By Doyice Cotten
Hundreds of running-related events are held each year. They include 5k runs, mile runs, marathons, half marathons, and events that include other activities such as the triathlon. There is risk in all of these, but most promoters take care to manage the risk as well as possible.
In a huge half marathon/5K run in California involving about 10,000 participants, a runner collapsed seconds after completion of the half marathon and died a few minutes later (Hass v. Rhodyco Productions, 2018). The purpose of this post is to examine some of the risk management procedures taken and the allegations against the promoter.
Requirements to Hold the Event
The city and county required submission of an emergency medical services plan (EMS Plan) for review and approval by the City’s Emergency Medical Services Agency (Agency). The approved plan provided:
- Palmer College of Chiropractic-West (PCCW) and American Medical Response (AMR) were to provide medical personnel for the event.
- This included chiropractic students who are CPR certified and have taken emergency response class.
- Med Teams to be located at key areas (Start Line, Finish Lines, Postrace Medical Tent, and mobile units on the course).
- Team to be led Dr. Hal Rosenberg (a chiropractor) onsite at the Postrace Medical Tent.
- AMR to provide an EMT who will be posted with PCCW Med Team in the postrace Medical Tent at the Finish of the race.
- AMR was also to provide an ALS ambulance to respond to medical emergencies; to be on standby posted on Lincoln at the Great Hwy․
- The Standby and Medical Team to be equipped with cellphone active Nextel radios with direct communication to the Event Coordinator and each other.
- Other portions of the approved EMS Plan, however, indicated that one M.D., 6+ EMTs, and one automatic external defibrillator (AED) would be located at the finish line.
Immediately after crossing the finish line at 10:05:34 a.m., Hass suffered a sudden cardiac arrest and collapsed. Another runner, a physician who crossed just ahead of Hass, heard him fall and immediately began providing CPR; he was subsequently relieved by an off-duty paramedic. Ten minutes after the collapse, another bystander brought the AED from the post-race tent located about 100 to 200 yards beyond the finish line. The AED showed that Hass had no shockable heart rhythm, but CPR efforts were then continued until paramedics from the City’s Fire Department arrived at approximately 10:31 a.m. They took over treatment which was stopped at 10:49 a.m. when the victim was pronounced dead.
Lawsuit and Allegations
About a year later, the Hass Family filed a wrongful death action making a number of allegations including:
- that RhodyCo had negligently organized and planned the Half-Marathon;
- they negligently “hired, retained, supervised, [and] controlled” the medical team;
- they negligently “managed, trained, supervised and controlled emergency and medical resources.”
- they used chiropractors rather than medical doctors,
- they used of chiropractic students rather than EMTs,
- they failed to have an ambulance at the finish line,
- their communication and communication devices were inadequate,
- they did not have adequate AEDs available. and ambulances.
The plaintiff also argued or presented evidence that medical emergencies are “more likely to occur near the finish line of a race because runners tend to push themselves to improve their times, causing an adrenaline rush and an arrhythmia.”
- Closing several major streets at the same time to accommodate a race often causes potential interference with emergency services.
- The plaintiff acknowledged that RhodyCo had properly identified the finish line as a “ ‘key area’ ” and indicated numerous resources would be stationed there—including a medical doctor, AED, and “6+” EMTs.
- They pointed out that the only medical personnel assigned to the finish line were Dr. Rosenberg (a chiropractor) and the Event Coordinator (a chiropractic student).
- They further stated that neither of them was actually at the finish line when Hass collapsed.
- They pointed to the fact that the AED was in the medical tent located approximately 200 yards away, not at the finish line.
- Further, no event medical personnel arrived at the scene until ten minutes after Hass collapsed.
- The AED arrived after 11 minutes – too late to help – and was brought by a bystander, not staff or medical personnel.
- They also presented evidence that while the EMS Plan called for “cell phone active radios,” in actuality, only six or seven radios were provided the medical team.
- They learned that neither the ambulance crew nor the chiropractor on site had radios; in fact, there was no radio in the medical tent.
- They presented declarations from several experts stating that the standard of care for an event like the Half Marathon is to have 1) a competent medical director who is a medical doctor; 2) to follow the medical plan; and 3) to provide “on-site ambulances (and/or backfilling of ambulances) to provide for rapid medical care for runners who collapse due to sudden cardiac arrest, particularly near the finish line.”
The liability waiver signed by Hass protected the provider from liability for ordinary negligence; however, the court concluded the evidence presented regarding gross negligence was sufficient that a reasonable juror might deem it to be gross. The court remanded the case to the trial court to determine if the actions did constitute gross negligence. This is important because liability waivers cannot protect a provider from liability for gross negligence in California.
Risk Management Thoughts
The case will probably be settled prior to returning to trial; probably a very large settlement to the plaintiff Hass Family.
If you organize such events, have a quality emergency plan and see that you follow it in every detail.
If you compete in such events, check the promoter and the event out very carefully. It is impossible for the competitor to learn all the emergency details, but we often hear of such risky practices as failure to provide adequate liquid during the race. At least look for the obvious evidences and don’t be afraid to ask specific questions regarding precautions taken.
Photo Credit: Thanks to Bo Jorgensen via Flickr.