## I L L I N O I S 

## O F F I C I A L 

## RE P O R T S Appellate Court

Hom e Star Ban k & Fin ancial Services v. Emergency Care & Health Organi zation , Ltd. , 2012 IL App (1st) 112321

Appellate Court Caption HOME STAR BA NK AND FI

NANCIAL

SERVI CES, Guardian of the Estate of Edwar d Ander son, a Disabled Person, and DARBY THOMAS, Plaintiffs-Appellants, v. EMERGENCY CARE AND HEAL TH ORGANIZ ATI ON, L TD., and M I CHAEL T. MURPHY, DefendantsAppellees (P ro vena Hospitals, d/b/a Provena St. Mary ’s Hospital, a Corporation, De fenda

nts).

District & N o. First District, F ifth Division
Docke t No. 1-11-2321

Filed Dec ember 21, 2012

Held (Note : This syl lab us

con st it ute s n o par t of the opi nio n of the cour t but has bee n pre

par ed by the Repo rt er o

f D e c i s i o n s f

o r t h e

c o n v e n i e n c e o

f t h e

rea der

. ) In a neg lige nce action ag ainst an emer g en cy room phy sician who

re s p o n d ed to a “code blue” for a hospital patient and attempted to i ntubate him, summary judgme nt was improperly enter ed for th e phy sician on the g round that he was immune from liability under the Good Samaritan Act, notwithstanding the fac t that no one was billed for the services provided, since the phy sician was paid to work in the

emer g ency room and he was not providing his service s “without fee ” for purposes of the Act.

Dec ision Under Review Appea l from the Circuit Court of Cook County
, No. 07-L -1340; the Hon. Eliz abeth M. B udzins ki, J udg e, pre siding.

J udg ment Reverse d and re manded.Counsel on

Appea l Keith A. Hebe isen, of Clifford L aw Offic es, of Chicag o (R o b ert P. Sheridan, of c ounsel), for appellants.

Kevin J . Vedrine and Christopher J. Solfa, both of Cunningham, Me y er & V edrine , PC, of W arr enville, for a ppellees.

Panel J USTI CE PAL MER delivered the judgme nt of the cour t, with opinion. Presiding J ustice McB ride and J ustice Taylor concur red in the judgme nt and opinion.

OP INION

¶ 1 Plaintiffs D arby Thomas and Home Star Ba nk & Financ ial Service s, as guardia n of the
estate of Edwar d Ander son, a disabled person, filed suit ag ainst defe ndants Michae l T. Murphy
, O.D., and his employer, Emerg ency Care & Hea lth Or gan i zation, Ltd. (ECHO), alleg ing Dr. Murphy was neg lige nt in treating A n d er s o n

. T he trial court gra nted s ummary judgme nt to defe ndants, finding Dr. Murphy immune from li ability pursuant to s ec tion 25 of the Good Samaritan Act (Ac t) (745 I L CS 49/25 (West 2010) ). Plaintiffs appea l, arguing the cour t erre d in gr anting summary judgme nt to defe ndants as (1) there is a g enuine issue

o f m aterial fac t reg arding whether Dr. Murphy ’s conduct was in g ood faith; (2) the Go o d Samaritan Act should not apply to Dr. Murphy
, a phy sician compensated to perf orm service s for patients in a hospital; and (3) there is no other basis for g ranting summary judgme nt. We

reve rse a nd rema nd.

¶ 2 BA CKGROUND ¶ 3 On August 25, 2 0 0 1
, Dr

. M u rp h y wa s working as an emer g ency phy sician in the

emer g ency

depar tment at Provena St. Mary ’s Hospi tal (St. Mary ’s or hospital). Dur ing his shift, he responde d to a “code blue” called for Ander son, a patient on another floor who Dr. Murphy had never met. Dr. Murphy attempted to intubate Ander son and otherwise respond
to the situation. Ander son suffe red perma nent b r a in in

ju r y

. Pl a in ti ffs filed a neg lige nce action
ag ainst Dr. Murphy and ECHO, alleg ing Dr. Murphy ’s car e and trea tment of Ander son wer e the ca use of Ande rson’s injuries. Dr. Murphy denied the a lleg ations. 1 ¶ 4 Dr. Murphy filed a mo ti o n f o r s u mm a r y ju d gment on plaintiffs’ third amende d complaint,

asser ting that section 25 of the Good Samaritan Act barr ed the neg lige nce action ag ainst him. Section 25 of the Ac t provides: “Any person licensed under t h e Medica l Practice Act of 1987 [(225 I L CS 60/1 et seq.

