JOSEPH STRACKE, et al.
ESTATE OF KERRY BUTLER, JR., et al.
Argued: June 7, 2019
Circuit Court for Baltimore City Case No. 24-C-14-001249
Barbera, C.J., [*] Greene, McDonald, Hotten, Getty,
Booth, Wilner, Alan M. (Senior Judge, Specially Assigned) JJ.
Estate of Kerry Butler, Jr., Ms. Crystal Butler, the widow of
Kerry Butler, Jr., Vera Ganey, parent and guardian of Kerry
Butler, Jr.'s sole minor child, and Mr. Kerry Butler,
Sr., the father of Kerry Butler, Jr. (collectively referred
to as "Respondents"),  filed a wrongful death and
survival action in the Circuit Court for Baltimore City.
Respondents alleged that Baltimore City Fire Department
medics, Joseph Stracke and Stephanie Cisneros (collectively
referred to as "Petitioners"),  were grossly
negligent in their treatment of Mr. Butler, and that their
gross negligence caused his ultimate demise.
jury found that Petitioners were grossly negligent, the trial
judge granted Petitioners' Motion for Judgment
Notwithstanding the Verdict ("JNOV"). Respondents
appealed to the Court of Special Appeals, which reversed the
trial court's grant of JNOV on the basis that Petitioners
were grossly negligent and not entitled to immunity under the
Fire and Rescue Company Act, Maryland Code, Courts &
Judicial Proceedings ("Cts. & Jud. Proc.")
§ 5-604(a). On appeal and cross-appeal, we are asked to
consider the following issues:
1. Does willful or gross negligence by an omission
defeat the immunity from liability granted to fire and rescue
personnel by the Maryland Fire and Rescue Company Act, Md.
Code, Courts & Judicial Proceedings § 5-604, or is
the immunity lost only by a willful or grossly negligent
2. Did CSA err in finding sufficient evidence that
Petitioners committed gross negligence that caused the death
of a patient, when undisputed evidence established that
Petitioners assessed the patient, including taking vital
signs, and within seven minutes transported the patient to
the hospital, where his condition suddenly worsened?
3. Does § 5-604 afford Petitioners, as employees of a
fire department, limited immunity against claims for simple
reasons outlined below, we conclude that Petitioners were not
grossly negligent in their treatment of Mr. Butler, and were
therefore afforded immunity under the Fire and Rescue Company
Act, Cts. & Jud. Proc. § 5-604(a). Because we hold
that Petitioners were not grossly negligent, we decline to
address the first issue presented. We further hold that Cts.
& Jud. Proc. § 5-604(a) does, and continues to,
grant immunity against simple negligence claims to employees
of a fire department. Accordingly, we reverse the judgment of
the Court of Special Appeals.
AND PROCEDURAL BACKGROUND
after 1:00 a.m. on March 2, 2011, Mr. Butler woke his wife
allegedly complaining of chest pains. Earlier that evening,
Mr. Butler had eaten a spicy chicken sandwich and Oreo
cookies, and drank a Hawaiian punch beverage prior to going
to bed. Ms. Butler called 9-1-1 and reported that her husband
was experiencing chest pain and having difficulty breathing
and speaking. Ms. Butler helped dress Mr. Butler and assisted
him down the steps to the first floor of their home to wait
for the emergency medics.
and Cisneros were dispatched to the Butlers' home in
response to the 9-1-1 call for a reported chest pain
emergency. Stracke and Cisneros are both first responders,
whose primary responsibilities involve the assessment and
transportation of patients. Neither Stracke nor Cisneros are
responsible for diagnosing medical conditions. Petitioners
arrived on the Butlers' street at approximately 1:18 a.m.
Petitioners experienced some difficulty locating the
residence because the relatively unlit street made it
difficult to identify the house numbers, and there had been
inconsistencies between the reported address and the actual
location of the Butlers' house. Due to the lack of lighting,
Stracke promptly exited the ambulance and walked along the
street in order to locate the correct house while Cisneros
remained in the ambulance. When Stracke reached Ms. Butler at
the correct address, around 1:20 a.m., he relayed his
location to Cisneros, who remained in the ambulance.
time Stracke reached the Butlers' residence, Ms. Butler
was standing just outside the front door and Mr. Butler was
sitting in a chair just inside the house. At the time, Mr.
