Lesa Samuels v. City Of Tacoma ( 2019 )


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  •                                                                                              Filed
    Washington State
    Court of Appeals
    Division Two
    IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
    October 1, 2019
    DIVISION II
    LESA M. SAMUELS,                                                  No. 51827-9-II
    Appellant,
    v.
    MULTICARE HEALTH SYSTEM and                                  UNPUBLISHED OPINION
    GLORIA N. LEM, ARNP, DOES 1-10,
    and CITY OF TACOMA,
    Respondents.
    SUTTON, J. — Lesa Samuels appeals the superior court’s order determining that the City of
    Tacoma was entitled to qualified immunity, dismissing her negligence claim, and awarding
    statutory costs to the City. Samuels argues that (1) the applicable standard of fault is simple
    negligence, (2) the qualified immunity statute, RCW 18.71.210(1), does not apply, and (3) there
    are genuine issues of material fact as to gross negligence, and thus, the City is not entitled to
    qualified immunity and the superior court erred. We hold that RCW 18.71.210(1) applies, there
    are no genuine issues of material fact under the applicable gross negligence standard, the City is
    entitled to qualified immunity as a matter of law, and thus, the superior court did not err. We
    affirm the superior court’s order and award of statutory costs.
    FACTS
    On December 24, 2015, Tacoma Fire Department emergency medical technicians (EMTs)
    and paramedics (collectively first responders) responded to a 911 call at Samuels’s home. Samuels
    asked her significant other, Arnold Williams, to call 911 because she was experiencing dizziness,
    No. 51827-9-II
    a headache, and numbness in her face and right arm. When the first responders arrived at
    Samuels’s home, they asked why they had been called to assist her and she said, “I think I’m
    having a stroke.” Clerk’s Papers (CP) at 426. She also told them that she started experiencing
    facial numbness about an hour earlier.
    Pierce County has adopted prehospital stroke triage procedures for first responders to
    identify stroke patients in the field and take those patients to the most appropriate hospital.
    According to the stroke protocols, the first responders are to assess the applicability for triage by
    getting a
    [r]eport from [the] patient or [a] bystander of one or more sudden:
       Numbness or weakness of the face, arm, or leg, especially on one side of
    the body
       Confusion, trouble speaking or understanding
       Trouble seeing in one or both eyes
       Trouble walking, dizziness, loss of balance or coordination
       Severe headache with no known cause
    CP at 69.
    When evaluating a patient for symptoms of a possible stroke, first responders administer a
    FAST examination to assess whether a patient might be having a stroke. A FAST examination
    requires a first responder to check the patient for the following symptoms:
    Face: unilateral face droop?
    Arms: unilateral drift or weakness?
    Speech: abnormal or slurred?
    Time last normal (determine [the] time patient [was] last known [as] normal)[.]
    CP at 69 (underscore omitted). If the patient demonstrates any one of these symptoms (face, arms,
    or speech), it is likely the patient is having a stroke, and the first responders are directed to transport
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    No. 51827-9-II
    the patient to the nearest stroke center, limit the time at the scene, and alert the destination hospital
    as soon as possible.
    The “F” of the FAST examination refers to asking the patient to smile, make a face, or
    “show his or her teeth,” to see if each side of the face moves as well as the other. CP at 70. A
    normal response occurs when both sides of the face move equally. An abnormal response is when
    one side of the face does not move as well as the other side.
    The “A” in the FAST examination refers to arm drift, where the first responders ask the
    patient to close her eyes and extend both arms straight out for 10 seconds. The palms should be
    facing up with thumbs pointing out. A normal response is for both arms to move in the same
    manner. An abnormal response is when one arm drifts down or one arm does not move at all.
    The “S” in the FAST examination refers to speech, where the first responders ask the
    patient to repeat a simple phrase such as, “Firefighters are my friends.” CP at 70. A normal
    response is for the patient to say the requested phrase correctly without slurring. An abnormal
    response occurs if the patient slurs, says the wrong words, or is unable to speak.