Pla int if f al so fi le d sui t agains t ass ort ed o the r def end ant s. T hos e cas es wer e set tl ed and 1 dis m is sedandar e no t a t i ssu e he re

.
-2-(West 2010))] or any person licensed to prac tice the treatment of human ailments in any other state or territory of the United States who, in g ood faith, provides emer g ency car e without fee to a person, shall not, as a result of his or her acts or omissions
, except willful

or wanton misconduct on the part of the person, in providing the car e, be liable for civil damag es.” 745 IL CS 49/ 25 (West 2010). Dr. Murphy

asser ted he was immune fr om liabilit y under the Act bec ause he had provide d

emer g ency car e to Ander son and no one was ever billed for that emer g ency car e. Dr. Murphy also asser ted his c onduct in pr oviding the car e and trea tment to Ander son met the standard of car e applicable to a rea sonably well-qua lified or car eful emer g enc y room phy sician. ECHO subsequently

joined in the motion. ¶ 5 Plaintiffs responde d that the Good Samaritan Act did not immu n i z e Dr

. Murphy from liability for his service s to Ander son. As rele vant to this appea l, plaintiffs agree d Dr. Murphy provided emer g ency car e to Ander son but asser ted that, as a matter of law, he did not provide

emer g ency car e “without fee ” as require d by the Act. Plaintiffs argued that Dr. Murphy was not a “volunteer ” providing emer g ency car e “without fee ” beca use, as the emer g ency phy sician working in the emer g ency room at St. Mary ’s, it was his job to respond to the code called for Ander son and he was paid hourly for his se rvice s at the hospital, which included responding to codes. Ag ain as rele vant to this appea l, plaintiffs argued, in the alterna tive, that there was a g enuine issue of materia l fac t reg arding whether the failur e to bill for Dr. Murphy ’s emer g ency

car e to Ander son was in “g ood faith.” ¶ 6 Ex hibits and discovery depositions we re fi l ed b y b o t h p ar t i es in support of their pleading s. T h e “e x clusive emer g ency room service s agree ment” betwee n ECHO and St. Mary ’s showed that, in exchang e for a monthly stipend, ECHO agree d to provide phy sician service s to staff the emerg ency room at S t. Mary ’s 24 hours a day an d 7 d ay s a week. The
agree ment stated that “[t] he primary obligation of ECHO’s phy sicians when in service at [S t. Mary ’s] emer g ency room shall be to car e for any and all patients prese nting themselves for
treatment at the emer g ency room.” ECHO phy sicians would “not furnish follow-up car e to

emer g ency patients except on an emer g ency basis or when reque sted by the Chief Ex ecutive Offic er or Ex ecutive Comm ittee of the Medica l Staff of [St. M ary ’s].” Phy sicians cove red by the agree ment wer e to discharg e their duties in acc ordanc e with the b y l aw s , ru l es, regulations and poli cies of the hospital and its medical staff . ECHO would bill and collect fee s direc tly from patients and/or third-par ty payors for the service s of its e merg ency room phy sicians. ¶ 7 An “indepe ndent contra ctor agree ment” betwee n ECHO and Dr. Murphy provided that ECHO eng ag ed Dr. Murphy to provi d e “e m er gency medical service s” at St. Mary ’s. An attachme nt to the ag ree ment descr ibed the “e merg ency medical se rvice s” as f

ollows: “The Phy sician shall provide such profe ssional service s ordinarily p ro v i d ed by

emer g ency

phy sicians in a hospital, includingbut not lim ited to the following : Phy sician shall provide emer g ency medical car e for the following classes of patients ***: 1. Emerg ency