Butler was 28 years old, five feet and seven inches tall, and
approximately 245 pounds. Without entering the house, Stracke
asked in a loud voice "what seems to be the
problem." Ms. Butler responded that Mr. Butler had told
her that he thought he was having a heart attack. According
to Ms. Butler, Mr. Butler had his hand on his chest. Stracke
asked Mr. Butler "what's going on my main
man" and Mr. Butler responded that "[his] right
side hurt." While standing in front of the Butlers'
residence, Stracke visually assessed Mr. Butler, in
accordance with relevant medical protocols, observing that he
was "a good shape gentleman[.]" Stracke expressed
the desire and need to bring Mr. Butler to the ambulance for
further evaluation and possible treatment.
Butler then claimed that Mr. Butler stood up and staggered
the short distance to the ambulance, approximately 30-40
feet, without the aid of Stracke or a stretcher. Stracke,
however, claimed that he instructed Mr. Butler to wait while
he retrieved a stretcher, but Mr. Butler declined, stating
that he was "ready to go" and began walking to the
ambulance on his own accord. Stracke quickly signaled to
Cisneros prior to escorting Mr. Butler from his residence to
the ambulance, and Cisneros promptly exited the ambulance
with a medical bag and oxygen bottle in order to fully and
properly assess Mr. Butler's condition.
performed a visual assessment of Mr. Butler as he approached
the ambulance. Ms. Butler stated that Mr. Butler was
staggering as he walked to the ambulance, while Cisneros
observed that Mr. Butler was taking "perfectly
normal" steps and did not appear to be in need of any
assistance. According to Petitioners, Mr. Butler entered the
ambulance unassisted and without difficulty. When Cisneros
asked Mr. Butler what was going on, Mr. Butler responded that
his throat was burning (he was holding his hand to his
throat) and that he had "[c]hest heartburn."
Although Cisneros recorded this symptom as "chest
hurt" in Mr. Butler's chart, she explained that this
was primarily due to a lack of accurate options that were
provided from a drop-down menu on the form.
the ambulance, Stracke took Mr. Butler's blood pressure,
heart rate, and blood oxygen level, while Cisneros recorded
these measurements in Mr. Butler's chart. Cisneros also
checked Mr. Butler for reproducible pain under his right arm
(there was none), felt his pulse, checked his pupils, looked
at his skin, and listened to his lungs, which were
"perfectly clear." All of Mr. Butler's vitals
appeared to be baseline, indicating that he was in stable
determined that Mr. Butler should be transported to the
nearest hospital, Harbor Hospital, which was less than a mile
away. Around 1:24 a.m., approximately seven minutes after
first arriving on the Butlers' street, Petitioners and
Mr. Butler departed for the hospital, with Stracke driving
the ambulance and Cisneros remaining with Mr. Butler in the
rear of the ambulance. Stracke explained that at this time,
it was Petitioners' priority "to deliver a viable
patient to appropriate definitive care, here Harbor Hospital,
as soon as possible[.]" According to Cisneros, Mr.
Butler was seated in a "position of comfort" and
"very pleasant" and "very chatty" during
the drive to the hospital. The ambulance arrived at Harbor
Hospital approximately three minutes later, around 1:27 a.m.
Stracke immediately retrieved a wheelchair for Mr. Butler,
who exited the ambulance unassisted but without difficulty,
and sat in the wheelchair. Stracke pushed Mr. Butler directly
into the emergency room while Cisneros alerted hospital staff
that Mr. Butler "had a burning in his throat."
waited with Mr. Butler in the emergency room for hospital
staff to triage Mr. Butler. While waiting in the emergency
room, a hospital technician observed Mr. Butler holding his
chest and complaining that his chest hurt. The hospital
technician observed this happening for another five to ten
minutes, with Mr. Butler's voice growing louder as the
time passed. After waiting in the emergency room for
approximately ten minutes, Mr. Butler became unconscious and
began to slide out of his wheelchair. Stracke prevented Mr.
