The family of a 59-year-old man who died of a heart attack has sued the Toronto EMS and the City of Toronto, as well as several individual paramedics and dispatchers. The suit papers seek damages in excess of $10 million Canadian based upon an alleged “unforgivable delay” in the EMS response time.
The ambulance crew arrived at the man’s apartment building 35 minutes after the first 911 call. Witnesses in the apartment building lobby claim that the man turned blue while waiting for the EMS personnel to arrive.
The coroner’s inquest determined that there were three separate 911 calls regarding the man’s heart attack. The call was not upgraded to high priority until the third call. Paramedics who responded to the initial call “staged” their response and waited for police a short distance from the man’s apartment building, allegedly out of fear that the scene might be dangerous.
The lawsuit alleges that the first-response paramedics were negligent in failing to properly assess the safety of the scene and that the Toronto EMS dispatchers failed to properly prioritize the man’s serious condition.
In the wake of criticism from the Ontario Health Ministry surrounding this incident, Toronto EMS has reportedly changed its policy on “staging.” The subsequent change in the staging policy will likely be inadmissible in the wrongful death lawsuit. Most Canadian provinces, like most American states, follow English common law. Under the common law, subsequent remedial measures are generally not admissible to prove negligence at the time of the event in question; this rule promotes the public policy of encouraging remedial measures after an injurious event.
The 35-minute delay here will be difficult to defend. However, the parties in the case will no doubt explore medical causation issues. The plaintiff has to prove not only a breach of the standard of care (in this case, an unreasonable delay in beginning treatment), but also that the breach of the standard of care caused injury or damage. In this situation, that will require proof that the gentleman more likely than not would have survived if treatment had been initiated within a customary, reasonable response time.
I will monitor this case and see how it develops.