Depa rtment * * *

-3-2. Inpatient Phy sician s h al l n o t provide any g ener al or routine car e of patients alre ady hospitaliz ed under

the ca re of another phy sician.
Howeve r, in dire emer g encie s, [ i.e. ], car diorespiratory (or impending) arr est, Phy sician may rende r service to any patient, as long as there is n o t an emerg ency depar tment patient requiring his/her immediate prese nce, and only until the patient[’] s persona l phy sician has a ssumed ong oing c are .” The agree ment provided that Dr. Murphy would be paid hourly and the hourly fee would be the “sole amount” he would rec ei v e for his service s. Dr. Murphy agree d to abide by and rende r emerg ency medical service s in acc ordanc e with the bylaws, rules and regulations of the hospital and depa

rtmental policies and pr ocedur es, usinghis professional judg ment. ¶ 8 A ty

ped “Clinical Oper ations/Nursing ” depar tment policy titled “Code Blue and Cardia c Arre st Tea

m” set out the “standa

rdized response ” for a patient suffe ring a car diopulmonary

arr est at St. Mary ’s. The policy provided that it aff ecte d assorted depar

tments, including the

emer g ency depar

tment, and identified “ER Phy sician” as a code blue team member with the duty to “[r] espond[ ] to all Code Blues in the hospital. D irec t[ ] [the] Code Blue Team.” A ty ped “Clinical Oper ations/Nursing ” depar tment po l i cy titled “Power Outag e Emerg ency Code Blue ” direc ted that “[s] hould a Code Blue occur [during a power outag e], the unit that has the e merg ency

will send a runne r to: *** [t ]he E.R. for the phy sician.” ¶ 9 I t is uncontested that ECHO billed Ander son for service s its phy sicians provided to him durin g a previous emer g ency room visit on August 22, 2001, but did not bill for Dr. Murphy ’s service s in responding to the code blue on August 25. St. Mary ’s billed Ander son for supplies used dur ing the code blue but not for any phy sician’s ser

vices. ¶ 10 By deposition, Dr. Murphy testified that the emer g ency room phy sician o n du t y at S t. Mary ’s was the phy sician who would be expected to respond to a code blue. He was the only

emer g ency room phy sician working at St. Mary ’s on the night of Ander son’s code blue. As

soon as he was notified of the code, he went to Ander son’s room. Dr. Murphy stated it was part of his job in the emer g ency room at St. Mary ’s to respond to a code. He had been involved in “a lot” of

codes at St. M ary ’s. ¶ 11 J oseph Danna
, M.D., the president and chief executive office r of ECHO, testified ECHO

was an independe nt contra ctor for St. Mary ’s, with an ex clusive contract with the hos pital
to provide emer g e n c y r o o m p hy sician service s to the hospital. Only ECHO phy sicians staffe d St. Mary ’s emerg ency depar tment. Dr. Murphy was one of those phy sicians under an independe nt contrac tor agree ment he had w ith ECHO. ¶ 12 Dr. Da

nna testified it was “ not an i nhere nt part of [Dr. Murphy ’s] work, of his job,” to respond to code blues at the hospital but, “if there wer e a dire emer g ency somewher e in the hospital wher e there was no one else available to respond, we would respond in the manner

a g ood Samaritan would respond to that dire emer g ency .” Dr. Danna had no understanding with the hospital that ECHO’s emer g ency phy sicians wer e part of the standard co d e b lue
response team. He considere d his phy sicians one of many available resour ces a nd, without exception, they wer e “th e last person” the hospital would call and would do so only if the private phy sician, ca

rdiolog ist, pulm onologist, surg eon or anae sthesiologist did not “show

-4-up.” Dr. Danna assumed Dr. Murphy responde d to the code called for Ander son beca use “he

was available to” and no other doctor was available that nigh t

. He was awa re that other

emer g ency room phy sicians had r esponded to c odes at the hospital in the past but fe lt they

wer e not obligated to respond. ¶ 13 Dr. Danna testified he knew “ver y littl e” about the Good Samaritan Act but understood it to protect him if he wer e driving home and stopped to he lp at the scene of an a ccide nt or if h e re s p o n d ed to a dire emer g ency at the hospital. He thought the Good Samaritan Act applied t o emer g ency room phy sicians responding to emer g encie s outside the emer g ency

room. ¶ 14 Dr

. Da n n a ex p l ai n ed t h at E C HO co n t ra ct ed with an outside company , P er -S e Tec hnologie s, to do the billing for any of ECHO phy sicians’ service s. ECHO only billed for 2 service s its phy sicians prov id e d in th e e merg ency depar tment. Dr. Danna testified that ECHO “neve r billed” when its emer g ency room phy sicians responde d to codes outside the