Butler's head from striking the floor as he slid out of
the wheelchair. Cisneros observed Mr. Butler's condition
and called for a nurse and doctor, who took Mr. Butler to a
code room with the assistance of Stracke. After Mr. Butler
was taken to the code room, and while he was receiving
treatment from hospital staff, Petitioners left the hospital
and went back on service to prepare for the next potential
the hospital staff's efforts, Mr. Butler could not be
resuscitated and ultimately died. At the time of his death,
doctors were unable to identify Mr. Butler's cause of
death. Following an autopsy, the medical examiner concluded
that Mr. Butler died of a myocardial infarction, more
commonly known as a heart attack.
in the Circuit Court for Baltimore City
filed a wrongful death and survival action against
Petitioners, and the Mayor and City Council of Baltimore
("the City") in the Circuit Court for Baltimore
City.Before commencement of trial, the City
moved that the circuit court determine whether it was immune
from suit under the doctrine of governmental immunity, and
Petitioners moved that the circuit court determine whether
the Fire and Rescue Company Act, Md. Code, Cts. & Jud.
Proc. § 5-604(a) granted them civil immunity in the
absence of any willful or grossly negligent act. The circuit
court answered both questions in the affirmative, entering
judgment in favor of the City due to its governmental
immunity. The suit against Petitioners proceeded to
trial to determine whether Petitioners acted in a willful or
grossly negligent manner.
close of Respondents' case, Petitioners moved for
judgment on the ground that Respondents "ha[d] not
proved that either [Petitioner], Stracke or Cisneros, was
grossly negligent by a preponderance of the evidence[.]"
The circuit court denied Petitioners' motion. Petitioners
renewed their motion, on the same ground, at the close of all
of the evidence, which the circuit court reserved ruling on
until after the jury returned its verdict. Following
deliberations, the jury found Petitioners were grossly
negligent in the treatment of Mr. Butler, that this gross
negligence caused Mr. Butler's death, and accordingly,
awarded Respondents $3, 707, 000. Following the announcement
of the jury's verdict, Petitioners moved for a JNOV on
the same grounds advanced in their earlier motions for
judgment. The circuit court granted Petitioners' motion,
concluding that Respondents' evidence of gross negligence
was insufficient. Judgment in favor of Petitioners was
entered by the circuit court on March 21, 2016.
to the Court of Special Appeals
filed a timely appeal to the Court of Special Appeals, and
Petitioners filed a timely cross-appeal. Estate of
Kerry Butler, Jr., et al. v. Joseph Stracke, et al., No.
238, 2018 WL 4761044 (Md. Ct. Spec. App. Oct. 1, 2018). The
Court first determined that the circuit court erred in
granting Petitioners' JNOV because "significant
evidence existed to show that [Petitioners] acted grossly
negligent." Id. at *4. Because there was
sufficient evidence of gross negligence, the Court reversed
the circuit court's grant of Petitioners' JNOV, and
ordered the circuit court to reinstate the jury's verdict
in favor of Respondents. Next the Court explained that,
because it was bound by Court of Appeals' precedent in
Mayor & City of Baltimore v. Chase, 360 Md. 121,
756 A.2d 987 (2000), the Fire and Rescue Company Act affords
immunity in simple negligence cases to municipalities and
their employees, not just volunteers. Id. at *6-7.
Judge Lawrence F. Rodowsky, sitting specially assigned,
dissented from the panel's majority opinion, citing
"the breadth of the grant of immunity to members of the
fire and rescue companies as recognized by [the Courts']
cases and, ultimately, as conferred by [the Fire and Rescue
Company Act]." Id. at *10 (Rodowsky, J.,
dissenting). After assessing the evidence that was submitted
at trial, Judge Rodowsky determined that the "evidence
may or may not be sufficient to support a finding of
negligence, but it is not evidence of gross negligence."
