest Ambulance moved for a revision of the summary judgment order on the issue of qualified immunity. The court denied the motion, and the case went to trial. The jury later rendered a general verdict for the Estate. The jury was not given a special verdict form directing it to state whether it found Northwest Ambulance liable for the negligent driving or for the failure to secure. Northwest Ambulance did not request such a form.
Northwest Ambulance appealed, assigning error to the trial court's order granting summary judgment on the qualified immunity issue.4Lang v. Platinum Nine
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Holdings, LLC, No. 86205-7-I, slip op. at 2 (Wash. Ct. App. July 28, 2025) (unpublished), https://www.courts.wa.gov/opinions/pdf/862057.pdf. Northwest Ambulance again argued that the trial court misconstrued RCW 18.71.210. However, the Court of Appeals rejected its arguments and affirmed that Northwest Ambulance was not entitled to qualified immunity. Id. at 3.
4. Issues Before This Court We granted Northwest Ambulance's petition for review as to whether the trial court properly granted partial summary judgment on the issue of qualified immunity.5 Today, we reach only whether an EMT and their employer are entitled to qualified immunity for negligent ambulance transportation. We do not decide whether securing the patient with all required safety restraints (here, the shoulder straps) falls within the scope of rendering emergency medical services. We need not answer that question because, here, the negligent driving was a sufficient basis for the jury's verdict. Because it went to its affirmative defense, Northwest Ambulance had the burden to propose a special verdict form if it wanted the jury to consider the negligent driving and the failure to restrain separately. Northwest Ambulance did not request a special verdict form, so we need not reach both issues on appeal. See Gerlach v. Cove Apts., LLC, 196 Wn.2d 111, 135, 471 P.3d 181 (2020) ("A party
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challenging the validity of one theory supporting an undifferentiated verdict is not entitled to a new trial unless it objected to the use of the verdict form at trial and proposed a special verdict form to clarify the jury's findings.").
II
AMBULANCE TRANSPORTATION IS NOT COVERED BY QUALIFIED IMMUNITY
We review a trial court's grant of summary judgment de novo. Keck v. Collins,
184 Wn.2d 358, 370, 357 P.3d 1080 (2015). We uphold a trial court's grant of summary judgment when no genuine issue exists as to any material fact and the moving party is entitled to judgment as a matter of law. Id. Here, the parties do not present any genuine issue of material fact. Instead, they dispute whether ambulance transportation is subject to qualified immunity as a matter of law. Accordingly, we review the qualified immunity statute de novo to ascertain and carry out the legislature's intent. Dep't of Ecology v. Campbell & Gwinn, LLC, 146 Wn.2d 1, 9, 43 P.3d 4 (2002). We look at the plain language of the statute and consider related provisions to determine the statute's meaning. Id. at 10.
A. Qualified Immunity Applies to Acts Done While Rendering Emergency Medical Services Within an EMT's Field of Medical Expertise RCW 18.71.210 provides that a licensed ambulance service will not be liable for any acts or omissions of an EMT "done or omitted in good faith while rendering emergency medical service . . . to a person who has suffered illness or bodily injury."
RCW 18.71.210(1). In other words, licensed ambulance services are entitled to
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qualified immunity for the ordinary negligence of its EMTs while rendering emergency medical services. The statute specifies that [t]his section shall apply to an act or omission committed or omitted in the performance of the actual emergency medical procedures and not in the commission or omission of an act which is not within the field of medical expertise of the physician's trained advanced emergency medical technician and paramedic, emergency medical technician, or first responder, as the case may be.
RCW 18.71.210(2). Accordingly, the statute limits immunity only to acts or omissions that are part of "actual emergency medical procedures." Id. It is undisputed that Northwest Ambulance is a licensed ambulance service under RCW 18.71.210(1)(f) and that Mr. Shaw and Mr. Wilson were EMTs acting in good faith while transporting Mr. Costa. However, the parties dispute whether driving an ambulance is within the scope of rendering emergency medical services. We hold that it is not. While "any licensed ambulance [provider]" is immune from liability under RCW 18.71.210(1)(f), the scope of that immunity is limited to
"medical treatment and care," RCW 18.73.030(11), and to "actual emergency medical procedures." RCW 18.71.210(2). Based on plain language and statutory context, qualified immunity does not apply to an EMT's negligent driving of an ambulance.
1. The Plain Language Shows That Driving an Ambulance Is Not an Act Done While Rendering Emergency Medical Services Northwest Ambulance argues that driving an ambulance is within the scope of emergency medical services rendered by an EMT. However, the definition of
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"emergency medical service" treats transportation as distinct from rendering emergency services.
"Emergency medical service" is limited to "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." RCW 18.73.030(11). Thus, only "medical treatment and care" can be an emergency medical service. While the statute mentions ambulance transportation, it does not define the act of transport itself as a form of medical treatment or care. Instead, the statute uses the phrase "while transporting" to describe when medical treatment or care may be provided.
