In Murphy v. City of Petaluma, published November 25, 2024, the First District Court of Appeal, Division 1 affirmed summary judgment in favor of the defendant city and two of its paramedics. The plaintiff was involved in a head-on collision. The defendant paramedics responded to the scene. They asked the plaintiff questions to determine her involvement in the collision and whether she was hurt or needed medical assistance. She stated she was not hurt and did not want or need medical assistance. The paramedics did not observe any signs of injury, any signs the plaintiff was in pain, or any signs of cognitive impairment. One of the paramedics explained to the plaintiff that it was possible she had suffered an injury of which she was unaware, that the injury could manifest later, and that the injury could be life-threatening. He recommended that she accept transportation to a hospital where she could be examined as a precautionary measure. The plaintiff responded she was aware of the risks, but again declined transportation to the hospital. The paramedic advised the plaintiff of the potential signs of serious injury of which she should be aware. After attending to the other driver, the paramedic returned to the plaintiff to ask if she had developed a headache or required medical assistance. She again refused medical assistance, and still did not display objective signs of injury or cognitive impairment. Before the paramedics left, one of the paramedics again obtained confirmation from the plaintiff that she did not want or need medical assistance. Based on their observation of the plaintiff, the paramedics concluded she was alert and oriented, had capacity, and had expressly exercised her right to refuse medical treatment. After leaving the scene, the plaintiff suffered a stroke in her sleep, due to a hypertensive crisis caused by the collision. The plaintiff sued the city and paramedics, alleging the paramedics were grossly negligent in their medical examination, evaluation, and treatment of her, including failing to take her blood pressure and failing to transport her to a medical facility. The trial court granted the defendants' motion for summary judgment, concluding that no medical care was initiated and that the paramedics did not take any action that created a duty to perform a full assessment of the plaintiff's medical condition.
The appellate court agreed. The plaintiff contended the paramedics owed her a duty of care to provide medical assistance in accordance with Health and Safety Code section 1799.106 under the negligent undertaking doctrine. Emergency rescue personnel, like other persons, have no general duty to protect others from the conduct of third parties. The negligent undertaking rule is an exception. Where one undertakes to aid another, the person is under a duty to exercise due care in acting, and is liable if the failure to do so increases the risk of harm or if the harm is suffered because the other relied on the undertaking. The plaintiff contended that by virtue of the paramedics interactions with her at the scene they assumed a duty to provide her with adequate medical care. She maintained her refusal to of medical care was irrelevant to the duty issue. She did not claim that the paramedics were negligent in their assessment that she had the cognitive capacity to exercise her right to refuse medical assistance. The court rejected the plaintiff's argument. As with other first responders, the scope of the duty the paramedics assumed must be measured by the particular level of service they provided. That level of service was dictated by the plaintiff's repeated refusal of medical assistance and transport. After she made these statements, the paramedics did not undertake a medical examination. Therefore, they did not assume a duty to conduct such an examination meeting the applicable standard of care. Further, there is no evidence that the paramedics' conduct increased the harm or risk of harm inflicted by the third party. The paramedics left the plaintiff in exactly the position she occupied before they arrived. They therefore did not have a duty to render medical assistance to the plaintiff in accordance with the standard of care.