Id. at *11. Judge Rodowsky also observed that even
"if there is willful or gross negligence by an omission,
the immunity [provided by Md. Code, Cts. & Jud. Proc.
§ 5-604(a)] is not lost." Id. at *13.
Section 5-604(a) of Cts. & Jud. Proc., first introduced
as Senate Bill 731 in the 1983 General Assembly session,
originally read: "A volunteer fire company is immune
from liability in the same manner as a local government
agency for any act or omission in the course of performing
its duties if . . . [t]he act or omission is not one of gross
negligence." However, according to Judge Rodowsky, the
General Assembly's removal of "omission"
evidenced its intent to only withhold immunity for grossly
negligent acts, not grossly negligent
omissions. Id. at *13 (citing
Chapter 546 of the Acts of 1983). Because Petitioners'
gross negligence was based on their failure to properly
question and examine Mr. Butler - i.e., a failure to
act - Judge Rodwosky concluded that Petitioners' immunity
under the Act was not defeated by their alleged grossly
negligent omissions from action. Id.
filed a timely petition for certiorari before this
Court, and Respondents' filed a timely cross-petition. We
granted certiorari on both Petitioners' petition
and Respondents' cross-petition. Stracke, et al. v.
Estate of Butler, Jr., et al., 462 Md. 556, 201 A.3d
review a grant or denial of a motion for JNOV for legal
correctness, by "viewing the evidence and the reasonable
inferences to be drawn from it in the light most favorable to
the non-moving party, and determining whether the facts and
circumstances only permit one inference with regard to the
issue presented." Cooper v. Rodriguez, 443 Md.
680, 706, 118 A.3d 829, 844 (2015) (quoting Scapa Dryer
Fabrics, Inc. v. Saville, 418 Md. 496, 503, 16 A.3d 159,
163 (2011)). Gross negligence is a question of law "when
reasonable [people] could not differ as to the rational
conclusion to be reached." Romanesk v. Rose,
248 Md. 420, 423, 237 A.2d 12, 14 (1968). "[I]f there is
no rational ground under the law governing the case for
upholding the jury's verdict, [JNOV] must be
granted." Bell v. Chance, 460 Md. 28, 52, 188
A.3d 930, 944 (2018). In this context, if the non-moving
party has offered sufficient evidence, so as reasonable minds
might differ, that the moving party engaged in a grossly
negligent manner, the motion for JNOV should be denied.
See Barnes v. Greater Balt. Med. Ctr., Inc., 210
Md.App. 457, 480, 63 A.3d 620, 634 (2013).
were not grossly negligent in their treatment of Mr.
involving gross negligence are often more troublesome than
those involving malice because a fine line exists between
allegations of negligence and gross negligence."
Barbre v. Pope, 402 Md. 157, 187, 935 A.2d 699, 717
(2007). Ordinary, simple negligence is "any conduct,
except conduct recklessly disregardful of an interest of
others, which falls below the standard established by law for
protection of others against unreasonable risk of harm."
Id. On the other hand, this Court has explained that
"gross negligence is an intentional failure to perform a
manifest duty in reckless disregard of the consequences as
affecting the life or property of another, and also implies a
thoughtless disregard of the consequences without the
exertion of any effort to avoid them." Id. We
have made clear that a claim for gross negligence "sets
the evidentiary hurdle at a higher elevation[.]"
Beall v. Holloway-Johnson, 446 Md. 48, 64, 130 A.3d
406, 415 (2016).
wrongdoer is guilty of gross negligence or acts wantonly and
willfully only when he inflicts injury intentionally or is so
utterly indifferent to the rights of others that he acts as
if such rights did not exist." Barbre, 402 Md.
at 187, 935 A.2d at 717.
Gross negligence is not just big negligence.
For these purposes, gross negligence "must be sufficient
. . . to establish that the defendant . . . had a wanton or
reckless disregard for human life . . . . Only conduct that
is of extraordinary or outrageous character will be
sufficient to imply this state of mind."
Thomas v. State, 237 Md.App. 527, 537, 186 A.3d 857,
863 (2018), rev'd, State v. Thomas, No.