emer g ency depar

tment. He stated ECHO understood there would be “cir cumstance s beyond
anyone’s control wher e a patient might need [t hem] beca use there was nowher e else to g o.” ECHO had never rec eived pay ment for any service s Dr. Murphy rende red to Ander son beca use it had never billed for those service s. ECHO had sent no such bill; Dr. Murphy was not allowed to bill Ander son or any patient; and the hospital would never bill for the service s of ECHO’s doctors. Dr. Dan n a testified ECHO might decide not to charg e a patient if the patient “wa s p articularly unhappy with the emer g ency depar tment car e,” such as wher e a patient waited hours to be seen and left beca use he was not happy

. Ty

pically the emer g ency room phy sician would have to make such a reque st. ¶ 15 Heather Cl u v er , t h e o ffice manag er for Echo Manag ement and Consulti ng , an ECHO aff iliated company , and R ichar d K. M ullin, founder of Abrix Emerg ency BillingService s, L L C, testified t h at Ab ri x did the billing for the service s of ECHO’s emer g ency room phy sicians from 1999 to 2003; it was up t o E C HO whether to send a bill to a patient; and there wer e si tuations in which a phy sician would call Dr

. Danna and request t hat a patient who had be en see n in the emer g ency room not be billed. ¶ 16 Paula J acobi, the president and chief executive office r of St. Mary ’s in 2001, testified that the exclusive emer g ency room s ervic e agree ment with ECHO provided for overa ll
compensation to ECHO for the service s of its doctors and that the doctors wer e independe nt contra ct ors and not employ ees of the hos pital. There was no ref ere nce in the agr eeme nt to

emer g ency room doctors responding to code blue ca lls. For the 20-plus year s J acobi had worke d at the hospital, first as a nurse and then as an administr at o r, t h e emerg ency room doctors “were the one[ s] responding to codes.” J acobi testified the agr eeme nt with ECHO did not addre ss whether the doctors wer e to respond to code blues beca use she assumed the long- standing prac tice at St. Mary ’s that the emer g ency ro o m p hy sician on duty would respond to a code blue would continue. She considere d responding to a code blue to be “par t of [ the EC HO emerg ency depar tment phy sicians’] responsibilities” and st ated a code b l u e

I n 2001
, at the ti m e of Ander son ’s cod e blu e, Abri x Em er gency Bil li ng Ser vices
, LLC, did 2 the bi ll ing fo r ECHO.

-5-is an emer g ency

.

¶ 17 J acobi testified that if a patient used service s in the emer g ency depar tment, ECHO would bill for the servic es of its emer g ency depar tment phy sicians and the hospital would bill for the fac ility char g es, such as supplies an d o v erhe ad. J acobi testified that a code blue was a billable event for St. Mary ’s. The hospital had, there fore
, billed for the drug s and equipment used i n the resuscitation of Anderson during the code blue. The hospital wa s not involved in any billing by

ECHO and J acobi did not know whether EC HO bil led for the s ervic es of its phy sicians duringa code blue. ¶ 18 J ac o b i t estified that the “Clinical Oper ations/Nursing ” depar tment “Cod e Bl u e an d Cardiac Arre st Team” pol icy
, as i t had for many y ear s, stated t hat i t was the responsibility of emerg ency room phy sicians to respond to code blue calls. She did not know whether there

was any thing else in writing that would inform a phy sician direc tly of the re quirement that the emer g ency room doctors respond to codes. She clar ified that it was up to the emer g ency

room doctor to deter

mine whether he should leave a patient he was treating in the emer g ency room to attend to a c ode, depe nding on which patient had the more e merg ent nee ds. ¶ 19 Nanc y Fr izz ell, RN, was the nursing supervisor at St. Mary ’s on the night of Ander son’s code blue. Fr izz ell testified it was part of her job to be part of a code team. When a code was “announc ed overhe ad,” she would respond. She had responde d to over 100 codes. She stated the “Code Blue and Cardiac Arre st Te am” policy was a nursing policy but e very employ ee of the hospital was expected to follow it. It was Fr izz ell’s understanding and experience that “duringthe nig ht the ER phy sician normally comes to codes” ; the emerg ency room doctor would “drop” what he was do i n g i n t h e emer g ency room to respond to a code; and, even when phy sicians on the unit responde d to a code, the emerg ency room doctor would still come “ when [he] can.” ¶ 20 Kenne th J ohnston, M.D., a lary ng ologist, testified that Ander son was his patient. In the