    The “T” in the FAST examination refers to asking the patient, family, or bystanders about
    the “[t]ime last normal (determine [the] time patient [was] last known [as] normal).” CP at 69.
    In her deposition, Samuels described what the first responders did during the FAST
    examination of her:
    A: He [referring to one of the first responders] looked in my eyes, and he looked
    in my throat, and then he also did the – the resistant (sic) test.
    ....
    Q: Did – when you say “the resistance test,” you’re – you held your hands out –
    we have to get this for the record – you held your hands out in front of you?
    3
    No. 51827-9-II
    A: Yes.
    Q: And you put your palms up and down?
    A: Yes.
    Q: Did he actually press on your hands to see whether –
    A: Yes.
    Q: – you could hold them up?
    A: Yes. He pushed down a little bit; so I had to push and pull.
    Q: Okay.
    A. I mean push and – and – and lift.
    Q: Okay.
    A. Right.
    Q: And did you have any trouble resisting the pressure that he put on your hands?
    A: No.
    CP at 50.
    The first responders took Samuels’s vitals, including her pulse, respiratory rate, blood
    pressure, glucose, and pulse oximetry. The FAST examination revealed that Samuels’s grip on
    each side was equal, her pupils were normal, her facial grimace was equal, she was able to lift both
    palms equally and steadily, she had control over her upper extremities, and she was oriented and
    able to communicate orally. Samuels claims that the first responders did not fully complete the
    FAST examination because they did not ask her to smile or grimace as required by the protocols.
    The first responders spoke with her for a period of time and were able to observe her speech. When
    4
    No. 51827-9-II
    asked, she denied experiencing any loss of consciousness, chest pain, shortness of breath, nausea,
    vomiting, or diarrhea. They observed that her skin was pink, warm, and dry, and her lungs were
    clear. She reported that she did not have any significant medical history and was not taking
    medication although she had recently taken an over-the counter cold medicine, which she had used
    before without incident.
    The first responders determined that the FAST examination was negative for a stroke
    because they (1) did not observe a unilateral face droop, (2) noted that there was no unilateral drift
    or weakness in her arms, and (3) observed that her speech was normal. According to the Pierce
    County protocols, a negative FAST examination meant that the patient qualified for basic life
    support transport if she wanted it. Following the protocols, the first responders recommended that
    Samuels either take a private ambulance to Tacoma General Hospital’s emergency room, or have
    her significant other drive her there. Samuels testified that one of the first responders told her,
    “[Y]ou’re not having a stroke.” CP at 53, 733.
    After about 10 minutes, the first responders left Samuels’s home believing that Samuels’s
    significant other was going to transport her to Tacoma General Hospital’s emergency room. The
    patient contact report for Samuels states that “the spouse of [the patient] was going to [transport]
    the [patient] [via privately owned vehicle] to [Tacoma General Hospital’s emergency room].” CP
    at 64. After the first responders left, Samuels continued to experience dizziness and suffer from a
    “squeezing” headache, but decided not to go to the emergency room. CP at 43. She went to work
    the next morning and worked a full shift and also worked her full shift for the next three days.
    5
    No. 51827-9-II
    On December 30, Samuels went to the MultiCare Westgate Urgent Care Center. At
    MultiCare, Gloria Lem, Advanced Registered Nurse Practitioner (ARNP), treated her for a
    headache and sent her home. On January 5, 2016, Samuels went to Tacoma General Hospital’s
    Emergency Room where a doctor examined her and determined that she was exhibiting symptoms
    that indicated she had recently suffered from a stroke.
    Samuels then sued the City of Tacoma. In her complaint, Samuels alleged that the City
    was liable for the first responders’ negligent conduct in misdiagnosing her medical condition and
    failing to properly treat her stroke. The City filed a motion for summary judgment arguing that
    there were no genuine issues of material fact and that it was entitled to qualified immunity as a
    matter of law under RCW 18.71.210(1) because the first responders were acting in good faith and
    without gross negligence. In support of its motion, the City filed the Pierce County protocols that
    the first responders were required to follow, the patient contact report from the incident, and
    portions of Samuels’s deposition testimony where she described what the first responders did in
    administering the FAST examination. In opposition to the summary judgment motion, Samuels
    provided the expert opinions of Dr. David Lombardi, a licensed medical doctor in California who
    specializes in treating stroke patients, and Dr. Kevin Brown, a licensed medical doctor in New
    York who specializes in emergency medicine.
