American National Bank & Trust Co. v. City of Chicago

JUSTICE MILLER

delivered the opinion of the court:

The plaintiff, American National Bank and Trust Company, as special administrator of the estate of Renee Kazmierowski, brought the present action in the circuit court of Cook County against the defendants, the City of Chicago and two of its paramedics, John Glennon and Kevin T. O’Malley. Raising several theories of liability, the plaintiff sought recovery for the defendants’ alleged failure to respond properly to an emergency call by the decedent for medical assistance. The circuit court granted the defendants’ motion for dismissal of the complaint. The appellate court affirmed that judgment in an unpublished order. No. 1 — 97—1212 (unpublished order under Supreme Court Rule 23). We allowed the plaintiffs petition for leave to appeal (177 Ill. 2d R. 315(a)), and we now affirm in part and reverse in part the judgment of the appellate court and remand the cause to the circuit court for further proceedings.

The following factual summary is derived from the allegations in the plaintiffs amended complaint and from the information contained in its accompanying exhibits, which include a transcript of the decedent’s emergency call and the paramedics’ report. At around 7:55 a.m. on April 24, 1995, the decedent, Renee Kazmierowski, suffered an asthma attack while at home at her apartment in Chicago. She called 911 to request help. She provided her address and telephone number and said that she lived on the third floor of the building. The 911 operator replied that paramedics were on the way; the operator did not attempt to keep the decedent on the telephone while the paramedics were responding to the call.

Two paramedics, John Glennon and Kevin T. O’Malley, were directed to respond to what they were told was a “heart attack” victim. They were allowed into the decedent’s apartment building by a neighbor in the building and went to the third floor. They asked the neighbor whether he had summoned help, and the neighbor replied that he had not. The paramedics then knocked on the door of the only other apartment located on the third floor, but they received no response. The neighbor escorted a firefighter, who had also responded to the call, through his apartment to the back of the building. The firefighter knocked on the back door, but he received no response and was not able to see into the apartment. While the firefighter was checking the back of the building, the paramedics called the dispatcher, who confirmed that they were at the correct address. In response to the paramedics’ questions, the dispatcher also said that the caller had not provided her age, and that an attempt to return the call had reached an answering machine. The neighbor told the paramedics that the apartment was occupied by a young couple, who did not appear to have any medical problems. The paramedics concluded that they were not needed at the address in question, and they left the scene. That afternoon, the same paramedics returned to the apartment, again in response to an emergency call. On this occasion, a man let the paramedics into the apartment, and they found the decedent lying dead on the floor.

The plaintiffs amended complaint comprised a total of 11 counts. These alleged negligence and willful and wanton misconduct, and sought recovery from the City and the two paramedics under the Wrongful Death Act and the Survival Act. An additional count sought to impose liability on the City under a federal civil rights provision. The complaint alleged that the 911 operator acted negligently, willfully, and wantonly in failing to keep decedent on the phone while the paramedics responded. The complaint further alleged that the front door of decedent’s apartment was unlocked when the paramedics responded to her call, and that the paramedics acted negligently, willfully, and wantonly in failing to try the unlocked door and enter the apartment.

The defendants moved to dismiss the amended complaint under section 2 — 615 of the Code of Civil Procedure (735 ILCS 5/2 — 615 (West 1994)). The defendants argued that they were immune from liability for the decedent’s death under the Emergency Medical Services (EMS) Systems Act (EMS Act) (210 ILCS 50/1 through 33 (West 1994)). The defendants further contended that the plaintiff had failed to adequately allege that they owed the decedent a special duty of care or engaged in willful and wanton misconduct. The circuit court granted the defendants’ motion, ruling that the defendants were immune from liability under the EMS Act and that the plaintiff had failed to adequately allege a special duty or willful and wanton misconduct.

The appellate court affirmed the circuit court judgment in an unpublished order. No. 1 — 97—1212 (1998) (unpublished order under Supreme Court Rule 23). The appellate court rejected the defendants’ contention, raised for the first time on appeal, that section 5 — 101 of the Local Governmental and Governmental Employees Tort Immunity Act (Tort Immunity Act) (745 ILCS 10/ 5 — 101 (West 1994)) granted immunity to the defendants. The appellate court concluded, however, that section 17 of the EMS Act (210 ILCS 50/17 (West 1994)) immunized the defendants from liability for the decedent’s death. The appellate court also held that the plaintiff had failed to adequately allege that the defendants owed the decedent a special duty or that their conduct was willful and wanton. We allowed the plaintiffs petition for leave to appeal. 177 Ill. 2d R. 315. We later granted leave to the Illinois Trial Lawyers Association and to the Illinois Governmental Association of Pools and the Illinois Municipal League to submit briefs as amici curiae. 155 Ill. 2d R. 345. For the reasons that follow, we now affirm in part and reverse in part the judgment of the appellate court, and we remand the cause to the circuit court for further proceedings.