ear ly morning of August 25, Dr. J ohnston rec eived a call at home from the hospital. He was told An d e r s o n w a s h a

v in g s erious respiratory problems and Dr. Murphy
, the emerg ency room doctor, was trying to intubate him. It was Dr. J ohnston’s understandin g that an “in-house

emer g ency room phy sician” was available 24 hours a day at the hospital and would respond
to an emer g ency

such as a code. ¶ 21 Eunice Riemer, a certified reg istered nur se ane sthetist at St. Mary ’s, attended the code blue called for Ander son. She testified she was not told why she was called to the code but assumed it was beca

use “the emer g ency phy sician could not acc ess the airwa y so reque sted help from someone else” beca use this was “the standard in the hospital.” Riemer had worke d
at St. Mary ’s since 1994 and it was her understanding that “whe n code blues wer e called that the emer g ency room phy sician would respond.” She testifie d th a t s h e a s s u me d the emer g ency

room phy sician was in char g e of the code beca use “they ’re usually there first, and then they call us.” ¶ 22 On May 8, 2009, following a hear ing, the trial court g rante d summary judgme nt to both Dr. Murphy and ECHO. The co u rt found no evidenc e that ECHO ever bi lled Ander son or his insurer for Dr. Murphy ’s s ervic es or that the decision not to bill was done in bad faith. I t held that Dr. Murphy ’s ac tions were, the ref ore, immune unde r the Good Sama ritan Ac t.

-6-¶ 23 The court g ave plaintiffs leave to file an amende d complaint in order to alleg e wilful and

wanton misconduct. Plaintiffs filed fourth and fifth amende d complaints, alleg ing wilful and
wanton misc o nduct. Plaintiffs moved for a Rule 304(a) (I ll. S. Ct. R. 304(a) (ef f. Fe b. 26, 2010)) finding with respe ct to the order of summary judgme n t , as s er ting Dr. Murphy and ECHO wer e the only rema ining de fenda nts and the fa cts underly

ing the wilful and wanton counts wer e the same as those underlying the dismiss al of the ne g lige nce c ounts under the Good Samaritan Act. The court g rante d t h e motion on August 12, 2011, finding no just

rea son to delay the appea l or enfor ceme nt of the order

. Plaintiffs timely appea led on August 15, 2011.

¶ 24 ANALYSI S ¶ 25 Plaintiffs argue summary judgme nt should be reve rsed as (1) a g enuine issue of materia l fac t exis ts reg arding whether Dr. Murphy ’s conduct in failing to bill for his emer g ency car e of Anderson was in g ood faith; (2) the Good S amar itan Act does not ap p ly to people such

as Dr. Murphy

who ar e hire d and paid to wor k in hospitals; and (3) there is no merit to D r. Murphy ’s alternate basis for summary judgme nt that, a s a matter of law, he did not deviate from the standa

rd of c are

. ¶ 26 A motion for summary judgme nt is a drastic means of disposing of litigation and should be “grante d only when ‘the pleading s, depositions, and admissions on file, toge ther with the aff idavits, if any , show that there is no g enuine issue as to any m at er i al fac t and that the moving party is entitled to a judgme nt as a mat t er o f l aw

. ’ ” (Interna l quotation marks omitted.) Axe n v. Ock

erlund Construction Co.
, 281 I ll. App. 3d 224, 229 (1996) (q u oting Purtill v. Hess
, 111 I ll. 2d 229, 240 (1986))

. The purpose of summary judgme nt is not to try

a question of fac t but to deter mine whether o n e ex ists or if rea sonable people could draw differ ent infere nces from the undisputed fac ts. Golden Rule Insurance Co. v. Schwartz
, 203 I ll. 2d 456, 462 (2003); W ood v. National L iabilit

y &Fire InsuranceCo. , 324 I ll. App. 3d 5 8 3
, 585 (2001). When ruling on a motion for summary judgme nt, we construe th e plea d i n gs, depositions, admissions and aff idavits strictly ag ainst the moving party and liberally in f

avor of the responde nt. Gauthier v. W estfall
, 266 I ll. App. 3d 213, 219 (1994). We revie w the trial court’s entry of summary judgme nt de novo

. Golden Rule Insurance Co.
, 203 I ll. 2d at 462.