    The superior court ruled that there was no genuine issue of material fact as to gross
    negligence and that the City was entitled to qualified immunity as a matter of law under RCW
    6
    No. 51827-9-II
    18.17.210. The court then granted the motion, dismissed Samuels’s negligence claim, and
    awarded statutory costs to the City under RCW 4.84.010. Samuels appeals.1
    ANALYSIS
    Samuels argues that (1) simple negligence, not gross negligence, is the applicable fault
    standard, (2) any alleged failure of the first responders to follow the Pierce County protocols
    precludes qualified immunity, and thus, RCW 18.71.210(1) does not apply, and (3) there are
    genuine issues of material fact as to gross negligence and the City was not entitled to qualified
    immunity. We hold that RCW 18.71.210(1) applies, there are no genuine issues of material fact
    under the applicable gross negligence standard, the City is entitled to qualified immunity as a
    matter of law, and thus, the superior court did not err.
    I. LEGAL PRINCIPLES
    We review a superior court’s order granting summary judgment de novo. Larson Motors,
    Inc. v. Snypp, 
    3 Wash. App. 2d
    127, 135, 
    413 P.3d 632
    , review denied, 
    191 Wash. 2d 1013
    (2018). We
    review the evidence and all reasonable inferences from the evidence in the light most favorable to
    the nonmoving party. Snypp, 
    3 Wash. App. 2d
    at 135. Summary judgment is appropriate where
    there is no genuine issue of material fact and the moving party is entitled to judgment as a matter
    of law. CR 56(c); Snypp, 
    3 Wash. App. 2d
    at 135. “If reasonable minds can reach only one
    1
    Samuels initially sued MultiCare Health System and Gloria Lem, ARNP, for medical malpractice
    under chapter 7.70 RCW, but settled with these defendants and amended her complaint to add the
    City as a defendant. Samuels sought discretionary review, which a commissioner of this court
    denied. Ruling Denying Review, 501413-8-II (Sept. 21, 2017). In January 2018, Samuels settled
    and dismissed her remaining claims against MultiCare and Lem.
    7
    No. 51827-9-II
    conclusion on an issue of fact, that issue may be determined on summary judgment.” Sutton v.
    Tacoma Sch. Dist. No. 10, 
    180 Wash. App. 859
    , 865, 
    324 P.3d 763
    (2014).
    II. QUALIFIED IMMUNITY
    A. APPLICABLE FAULT STANDARD
    Samuels initially argues that RCW 18.71.210 does not apply and that simple negligence,
    not gross negligence, is the correct fault standard. She also argues that any deviation from the
    treatment protocols defeats qualified immunity. We hold that gross negligence is the applicable
    fault standard and that Samuels’s interpretation of RCW 18.17.210 is not consistent with the plain
    language of the statute. Thus, her arguments on this basis fail.
    We review interpretations of a statute de novo. Jametsky v. Olsen, 
    179 Wash. 2d 756
    , 761,
    
    317 P.3d 1003
    (2014). When engaging in statutory interpretation, we endeavor to determine and
    give effect to the legislature’s intent. 
    Jametsky, 179 Wash. 2d at 762
    . In determining the legislature’s
    intent, we must first examine the statute’s plain language and ordinary meaning. 
    Jametsky, 179 Wash. 2d at 762
    . Legislative definitions included in the statute are controlling, but in the absence of
    a statutory definition, we give the term its plain and ordinary meaning as defined in the dictionary.