33, 2019 WL 2574642 (Md. June 24, 2019) (quoting State v.
Kramer, 318 Md. 576, 590, 569 A.2d 674, 681 (1990))
Beall, we considered, inter alia, whether
there was sufficient evidence to support a finding of gross
negligence against a police officer whose cruiser collided
with a fleeing motorcyclist during a high-speed chase, and
which resulted in the death of the motorist. 446 Md. at
57-62, 130 A.3d at 411-14. We reiterated that a claim of
gross negligence must be supported by sufficient evidence
that the defendant "acted with 'wanton or reckless
disregard for the safety of others[.]'" Id.
at 64-65, 130 A.3d at 415 (quoting Boyer v. State,
323 Md. 558, 580-81, 594 A.2d 121, 132 (1991)). Even given
this objectively higher threshold assigned to proving gross
negligence, our opinion in Beall morphed the
distinctions between simple and gross negligence by holding
that "a legally sufficient case of ordinary negligence
will frequently be enough to create a jury question of
whether such negligence was or was not gross."
Id. at 64, 130 A.3d at 415.
decline to further muddy this already unclear area of law. If
in almost all instances where a plaintiff can prove
negligence, and the case is submitted to the jury to consider
gross negligence, then many first responders will be stripped
of the protective shield that the immunity was intended to
provide, forcing them to go through the entire litigation
process when there is only evidence of simple negligence.
This result runs contrary to the heightened threshold of
gross negligence we have articulated, and in many cases,
gross negligence will be treated as "just big
negligence." See Thomas, 237 Md.App. at 537,
186 A.3d at 863.
evidence submitted at trial of Petitioners' actions, or
failures to act, while potentially sufficient to establish
simple negligence, was not sufficient to establish gross
negligence, even when taken in the light most favorable to
Respondents as the non-moving party. See Cooper v.
Rodriguez, 443 Md. 680, 706, 118 A.3d 829, 844 (2015).
Respondents point out that "if a trier of fact
disbelieves part or all of a witness' testimony, that
discredited testimony is assigned no weight and plays no role
in the consideration of the ultimate issue." Grimm
v. State, 447 Md. 482, 506, 135 A.3d 844, 858 (2016).
However, "disbelief is not evidence in and of
itself." Id. Even given this principle, there
is not sufficient evidence to conclude that Petitioners made
a deliberate and conscious choice to not help Mr. Butler
survive. Assuming the facts as they were presented by
Respondents, as the non-moving party, Petitioners still
responded to Mr. Butler's 9-1-1 call, provided him with
immediate attention and treatment, and transported him to the
nearest hospital in under ten minutes.
Tatum v. Gigliotti, the Court of Special Appeals
concluded that a paramedic who failed to properly diagnose a
medical condition and administer proper treatment, eventually
leading to the patient's death, did not perform his
duties in a grossly negligent manner. 80 Md.App. 559, 569,
565 A.2d 354, 358-59 (1989). There, the medic attempted to
put a paper bag over the patient's face, believing that
he was suffering from hyperventilation. Id. at 562,
565 A.2d at 355. However, the patient was actually suffering
from a severe asthma attack. Id. The medics escorted
the patient to the ambulance, but did not transport him on a
stretcher. Id. While in the ambulance and en route
to the hospital, the patient slid from his seat and fell onto
the floor of the vehicle. Id. An emergency room
nurse testified that when the patient arrived at the
hospital, he was in cardiac arrest. Id. at 563, 565
A.2d at 355. The patient ultimately died from a lack of
oxygen. Id. The Court of Special Appeals reasoned
that, even considering these facts in the light most
favorable to the plaintiff, "[t]he evidence in [the]
case indicated that although the actions of [the medic] may
have amounted to negligence, they [did] not satisfy the
threshold of gross negligence." Id. at 569, 565
A.2d at 358.
