By Damian D. Capozzola, Esq., and Jamie Terrence, RN
News
In July 2020, a 55-year-old experienced a severe heart attack requiring immediate intervention. Rather than directing emergency responders to a nearby hospital equipped to treat the condition, a healthcare system admitted the patient to one of its smaller hospitals and delayed care by transferring him to a larger, in-network facility farther away. The transfer was marred by 90 minutes of delay. When the patient finally arrived, efforts to stabilize him failed, and he died shortly after.
The patient’s family alleged that the healthcare system’s internal policies placed business interests ahead of the patient’s survival, a claim that clearly resonated with the jury. Although the defendant invoked Florida’s Good Samaritan Act to argue for immunity under the “reckless disregard” standard, the jury found that the delays constituted reckless conduct. On April 9, 2025, the jury awarded $45 million in damages to the surviving widow and two children. This case highlights the consequences that can result when healthcare systems prioritize network loyalty over patient care in emergency situations.
Background
In July 2020, the deceased, a 55-year-old Central Florida resident, had a severe heart attack known as an ST-elevation myocardial infarction (STEMI), which is caused by complete blockage of a coronary artery. It requires immediate intervention. Emergency medical responders recognized the condition and transported him to the initial hospital, which was operated by a regional healthcare system. However, the hospital lacked a cardiac catheterization laboratory capable of treating a STEMI patient.
Rather than instructing the medical team to bypass the initial hospital in favor of another nearby hospital that had a cardiac catheterization laboratory, the initial hospital admitted the plaintiff and transferred him to the healthcare system’s affiliate hospital located farther away. Although another hospital with catheterization capabilities was located less than four miles away, the decision was made to transfer the patient by air within the healthcare network instead.
However, the transfer process was delayed. After arriving at the initial hospital, the patient waited nearly 90 minutes before a helicopter departed. The helicopter crew also spent more than 20 minutes burning excess fuel to address weight concerns before takeoff, which caused an additional delay. During this time, the plaintiff remained untreated for his critical blockage.
Upon arriving at the hospital, the plaintiff was transported to the catheterization lab. The medical team tried to place a breathing tube to help him breathe. However, they did not have the equipment needed to confirm that the tube was positioned correctly. After an unsuccessful attempt at ventilation and the removal of the tube, the plaintiff’s condition worsened. A code blue was started, but the medical team’s resuscitation efforts were not successful, and the patient was pronounced dead less than an hour after reaching the receiving hospital.
The plaintiff’s family sued the healthcare system, alleging that internal policies prioritized retaining heart attack patients within the hospital’s network over providing immediate medical care at an out-of-network hospital. They alleged that the transfer decision was influenced by business interests rather than the plaintiff’s welfare, with the plaintiff dying as a result.
The healthcare system defended its actions by using Florida’s Good Samaritan Act, which requires that medical providers be liable for reckless disregard in emergency situations, not mere negligence. The healthcare system argued that its providers delivered appropriate emergency care and that the deceased’s dire medical situation justified their actions. The healthcare system argued that there was no reckless disregard for the deceased’s safety.
On April 9, 2025, an Orange County, Florida, jury found that the healthcare system acted with reckless disregard, although it did not find ordinary negligence against the defendant. The jury awarded $45 million in damages — $15 million to the deceased’s widow and two of his six children, the only surviving family members eligible to recover under Florida’s current wrongful death statute.
What This Means for You
The $45 million verdict in this case underscores how the appearance of decisions that prioritize financial interests over patient outcomes can expose healthcare providers to substantial liability, even under heightened legal protections like Florida’s Good Samaritan Act. The case demonstrates that business-driven decisions in emergency care settings are legally dangerous. The plaintiff’s attorneys reframed what might have been seen as logistical issues, such as transferring the patient by helicopter rather than ground ambulance, into evidence of a policy that put patient safety in the backseat in favor of profits.
The plaintiff’s attorneys argued that the healthcare system showed reckless disregard by skipping over closer hospitals that were capable of addressing the plaintiff’s heart attack in favor of keeping him in-network. Healthcare providers should recognize that juries can be sensitive to arguments suggesting corporate self-interest interferes with a patient’s wellbeing.
This concern is heightened where the situation involves emergency care, such as with a heart attack. Delays that are administrative in nature or otherwise not directly tied to treating, such as waiting to burn helicopter fuel to manage weight issues, can shift jury perceptions from unfortunate error to reckless indifference. Here, the 90-minute delay between the deceased’s arrival at the initial hospital and his eventual transfer proved fatal.