The dissent reads the definition differently, arguing that "the statute expressly 'include[s] ambulance transportation.'" Dissent at 6 (alteration in original) (quoting RCW 18.73.030(11)). However, the quoted portion of the definition—"including ambulance transportation between medical facilities"—does not define driving an ambulance as an emergency medical service. Instead, it makes clear that care may still be considered "emergency" care even when given to a patient being transported between facilities, not only between the scene of an injury and a hospital. In short, while medical treatment and care may be rendered during ambulance transport, the act of driving is not itself medical treatment or care under the qualified immunity statute.
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The dissent further argues, "The majority's interpretation defeats the purpose of the immunity, which is to allow EMTs to think and act quickly in an emergency without second-guessing themselves because of the risk of liability." Id. at 5. This argument fails for two reasons.
First, this argument ignores the plain meaning of the words the legislature used in the statute. There is nothing in the statute to indicate that the legislature intended to allow ambulance drivers to drive the ambulance below the standard expected of a reasonably prudent ambulance driver and not allow an injured patient to recover for that negligence. Likewise, there is nothing in the legislative history that supports this assertion.
Second, the dissent's construction is undermined by the fact that the legislature does not provide immunity from civil liability for the negligent driving of law enforcement officers or firefighters. The legislature does not prevent people from being compensated for injuries caused by the negligent driving of law enforcement officers or firefighters when they are responding to emergencies. It would be anomalous to believe that the legislature provided that immunity for an ambulance driver who happens to be an EMT.
2. Reading the Qualified Immunity Provision in Context Further Demonstrates That Transport Itself Is Not Covered Reading RCW 18.71.210(1) and (2) together further demonstrates that transport itself is not within the scope of emergency medical services rendered by an EMT.
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RCW 18.71.210(2) clarifies subsection (1) by limiting qualified immunity to acts or omissions done or omitted while performing "emergency medical procedures." WAC 246-976-010(33) defines "emergency medical procedures" as "skills that are performed within the scope of practice of EMS [(emergency medical services)] personnel certified by the secretary under chapters 18.71 and 18.73 RCW."6The WACs set out the required training for EMTs to receive certification, including training on various medical procedures. See RCW 18.71.205; WAC 246-976- 023(4)(a) (referencing the Washington State Department of Health (DOH) approved skills and procedures list (DOH 530-173) for EMS training requirements); see also WAC 246-976-182(1)(c) (providing that EMTs are authorized to provide patient care only "[w]ithin the scope of care that is included in the approved instructional guidelines/curriculum or approved specialized training and is included on the department-approved EMS skills and procedures list (DOH 530-173) for the individual's level of certification"). Driving an ambulance is not included in an EMT's training or certification requirements as proscribed by the WACs. The dissent points out that Mr. Wilson and Mr. Shaw received some training on how to drive an ambulance. First, this training is irrelevant to the central question in this case: whether the plain language of the statute expresses the legislature's intent to
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grant EMTs immunity for negligent driving. Second, the state does not include emergency vehicle driving training in any part of the EMT certification process. If driving an emergency vehicle was meant to be considered "rendering emergency medical service," then training would be a required part of the certification process. Third, there are no state standards for what training is required. Indeed, Northwest Ambulance allowed Mr. Shaw to drive an ambulance with the barest of training. Mr. Shaw's training in emergency driving was limited. Mr. Shaw testified:
Q. Okay. For—for driving—and this—I'm somewhat curious
about this because you go through all the training for the EMT. Do you guys have like driver training or is that just kind of on that third ride- along, there's like, "Hey, man, go ahead and drive"?
A. Yeah. So the driver training is a—is a PowerPoint that we took in the classroom.
CP at 707.
Mr. Shaw recalled that the PowerPoint training lasted "maybe an hour or two."
CP at 709. That was the extent of his training before he started driving ambulances for Northwest Ambulance. Id. Despite the lack of training, Mr. Shaw was willing to drive code and figure it out on the job.
A. Looking back on it, looking back on it. At the time I didn't—I didn't—you know, I would never back down from—from—if
someone—you know, at that time I'm a very impressionable EMT. If someone asks me to do something, I'm going to try to do it, whatever— to whatever extent—you know what I mean?
So if they ask you to drive code, I'm going to figure out, even if I haven't been trained. And I—I don't want to speak for other people in
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my position. But a lot of us were brand new EMT's [sic] that were kind of gung-ho. We wanted to be the—you know, we wanted to be the [set] it and forget it person and—and be reliable. So we didn't want to say, you know, "I can't—I can't do that." You know, you figure out how you can do it and you do it.
CP at 710.
The dissent asserts that Mr. Shaw took an emergency vehicle incident prevention course. Dissent at 8. However, as noted by the dissent, Mr. Shaw took that course after the accident at issue in this lawsuit. In fact, Northwest Ambulance did not provide that training to Mr. Shaw; instead, Mr. Shaw received that training from his next employer. CP at 744.
The dissent asserts, "As the record shows, driving an ambulance requires specialized training beyond that of an average driver." Dissent at 8. Just the opposite:
the record shows that Mr. Shaw was an average driver who was put in a position of driving an ambulance in an emergency situation.
RCW 18.71.210(2) does not provide immunity for the "commission or omission of an act which is not within the [EMT's] field of medical expertise."
