Lesa Samuels v. City Of Tacoma

Court of Appeals of Washington·Decided October 1, 2019·No. 51827-9·Unpublished

Opinion

Filed

Washington State

Court of Appeals

Division Two

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON October 1, 2019

DIVISION II

LESA M. SAMUELS, No. 51827-9-II

Appellant,

v.

MULTICARE HEALTH SYSTEM and UNPUBLISHED OPINION GLORIA N. LEM, ARNP, DOES 1-10, and CITY OF TACOMA,

Respondents.

SUTTON, J. — Lesa Samuels appeals the superior court’s order determining that the City of Tacoma was entitled to qualified immunity, dismissing her negligence claim, and awarding statutory costs to the City. Samuels argues that (1) the applicable standard of fault is simple negligence, (2) the qualified immunity statute, RCW 18.71.210(1), does not apply, and (3) there are genuine issues of material fact as to gross negligence, and thus, the City is not entitled to qualified immunity and the superior court erred. We hold that RCW 18.71.210(1) applies, there are no genuine issues of material fact under the applicable gross negligence standard, the City is entitled to qualified immunity as a matter of law, and thus, the superior court did not err. We affirm the superior court’s order and award of statutory costs.

FACTS

On December 24, 2015, Tacoma Fire Department emergency medical technicians (EMTs)

and paramedics (collectively first responders) responded to a 911 call at Samuels’s home. Samuels asked her significant other, Arnold Williams, to call 911 because she was experiencing dizziness,

a headache, and numbness in her face and right arm. When the first responders arrived at Samuels’s home, they asked why they had been called to assist her and she said, “I think I’m having a stroke.” Clerk’s Papers (CP) at 426. She also told them that she started experiencing facial numbness about an hour earlier.

Pierce County has adopted prehospital stroke triage procedures for first responders to identify stroke patients in the field and take those patients to the most appropriate hospital. According to the stroke protocols, the first responders are to assess the applicability for triage by getting a

[r]eport from [the] patient or [a] bystander of one or more sudden:

 Numbness or weakness of the face, arm, or leg, especially on one side of the body

 Confusion, trouble speaking or understanding  Trouble seeing in one or both eyes  Trouble walking, dizziness, loss of balance or coordination  Severe headache with no known cause

CP at 69.

When evaluating a patient for symptoms of a possible stroke, first responders administer a FAST examination to assess whether a patient might be having a stroke. A FAST examination requires a first responder to check the patient for the following symptoms:

Face: unilateral face droop?

Arms: unilateral drift or weakness?

Speech: abnormal or slurred?

Time last normal (determine [the] time patient [was] last known [as] normal)[.]

CP at 69 (underscore omitted). If the patient demonstrates any one of these symptoms (face, arms, or speech), it is likely the patient is having a stroke, and the first responders are directed to transport

the patient to the nearest stroke center, limit the time at the scene, and alert the destination hospital as soon as possible.

The “F” of the FAST examination refers to asking the patient to smile, make a face, or “show his or her teeth,” to see if each side of the face moves as well as the other. CP at 70. A normal response occurs when both sides of the face move equally. An abnormal response is when one side of the face does not move as well as the other side.

The “A” in the FAST examination refers to arm drift, where the first responders ask the patient to close her eyes and extend both arms straight out for 10 seconds. The palms should be facing up with thumbs pointing out. A normal response is for both arms to move in the same manner. An abnormal response is when one arm drifts down or one arm does not move at all.

The “S” in the FAST examination refers to speech, where the first responders ask the patient to repeat a simple phrase such as, “Firefighters are my friends.” CP at 70. A normal response is for the patient to say the requested phrase correctly without slurring. An abnormal response occurs if the patient slurs, says the wrong words, or is unable to speak.

The “T” in the FAST examination refers to asking the patient, family, or bystanders about the “[t]ime last normal (determine [the] time patient [was] last known [as] normal).” CP at 69.

In her deposition, Samuels described what the first responders did during the FAST examination of her:

A: He [referring to one of the first responders] looked in my eyes, and he looked in my throat, and then he also did the – the resistant (sic) test.

....

Q: Did – when you say “the resistance test,” you’re – you held your hands out – we have to get this for the record – you held your hands out in front of you?

A: Yes.

Q: And you put your palms up and down?

A: Yes.

Q: Did he actually press on your hands to see whether – A: Yes.

Q: – you could hold them up?

A: Yes. He pushed down a little bit; so I had to push and pull.

Q: Okay.

A. I mean push and – and – and lift.

Q: Okay.

A. Right.

Q: And did you have any trouble resisting the pressure that he put on your hands?

A: No.

CP at 50.

The first responders took Samuels’s vitals, including her pulse, respiratory rate, blood pressure, glucose, and pulse oximetry. The FAST examination revealed that Samuels’s grip on each side was equal, her pupils were normal, her facial grimace was equal, she was able to lift both palms equally and steadily, she had control over her upper extremities, and she was oriented and able to communicate orally. Samuels claims that the first responders did not fully complete the FAST examination because they did not ask her to smile or grimace as required by the protocols. The first responders spoke with her for a period of time and were able to observe her speech. When

asked, she denied experiencing any loss of consciousness, chest pain, shortness of breath, nausea, vomiting, or diarrhea. They observed that her skin was pink, warm, and dry, and her lungs were clear. She reported that she did not have any significant medical history and was not taking medication although she had recently taken an over-the counter cold medicine, which she had used before without incident.

The first responders determined that the FAST examination was negative for a stroke because they (1) did not observe a unilateral face droop, (2) noted that there was no unilateral drift or weakness in her arms, and (3) observed that her speech was normal. According to the Pierce County protocols, a negative FAST examination meant that the patient qualified for basic life support transport if she wanted it. Following the protocols, the first responders recommended that Samuels either take a private ambulance to Tacoma General Hospital’s emergency room, or have her significant other drive her there. Samuels testified that one of the first responders told her, “[Y]ou’re not having a stroke.” CP at 53, 733.

After about 10 minutes, the first responders left Samuels’s home believing that Samuels’s significant other was going to transport her to Tacoma General Hospital’s emergency room. The patient contact report for Samuels states that “the spouse of [the patient] was going to [transport] the [patient] [via privately owned vehicle] to [Tacoma General Hospital’s emergency room].” CP at 64. After the first responders left, Samuels continued to experience dizziness and suffer from a “squeezing” headache, but decided not to go to the emergency room. CP at 43. She went to work the next morning and worked a full shift and also worked her full shift for the next three days.

On December 30, Samuels went to the MultiCare Westgate Urgent Care Center. At MultiCare, Gloria Lem, Advanced Registered Nurse Practitioner (ARNP), treated her for a headache and sent her home. On January 5, 2016, Samuels went to Tacoma General Hospital’s Emergency Room where a doctor examined her and determined that she was exhibiting symptoms that indicated she had recently suffered from a stroke.

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