    American Cont’l Ins. Co. v. Steen, 
    151 Wash. 2d 512
    , 518, 
    91 P.3d 864
    (2004). In addition, we
    consider the specific text of the relevant provision, the context of the entire statute, related
    provisions, and the statutory scheme as a whole when analyzing a statute’s plain language. Lowy
    v. PeaceHealth, 
    174 Wash. 2d 769
    , 779, 
    280 P.3d 1078
    (2012).
    If there is more than one reasonable interpretation of the plain language, the statute is
    ambiguous. 
    Jametsky, 179 Wash. 2d at 762
    . When a statute is ambiguous, we resolve ambiguity by
    engaging in statutory construction and considering other indications of legislative intent.
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    No. 51827-9-II
    
    Jametsky, 179 Wash. 2d at 762
    . However, if the statute is unambiguous, we apply the statute’s plain
    meaning as an expression of legislative intent without considering other sources. 
    Jametsky, 179 Wash. 2d at 762
    .
    The qualified immunity statute, RCW 18.71.210(1) states:
    No act or omission of any physician’s trained advanced emergency medical
    technician and paramedic, as defined in RCW 18.71.200, or any emergency medical
    technician or first responder, as defined in RCW 18.73.030, done or omitted in good
    faith while rendering emergency medical service under the responsible supervision
    and control of a licensed physician or an approved medical program director or
    delegate(s) to a person who has suffered illness or bodily injury shall impose any
    liability upon:
    ....
    (g) Any federal, state, county, city, or other local governmental unit or
    employees of such a governmental unit.
    (Emphasis added.)
    RCW 18.71.210 applies to emergency medical service personnel, allowing them immunity
    from liability for actions or omission done in good faith while rendering emergency medical
    service. Marthaller v. King County Hosp. Dist. No. 2, 
    94 Wash. App. 911
    , 915-16, 
    973 P.2d 1098
    (1999). The statute’s purpose is “to protect [first responders] from ‘the unduly inhibiting effect
    the fear of personal liability would have on the performance of [their] professional obligations.’”
    
    Marthaller, 94 Wash. App. at 916
    (quoting Savage v. State, 
    127 Wash. 2d 434
    , 441-42, 
    899 P.2d 1270
    (1995)). Under RCW 18.71.210, “Qualified immunity is immunity from suit, not simply from
    liability.” 
    Marthaller, 94 Wash. App. at 916
    .
    9
    No. 51827-9-II
    The immunity from suit does not extend to “any act or omission which constitutes either
    gross negligence or willful or wanton misconduct.” RCW 18.71.210(5). “Gross negligence” is
    “negligence substantially and appreciably greater than ordinary negligence.” Nist v. Tudor, 
    67 Wash. 2d 322
    , 331, 
    407 P.2d 798
    (1965). “Gross negligence” also means the “failure to exercise
    slight care.” 
    Nist, 67 Wash. 2d at 331
    . “Gross negligence” does not mean the total absence of care,
    but care substantially or appreciably less than the quantum of care inhering in ordinary negligence.
    
    Nist, 67 Wash. 2d at 331
    ; Johnson v. Spokane to Sandpoint, LLC, 
    176 Wash. App. 453
    , 460, 
    309 P.3d 528
    (2013).
    Our Supreme Court recently clarified the definition of gross negligence:
    To survive summary judgment in a gross negligence case, a plaintiff must provide
    substantial evidence of serious negligence. In determining whether the plaintiff has
    provided substantial evidence, the court must look at all the evidence before it,
    evidence that includes both what the defendant failed to do and what the defendant
    did. If a review of all the evidence suggests that reasonable minds could differ on
    whether the defendant may have failed to exercise slight care, then the court must
    deny the motion for summary judgment. But if a review of all the evidence reveals
    that the defendant exercised slight care, and reasonable minds could not differ on
    this point, then the court must grant the motion.
    Harper v. State, 
    192 Wash. 2d 328
    , 345-46, 
    429 P.3d 1071
    (2018).
    Thus, we hold that the applicable fault standard is gross negligence here, not simple
    negligence as Samuel claims. To defeat summary judgment, under Harper, Samuels must provide
    substantial evidence of serious negligence.