Although an EMT is trained to perform emergency medical procedures during ambulance transport, as noted, there is no requirement by the State or Northwest Ambulance that the driver receive specialized training for emergency driving. Moreover, driving itself does not involve any medical expertise. An EMT who is driving cannot also attend to patient care or render medical services. Indeed, RCW
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18.73.150 provides that if there are two or more EMTs operating the ambulance, the nondriving EMT must be with the patient attending to their care. That was the case here. Northwest Ambulance EMTs operate ambulances in teams of at least two, with one EMT responsible for providing patient care while the other EMT drives. Accordingly, an EMT driving an ambulance is not performing an emergency medical procedure within their field of medical expertise.
3. Subsection (4) Expands Qualified Immunity to Acts or Omissions Done or Committed in Good Faith During Transport to Certain Nonmedical Facilities. It Does Not Expand Qualified Immunity to Transport Itself
Contrary to Northwest Ambulance's main argument on appeal, RCW 18.71.210(4) does not establish that transport itself is subject to qualified immunity. Instead, subsection (4) reinforces our conclusion that ambulance transport is different from the emergency medical services rendered by an EMT. The subsection provides:
This section shall apply also, as to the entities and personnel described in subsection (1) of this section, to any act or omission committed or omitted in good faith by such entities or personnel involved in the transport of patients to mental health facilities or chemical dependency programs, in accordance with applicable alternative facility procedures adopted under RCW 70.168.100.
RCW 18.71.210(4).
Subsection (4) was adopted to expand qualified immunity to acts or omissions done or committed in good faith during transport to certain nonmedical facilities. However, the provision does not expand qualified immunity to transport itself.
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A brief history of the law makes this clear. At the time the legislature established qualified immunity under RCW 18.71.210, ambulance services were statutorily allowed to transport patients only to medical facilities. The legislature later amended chapter 18.73 RCW to allow ambulance services to also transport patients to certain nonmedical facilities, such as mental health facilities and chemical dependency programs. RCW 18.73.280. When the legislature made that amendment to chapter 18.73 RCW, it also amended the qualified immunity statute to cover emergency medical services rendered during transport to such nonmedical facilities through subsection (4). LAWS OF 2015, ch. 157, §§ 4, 5; RCW 18.71.210(4). Accordingly, subsection (4) did not carve out qualified immunity for transport itself. Instead, it extended qualified immunity for an EMT's ordinary negligence while rendering emergency medical services during transport to medical and certain nonmedical facilities alike.
B. Ambulance Services Are Not Subject to Immunity for an EMT's
Negligent Driving. Instead, EMTs Are Subject to a Standard of
Reasonable Care for Emergency Vehicle Drivers
Altogether, the plain text of the statute and related provisions demonstrate that ambulance transportation itself is not covered by the qualified immunity statute. While we need not look further under our plain text analysis, two other statutes support the conclusion that the legislature did not intend to provide qualified immunity for negligent ambulance transport.
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1. The Legislature Knows How To Provide Immunity for Ambulance Transportation but Did Not Do So Here
First, the legislature has established qualified immunity for emergency medical transportation in other contexts, unlike here. Specifically, RCW 4.24.300(1) provides qualified immunity for volunteer providers of emergency or medical services "in the rendering of such emergency care or in transporting such persons." In that statute, the legislature specifically carved out qualified immunity for volunteers for the distinct acts of care or transportation.
By contrast, in the statute at issue here, the legislature limited the scope of qualified immunity to an EMT's acts or omissions done while rendering medical care and treatment. RCW 18.71.210. We must assume the different language in the two statutes shows a different legislative intent. State v. Roberts, 117 Wn.2d 576, 586,
817 P.2d 855 (1991). Volunteers are immune from liability for care and transportation alike while EMTs are immune only for care.
2. The Legislature Has Established That Drivers of Emergency Vehicles Are Required To Act with Ordinary Care. Providing Qualified Immunity for Negligent Ambulance Transportation Would Create a Statutory Conflict
Second, it makes sense that the legislature did not carve out qualified immunity for ambulance transportation since it has already established a standard of reasonable care for emergency vehicle drivers. The statute on driving emergency code, RCW 46.61.035, provides certain privileges for drivers of authorized emergency vehicles
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when responding to emergency calls, including allowing ambulances to disregard certain traffic rules while driving code. However, the statute makes clear that the driving privileges "shall not relieve the driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons." RCW 46.61.035(4). Accordingly, ambulance drivers are not immune from liability for negligent driving but are held to the ordinary standard of care for emergency vehicle drivers.
III
CONCLUSION
The legislature granted EMTs immunity from liability for their negligent acts or omissions while rendering emergency medical services. This immunity includes their rendering medical services while the patient is being transported. However, Northwest Ambulance contends that the legislature, in enacting RCW 18.71.210(1), intended to give ambulance drivers who are EMTs something that the legislature has not given law enforcement officers or firefighters—the right to drive negligently and not be held responsible for that negligent driving. Its argument fails. A plain reading of the statute demonstrates that the legislature granted EMTs immunity from civil liability for their negligent acts only in providing medical treatment, not for negligent driving. Indeed, the plain language of the statute and related statutes shows that EMT ambulance drivers have a duty to drive with due regard for the safety of all persons. We affirm.
