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Bowden v. Cary Fire Protection District

April 29, 1999


Appeal from the Circuit Court of McHenry County. No. 91--LA--201 Honorable Michael J. Sullivan, Judge, Presiding.

The opinion of the court was delivered by: Justice Geiger


The plaintiff, Mary Bowden, as special administrator of the estate of William Bowden, deceased, appeals from the May 13, 1998, order of the circuit court of McHenry County granting summary judgment on behalf of the defendant, Cary Fire Protection District (CFD). The plaintiff's complaint against the CFD was predicated upon the doctrine of respondeat superior and alleged that the decedent's death was the result of the wilful and wanton conduct of its emergency medical technicians (EMTs). The complaint also alleged that the CFD was wilful and wanton in its failure to hire and provide properly trained EMTs. We affirm.


A. Events of July 21, 1990

The following facts are taken from the pleadings and the depositions filed with the pleadings. On July 21, 1990, the decedent, William Bowden, experienced severe respiratory arrest as a result of an asthma attack. At the time of this attack, the decedent was in his driveway after having just returned home from a drive. When the decedent appeared that he was about to collapse, his son, Greg Bowden, called 911. Greg then gave the decedent several chest compressions and began to administer mouth-to-mouth resuscitation on his father. At his deposition, Greg testified that he observed the decedent's chest rise and fall as he administered mouth-to-mouth resuscitation.

The CFD received the 911 call at 7:08 p.m. on the date in question. The CFD dispatched a five-man ambulance team to the site. The ambulance team included two licenced EMTs, Donald Shoevlin and Robert Miller. The ambulance arrived at the decedent's home at 7:18 p.m. Upon arrival, one of the EMTs apparently asked Greg to cease the mouth-to-mouth resuscitation and asked him some questions about the decedent's condition. Another EMT went into the house to get the decedent's medical history from the decedent's wife, who is the plaintiff herein. The decedent's prior medical history included two respiratory arrests and one cardiac arrest, which had also been triggered by asthma attacks. The decedent also had moderate obstructive coronary artery disease and his major heart vessels were 40% to 60% occluded.

EMTs Shoevlin and Miller assessed the decedent's airway, breathing, circulation, and vital signs. At this time, they determined that the decedent was conscious and was breathing shallowly on his own. The decedent was respiring at a rate of approximately 10 breaths per minute and had a pulse. At their depositions, both Shoevlin and Miller testified that CPR was not indicated because the decedent had a pulse. When Greg questioned why they were not performing CPR or continuing mouth-to-mouth resuscitation, Miller explained that the decedent had a pulse and was breathing.

The EMTs did administer high-flow oxygen through a face mask in order to assist the decedent's ventilation. After the decedent was given oxygen, his color improved slightly and the paramedics again checked the decedent's lung sounds and chest rise. Prior to the decedent's being placed into the ambulance, his respiratory rate suddenly dropped and the EMTs "bagged" him in order to force oxygen into his lungs. Although the decedent's condition improved somewhat as a result of bagging, the EMTs determined that the decedent required immediate transport to the hospital. In loading the decedent into the ambulance, the EMTs apparently had some difficulty placing him onto the backboard and stretcher, and Greg was required to assist them. In total, the paramedics spent seven minutes at the decedent's residence before leaving for the hospital.

On route to Good Shepard Hospital in Barrington, the EMTs made radio contact with their base hospital and transmitted information about the decedent's condition. The EMTs took the decedent's vital signs, started intravenous (IV) therapy, and used a cardiac monitor to monitor his condition. The EMTs continued to keep the decedent's airway open and assisted his ventilation by bagging oxygen.

A couple of minutes before arriving at the hospital, the decedent's respiratory rate decreased, and the decedent went into full cardiopulmonary arrest. The EMTs initiated CPR and asked the base hospital for orders. The base hospital ordered the EMTs to intubate the decedent. EMT Shoevlin told the base hospital that no one was "certified" to perform intubations on the ambulance, although he had performed intubations before. The EMTs stopped the ambulance to make it easier to intubate, but they were unsuccessful and the decedent vomited. The EMTs suctioned the vomit out of the decedent's airway and administered additional oxygen. As the ambulance was close to the hospital, the hospital ordered the EMTs not to attempt intubation again. The ambulance arrived at Good Shepard Hospital at 7:35 p.m., approximately 27 minutes after the CFD received the 911 call.

The decedent was treated in the emergency room and then admitted to Good Shepard Hospital. The decedent was maintained on life support equipment until he died on July 29, 1990. The coroner's report indicates that the decedent's cause of death was status asthmaticus, which is an unrelenting asthma attack that does not respond to normal respiratory therapy.

B. The McHenry EMS System

The CFD is part of an emergency medical system established by the legislature through the Emergency Medical Services (EMS) Systems Act (the EMS Act) (Ill. Rev. Stat. 1989, ch. 111½, par. 5501 et seq.). The purpose of an EMS system is to provide "emergency medical services rendered to emergency patients for analytic, resuscitative, stabilizing, or preventative purposes, precedent to and during transportation of such patients to hospitals." Ill. Rev. Stat. 1989, ch. 111½, par. 5504.16. Each EMS system includes associate, participating, and resource hospitals. Ill. Rev. Stat. 1989, ch. 111½, pars. 5504.22 through 5504.24. The resource hospital appoints a project medical director, who is a medical physician who has the ultimate responsibility for patient management (Ill. Rev. Stat. 1989, ch. 111½, pars. ...

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