in McCoy v. Hatmaker, the Court of Special Appeals
concluded that a paramedic's failure to follow medical
protocol and subsequent erroneous medical judgment was not
sufficient to establish gross negligence. 135 Md.App. 693,
707-08, 763 A.2d 1233, 1241 (2000). There, paramedic Billie
Hatmaker diagnosed the patient, William McCoy, as dead after
observing him unconscious, having unresponsive eyes, a
significantly lowered body temperature, and having already
released bodily fluids. Id. at 699-702, 763 A.3d at
1236-38. Instead of performing advanced life support
procedures, Hatmaker proceeded to fill out a Maryland
Ambulance Information Sheet and called the police and medical
examiner. Id. at 702, 763 A.3d at 1237-38. McCoy
alleged that Hatmaker breached his duty of care to McCoy by
failing to provide appropriate resuscitative medical
treatment and by violating relevant Maryland State Protocol
and Emergency Medical Technician/Paramedic Guidelines.
Id. at 701-02, 763 A.3d at 1238. The Court of
Special Appeals disagreed, reasoning,
we cannot equate a well-intended error in medical judgment -
even if it costs the patient's life - with wanton and
reckless disregard for the life of that patient. Medical
protocols seek to establish best practices for successfully
treating certain conditions. Failure to follow such protocols
might sometimes be deliberate, but more often than not, we
believe, such failure to heed them during an emergency would
be purely accidental and, therefore, at most simple
negligence. Even resolving all inferences in [McCoy's]
favor, the undisputed facts here simply do not show that
Hatmaker's failure falls into the former category.
[McCoy] cannot point to any facts that show he made
a deliberate choice not to give McCoy a chance to
survive, and, at the end of the day, it is deliberateness
that lies at the core of the Tatum standard of
willfulness and wantonness.
Id. at 713-14, 763 A.2d at 1244 (footnote omitted)
(emphasis in original).
and the Dissent point to Petitioners' failure to adhere
to the Maryland Medical Protocols for Emergency Medical
Services Providers ("the Protocols") and the
Emergency Medical Services procedures set forth in the
Baltimore City Manual of Procedures ("MOP") as
evidence of Petitioners' gross negligence. The Protocols
were developed to "help [Emergency Medical Service]
providers anticipate and be better prepared to give the
emergency patient care ordered during the medical
consultation." The Protocols outline various procedures
in which applicability and strict compliance varies based on
the circumstances of the emergency response. For example, the
Protocols mandate that algorithms for general patient care
must be followed according to the specific sequence, but all
other treatment protocols do not require a strict or
mandatory sequence. There are also varying categories that
certain procedures and instructions may fall under. Some
sections of the Protocols merely describe and define
illnesses or emergencies, and what symptoms those diagnoses
may exhibit. If a paramedic determines that a patient is
suffering from certain conditions, such as cardiac arrest or
acute coronary syndrome ("ACS"), then the Protocols
require specific procedures to be taken to ensure the safety
of the patient. However, if a paramedic determines that a
patient is not in fact suffering from a described condition,
then the specific procedures do not necessarily have to be
strictly followed. Additionally, other protocols in the
Baltimore City MOP are explicitly situation dependent,
including whether there are non-emergency passengers, the
weight of the patient, and the location or type of building
the patient may be located in. Finally, some procedures are
administrative, and do not primarily serve to support the
health and safety of the patient. For example, if a patient
refuses to be transported via stretcher, paramedics are
instructed to obtain a signed and witnessed "release
from responsibility" form.
Protocols describe a patient who is experiencing ACS as
someone with chest, epigastric (the area of the upper
abdomen, just below the ribs), arm, or jaw pain or
discomfort, and possible diaphoresis (sweating), nausea,
shortness of breath, or difficulty breathing. The Protocols
explain that a patient with such symptoms should be placed
into a position of comfort and transported to the nearest
hospital cardiac catheterization center. In assessing the
patient, the medics should first perform a visual assessment
of the patient regarding their symptoms, then transport the
patient to the ambulance via a stretcher. Respondents assert
that "Petitioners violated virtually every [Protocol]
and MOP policy governing their encounter with [Mr.]