    Samuels further argues that RCW 18.71.210 simply provides a standard of fault greater
    than simple negligence when the protocols are followed. According to Samuels, RCW 18.71.210
    does not provide qualified immunity to first responders even if they follow all of the applicable
    protocols. Samuels’s argument is inconsistent with the plain language of the statute that explicitly
    10
    No. 51827-9-II
    provides qualified immunity to first responders for their actions when “done or omitted in good
    faith while rendering emergency medical service under the responsible supervision and control of
    a licensed physician or an approved medical program director.” RCW 18.71.210(1). Further,
    Samuels’s argument is inconsistent with the policy underlying the statute—that RCW 18.71.210
    is intended, “to protect [first responders] from ‘the unduly inhibiting effect the fear of personal
    liability would have on the performance of [their] professional obligations.’” Marthaller, 94 Wn.
    App. at 916 (quoting 
    Savage, 127 Wash. 2d at 441-42
    ). Because the statute’s language and the
    underlying policy provide immunity from suit, we hold that Samuels’s argument on this basis fails.
    We address Samuels’s additional arguments related to gross negligence below.
    B. VIOLATION OF PROTOCOLS
    Samuels argues that there are genuine issues of material fact because the first responders
    failed to complete the FAST examination and did not operate under the direction of an approved
    medical program director as required by the Washington Administrative Code. Thus, Samuels
    claims that the superior court erred by granting summary judgment dismissal of her claim. We
    disagree.
    1. FAST Examination
    Samuels argues that a FAST examination was not administered to her and that she
    presented symptoms of high blood pressure, facial numbness, facial droop, and self-reported
    indications of a stroke. Even assuming these facts in the light most favorable to Samuels, they do
    not create any genuine issues of material fact of gross negligence based on this record.
    11
    No. 51827-9-II
    Under Harper, Samuels must provide substantial evidence of serious negligence to survive
    summary judgment. 
    Harper, 192 Wash. 2d at 342
    . Here, the first responders exercised at least slight
    care in their FAST examination of Samuels. They took actions that allowed them to evaluate each
    aspect of the FAST examination (face, arms, speech) and, based on that evaluation, determined
    that there were no positive stroke symptoms. Under the protocols, because Samuels’s symptoms
    did not meet the requirements under the FAST examination for immediate transport, they did not
    immediately transport her to the nearest stroke center at Tacoma General Hospital. They advised
    her to go to the emergency room either by private ambulance or personal vehicle and after they
    were done, they left believing that her significant other would be taking her to the hospital,
    although Samuels disputes this fact.
    Viewing the evidence in the light most favorable to Samuels, reasonable minds could not
    differ on whether the first responders exercised at least slight care. Because the first responders
    exercised at least slight care, Samuels fails to raise a genuine issue of material fact as to gross
    negligence.
    2. Supervision by an Approved Medical Director and Scope of Authority
    Samuels next argues that “[o]nly EMTs and paramedics trained under the supervision of
    an approved medical director, among other things, are subject to, and the beneficiaries of, RCW
    18.71’s rules and privileges” Appellant’s Opening Br. at 30. That statement is incorrect.
    RCW 18.71.210(1)(g) specifically provides in relevant part that qualified immunity to
    “[a]ny . . . city, or other local governmental unit or employees of such a governmental unit.” This
    language includes the first responders here. The first responders also meet the requirements set
    out in RCW 18.71.210(1). There is no dispute that the first responders were acting as first
    12
    No. 51827-9-II
    responders or EMTs as defined in the statute. Further, Samuels has not presented any evidence
    showing that the first responders were not acting in good faith. See 
    Marthaller, 94 Wash. App. at 917
    (“[R]easonable minds could not differ on the question here because there is absolutely no
    evidence in the record to suggest that the paramedics acted without good faith.”).
    “Emergency medical service” means “medical treatment and care which may be rendered
    at the scene of any medical emergency or while transporting any patient in an ambulance to an
    appropriate medical facility, including ambulance transportation between medical facilities.”