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_______________________________
WE CONCUR:
Melody, J.
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No. 104498-4 MONTOYA-LEWIS, J. (dissenting)—The legislature granted civil immunity for an emergency medical technician (EMT) or paramedic's acts or omissions
"while rendering emergency medical service." RCW 18.71.210(1). I disagree with the majority that only medical procedures that require medical expertise are immunized and that "rendering emergency medical services" does not include operating an ambulance. Majority at 11-12. The legislature broadly defined
"emergency medical service" to include the services provided by operating an ambulance. RCW 18.73.030(11). Further, "actual emergency medical procedures"
"within the field of medical expertise" recognizes that different types of emergency medical service providers are licensed to perform varying levels of medical skills and procedures, and the immunity applies when those providers perform medical services for which they are qualified. RCW 18.71.210(2). I would conclude summary judgment should have been granted to Northwest Ambulance because RCW 18.71.210(1) expressly immunizes it from liability for injuries resulting from the ambulance crash. I dissent.
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FACTUAL BACKGROUND
Frank Costa was a cancer patient at Genesis HealthCare Center in Everett. After Mr. Costa's lab results came back abnormal, Genesis determined that Mr. Costa needed to go to the emergency department at Providence Medical Center to receive medical treatment. Genesis requested an ambulance to transfer Mr. Costa to the hospital. Northwest Ambulance sent an ambulance staffed by Jack Wilson (lead EMT), Henry Shaw (driver and EMT), and Katelyn Averill (EMT in training). For transport, Mr. Wilson and Mr. Shaw secured Mr. Costa on a gurney using guardrails and lap belts secured over both his waist and knees. Although Northwest Ambulance's policy required the use of shoulder restraints, the EMTs did not strap Mr. Costa's shoulders to the gurney with the third strap. En route to the hospital, Mr. Wilson evaluated Mr. Costa in the ambulance and noticed that Mr. Costa was presenting with an irregular heart rate. Mr. Wilson determined that Mr. Costa needed further emergency evaluation and assistance because his abnormal heart rhythm could have been a symptom of a possible cardiac issue, and he instructed Mr. Shaw to "driv[e] code."
3 Clerk's Papers (CP) at 772, 929; 1 CP at 154. Mr. Shaw complied and used the ambulance control panel to turn on his lights and sirens. He increased their speed and engaged in defensive driving to get the patient to a medical facility swiftly. The ambulance crashed when Mr. Shaw attempted to overtake a garbage truck
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on the highway. Mr. Costa was ejected from the stretcher and struck the wall of the ambulance, injuring his head, neck, and arm. Another ambulance transported Mr. Costa to the hospital, where he died.
P ROCEDURAL HISTORY
As personal representative of Mr. Costa's estate, Michael Lang sued Northwest Ambulance for wrongful death and survival actions. Mr. Lang alleged Northwest Ambulance negligently failed to secure Mr. Costa to the gurney and failed to avoid the collision. The complaint did not allege gross negligence. Northwest Ambulance raised statutory qualified immunity under RCW 18.71.210 as an affirmative defense. Northwest Ambulance subsequently admitted ordinary negligence and proximate cause, but it continued to deny gross negligence and to assert immunity under RCW 18.71.210. A jury rendered a judgment for Mr. Lang. Northwest Ambulance appealed, and the Court of Appeals affirmed.
A NALYSIS
The meaning of a statute is a question of law, reviewed de novo to ascertain and carry out the legislature's intent. Dep't of Ecology v. Campbell & Gwinn, LLC,
146 Wn.2d 1, 9, 43 P.3d 4 (2002). The plain meaning of a statute is derived from what the legislature has said in the statute and related statutes. Id. at 11. "[W]hen we interpret statutory language, '[e]very provision must be viewed in relation to other provisions and harmonized if at all possible.'"
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Associated Gen. Contractors of Wash. v. State, 2 Wn.3d 846, 863, 544 P.3d 486 (2024) (second alteration in original) (internal quotation marks omitted) (quoting In re Est. of Kerr, 134 Wn.2d 328, 355, 949 P.2d 810 (1998)); Quadrant Corp. v. Cent. Puget Sound Growth Mgmt. Hr'gs Bd.,
154 Wn.2d 224, 238-39, 110 P.3d 1132 (2005). We read statutes as a whole and
"should not interpret statutes in a way that would render any language 'meaningless or superfluous.'" Wash. State Ass'n of Counties v. State, 199 Wn.2d 1, 12-13, 502 P.3d 825 (2022) (internal quotation marks omitted) (quoting State v. J.P., 149 Wn.2d 444, 450, 69 P.3d 318 (2003)). Courts presume the legislature did not intend absurd results. Spokane County v. Dep't of Fish & Wildlife, 192 Wn.2d 453, 458, 430 P.3d 655 (2018). RCW 18.71.210 grants immunity to an act performed in good faith by an EMT
"while rendering emergency medical service." The act must be "in the performance of the actual emergency medical procedures," and it must be "within the field of medical expertise" of the EMT. RCW 18.71.210(2). That immunity does not apply to any willful or wanton misconduct or acts that constitute gross negligence.