The case also shows that so-called “good Samaritan” laws, such as Florida’s Good Samaritan Act, are not insurmountable barriers for plaintiffs pursuing emergency medical malpractice claims. Florida’s Good Samaritan Act, like similar statutes in other states, is designed to shield healthcare providers from liability for decisions made during emergency treatment, unless their conduct amounts to “reckless disregard” rather than ordinary negligence. The law reflects a public policy that emergency medical providers must act under intense time pressure and with limited information, and they should not face routine malpractice claims simply because their decisions at the time turn out to be wrong. As a result, plaintiffs in these cases must meet a higher standard than typically is required in medical malpractice litigation.
Under the ordinary negligence standard, a plaintiff need only show that a provider failed to exercise reasonable care under the circumstances. In contrast, “reckless disregard” requires proof that the provider acted with a conscious indifference to the consequences or engaged in conduct that went beyond a mere mistake and was more of a gross deviation from the standard of care. This may require evidence that the provider’s actions involved a knowing or willful disregard for the patient’s safety.
Despite this heightened burden, the outcome in this case makes clear that juries are willing to find reckless disregard when the facts suggest that a healthcare provider failed to take reasonable, available steps to save a patient’s life. The plaintiff’s attorneys reframed what might have been portrayed by the defense as an unfortunate delay into evidence of recklessness: prioritizing in-network referrals over life-saving intervention. The plaintiffs persuaded the jury that the healthcare system’s conduct crossed the line from mere error to reckless indifference.
The verdict also is noteworthy for the plaintiff’s approach in arguing systemic liability against the regional healthcare provider rather than focusing solely on the conduct of individual doctors or nurses. The plaintiff framed the lawsuit around institutional practices and corporate financial incentives. Plaintiffs’ attorneys may continue to argue that hospital networks prioritize network preference at the expense of what is in the best interest of the patient. Defense counsel should prepare to defend not only the medical decisions but also the business side of hospitals that could influence those decisions.
More generally, decisions made by administrative staff, locally or on a corporate level, that are questionable to medical staff providing care, be they physicians, nurses, or technicians, can and should be overridden by those who question the safety of those decisions. Every healthcare organization has a chain of command accessible to all clinical and administrative staff. It can be accessed even by emergency paramedics who question the patient’s safety during transport from one facility to another. It simply takes a phone call to the immediate supervisor, who can then contact their supervisor until the necessary response is received. It also is appropriate to skip one or more levels within the chain if the immediate supervisor does not agree with the caller’s assessment of risk to the patient.
Another medical practice issue in this case involves the unsuccessful intubation because of a lack of equipment required to confirm placement. That situation is unacceptable by regulatory and accreditation requirements. It is the same as if an emergency department has a cardiac defibrillator but no monitor to read the rhythm. These are both accepted healthcare standards the patients trust their healthcare facility staff to follow.
The case also sheds light on the ongoing legislative debate surrounding wrongful death claims in Florida, particularly in the context of medical malpractice. Under current law, adult children older than 25 years of age are barred from recovering noneconomic damages, such as pain and suffering, for the death of a parent caused by medical negligence. This restriction, often referred to as the “free kill” law by its critics, limits recovery in cases involving older family members. In this case, although the deceased left behind six children, only two were younger than 25 years of age and, thus, eligible to receive damages. The other four adult children, despite the significant emotional loss they experienced, had no standing to pursue compensation for their pain and suffering.
Proposed legislation seeks to eliminate this age-based limitation by allowing all surviving children to bring wrongful death claims against healthcare providers, regardless of their age at the time of the parent’s death. If the bills are enacted, Florida would join the majority of states that allow adult children to recover noneconomic damages in wrongful death cases. The proposed new law would greatly change the litigation landscape in Florida. Plaintiffs’ attorneys no longer would consider turning away cases simply because the only survivors are older than 25 years of age. At the same time, healthcare providers, hospitals, and their insurers would face greater financial exposure, for both settlement pressure and jury awards. These laws vary greatly by state, so always consult informed local counsel.
Reference
- Verdict on April 7, 2025, in the Circuit Court of the Ninth Judicial Circuit, Orange County, Florida, Case No. 2021-CA-010737-0.
Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles
Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles
In July 2020, a 55-year-old experienced a severe heart attack requiring immediate intervention. Rather than directing emergency responders to a nearby hospital equipped to treat the condition, a healthcare system admitted the patient to one of its smaller hospitals and delayed care by transferring him to a larger, in-network facility farther away. The transfer was marred by 90 minutes of delay. When the patient finally arrived, efforts to stabilize him failed, and he died shortly after. The patient’s family alleged that the healthcare system’s internal policies placed business interests ahead of the patient’s survival, a claim that clearly resonated with the jury. Although the defendant invoked Florida’s Good Samaritan Act to argue for immunity under the “reckless disregard” standard, the jury found that the delays constituted reckless conduct.
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