    RCW 18.73.030(10). The first responders rendered emergency medical services because they
    were assessing Samuels for what she thought was a stroke. The first responders acted under the
    responsible supervision and control of an approved medical program director. The first responders
    rendered emergency medical service to a person who suffered illness or bodily injury because they
    took Samuels’s vitals and assessed her for stroke symptoms in her home when she thought she was
    having a stroke. Accordingly, her argument on this basis fails because the first responders meet
    the requirements of both RCW 18.71.210(1) and RCW 18.71.210(1)(g).
    Samuels also argues the first responders were required to contact their medical program
    director “when unresolved potential stroke symptoms, including . . . a self-diagnosis of stroke by
    the patient,” are known to them, and by not doing so, they acted outside their scope of authority
    and violated WAC 246-976-182(2). Appellant’s Opening Br. at 32. Even viewing the evidence
    in the light most favorable to Samuels, she fails to create a genuine issue of material fact as to
    gross negligence.
    13
    No. 51827-9-II
    Under WAC 246-976-182(2),
    If protocols and regional patient care procedures do not provide off-line direction
    for the situation, the certified person in charge of the patient must consult with their
    online medical control as soon as possible. Medical control can only authorize a
    certified person to perform within their scope of practice.
    Under WAC 246-976-182, first responders are required to contact the medical program
    director only when the protocols did not provide appropriate direction for the circumstance. Here,
    the protocols governed the first responders’ interaction with Samuels and they acted within those
    protocols by performing the FAST examination.
    As discussed above, “gross negligence means the failure to exercise slight care.” 
    Nist, 67 Wash. 2d at 324
    . Under Harper, Samuels must provide substantial evidence of serious 
    negligence. 192 Wash. 2d at 342
    . Samuels fails to provide substantial evidence of departure from the protocols.
    Further, her interpretation of RCW 18.71.210 would lead to absurd results that would defeat
    qualified immunity and permit liability even where the first responders acted in good faith and
    without gross negligence. Such an interpretation is not consistent with the plain language of the
    statute or the legislature’s purpose as discussed above. And we avoid construing a statute to lead
    to absurd results. Jespersen v. Clark County, 
    199 Wash. App. 568
    , 578, 
    399 P.3d 1209
    (2017).
    Thus, Samuels’s argument on this basis fails.
    3. Medical Diagnosis
    Samuels also argues that the first responders gave her a medical diagnosis when one of
    them told her that “you’re not having a stroke,” and that neither the applicable regulation nor the
    protocols allow first responders to diagnose or rule out a medical condition. We disagree.
    14
    No. 51827-9-II
    The first responders are required, as part of their job and within the scope of their practice,
    to assess and communicate to the patient at the time.2 Viewing the evidence in the light most
    favorable to Samuels, even if this statement was made to her by a first responder, Samuels fails to
    present substantial evidence of serious negligence. In sum, reasonable minds could not differ on
    whether the first responders acted with gross negligence and that the City is entitled to qualified
    immunity as a matter of law. Thus, we hold that the superior court did not err by granting summary
    judgment and dismissing her claim.3
    IV. COSTS
    Samuels argues that the superior court erred in awarding statutory costs to the City. We
    hold that the award of costs to the City was appropriate, and thus, the court did not err.
    RCW 4.84.010 provides that “[t]he measure and mode of compensation of attorneys and
    counselors, shall be left to the agreement, expressed or implied, of the parties, but there shall be
    allowed to the prevailing party upon the judgment certain sums for the prevailing party’s expenses
    in the action, which allowances are termed costs.” In other words, the prevailing party is entitled
    to costs under RCW 4.84.010.
    Here, the City prevailed on its motion for summary judgment. The superior court then
    awarded $200 in costs to the City pursuant to RCW 4.84.010. Because the statute permits the
    award of costs to the prevailing party and the City prevailed, we affirm the superior court’s award
    of statutory costs.