Before this court, the plaintiff does not challenge the dismissal of counts I, II, and XI of the amended complaint; counts I and II charged the City with negligence, and count XI alleged a violation of the decedent’s civil rights. Among the counts that remain, counts III and IV allege willful and wanton misconduct by the City for its failure to implement and enforce proper training for paramedics and for its failure to train and supervise the paramedics; count V seeks to recover from the City for its vicarious liability for the willful and wanton misconduct of the two paramedics in this case. Counts VI, VII, VIII, and IX are directed against paramedics Glennon and O’Malley; these counts allege negligence by the paramedics and seek recovery under the Wrongful Death Act and the Survival Act. The final count remaining for our consideration is count X, which alleges willful and wanton misconduct by the two paramedics.

A motion to dismiss brought pursuant to section 2 — 615 of the Code of Civil Procedure (735 ILCS 5/2— 615 (West 1994)) attacks the legal sufficiency of a complaint. In ruling on a section 2 — 615 motion, a court must accept as true all well-pleaded facts in the complaint and all reasonable inferences that may be drawn from the complaint. The court is to interpret the allegations of the complaint in the light most favorable to the plaintiff. A cause of action should not be dismissed on the pleadings unless it clearly appears that no set of facts can be proved under the pleadings that will entitle the plaintiff to recover. McGrath v. Fahey, 126 Ill. 2d 78, 90 (1988).

The plaintiff initially argues that the defendants’ section 2 — 615 motion to dismiss should not have been considered by the trial court because portions of the motion instead should have been included in a motion brought under section 2 — 619 of the Code of Civil Procedure (735 ILCS 5/2 — 619 (West 1994)), which permits the dismissal of an action because of certain affirmative defects or defenses. We believe that the plaintiff has waived this objection, however, for the plaintiff failed to raise it in the circuit court. See Haudrich v. Howmedica, Inc., 169 Ill. 2d 525, 536 (1996). We now turn to the merits of the present appeal.

In support of the appellate court’s and circuit court’s rulings, the defendants contend that the present action is barred by the immunity provision found in section 5 — 101 of the Tort Immunity Act (745 ILCS 10/5 — 101 (West 1994)). The defendants did not raise this contention in the circuit court, but they argued the point before the appellate court in support of the circuit judge’s favorable ruling. The appellate court disagreed with the defendants, who renew the contention before this court, arguing that section 5 — 101 of the Tort Immunity Act applies to this case and grants them immunity in these circumstances. Section 5 — 101 provides:

“Neither a local public entity nor a public employee is liable for failure to establish a fire department or otherwise to provide fire protection, rescue or other emergency service.
As used in this Article, ‘rescue services’ includes, but is not limited to, the operation of an ambulance as defined in the Emergency Medical Services (EMS) Systems Act.” 745 ILCS 10/5 — 101 (West 1994).

The appellate court ruled that section 5 — 101 provides immunity “only where a public entity chooses not to provide any fire protection, rescue or emergency services at all, and not where a public entity offers these services in general but fails to provide them in a particular case.” The defendants challenge the appellate court’s interpretation, arguing that the statute immunizes a local public entity that establishes a rescue service but fails to competently use that service when summoned by a particular plaintiff. We do not agree.

We believe that section 5 — 101 immunizes only a local public entity that has not established a fire department or rescue service, or has not instituted a system for otherwise providing fire or rescue services. This result is clear from a reading of section 5 — 102, which immediately follows section 5 — 101. Section 5 — 102 immunizes “a local public entity that has undertaken to provide fire protection service” from liability for injuries “resulting from the failure to suppress or contain a fire.” 745 ILCS 10/5 — 102 (West 1994). Because section 5 — 102 applies to municipalities that have “undertaken to provide” fire protection service, it was clearly meant to contrast with section 5 — 101, which governs municipalities that have not undertaken to provide such service. Further support for this interpretation comes from section 5 — 101 itself, which defines “rescue services” as including the “operation of an ambulance.” 745 ILCS 10/ 5 — 101 (West 1994). Under section 5 — 101, public entities that have not provided for the “operation of an ambulance” are thus immune from liability for that omission, while public entities that do provide for the “operation of an ambulance” are not covered by the statute— they are covered by the provisions of the EMS Act instead. Because the complaint in the instant case alleged that the City of Chicago has established a system for providing emergency rescue services, section 5 — 101 does not apply in these circumstances.