¶ 27 1. “Without Fee” ¶ 28 Plaintiffs first argue summary judgme nt should be reve rsed be cause a g enuine issue of materia l fac t exis ts reg arding wh ether the failure to bill for Dr. Murphy ’s service s to Ander son was in g ood faith. Since we agree with plaintiffs’ second contention on appea l that the leg islature did not intend section 25 of t he Good Samaritan Ac t to apply to the fac ts of this case , we need not rea ch the question of whe ther Dr . Murphy acte d in g ood faith when he did not bill for the emer g ency car e he pr ovided to Ander son. ¶ 29 Ba

rri n g wi l fu l an d wa n t o n m i sconduct, a phy sician who, “in g ood faith, provides

emer g ency

car e without fee to a per son,” i s immune from li ability for that emerg ency car e pursuant to section 25 of the Good Samaritan Act. 745 I L CS 49/25 (West 2010). State courts

-7-have historically found that a phy sician claiming immunit y under the Act must show that he

or she in g ood faith (1) provided “eme rg ency car e” and (2) “did not char g e a fee .” Estate of Heanue v. Edgcomb
, 355 I ll. App. 3d 645, 648 (2005). Courts have applied the Act to protec t phy sicians who provided emer g ency car e without fee in hospital and medical clinic settings. Estate of Heanue
, 355 I ll. App. 3d 645 (in hospital); Blanchard v. Murray
, 331 I ll. App. 3d 961 (2002) ( in hospital); Rivera v . Arana , 322 I ll. App. 3d 641 (2001) (in medical ce nter); Johnson v. M

atviuw , 176 I ll. App. 3d 907 (1988) (in hospital). ¶ 30 The most rec ent state law development reg arding the “without fee ” require ment occur red in Estate of Heanue , 355 I ll. App. 3d 645, where the cour t held that unless a phy sician has billed specific ally for the emer g ency car e service s, he has not char g ed “a fee ” as contemplated by the leg islature in section 25 of the Act. Estate of H eanue , 355 I ll. App. 3d at 650. ¶ 31 In Heanue
, a phy si ci an p ro v i d ed emer g ency car e to a patient when the patient’s own doctor wa s not available. The phy sician wa s a member of the same surg ical prac tice as the patient’s own doctor and treated the patient at the reque st of the prac tice. He did not char g e

a fee for the emer g ency car e he provided and claimed immunit y under the Act. The plaintiffs

asser ted the phy sician was not immune beca use (1) as a member and compensated ag ent of the prac tice, he had a pree x isting duty to treat a patient of the prac tice; an d (2) he did not provide the emer g ency car e “without fee ” beca use the prac tice rec eived thousands of dollars from the patient and, as a member of the prac tice, he benefi t t ed fi nancia lly from the
prac tice’s r elationship with the patient. ¶ 32 The Heanue court found the first argument was fore closed, beca use “ ‘a phy sician need

n o t p ro v e t he absenc e of a pree x isting duty to rende r aid to the patient in order to b e immuniz ed under section 25 of the Act.’ ” Estate of Heanue
, 355 I ll. App. 3d at 648 (quoting Neal v. Y ang , 352 I ll. App. 3d 820, 829 (2004))

. With reg ard to the second argument,

acc epting for purposes of appea l that the phy sician benef itted financ ially from the prac tice’s relationship wit h the patient, the court “ never theless” c oncluded this financ ial relationship did “not constitute char g ing a fee for service s as contemplated by the Act.” Estate of Heanue
, 355 I ll. App. 3d at 649. ¶ 33 The court found that the mere fac t that the phy sic i an re ce i v ed some economic be nefit from the relationship was not sufficie nt to remove him from the protec tion of the Act wher e he did not char g e a fee specific ally for the service s at issue. Estate of Heanue
, 355 I ll. App. 3d at 649-50. L ooking to the plain and ordinary meaning of the word “fe e,” the court found definitions of the word “envision a very specific sort of relatio n s hip wher e the economic benef it is derive d direc tly from the service perf ormed. In other words, a fee is g ener ated by and tied to the service perf ormed.” Estate of