    2
    See Wash. Court of Appeals oral argument, Samuels v. City of Tacoma, No. 51827-9-II (June 25,
    2019) at 23 mi., 30 sec. to 24 min., 13 sec. (on file with court.)
    3
    Because we affirm, we do not reach the issue of whether expert opinion testimony is required.
    15
    No. 51827-9-II
    We affirm the superior court’s order granting summary judgement and award of statutory
    costs.
    A majority of the panel having determined that this opinion will not be printed in the
    Washington Appellate Reports, but will be filed for public record in accordance with RCW 2.06.040,
    it is so ordered.
    SUTTON, J.
    I concur:
    GLASGOW, J.
    16
    No. 51827-9-II
    MELNICK, P.J. (concur in part, dissent in part) — Because material issues of fact are in
    dispute, I respectfully disagree with the majority’s decision to affirm the trial court’s grant of
    summary judgment. Even if we resolve all of the disputed material facts in favor of Lesa Samuels,
    I believe that reasonable minds can differ as to whether the City of Tacoma’s acts constituted
    negligence or gross negligence. If a finder of fact determined that the City’s acts constituted mere
    negligence, I agree with the majority that the City would have statutory immunity.
    We engage in the same inquiry as the trial court and review a summary judgment order de
    novo. Woodward v. Lopez, 
    174 Wash. App. 460
    , 467, 
    300 P.3d 417
    (2013). We consider all
    evidence and all reasonable inferences that arise therefrom in the light most favorable to the
    nonmoving party. 
    Woodward, 174 Wash. App. at 468
    .
    Summary judgment is appropriate “if the pleadings, affidavits, and depositions before the
    trial court establish that there is no genuine issue of material fact and that as a matter of law the
    moving party is entitled to judgment.” Ruff v. King County, 
    125 Wash. 2d 697
    , 703, 
    887 P.2d 886
    (1995). The burden is on the moving party to demonstrate there is no genuine issue of material
    fact. 
    Woodward, 174 Wash. App. at 468
    . On summary judgment, questions of fact may be
    determined as a matter of law “‘when reasonable minds could reach but one conclusion.’” 
    Ruff, 125 Wash. 2d at 704
    (quoting Hartley v. State, 
    103 Wash. 2d 768
    , 775, 
    698 P.2d 77
    (1985)).
    “‘After the moving party submits adequate affidavits, the nonmoving party must set forth
    specific facts which sufficiently rebut the moving party’s contentions and disclose the existence
    of a genuine issue as to a material fact.’” 
    Woodward, 174 Wash. App. at 468
    (internal quotation
    marks omitted) (quoting Visser v. Craig, 
    139 Wash. App. 152
    , 158, 
    159 P.3d 453
    (2007)). However,
    “a nonmoving party ‘may not rely on speculation [or on] argumentative assertions that unresolved
    17
    No. 51827-9-II
    factual issues remain.’” 
    Woodward, 174 Wash. App. at 468
    (internal quotation marks omitted)
    (quoting 
    Visser, 139 Wash. App. at 158
    ). “An expert opinion on an ultimate issue of fact is sufficient
    to preclude summary judgment.” 
    Woodward, 174 Wash. App. at 468
    ; see Lamon v. McDonnell
    Douglas Corp., 
    91 Wash. 2d 345
    , 353, 
    588 P.2d 1346
    (1979). When a material fact is in dispute, a
    court must deny summary judgment. Smith v. Safeco Ins. Co., 
    150 Wash. 2d 478
    , 485-86, 
    78 P.3d 1274
    (2003).
    In the present case, Samuels identifies a number of material facts, both acts and omissions,
    she claims are in dispute. I agree with her. Samuels first asserts that the Tacoma Fire Department
    emergency medical technicians and paramedics (collectively first responders) did not perform the
    FAST test properly and did not follow established protocols. There is a dispute of a material fact
    as to whether the first responders performed all parts of the FAST test. Next, Samuels asserts there
    is a dispute as to whether the first responders rendered a medical opinion that Samuels was not
    having a stroke. Because of this opinion, Samuels asserts she did not have the first responders
    transport her to the hospital. Lastly, Samuels asserts that there is a factual dispute as to whether
    the first responders recommended she take a private ambulance to the hospital or have her
    significant other drive her.4 Because these factual disputes are material, I believe the court erred
    in granting summary judgment.
