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The “Sudden Medical Emergency” Defense in New Jersey: Suggested Approaches

Your client is involved in a motor vehicle accident in the State of New Jersey.  He claims to have suffered a loss of consciousness due to a medical condition that he never experienced before or was otherwise diagnosed with any condition that may have led to his losing consciousness.  Surely New Jersey case law has addressed this issue before, right?  Not so fast.

As of October 2022, New Jersey case law has yet to address the sudden medical emergency issue.  There is, however, established case law addressing the “sudden emergency” doctrine.  In
Harpell v. Public Service Coordinated Transport, 20 N.J. 309 (1956), the New Jersey Supreme Court affirmed the Appellate Court’s ruling affirming the trial court’s judgment entering a verdict in favor of plaintiff, Albert E. Harpell.  Mr. Harpell was a passenger on an electric trolley who was struck by a piece of concrete that had been thrown by a 15-year-old boy from a spot outside the fenced-in area that bordered the trolley route.  Plaintiff was seated by a trolley window that was equipped with a metal screen that extended half-way up the window.  The screen was designed to prevent injuries to passengers’ arms.

Of import, defendant’s discovery responses indicated knowledge of prior incidents similar to the one that injured plaintiff.  An employee of defendant acknowledged that there were three similar incidents in the month prior to plaintiff’s injuries.  Also, the trolley operator testified that there was nothing unusual about encountering rocks thrown at the trolley. 

The Supreme Court affirmed the lower courts’ verdict in favor of plaintiff.  In doing so, the Court established the criteria for a “sudden emergency” defense.  The Court held that when a person experiences a sudden emergency with no time to consider alternative courses of action and must make a “speedy” decision based on instinct or impulse, the actions must be reasonable under the circumstances to avoid being liable for the conduct. Id. at 317.  The Harpell Court further held that absent a situation where the defendant was presented with a situation that would elicit only one response from “reasonable minds”, the question of negligence is one for a jury.  Id. 

 In 1981, the sudden emergency defense was addressed in the context of a motor vehicle accident.  In Roberts v. Hooper, 181 N.J. Super 474 (App. Div. 1981), a taxicab driver was injured during a rear-end collision while the taxicab was stopped at an intersection.  Id. at 477.  Defendant testified of suddenly realizing that his brakes were not functioning as he approached plaintiff’s stopped vehicle.  A jury handed defendant a no cause and plaintiff appealed. 

The Appellate Court reversed and remanded for a new trial, finding that the trial court’s jury instructions overemphasized the “sudden emergency” defense over plaintiff’s objections.  The instructions failed to advise the jury that it could exonerate the defendant only if it determined that defendant had met his burden of evidence as to the sudden brake failure and whether defendant’s choice of course of action was reasonable under the circumstances.  Id. at 477-478.

The Appellate Court further determined that to invoke the sudden emergency doctrine, defendant had to be confronted with a “sudden emergency over which he had no control, without fault on his part.” Id. at 478.  The Court also ruled that the sudden emergency doctrine was an issue for a jury to decide.  Id.  A jury charge addressing the doctrine would be available concerning defendant’s negligence and plaintiff’s contributory negligence.  Id.     

In consideration of Harpell and Roberts, how would New Jersey address the “sudden medical emergency” defense?  As an initial point, it seems that New Jersey courts would view the issue as one for the jury to decide.   As to the criteria to be successful on a “sudden medical emergency” defense, a factual inquiry as to a defendant’s knowledge of a potential sudden medical emergency and his or her conduct prior to the emergency would be necessary.  As examples, was a diabetic or someone with hypertension/high cholesterol ever informed of his or her diagnosis?  Similarly, were they advised by a qualified medical professional that he/she should not drive or perform any other activity?  Was the defendant compliant with his or her medication regimen?  If so, was he or she told by a qualified medical professional that adherence to a medication schedule, exercise program and dietary restrictions would eliminate any chance of suffering from an adverse event?  These are but a few examples of determinative factors in deciding whether a sudden medical emergency was foreseeable or truly something over which the defendant had no control.      

Faced with the novel issue of a sudden medical emergency defense, New Jersey Courts may look to neighboring states for guidance.  Pertinent case law provides the required criteria in determining whether a defendant’s claim of a sudden medical emergency would offer that defendant a viable defense.     

Pennsylvania’s approach 

Shiner v. Ralston, 64 A.3d 1 (2013).  In Shiner, plaintiff was operating his vehicle northbound on a roadway divided by a grassy median and rumble strips when the vehicle driven by defendant/decedent crossed over the median from the southbound lanes and struck plaintiff’s vehicle.  an autopsy determined decedent suffered a cardiac dysrhythmia secondary to coronary atherosclerosis which caused decedent to lose consciousness during the operation of his vehicle.  The parties’ experts concurred in this opinion. 

Defendant moved for summary judgment asserting the collision was the result of a “sudden and unforeseeable medical emergency” and as such, neither decedent nor his employer could be found liable for plaintiff’s injuries.  The trial court granted defendant’s summary judgment motion and plaintiff appealed. 

The Superior Court held that material issues of fact as to whether defendant driver’s medical emergency was unforeseen and whether defendant driver established sudden medical emergency defense precluded grant of summary judgment to estate of defendant driver on plaintiff’s negligence claim.

The Shiner Court also pointed out that pursuant to the Pennsylvania Rules of Civil Procedure, the sudden medical emergency defense is an affirmative defense often pled as sudden loss of consciousness or incapacitation, and since the defense avoids negligence, it must be pled as new matter and proven by the defendant. Rules Civ.Proc., Rule 1030, 42 Pa.C.S.A.

Delaware approach

Lutzkowitz v. Murray, 339 A.2d 64 (Del. 1975) – where a driver of a vehicle suddenly becomes physically or mentally incapacitated without warning, he is not liable for injuries resulting from operation of motor vehicle while so incapacitated, but where a prima facie case of neglect has been established by plaintiff, burden of proof is on defendant to show sudden illness or attack and that such illness or attack was unanticipatable and unforeseen.

In Lutzkowitz, plaintiff was stopped at a red light when his vehicle was rear-ended by defendant’s vehicle.  Defendant claimed to have blacked out.  The sole issue was defendant’s negligence as there was no negligence established on the part of plaintiff.  The Superior Court entered judgment upon jury verdict in favor of defendant.  The jury instructions included governing law about unavoidable accidents but did not include the issue of whether defendant’s black out was foreseeable.  On appeal from the trial court, the Delaware Supreme Court reversed and remanded after determining that the jury instructions given should have included the foreseeability issue. 

If New Jersey were to elicit its “sudden medical emergency” doctrine from Delaware and Pennsylvania, the emergency would have to be found to have been sudden, unforeseeable, and unable to be anticipated.  Likewise, if New Jersey were to encompass Pennsylvania’s view on affirmative defenses, defendants would have to include the emergency as an affirmative defense.