Author: Nina Abangan
Judgment date: 13 August 2020
Citation: Queensland v Masson  HCA 28
Jurisdiction: High Court
Prior to her arrival at hospital, Ms Masson sustained severe and irreversible brain damage as a result of deprivation of oxygen. She lived in a vegetative state for the next 13.5 years while being cared for at home by her parents and unfortunately, passed in 2016.
It was alleged there was a failure to promptly administer Ms Masson with Adrenalin which constituted a negligent omission for which the State was vicariously liable. It was alleged the failure was contrary to the instructions of the QAS Clinical Practice Manual (the Manual). In the alternative, should the QAS officers not be negligent, the training and instruction given by QAS was inadequate such that the State was directly liable for the failure to administer the Adrenaline earlier.
The trial judge held at first instance that the ICP acted with reasonable care and had "considered" the use of IV adrenaline, but opted for the administration of IV Salbutamol considering Ms Masson's clinical context of high blood pressure and high heart rate. The trial judge also held this course of treatment was supported by a responsible body of opinion within the medical profession.
The Respondent appealed to the Queensland Court of Appeal (QCA). Contrary to the trial judge's finding, the QCA found that the ICP failed to consider the use of adrenaline and was negligent for failing to administer same to Ms Masson at the outset.
This was inconsistent with the exercise of reasonable care and skill for QAS officer to depart from the guidance of the Manual, even if following such guidance would have entailed risk in the circumstances. The Manual provided guidance that, where a patient presents with symptoms such as that of Ms Masson, to "consider" administering adrenaline.
The High Court formed the view that the QCA correctly observed that intensive care paramedics cannot be expected to make fine, professional judgments of a kind that require the education, training and experience of a medical specialist. The High Court said that an intensive care paramedic is still expected to exercise clinical judgment but the standard of care that was expected of the ICP was that of the ordinary skilled intensive care paramedic operating in the field in circumstances of injury, which is a less exacting standard than expected of specialists in emergency medicine.
When considering the liability of a party, consideration ought to be given not just to whether there is specialist knowledge but the reasonableness of the response in the circumstances.