RCW 18.71.210(5).
The majority conflates these provisions to offer immunity only for an EMT's acts that are part of "'actual emergency medical procedures.'" Majority at 12 (quoting RCW 18.71.210(2)). It holds that the "act of driving is not itself medical
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treatment or care under the qualified immunity statute." Id. This assertion conflicts with the statute's plain language. "Driving code" is a type of driving unique to operating emergency vehicles, as part of the performance of an actual medical procedure. The skill of driving code is part of the training and expertise of an EMT and requires medical experience, training, and knowledge. The majority's interpretation defeats the purpose of the immunity, which is to allow EMTs to think and act quickly in an emergency without second-guessing themselves because of the risk of liability.
Reading the statute as a whole, the plain language indicates that "emergency medical services" include operating an ambulance and securing a patient. RCW 18.71.210(1) states in pertinent part, "No act or omission of any . . . emergency medical technician or first responder, . . . done or omitted in good faith while rendering emergency medical service . . . shall impose any liability upon" an EMT or licensed ambulance service. (Emphasis added.) In the context of ambulances, transportation and medical treatment are integral to rendering emergency medical service. Further, the context of each of its provisions and related statutes demonstrates the legislature's intent to offer protection to EMTs providing emergency medical services, which includes transporting patients. For these reasons, I would conclude the EMTs' conduct fell
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within the scope of immunity under RCW 18.71.210 and summary judgment should have been granted to Northwest Ambulance.
A. Ambulance Operation
1. Plain Meaning RCW 18.71.210 immunizes EMTs' good faith conduct "while rendering emergency medical service." "Emergency medical service" is defined 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."
RCW 18.73.030(11); RCW 18.71.010(2) ("emergency medical service" has the same meaning in chapter 18.71 RCW as in chapter 18.73 RCW). While the majority asserts that the phrase "while transporting" means medical treatment is distinct from transportation, the statute expressly "include[s] ambulance transportation."
Majority at 13; RCW 18.73.030(11).
The majority separates medical services and transportation and its holding depends on that distinction. The primary purpose of an ambulance is to transport patients who need emergency care while en route to a care facility. RCW 18.73.030(11). Transporting the patient and providing medical treatment and care cannot be mutually exclusive; to read these as separate acts creates a legal fiction unnecessary to interpret this statute. See RCW 18.73.030(4)
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(an ambulance is designed to treat patients before and during transportation), .150(1)(a) ("a nondriving [EMT] shall be in command of the vehicle"). Northwest Ambulance operates ambulances in teams of two EMTs, who take turns as driver and lead medical provider. 3 CP at 909. Those teams collaborate to provide emergency medical services. The provider in the back with the patient makes immediate medical decisions and, in consultation with the driver, makes decisions about when to elevate a transport to a code. Medical decision-making in ambulances requires not only the skill to drive the ambulance at high speed but also to make driving decisions based on the medical condition of the patient. These decisions happen in tandem, in real time. Any conclusion otherwise imagines a separation of tasks that does not happen on the ground.
Ambulances provide one major function: transporting patients who require medical care during transport. Driving an ambulance and transporting patients are integral to the emergency medical services that EMTs provide. EMTs can recognize symptoms of a medical emergency, render emergency medical services during transport, and make medical judgments about how quickly the patient needs to get to the next medical facility. Id. at 902; see RCW 18.73.030(4) (ambulances are designed "to transport the ill and injured" and "to treat patients before and during transportation"). Ambulances are equipped to provide medical care and transportation under the care of "someone trained to recognize certain signs and
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symptoms." 3 CP at 902. Ambulances must be operated by sufficient personnel for adequate patient care, at least one of whom must be an EMT. RCW 18.73.150(1)(a). If there are two or more EMTs operating the ambulance, the nondriving EMT is
"in command of the vehicle" and is responsible for the "operation" of the ambulance and "the care of patients both before they are placed aboard the vehicle and during transit." Id. The plain language of these statutory provisions indicate that the legislature understood ambulance operation as integral to the work of emergency medical service providers such as EMTs. These statutory provisions demonstrate that the legislature recognized the specialized nature of the work provided by EMTs. Carving out the operation of an ambulance from the statutory immunity defeats the purpose of this statutory scheme and requires the conclusion that driving an ambulance is the same as driving any other vehicle. Such a conclusion not only contradicts this statute—it ignores the reality of what this work requires. As the record shows, driving an ambulance requires specialized training beyond that of an average driver. Northwest Ambulance provided new EMT employees, including Mr. Wilson and Mr. Shaw, with classroom and field training on driving an ambulance and operating its lights and sirens. 1 CP at 287-90; 3 CP at 707-08, 900-01, 953. This training covered acceleration and hard stops in a weighted vehicle and driving defensively in anticipation of other drivers' reactions to lights and sirens. 1 CP at 287-88.
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Mr. Wilson also drove an ambulance in an emergency vehicle incident prevention course; Mr. Shaw took a similar course after this collision. 3 CP at 744-48, 901.