    4
    In addition, Samuels alleges that the first responders went outside of their field of expertise by
    not contacting a base-station (on call) physician, in violation of administrative rules. She alleges
    they failed to follow protocol. Samuels agrees that this issue does not involve a factual dispute.
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    No. 51827-9-II
    The majority seems to imply that even if all of these factual disputes are settled in
    Samuels’s favor, that she would only prove negligence, not gross negligence. The majority asserts
    that reasonable minds could not differ on this issue. I disagree.
    First, however, I agree with the majority that if all of the facts show nothing more than
    mere negligence, that RCW 18.71.210 provides the City with immunity. However, I disagree with
    the majority’s view that reasonable minds could not differ on whether these acts and omissions
    constitute negligence or gross negligence. I believe that this determination is for a trier of fact.
    Ordinary negligence “is the act or omission which a person of ordinary prudence would do
    or fail to do under like circumstances or conditions; it is that degree of care which the reasonable
    prudent person would exercise in the same or similar circumstances.” Nist v. Tudor, 
    67 Wash. 2d 322
    , 331, 
    407 P.2d 798
    (1965) (automobile accident).              Gross negligence is “negligence
    substantially and appreciably greater than ordinary negligence. . . . In determining the degree of
    negligence, the law must necessarily look to the hazards of the situation confronting the actor.”
    
    Nist, 67 Wash. 2d at 331
    . Nist recognized that the application of the terms negligence and gross
    negligence has not been uniform. “In some instances, negligence, which has been declared
    insufficient to constitute gross negligence as a matter of law, has been held in similar cases to
    create an issue of gross negligence” for the trier of fact. 
    Nist, 67 Wash. 2d at 329
    .
    Additionally, in Harper v. State, 
    192 Wash. 2d 328
    , 341, 
    429 P.3d 1071
    (2018), where the
    plaintiff sued the Department of Corrections (DOC) for failing to supervise a probationer who
    killed his girlfriend, the court recognized that normally the issue confronting us is one for the trier
    of fact, unless reasonable minds could not differ. It affirmed Nist’s principles and affirmed that
    19
    No. 51827-9-II
    courts must specifically identify the relevant failure(s) identified by the plaintiff. 
    Harper, 192 Wash. 2d at 344
    .
    Following guidance from Nist, in ruling on a motion for summary judgment,
    trial courts must specifically identify the relevant failure alleged by the plaintiff. If
    the evidence shows that the defendant may have failed to exercise slight care in the
    specific area that is relevant to the case (e.g., turning into oncoming traffic), then
    the trial court should not grant summary judgment—even if a defendant exercised
    great care in other respects (e.g., allowing a car to pass).
    
    Harper, 192 Wash. 2d at 344
    .
    In so ruling, the court said that a plaintiff must provide substantial evidence of serious
    negligence. The court must look at what the defendant did as well as what it failed to do.
    If a review of all the evidence suggests that reasonable minds could differ on
    whether the defendant may have failed to exercise slight care, then the court must
    deny the motion for summary judgment. But if a review of all the evidence reveals
    that the defendant exercised slight care, and reasonable minds could not differ on
    this point, then the court must grant the motion.
    
    Harper, 192 Wash. 2d at 346
    .
    In the present case I believe the superior court erred by granting summary judgment. First,
    it failed to specifically identify the relevant failure(s) alleged by Samuels. Second, there are
    material facts in dispute. Third, even if all the material facts are resolved in the light most favorable
    to the City, as the majority seems to say it is doing, I believe reasonable minds could differ on
    whether this case involves negligence or gross negligence. This case is qualitatively different from
    a car accident case and a DOC failure to supervise case. I would reverse the trial court’s granting
    of summary judgment.
    MELNICK, P.J.
    20