In State of Queensland v Masson [2020] HCA 28 the High Court made a number of important findings on the standard of care owed by paramedics in emergency situations.
In doing so, the High Court overturned a decision of the Queensland Court of Appeal and found a paramedic was not negligent in deciding between two competing forms of treatment.
Facts
Ms Masson was a chronic asthmatic, who in 2002 suffered a severe asthma attack. The attending paramedic treated her immediately by administrating the drug salbutamol. After 20 minutes, while Ms Masson was being transported to the hospital, her condition deteriorated and the paramedic administered adrenaline. Both drugs are used to treat asthma attacks by expanding the airways in the lungs to facilitate breathing. By the time Ms Masson arrived at the hospital, she had suffered irreversible brain damage due to oxygen deprivation. She remained in a vegetative state until her death in 2016.
Ms Masson brought proceedings against the State of Queensland as the provider of the services of the Queensland Ambulance Service. After Ms Masson’s death, the claim survived in the hands of her estate.
Ms Masson alleged (relevantly for the purpose of the High Court appeal) that the paramedic was negligent for failing to administer adrenaline immediately, rather than only doing so 20 minutes after initial treatment. An essential element of Ms Masson’s case was the paramedic’s failure to comply with the Clinical Practice Manual (CPM) provided by the QAS for field use. The CPM’s asthma flowchart listed pre-hospital treatment options for asthmatic patients in three categories, which in descending order of severity were labelled ‘Imminent Arrest’, ‘Severe Asthma’ and ‘Moderate Asthma’. Ms Masson was within the ‘imminent arrest’ category. The guidance that the flowchart provided in relation to patients in this category was to ‘consider adrenaline’, while the guidance for patients in the ‘severe asthma’ category was to ‘consider salbutamol’.