Butler." However, Petitioners did not "knowing[ly],
conscious[ly], deliberate[ly]" fail to adhere to
"virtually every protocol adopted both by the State
agency authorized by law to promulgate such protocols and
their own municipal employer[.]" Dissent at 1. Stracke
visually assessed Mr. Butler while Mr. Butler was seated in
his residence, and Cisneros conducted a visual assessment as
Mr. Butler was escorted towards the ambulance. Additionally,
Cisneros testified that Mr. Butler was in fact in a position
of comfort while being transported to the hospital in the
ambulance. Furthermore, the failure to adhere to protocols
and policies does not itself establish a reckless disregard
for human life or amount to gross negligence. See
Tatum, 80 Md. App at 571, 565 A.2d at 359-60; see
also McCoy, 135 Md.App. at 707-08, 763 A.2d at 1241.
to Tatum and McCoy, here, Petitioners
responded to a 9-1-1 call to give assistance to Mr. Butler.
At the time of his death, Mr. Butler was 28 years old, five
feet and seven inches tall, and weighed approximately 245
pounds. He had no history of heart problems and was
apparently in relatively good health. Petitioners escorted
Mr. Butler to the ambulance and conducted a number of
assessments while there, including taking his blood pressure,
heart rate, and blood oxygen levels. Believing Mr. Butler
needed further care, Petitioners transported him to the
closest hospital. Mr. Butler was brought into the emergency
room less than ten minutes after making first contact with
Petitioners. It was not until Mr. Butler had been waiting in
the hospital for an additional ten minutes did his symptoms
begin to worsen and he eventually went into cardiac arrest,
at which point he was taken into the care of the hospital
staff. There was no evidence submitted at trial or reflected
in the record that contradicts these facts.
is 20/20, and it is clear from the medical examiner's
autopsy that Petitioners' assessment did not conform to
Mr. Butler's actual medical condition and needs. It is
true that Petitioners did not follow protocol by failing to
transport Mr. Butler via stretcher from his home to the
ambulance, and by transporting him to the nearest hospital
rather than a cardiac catheterization center. While this may
- or may not - be sufficient to establish negligent conduct,
the evidence presented by Respondents is not sufficient to
establish gross negligence. "Gross negligence is not
just big negligence." Thomas, 237 Md.App. at
537, 186 A.3d at 863, rev'd, State v.
Thomas, No. 33, 2019 WL 2574642 (Md. June 24, 2019). The
mere fact that Petitioners inaccurately diagnosed and treated
their patient does not elevate their conduct to gross
negligence. "[W]e cannot equate a well-intended error in
medical judgment - even if it costs the patient's life -
with wanton and reckless disregard for the life of that
patient." McCoy, 135 Md.App. at 713, 763 A.2d
the jury disbelieved all of the evidence submitted by
Petitioners, and all contradicted evidence was settled in
favor of Respondents, it is undisputed that Petitioners made
a concerted effort to locate Mr. Butler, assess him, take his
vitals, and transport him to the nearest hospital for further
review and treatment in less than ten minutes. Under these
conditions, Petitioners did not possess a wanton and reckless
disregard for Mr. Butler's life, nor did they present an
utter indifference to his rights and well-being. On the
contrary, Petitioners arrived at Mr. Butler's home,
despite initially receiving an incorrect address, and
provided the care they assessed as necessary for the
situation before them. "There is no legally sufficient
evidence that [Petitioners] made a deliberate choice not to
give Mr. Butler a chance to survive." Estate of
Kerry Butler, Jr., et al. v. Joseph Stracke, et al., No.
238, 2018 WL 4761044, at *13 (Md. Ct. Spec. App. Oct. 1,
2018) (Rodowsky, J., dissenting). This does not represent
"an intentional failure to perform a manifest duty in
reckless disregard of the consequences[, ]" or an utter
indifference to the rights of others. Barbre v.
Pope, 402 Md. 157, 187, 935 A.2d 699, 717 (2007).
the practical implications of holding otherwise cannot be
overstated. Concluding that Petitioners were grossly
negligent would have a negative impact on not only the number
of individuals who seek employment as first responders in the
future, but would create a chilling effect on their conduct.