We next consider the provisions of the EMS Act and the immunity afforded by it. As an initial matter, the plaintiff argues that the provision is not applicable at all to this case. At the time of the decedent’s death, in April 1995, section 17(a) of the EMS Act provided as follows:

“Any person, agency or governmental body licensed or authorized pursuant to this Act or its rules, who in good faith provides life support services during a Department approved training course, in the normal course of conducting their duties, or in an emergency shall not be civilly or criminally liable as a result of their acts or omissions in providing those services unless the acts or omissions, including the bypassing of nearby hospitals or medical facilities for the purpose of transporting a trauma patient to a designated trauma center in accordance with the protocols developed pursuant to section 27 of this Act, are inconsistent with the persons’s training or constitute willful or wanton misconduct.” 210 ILCS 50/17(a) (West 1994).

Section 17(b) of the EMS Act similarly provided immunity for acts or omissions “in connection with administration, sponsorship, authorization, support, finance, or supervision of emergency medical services personnel, where the act or omission occurs in connection with their training or with services rendered outside a hospital unless the act or omission was the result of gross negligence or willful misconduct.” 210 ILCS 50/ 17(b) (West 1994). We note that both provisions have been amended since the decedent’s death. The legislature has now omitted, from section 17(a), the reference to acts or omissions “inconsistent with the person’s training,” and has reformulated, in section 17(b), the standard of non-immunized conduct to be that involving “willful and wanton misconduct.” See 210 ILCS 50/ 3.150(a), (b) (West 1996). The parties agree that the operative provisions in this case are the ones that were in force at the time of the decedent’s death.

The plaintiff contends that section 17(a) applies only when paramedics have actually rendered life support treatment to a patient; the plaintiff maintains that the failure of the responding paramedics in this case to administer any treatment at all to the decedent means that the provision has no application here. In support of this interpretation, the plaintiff cites the provisions appearing in sections 4.02, 4.06, and 4.20 of the EMS Act, which respectively define the terms “Advanced Life Support — Mobile Intensive Care Services,” “Basic Life Support Services,” and “Intermediate Life Support Services.” 210 ILCS 50/4.02, 4.06, 4.20 (West 1994). The plaintiff notes that each of these levels of life support treatment involves the performance of acts or procedures directly involving patient care. The plaintiff thus construes these definitions as signifying that the reference to life support services in the immunity provision of section 17(a) must refer to the actual rendition of medical treatment, and not to the conduct at issue in this case, in which no treatment was ever administered.

We do not believe that the scope of section 17(a) is as narrow as the plaintiff believes it to be. We conclude that the provision applies to this case, even though the acts and omissions alleged here do not relate to the actual rendition of life support treatment. Although the EMS Act does not define the general term “life support services,” we do not believe that we are limited, in interpreting section 17(a), by the specialized meanings assigned to the terms “advanced life support — mobile intensive care services,” “basic life support services,” and “intermediate life support services.” Those definitions are designed to distinguish one level or form of care from another, and the legislature could reasonably have decided to omit from the definitions conduct that is common to them all or, though preparatory to the actual rendering of medical care, is no less an integral part of providing life support services. Moreover, section 17(a) also refers to the transportation of patients. If transporting a patient to a hospital is an aspect of life support services, then so too is locating a patient in the first place. Other provisions in the EMS Act also demonstrate that the immunity provisions of section 17 apply in these circumstances. Elsewhere, the Act regulates matters such as communications, response time, and standards for ambulance operation. 210 ILCS 50/7, 7.1, 9 (West 1994). These additional measures are evidence of the Act’s broad scope, and of the equally broad meaning we believe must be given to the term “life support services” in the immunity provisions.

