## Facts

- Irene McIntosh, a licensed paramedic, transported a critically ill patient to Kentucky River Medical Center’s emergency room entrance.
- Immediately outside the ER door was an eleven-foot-wide flat area bordered by an unmarked, unprotected curb that resembled a curb ramp but was flat rather than sloped.
- McIntosh had used the entrance many times without incident, but while moving the stretcher she focused on patient care and avoiding entanglement of IV lines with the stretcher wheels.
- McIntosh tripped over the curb and fell, fracturing her hip and spraining her wrist.
- Evidence indicated such a tripping hazard at an ER entrance was rare in the area and nearby hospitals had smooth transitions from ambulance docks to ER doors.
- McIntosh sued, alleging the curb was an unreasonably dangerous condition; the Hospital argued the condition was open and obvious and barred recovery.

## Issues

1. Whether the open and obvious nature of the curb relieved the Hospital of a duty to McIntosh as a matter of law, requiring judgment notwithstanding the verdict.
2. Whether, under premises liability and comparative fault principles, foreseeability that emergency personnel could be distracted required submission of duty and fault allocation to the jury.

## Decision

- The Supreme Court of Kentucky affirmed the judgment for McIntosh and the denial of JNOV.
- The Court held that an open and obvious condition does not automatically eliminate a land possessor’s duty to invitees.
- Applying Restatement (Second) of Torts § 343A, the Court concluded a possessor may be liable for an obvious danger when it should anticipate harm despite the obviousness.
- The evidence permitted a finding that the Hospital could foresee paramedics would be distracted by patient care and could trip at an unmarked curb immediately outside the ER entrance.
- Any negligence by McIntosh in failing to watch her footing was for comparative fault apportionment by the jury, not a categorical bar to recovery.

## Legal Principles

- A land possessor owes invitees a duty to discover, correct, or warn of unreasonably dangerous conditions, subject to limits where dangers are known or obvious.
- The open and obvious character of a hazard is not, by itself, dispositive of duty; liability may remain when the possessor should anticipate harm notwithstanding the hazard’s obviousness.  
- Foreseeability is central to duty analysis in premises liability, including circumstances where an invitee may be distracted or otherwise fail to protect herself from an obvious danger.
- Under comparative fault, an invitee’s failure to avoid an open and obvious hazard typically affects fault allocation and damages reduction rather than operating as an absolute bar.

## Conclusion

The court affirmed the verdict for the paramedic, holding that the hospital was not entitled to judgment as a matter of law because an open and obvious hazard can still support liability when the hospital should foresee harm despite the hazard’s obviousness, leaving comparative fault issues for the jury.


Ky. River Med. Ctr. v. McIntosh, 319 S.W.3d 385 (Ky. 2010)