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  • Frank Robert Flaspohler

Lights, Sirens & Emergency Transport (or Not?)

Most often, we think of emergency transports as those in which our units respond, lights and sirens, racing to the scene of an emergency. However, we also run a fair number of calls for transport from one facility to the next, and often times, although those calls may be urgent, we don’t run with lights and sirens. In the event of an accident, that simple decision could truly be a million dollar question.



In 2017, the Marion County Ambulance District was transporting a stroke patient to the University Hospital in Columbia, Missouri, after the Staff for Life was unable to make the transfer due to poor weather. The transferring physical had issued a “stat” order, and the district classified the trip as an “emergency interfacility transfer.” Unfortunately, while en route to University Hospital and with the patient on board, the ambulance unit was involved in a single-vehicle rollover, after hydroplaning on the roadway. The patient suffered debilitating injuries and sued the ambulance district, the ambulance driver, and the district’s director.


The district argued that because it was on an emergency run, it was entitled to sovereign immunity, which would have capped the liability at just over $400,000. But, the trip was recorded as a transport with “no lights and sirens,” and the Missouri Highway Patrol crash report documented that the unit was not on an emergency run. The patient claimed that because the run was not an emergency run, the district was not entitled to the protection of sovereign immunity, and the district director was not protected by official immunity.


Instead of being limited by the statutory caps on damages, the district eventually settled the lawsuit for $1,500,000, more than three times what it would have paid had it been protected by the immunity provisions. Determining whether or not sovereign immunity or official immunity applies can be very fact specific, but if this case serves as a warning to those who run fact without their emergency warning systems.


If your unit is responding in an emergency, whether to the scene or to transport a patient, its essential to respond with lights and sirens. Responding “emergency” without running “hot” can produce results that no one wants to face.

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