The parties also dispute the scope of the immunity provided by section 17(a) of the EMS Act. That provision, by its terms, affords immunity to two distinct types of activity: conduct that is “inconsistent with the person’s training” as a paramedic, and conduct that is willful and wanton. The parties do not agree on the reach of the former category, involving conduct that is “inconsistent with the person’s training.” The plaintiff insists that the provision does not afford immunity for conduct that is contrary to or violates training received by a paramedic. The defendants, in contrast, construe this exception more narrowly, contending that it withholds immunity merely for conduct that is beyond the level of a paramedic’s training; the defendants maintain that the provision otherwise provides complete immunity for negligence.

We agree with the defendants’ interpretation. We believe that this portion of section 17(a) means that conduct that is beyond the level of a paramedic’s training is not immunized, while conduct that merely deviates from a paramedic’s training and constitutes negligence is subject to immunity. The appellate court has adopted this interpretation in a series of cases. Bowden v. Cary Fire Protection District, 304 Ill. App. 3d 274, 280 (1999); Brock v. Anderson Road Ass’n, 287 Ill. App. 3d 16, 23-24 (1997); Gleason v. Village of Peoria Heights, 207 Ill. App. 3d 185, 188-89 (1990). We believe that that construction of the statutory language better effectuates the legislative intent. Under the plaintiff’s broad reading, which would withhold immunity for conduct that violates a person’s training, the exception would threaten to. supplant the immunity rule, for virtually any negligent act could be said to be inconsistent with or in violation of a person’s training. The plaintiff has not alleged that the actions of the paramedics were beyond their level of training, and therefore we conclude that section 17(a) operates to immunize them for their conduct, unless it rises to the level of willful and wanton misconduct.

We next consider whether the plaintiff’s amended complaint sufficiently alleges willful and wanton misconduct. The circuit court believed that the allegations were merely conclusory, and the appellate court agreed. The defendants argue that the lower courts’ determinations were correct.

It is the plaintiffs duty to sufficiently allege conduct that falls within the scope of a recognized cause of action. Moreover, mere conclusory allegations are not sufficient. We believe, however, that the allegations contained in the plaintiffs amended complaint are sufficient to withstand the defendants’ motion to dismiss.

This court has previously defined “willful and wanton misconduct” in the following terms:

“ ‘A wilful or wanton injury must have been intentional or the act must have been committed under circumstances exhibiting a reckless disregard for the safety of others, such as a failure, after knowledge of impending danger, to exercise ordinary care to prevent it or a failure to discover the danger through recklessness or carelessness when it could have been discovered by the exercise of ordinary care.’ ” Ziarko v. Soo Line R.R. Co., 161 Ill. 2d 267, 273 (1994), quoting Schneiderman v. Interstate Transit Lines, Inc., 394 Ill. 569, 583 (1946).

We believe that the allegations in the plaintiff’s amended complaint are sufficient, creating a question for the trier of fact to determine whether the defendants’ conduct was willful and wanton. According to the complaint, the decedent, Renee Kazmierowski, called 911 on the morning of April 24, 1995, and requested help, explaining that she was having an asthma attack. She provided her address and telephone number and said what floor she lived on. She also told the dispatcher, “I think I’m going to die. Hurry.” The dispatcher did not attempt to keep Renee on the line, however, as required by applicable standards.

Moreover, according to the allegations in the plaintiffs amended complaint, paramedics routinely receive instruction on how to respond to calls and, in particular, on how to locate persons in need of emergency medical treatment. The plaintiff alleges that training given to paramedics in Chicago, like training given to paramedics everywhere else, includes the following:

“[I]nstruction, training and enforcement of the standard ‘Try Before You Pry’ which dictates that firefighters, paramedics and other rescue personnel should always attempt to open a shut door by turning the door knob before engaging in destructive methods to gain access, or before exiting the scene altogether, without gaining access in order to ensure delivery of emergency health care services to the critically ill caller.”

. In the present case, the victim’s door was unlocked. If the paramedics had been following these vital and basic precepts of their training, as alleged, they would have found the victim inside the residence, and perhaps then they could have saved her life. Locating a person in need of emergency medical treatment is the first step in providing life support services. Not even that first step was taken here. We believe that the portions of the amended complaint that allege willful and wanton misconduct by the defendants are sufficient to withstand the defendants’ motion to dismiss, and we therefore remand the action to the circuit court for further proceedings.

For the reasons stated, the judgment of the appellate court, affirming the judgment of the circuit court of Cook County, is affirmed in part and reversed in part, and the cause is remanded to the circuit court of Cook County for further proceedings.

Affirmed in part and reversed in part;

cause remanded.