Heanue
, 355 I ll. App. 3d at 649. As a matter of fi rs t impression, the court held “the leg islature contemplated that section 25 would app l y except wher e a doctor char g es a fee specific ally for the service s at issue.” Estate of Heanue
, 355 I ll. App. 3d at 650. ¶ 34 In Heanue
, the phy sician had not billed specific ally for the emer g ency car e he provided. The court , t h er ef

o re, found the phy sician had not char g ed “a fee ” as contemplated by the leg islature and the question of whether the phy sician acquir ed some economic benef it from

-8-the patient’s rela tionship with the surg ical g roup immaterial. Estate of Heanue
, 355 I ll. App. 3d at 650. The court then remanded for a determination reg arding whether the phy sician’s decision not to char g e a fee was m ad e i n go o d faith. Estate of Heanue
, 355 I ll. App. 3d at 651. I t expla i n ed : “[ a]s it appea rs in the statute, ‘g ood faith’ modifies both ‘provides

emer g ency car e’ a

nd ‘without fee .’ ” Estate of H eanue , 355 I ll. App. 3d at 650. The rec ord in the case allowed an infere nce that the rea son no bill was sent for the emer g ency car e was to trig g er the Act, i.e.
, it was done in bad faith. The court rema nded so that the parties could addre ss whether

the dec ision not to bill was made in g ood faith. Estate of Heanue , 355 I ll. App. 3d at 651. ¶ 35 I t i s uncontested that Dr. Murphy in g ood faith provided emer g ency car e to Anderson. I t is also uncontested that: neither Ander son nor his insurer was billed for the emer g ency car e provided by Dr. Murphy ; neither Dr. Murphy nor ECHO was ever specific ally compensated for that emer g ency car e; althou gh t h e h ospital billed for the supplies used during the code blue, i t did not bill and was not compensated for Dr. Murphy ’s emerg ency car e during the code blue; pursuant to St. Mary ’s agreement with ECHO, only ECHO could bill for the service s of its phy sicians; an d ECHO did not bill for Dr. Murphy ’s emer g ency car e to Ander son. Under Heanue
, since no bill was sent for Dr. Murphy ’s emer g ency car e service s to Ander son, Dr. Murphy perf ormed those service s “without fee ” as contemplated by section 25 of the Act. Estate of Heanue
, 355 I ll. App. 3d at 649-50. We find Heanue unpersua sive. “We are not bound by

the opinions of sister appe llate courts.” Valent BioScienc es Corp. v

. Kim-C1, LL C , 2011 I LApp (1st) 102073, ¶ 24 n.4. ¶ 36 Our main objective in interpr etinga statute is to deter mine and g ive eff

ect to the intent of the leg islature. Solon v. Midwest Medic al Rec ords Ass’n
, 236 I ll. 2d 433, 440 (2010). The most reliable indi cator of t he legislature ’s intent is the languag e of the statute, which must be g iven its plain and ordinary meaning

. Solon
, 236 I ll. 2d at 440. Clear a nd unambiguous

s t atutory languag e must be applied as written, without resor t to extrinsi c aids of s t at u t o ry construction and wi thout rea ding into it exceptions, limit ations or conditions that conflict with the ex presse d intent or t hat render any part of the statute meaning less or superfluous. Solon
, 236 I ll. 2 d at 4 4 0 -41. We may consider the conseque nces that would result from construing the statute o n e wa y o r the other, alway s presuming that the leg islature did not intend absurd, inconvenient or unjust conseque nces. Solon
, 236 I ll. 2d at 441. Only if a statute is ambiguous, if it is capa ble of being underst o o d b y rea sonably well-infor med
persons in two or more differ ent way s, will we consider extrinsi c aids of const ru ction to discern the leg islative intent. Solon , 236 I ll. 2d at 440. ¶ 37 S t at e co u rt d ec i s i ons have found the Act clea r on its fac e and, there fore
, have not examined the intent of the leg islature in cre ating the Act. H oweve r, as explained persua sively by the United Sta t es Di s t ri ct Court in Henslee v. Provena Hospitals
, 373 F. Supp. 2d 802 (N.D. I ll. 2005)
, the Act is ambiguous. Henslee , 373 F. Supp. 2d at 812. The Act does not 3

We re cognize tha t fe der al dis tr ic t cou rt and sub seq uen t Sevent h Cir cui t rul ings ar e not 3 b i n d i n g on us, but dec is ion s of the lowe r fe der al cou rt s m ay be per sua si ve aut hor it y. Coone y v

. Ross it er , 201 2 I L App ( 1st ) 1 0212 9, ¶ 30.