"Driving code" requires specialized knowledge: the ambulance was equipped with a mapping and communication system, allowing the driver to divert to a fire station or other nearby facility if the lead EMT determined the patient's medical emergency needed to be addressed by a paramedic before they could reach the hospital. Id. at 711-14. The driver's area of an ambulance is furnished with a console of buttons for lights, a dial to produce different siren patterns, and a computer to communicate with dispatch and map the locations of fire stations and other medical aid providers. Id. In this case, Mr. Shaw drove code for the first time as a trainee, under the supervision of a field training officer, and he estimated he had driven code at least 30-40 times before the day of this incident. Id. at 706-07, 840. The ambulance was operated by two EMTs: Mr. Wilson and Mr. Shaw. Ms. Averill was in training and not yet certified as an EMT. Consistent with RCW 18.73.150(1), Mr. Wilson was the lead EMT responsible for the operation of the vehicle and the care of the patient, and Mr. Shaw was the driver—an EMT who drove the vehicle at the lead EMT's command.
Mr. Wilson exercised medical judgment in deciding whether to call for Mr. Shaw to adjust from normal transport driving to code driving. To be sure, Mr. Wilson was also rendering other medical treatment and care at the same time he
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was responsible for the operation of the ambulance, assessing Mr. Costa's heart rate while Mr. Shaw was driving the ambulance. See RCW 18.73.150(1)(a) (lead EMT is responsible for operating the ambulance and patient care). But Mr. Shaw's driving of the vehicle was part and parcel of the EMTs' operation of the ambulance and their "medical treatment and care" during Mr. Costa's medical emergency requiring code driving to transport him to the hospital quickly for further treatment. RCW 18.73.030(11). Mr. Shaw's speed and maneuvering of the ambulance may not have been consistent with his training, but that is a question of negligence—whether he acted with due regard for safety, in good faith, or with gross negligence—not whether driving and operating an ambulance is within the scope of the statutory immunity. Compare RCW 18.71.210(1) (providing immunity for ambulance services), with .210(5) (excluding from immunity acts or omissions constituting gross negligence). I would hold that the statutory immunity included the driver of the emergency vehicle.
Driving an ambulance must be covered by the statute because it requires medical training and expertise. The only circumstances in which an ambulance may be lawfully driven by a person without medical or first aid training are in ambulance services established by a volunteer or municipal corporation or an association made up of two or more municipalities in rural areas, with approval of the Department of Health. RCW 18.73.150(2). Average drivers of motor vehicles
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are not required to get an additional level of approval from the Department of Health to drive a vehicle. Thus, there must be a distinction between driving an emergency vehicle and an average vehicle. Further, even in the case of such volunteer or rural emergency service provision, the legislature anticipates that the driver might be called on to assist in medical care because it permits that type of driver to "only provide[] medical care to patients to the level that they are trained." Id. In rural ambulance services with nonmedically trained drivers, injuries caused by the operation of the vehicle should be covered by the same immunity under RCW 18.71.210 because an EMT is "in command" of the ambulance and has "responsibility for its operation." RCW 18.73.150(1)(a). Concluding otherwise defeats part of the purpose of the statute, which is to ensure that volunteer and rural emergency services can provide those services without the specter of liability looming when they are providing those services. The majority's conclusion puts the provision of rural emergency medical care in real peril.
2. Harmonizing the Statutory Provisions Our canons of statutory interpretation require us to read statutes as a whole and harmonize provisions. Associated Gen. Contractors of Wash.,
2 Wn.3d at 863; Quadrant Corp., 154 Wn.2d at 239. We must read subsections
(1) and (2) "as a whole so that, if possible, 'no clause, sentence, or word shall be superfluous, void, or insignificant.'" Ralph v. Dep't of Nat. Res.,
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182 Wn.2d 242, 248, 343 P.3d 342 (2014) (internal quotation marks omitted) (quoting State ex rel. Baisden v. Preston, 151 Wash. 175, 177, 275 P. 81 (1929)); Wash. State Ass'n of Counties, 199 Wn.2d at 12-13; Spokane County,
192 Wn.2d at 458. Reading subsection (2) as the majority does creates unnecessary inconsistency in the statute and renders subsection (1) void and insignificant. The majority determines that the second subsection of the statute limits the first by narrowing the scope of immunity from all emergency medical services to only medical procedures and only those that require medical expertise. Majority at 12-14. The opinion's conclusion that driving an ambulance is not a medical procedure and does not require medical expertise claws back the immunity created by subsection (1). I disagree with both conclusions.