First responders must have broad discretion to proceed in
their assessment and treatment of patients without the fear
of liability. Judges or juries would be permitted to engage
in a post hoc, hindsight assessment of the first
responders' conduct. In reality, the trier of fact cannot
be expected to review the conduct as if they stood in the
shoes of the first responders and made split-second decisions
that could impact the health and life of those they are
treating. First responders fulfill a vital role throughout
our State, and we must not minimize their service by
second-guessing their actions through a 20/20 lens.
5-604(a) provides immunity against simple negligence claims
to employees of municipal fire departments.
arguendo, that Petitioners were merely negligent in
their actions with respect to Mr. Butler, Respondents
alternatively assert that Cts. & Jud. Proc. §
5-604(a) only confers immunity from simple negligence claims
upon private and volunteer fire and rescue companies, not
municipalities or their employees. Matters of statutory
interpretation are questions of law that are reviewed de
novo. Schisler v. State, 394 Md. 519, 535, 907
A.2d 175, 184 (2006). We must interpret a statute as "to
give every word effect, avoiding constructions that render
any portion of the language superfluous or redundant."
Blondell v. Balt. City Police Dep't, 341 Md.
680, 691, 672 A.2d 639, 644 (1996). To that end, we will
first look to the plain meaning of the statutory language,
and give effect to the clear and unambiguous language.
Jones v. State, 336 Md. 255, 261, 647 A.2d 1204,
1206-07 (1994). If the language is unclear or ambiguous, we
will then look to the legislative objectives and goals in
order to discern the proper interpretation and construction.
Whack v. State, 338 Md. 665, 672, 659 A.2d 1347,
1350 (1995). A review of the statute and our prior case law
make clear that Cts. & Jud. Proc. § 5-604(a)
unambiguously confers immunity from simple negligence claims
upon municipal fire departments and their employees, as
Petitioners indisputably are.
analysis begins and ends with our previous decision in
Mayor & City of Baltimore v. Chase, 360 Md. 121,
756 A.2d 987 (2000), in which we concluded that the General
Assembly intended the Fire and Rescue Company Act to immunize
municipal and private fire departments, as well as their
employees, from simple negligence claims. In Chase,
a Baltimore City Fire Department paramedic was sued for
alleged negligent and grossly negligent treatment of a
patient. Id. at 124, 756 A.2d at 989. The Court of
Special Appeals held that § 5-604(a) applied only to
volunteer and private fire and rescue companies, and
therefore did not bestow immunity upon municipal fire
departments and their employees. Id. We reversed,
determining that "fire company" and "rescue
company" unambiguously included municipal fire
departments and their personnel, and therefore the plain
language of the statute controlled. Id. at 130-32,
756 A.2d at 992-94. We further explained that the General
Assembly's exclusion of the word "volunteer"
from the title of the original bill indicated their intent to
afford immunity to all fire and rescue personnel, including
municipalities and their employees, not just private and
volunteer entities. Id. at 126, 756 A.2d at 990.
this clear precedent in Chase that applies §
5-604(a) immunity to municipal fire departments, Respondents
assert that our more recent opinion in TransCare
Maryland v. Murray, 431 Md. 225, 64 A.3d 887
(2013), concluded that the terms "fire company" and
"rescue company" were ambiguous, thus requiring
this Court to revisit the interpretation of the statute and
its legislative history. Respondents' position fails in
two regards. First, we did not hold in TransCare
that the phrases "fire company" and "rescue
company" were, standing alone, ambiguous. We explained,
[a]s TransCare is a commercial ambulance company, the
application of [Cts. & Jud. Proc.] § 5-603(b)(3) to
it depends, in part, on whether the adjective
"volunteer" modifies only "fire
department" or also modifies "ambulance and rescue
squad." If "volunteer" modifies only
"fire department," TransCare potentially has
immunity as an "ambulance squad" (if its
"members" have immunity). If "volunteer"
also modifies "ambulance and rescue squad,"
TransCare does not have immunity under this provision
(regardless of whether its "members" or employees
have immunity). Either construction of the phrase is
grammatically correct; in light of this ambiguity in meaning,