Key Points

  • The Washington Supreme Court held that an EMT's negligent driving of an ambulance is not 'rendering emergency medical service' within the immunity of RCW 18.71.210, so Northwest Ambulance was not immune from the wrongful-death claims.
  • The majority, by Justice Mungia, read RCW 18.71.210(2) to limit the immunity to actual emergency medical procedures within an EMT's field of medical expertise, and read the definition in RCW 18.73.030(11) to describe when care is given rather than to make transport itself a form of care.
  • The court declined to decide whether failing to secure a patient with shoulder restraints is immunized, because Northwest Ambulance did not propose a special verdict form separating that theory from the negligent driving, which alone supports the general verdict.
  • Justice Montoya-Lewis dissented, arguing that ambulance transport and medical treatment are inseparable, that both the driving and the securing of the patient were immunized, and that the ruling endangers rural emergency medical care.
  • The court affirmed the Court of Appeals, leaving the jury verdict for the estate in place.

Washington's legal shield for emergency medical technicians does not protect an ambulance company when one of its EMTs crashes the ambulance, the Washington Supreme Court held Thursday. The ruling upholds a wrongful-death verdict for the estate of a patient who was thrown from a stretcher into the ambulance wall after the vehicle hit a highway divider.

Justice Mungia wrote for the court that the immunity statute, RCW 18.71.210, protects only acts that draw on an EMT's medical training. "It did not immunize an EMT's acts that did not involve their medical expertise, such as driving an ambulance," Mungia wrote. Justice Montoya-Lewis dissented.

The decision leaves licensed ambulance services in Washington liable for ordinary negligence behind the wheel, including on emergency runs with lights and sirens. The court affirmed rulings by a trial court and the state Court of Appeals that Platinum Nine Holdings LLC, which does business as Northwest Ambulance, could not invoke the statute. It left open whether the immunity covers a crew's failure to strap a patient in.

The case arose from the transport of Frank Costa to a hospital. According to the majority, the two EMTs on the crew, Jack Wilson and Henry Shaw, secured Costa to a gurney with guardrails and two lap belts but did not use shoulder restraints, even though company policy required them. Wilson stayed in the back with an EMT trainee while Shaw drove.

On the way, Wilson believed Costa's heartbeat was becoming irregular and called an emergency code, which lets the driver exceed speed limits and pass red lights but still requires driving "with due regard for the safety of all persons," under state traffic law. Shaw accelerated to pass a garbage truck, swerved when the truck moved back into his lane and hit a divider head-on. Costa was ejected into the ambulance wall, injuring his head, neck and arm, and died later that day.

Northwest Ambulance fired Shaw and Wilson, citing in a termination letter the failure to use proper restraints, "lack of defensive driving which caused a preventable accident" and speeding beyond company limits. In the litigation, the company admitted that its crew was negligent in both respects and that the driver's negligence caused the crash. It argued instead that the statute made it immune.

The statute shields licensed ambulance services from liability for an EMT's good-faith acts or omissions "while rendering emergency medical service." A second subsection limits that protection to acts "in the performance of the actual emergency medical procedures" and within the EMT's "field of medical expertise." The court called that protection qualified immunity. It reaches ordinary negligence, but another subsection excludes gross negligence and willful or wanton misconduct.

The trial court ruled on summary judgment that "driving an ambulance is not emergency medical service," and a jury returned a general verdict for the estate, brought by its personal representative, Michael Lang. The Court of Appeals affirmed in an unpublished July 2025 opinion.

Mungia's majority opinion read the statutory definition of emergency medical service, "medical treatment and care" rendered at an emergency scene or while transporting a patient, as describing when care happens, not making the trip itself a form of care. "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," the court held.

The majority also pointed to the state's certification rules, which do not include ambulance driving among the skills an EMT must learn. Shaw testified that his driver training was a classroom PowerPoint lasting "maybe an hour or two." Responding to the dissent's view that ambulance driving demands specialized skill, Mungia wrote that "the record shows that Mr. Shaw was an average driver who was put in a position of driving an ambulance in an emergency situation."

The court noted that state law gives no comparable immunity to police officers or firefighters who drive negligently on emergency calls. "It would be anomalous to believe that the legislature provided that immunity for an ambulance driver who happens to be an EMT," Mungia wrote. The majority contrasted a separate statute that expressly protects volunteer rescuers for both care and transportation, concluding that "EMTs are immune only for care."

The justices did not decide whether securing a patient with restraints counts as emergency medical service. Because the immunity was Northwest Ambulance's affirmative defense, the majority said, the company bore the burden of proposing a special verdict form, which would have required jurors to state whether they found it liable for the driving or for the failure to secure Costa. It did not request one, and the majority wrote that "the negligent driving was a sufficient basis for the jury's verdict."

In dissent, Montoya-Lewis argued that the statute's definition expressly includes ambulance transportation and that driving and treatment are a single service. "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," she wrote. She described EMTs deciding together, in real time, when a patient's condition warrants driving code.

Montoya-Lewis wrote that Shaw's speed and maneuvering "may not have been consistent with his training, but that is a question of negligence," not of the immunity's scope. She also warned that rural and volunteer services rely on the protection, writing that "the majority's conclusion puts the provision of rural emergency medical care in real peril." She would have held that both the driving and the securing of Costa fell within the immunity and that the company should have won summary judgment.

The Washington Ambulance Association and the Washington State Association for Justice Foundation filed friend-of-the-court briefs.

The court affirmed the Court of Appeals without remanding, leaving the jury's verdict for Costa's estate in place.