"Emergency medical service" (in subsection (1)) is a defined term, while
"actual emergency medical procedures" (in subsection (2)) is not defined by the legislature. If a term is defined, we will use that definition; if a term is undefined, we will use its plain and ordinary meaning. United States v. Hoffman,
154 Wn.2d 730, 741, 116 P.3d 999 (2005). Plain and ordinary meaning of an undefined term is gleaned from the context of the statute, not in isolation, though we may consult a dictionary definition. Campbell & Gwinn, 146 Wn.2d at 11; State v. Roggenkamp, 153 Wn.2d 614, 623, 106 P.3d 196 (2005); Columbia Riverkeeper v. Port of Vancouver USA, 188 Wn.2d 421, 435,
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395 P.3d 1031 (2017). Although the legislature has not defined "emergency medical procedures," Department of Health regulations provide a definition of that term as "the skills that are performed within the scope of practice of EMS [(emergency medical services)] personnel certified by the secretary under chapters 18.71 and 18.73 RCW." WAC 246-976-010(33). Under those regulations, the scope of practice for EMS personnel means they are "authorized to provide patient care" "[w]ithin the scope of care" for their "level of certification" "[i]n a prehospital emergency setting," "[d]uring interfacility ambulance transport," and other specified settings and when following protocols. WAC 246-976-182(1)(a)-(d). Thus, "actual emergency medical procedures" "within the field of medical expertise" of the EMT refers to EMTs conducting the medical care for which they are licensed, and not those skills that are beyond their level of certification. RCW 18.71.210(2); WAC 246-976-010(33), -182(1)(a)-(d). Emergency medical service providers perform varying levels
of medical care depending on their specific classification and license. See, e.g., RCW 18.73.030(13), (15). Reading subsections (1) and (2) together, the statute immunizes the conduct of EMTs when they perform within the scope of their training, but not if they attempt medical procedures they are not qualified to perform. RCW 18.71.210(1), (2). I agree with the majority that subsection (2) limits the scope of immunity provided to EMTs; subsection (2) limits the scope of immunity
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to negligent performance of emergency medical service within the provider's qualifications.
I disagree, however, that subsection (2) limits the scope of immunity to only
"medical procedures." If subsection (2) limited the entire immunity to medical procedures, it would contradict subsection one, which plainly provides immunity for acts and omissions "while rendering emergency medical service."
RCW 18.71.210(1). Contra Wash. State Ass'n of Counties, 199 Wn.2d at 12-13.
"Emergency medical service" is not limited to procedures; it is defined as "medical treatment and care" that can be rendered at the scene of an emergency or in an ambulance. RCW 18.73.030(11). If the immunity applies only to "medical procedures," it cannot also apply broadly to any acts and omissions while rendering emergency medical service, which has a more expansive meaning. RCW 18.71.210(1), (2); RCW 18.73.030(11).
I would hold that subsection (2) acknowledges that EMTs, paramedics, and first responders may be licensed to perform specific medical procedures and extends the immunity to those procedures only for which they have the appropriate expertise. Interpreting the statute as the majority has renders subsection (1) and the enumerated definition of "emergency medical service" void and insignificant. The legislature expressly immunized an EMT's ordinary negligence and broadly defined "emergency medical service"; limiting that immunity to cover
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only medical procedures makes the protection covered in subsection (1) void and the broad language insignificant. As a whole, RCW 18.71.210 functions to limit liability; subsection (2) recognizes that emergency medical service providers should not attempt to perform a medical procedure that exceeds their training and expertise, and immunity for negligently performed emergency medical service extends only to those medical procedures they are qualified to perform.
3. Related Statutes We also look to what the legislature said in related statutes to discern legislative intent. Campbell & Gwinn, 146 Wn.2d at 11. The legislature addressed medical and emergency transportation in several other statutes that provide immunity for volunteers, allow for EMTs to disregard traffic safety laws when responding to emergency calls, and provide immunity for EMTs while transporting people to nonemergency medical facilities. See RCW 4.24.300; RCW 18.71.210(4); RCW 46.61.035. A review of these sections demonstrates this point, conclusively. First, RCW 4.24.300(1) provides qualified immunity for volunteer providers of emergency or medical services "in the rendering of such emergency care or in transporting such persons." The majority asserts that the differences between the language of these statutes indicates intent to immunize volunteers for care and transportation and EMTs only for care. Majority at 20. As discussed above, volunteers do not have statutory authority to render medical care or transport
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patients. When a layperson volunteers to help in an emergency where they otherwise have no duty to do so, RCW 4.24.300(1) removes the disincentive of the possibility of a civil suit to encourage people to volunteer to help others. In contrast, EMTs have a duty to provide emergency medical services and transportation as their job; RCW 18.71.210 immunizes good faith emergency medical service to allow EMTs to do their job without second-guessing for fear of a civil suit for an ordinary mistake. Transportation is immunized when EMTs are also providing medical care because both go in tandem as emergency medical services. RCW 18.73.030(11). A person volunteering medical assistance does not have the same inherent authority to provide medical care and transportation as does an EMT; transportation is not within the field of expertise or medical care of a volunteer because they have none, the legislature expressly granted that protection. Thus, RCW 4.24.300 does not lend itself to an interpretation of RCW 18.71.210 that carves out protection for an EMT's negligent driving; RCW 4.24.300 demonstrates that the legislature intended driving and operating an ambulance to be included in an EMT's provision of emergency medical services.
