Business Law

T.L. v. City Ambulance of Eureka, Inc. (Sept. 29, 2022, A162508) __ Cal.App.5th __ [2022 WL 4544295]

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Ambulance company owed a general duty of care to a patient who jumped out of a moving ambulance while being transported.

T.L., a minor, was admitted to a crisis stabilization unit where a clinician placed her on a 72-hour mental health hold under the Welfare and Institutions Code. The following day, T.L.’s attending psychiatrist determined that she was stable and could be safely transferred to an in-patient facility where she could receive a higher level of care. The psychiatrist decided not to prescribe specific transfer protocols, such as a sedative or safety restraints.  Discharge nurses advised the paramedics and the EMT staffing the transfer ambulance that T.L. was on a mental health hold, but that she was calm, cooperative, and stable for transfer.  Ambulance personnel reviewed T.L.’s medical records and saw no behavioral problems warranting the use of restraints. They placed T.L. on a gurney and buckled her in to the ambulance with two safety belts.  Fifteen minutes into the transport, and without warning, T.L. unbuckled both belts and stepped out of the back of the moving ambulance, suffering serious injuries. T.L. sued the ambulance company for negligence.  It moved for summary judgment on the ground that, under Hernandez v. KWPH Enterprises (2004) 116 Cal.App.4th 170, it owed no duty to prevent T.L. from engaging in “impulsive, reckless, irrational and self-harming conduct.” The trial court granted the motion, concluding Hernandez was dispositive, and T.L. appealed.

The Court of Appeal reversed. The court distinguished Hernandez, which involved a patient who had entered an ambulance voluntarily and then ran away after arriving at the hospital, and who was later struck by a car while crossing a road. By comparison, T.L. was being transferred involuntarily from one facility to another, and was injured during transport, rather than after arrival. The court rejected the defendants’ argument that they had no duty to protect T.L. from unilaterally and unexpectedly unbuckling the belts and stepping out of the ambulance. To the contrary, the trained and licensed paraprofessionals providing a medical transportation services owed T.L. a general duty to act with due care based on their special relationship with her. The court further determined that the Rowland factors did not warrant a departure from a general duty to use reasonable care to protect T.L. during transport. The court did not hold that ambulance personnel acted negligently, or that they had a duty to restrain T.L. because she was on a mental health hold. The court only held that they had a duty to use reasonable care under the circumstances (such as equipping the gurney with a shoulder harness, and/or locking the rear door of the ambulance) to ensure safe transport.

The bulletin describing this appellate decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson and Peder K. Batalden, who are partners at the appellate firm Horvitz & Levy LLP, and is republished with permission.

For more information regarding this bulletin, please contact H. Thomas Watson, Horvitz & Levy LLP, at 818-995-0800 or

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