Thought Leadership

During the COVID-19 pandemic, the decedent’s family urgently called 911 as she struggled to breathe and had dangerously low blood-oxygen levels. However, the responding EMTs allegedly refused to provide immediate medical care, citing concerns for their own safety. Despite eventually calling an advanced life support team, the decedent died the following day. Her family sued under § 1983, arguing that the EMTs’ actions violated her Fourteenth Amendment rights under the state-created danger doctrine. The court, while recognizing the EMTs’ disregard for serious harm, ultimately dismissed the claim, finding that their actions did not render the decedent more vulnerable than if they had not intervened at all.

This matter was brought by Ms. Jones’s survivors against the fire department, the township, the EMTs and others for violating Ms. Jones’s Fourteenth Amendment rights under the state-created danger doctrine pursuant to § 1983 and additional claims. 

In their motions to dismiss, the defendants argued that Ms. Jones had no constitutional right to emergency services as it is not a generally recognized constitutional right. Specifically, neither a special relationship nor state-created danger transforms the claim of “non-feasance” into a constitutionally guaranteed affirmative obligation on the state to rescue Ms. Jones, and the COVID-19 pandemic made Ms. Jones’s right to emergency services far from clearly established. 

The state-created danger doctrine includes four elements: (1) the harm caused was foreseeable and direct; (2) a state actor acted with a degree of culpability that shocks the conscience; (3) a relationship between the state and the plaintiff existed such that the plaintiff was a foreseeable victim of the defendant’s actions; and (4) a state actor affirmatively used his authority in a way that created a danger to the citizen or rendered the citizen more vulnerable to danger than had the state not acted at all.
    
The court analyzed the second and fourth elements. The second element, shocking the conscience, is categorized in three ways. First, if the circumstances are highly pressurized, the intentional harm must be shown. Second, if the state actor is required to act within hours or minutes, they must have disregarded a great risk of serious harm. Third, where the actor has time to make an unhurried judgment, a plaintiff must show an inference that the official acted with a mental state of deliberate indifference. 

The court found the allegations demonstrated a situation in which the actor was required to act in a matter of hours or minutes in that the 911 call displayed immediacy when it was relayed that Ms. Jones was struggling to breathe. Specifically, an EMT had neglected two separate blood-oxygen readings which displayed unstable breathing, commenting, “She would be dead” if the oximeters were measured accurately. The other EMT declined to evaluate Ms. Jones’s condition, saying they had a wife and kids to think about. The court believed facts were put forth that demonstrated that the EMTs disregarded a great risk of serious harm.

The court found that the fourth element of the state-created danger exception, however, was not satisfied. There are three conditions necessary to satisfy this element, which include: (1) a state actor exercised their authority, (2) the state actor took an affirmative action, and (3) this act created a danger to the citizen or rendered the citizen more vulnerable to danger than if the state had not acted at all. The court found that the EMTs took affirmative acts by dismissing the ALS unit and reporting that no patient was assessed after evaluating Ms. Jones. However, these affirmative acts did not make Ms. Jones more vulnerable to danger than had the EMTs not acted at all. Therefore, the state-created danger claim was dismissed. 

_{Case Law Alerts, 2nd Quarter, April 2025 is prepared by Marshall Dennehey to provide information on recent developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2024 Marshall Dennehey, all rights reserved. This article may not be reprinted without the express written permission of our firm.}