Second, RCW 46.61.035 provides for the traffic procedures and safety protocols for authorized emergency vehicles when responding to emergency calls. This statute allows ambulance drivers to exceed the maximum speed limit, proceed past red lights, etc., providing that the privileges granted do not "relieve the
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driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons." RCW 46.61.035(1), (2), (4). According to the majority, these provisions mean that ambulance drivers are held to the ordinary standard of care for emergency vehicle drivers and are not immune for their driving decisions. Majority at 20-21. However, RCW 18.71.210 does not set out a different standard of care for authorized emergency vehicles; EMTs operating ambulances must still practice ordinary care when responding to emergency calls, RCW 18.71.210 immunizes only that EMT's ordinary negligence. This immunity will apply only to acts or omissions done in good faith, and not conduct that amounts to gross negligence or willful or wanton misconduct. RCW 18.71.210(1), (5). Reading these statutes together, I would conclude that EMTs must act with ordinary care when operating an ambulance; ordinary negligence while driving an ambulance in good faith is subject to civil immunity, but gross negligence is not. Third, the same entities and personnel immunized under RCW 18.71.210(1) are also immunized when they are "involved in the transport of patients to mental health facilities or chemical dependency programs." RCW 18.71.210(4). The majority contends that subsection (4) "extended qualified immunity for an EMT's ordinary negligence while rendering emergency medical services during transport to medical and certain nonmedical facilities alike." Majority at 19. Since, as explained above, I would hold that RCW 18.71.210(1) and (2) offer qualified
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immunity for providing medical services as well as transporting patients while providing those services, subsection (4) offers the same immunity for an EMT's ordinary negligence when providing care while transporting patients to mental health facilities, etc. RCW 18.71.210(4); L AWS OF 2015, ch. 157, §§ 4-5 (authorizing ambulance transport to facilities other than hospitals and amending RCW 18.71.210 to immunize medical personnel and entities involved in the transport of patients to nonmedical mental health facilities or chemical dependency programs); see also F INAL B. REP. ON SUBSTITUTE H.B. 1721, at 2, 64th Leg., Reg. Sess. (Wash. 2015) ("Immunity from liability that generally applies to emergency medical services providers is extended to acts or omissions by those providers when transporting a patient to a mental health facility or chemical dependency treatment program."). Accordingly, driving an ambulance is within the scope of the conduct that is immunized by RCW 18.71.210. The legislature broadly defined
"emergency medical services" to clearly include transporting a patient and has established that transportation is a foundational function of ambulance services. Further, driving an ambulance in response to a medical code requires medical knowledge, training, and expertise that is within an EMT's field. Subsection (2) works to ensure that EMTs are providing only services that they have been trained and certified to do; it does not limit the scope of the immunity to cover only
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medical procedures. Thus, I disagree with the majority that driving an ambulance is not immunized by the statute.
B. Securing the Patient
Additionally, physically securing a patient is part of "rendering emergency medical service." RCW 18.71.210(1). As noted, "emergency medical service"
may occur "at the scene of any medical emergency or while transporting any patient in an ambulance." RCW 18.73.030(11). Mr. Wilson testified that he was trained on loading patients in and out of ambulances on gurneys and that the first thing he did after the collision was secure Mr. Costa's spine. 3 CP at 900, 936. In depositions, Northwest Ambulance employees discussed their training and experience securing patients and operating ambulances. Northwest Ambulance's designee said company policy required the use of all straps on a stretcher or gurney, including shoulder straps. 1 CP at 111-12. It terminated Mr. Shaw and Mr. Wilson for violating this policy as well as a policy requiring defensive driving to prevent collisions. Id. at 85-87, 111-30, 132-36; 3 CP at 823, 828, 944-45. All three employees involved in the collision had experience operating gurneys and securing patients, although none knew of the company policy requiring restraints or recalled specific training on restraints. 3 CP at 766-67, 946-55, 1034. Mr. Wilson and Mr. Shaw had been trained on loading stretchers and gurneys in and out of ambulances. Id. at 851-53, 900, 954-55. Both believed the standard practice was to use the waist
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and midleg belts but not the shoulder straps, which they thought should be used only for patients in specific conditions. Id. at 768, 955-56. Ms. Averill believed there was a debate among EMTs whether all the straps were important and that many EMTs thought patients would be secure without the shoulder straps. Id. at 1006, 1024, 1042-43.
Thus, securing a patient is part of the emergency medical services an EMT renders at the scene. Securing a patient requires training and medical knowledge that is within the field of the EMT. Whether the EMTs in this case were adequately trained or followed their training regarding the use of restraints is a question of negligence, not whether securing a patient is part of rendering emergency medical services. See RCW 18.71.210(1); RCW 18.73.030(11). Given the legislature's decision to define that term broadly, I would conclude that securing a patient is part of rendering emergency medical services and covered by the immunity.
C ONCLUSION
The dual function of ambulances to transport the ill and provide medical services cannot be separated. Doing so, as the majority does, ignores the reality of how emergency services are provided throughout the state. RCW 18.71.210 immunizes EMTs' ordinary negligence when rendering emergency medical services. This immunity intended to ensure that those who are making quick decisions to save people's lives are not punished for mistakes that they may make
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when working for the best interests of the patient, using their training, experience, and expertise. The legislature's express broad grant of immunity in this area should not exclude an integral and basic part of providing emergency services. I respectfully dissent.
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Madsen, J.P.T.
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