-9-define “without fee ” and, as did the court in Henslee
, we respe ctfully disag ree with previous

I ll i n o i s appellate courts that have found the phrase t o be clear and unambiguous. Henslee
, 373 F. Supp. 2d at 812. ¶ 38 “F ee ” i s u n d efine d in the statute. There fore
, we must g ive it its ordinary and prope rly understood mea

ning. Johnson v. M

atviuw , 176 I ll. App. 3d 907, 917 (1988). B ut “fe e” ha s

more than one meaning

. I t does not only encompa ss a situation wher e a patient is billed for the specific service s a phy sician provides, as Heanue appea rs to hold. Henslee
, 373 F. Supp. 2d at 809. I f this wer e its sole meaning
, then if a d o ct o r o r hospital neg lected to send the patient a bill itemiz ing the doctor’s specific emer g ency car e, the Act wo u l d apply to the doctor, reg ardle ss of whether the doctor intended to bill for that car e in the future or whether he re ceive d an indirec t economic be nefit fr om the patient’s ca re. Henslee , 373 F. Supp. 2d
at 809-10 (citing Rivera
, 322 I ll. Ap p

. 3 d at 6 48 (phy sician’s intentions reg arding future billing for emer g ency car e he provided are irrele vant under the Act); Heanue
, 355 I ll. App. 3d at 649-50 (only

a spec ific fe e or bill for e merg ency car e provide d trig g ers the A ct)). ¶ 39 The wor d “fe e” a lso encompasse s a situation where a phy sician is paid.

“[T] he ty pical fee transac tion implicitl y includes two steps: first, a party is billed; second,

a profe ssional is paid. Be cause the Good Samaritan Act does not restric t ‘fe e’ to only one side of the ty

pical fee transac tion, this Court deter mines that the meaning of ‘f ee ’ is ambiguous. This Court proposes that a rea sonable definition of ‘fe e’ would be a situation in which either a doctor is paid for his service s or the client pay s a bill for those service s. Under this interpre tation of the Act, a ‘fe e’ exis ts when a doctor is paid for the

emer g ency service s he rende rs.” (Emphase s in orig inal.) Henslee
, 373 F. Supp. 2d at 812.
Hea nue’s inter

preta tion of “fe e” c apture s only one si de of a

ty pical fe e situation–the client being billed. Henslee
, 373 F. Supp. 2d at 812. The Act does not restric t “fe e” to only the one part of a fee transact i o n

. “F ee ” i s capa ble of being understood in two differ ent way s, the client beingbilled or the phy sician beingpaid, and is, there fore , ambiguous. ¶ 40 Heanue ’s interpre tation of the statute reinfor ces our deter mination that the term “w ithout fee ” is ambiguous. Heanueheld “the le g islature conte mplated that sec tion 25 would apply except wher e a doctor char g es a fee specific ally for the service s at issue.” Estate of Heanue
, 355 I ll. App. 3d at 650. Heanue essentially adds languag e to the statute, limit ing the statutory “without fee ” by adding “spec ifically for the service s at issue.” I f the Act wer e unambiguous, this additional langua g e would not be ne cessa ry to effe ctuate the Act’s statutory purpose. ¶ 41 Since “fe e” as used in section 25 is ambiguous, we must follow th e p ri m ar y ru l e of statutory construction and g ive eff ect to the intent of the leg islature. Henslee
, 373 F. Supp. 2d at 812. Heanueand the other I llinois case s stray far from the intent of the Act. In 1965, in section 2a of the Medical Practice Act, t h e leg islature originally provided im munity for

a phy sician “who in g ood faith provides emer g ency car e without fee at the scene of a motor vehicle acc ident or in case of a nuclea r attack.” I ll. Rev. Stat. 1965, ch. 91, ¶ 2a. In 1969, the leg islature expanded c overa g e under section 2a by amending it to apply to emerg ency

car e provided “without fee to a victim of an acc ident at the scene of [t he] acc ident or in the case of nuclea r attack,” there by eliminating the require ment that the acc ident be vehicular

. Pub. Act 76-1205 ( eff

. Sept. 11, 1969) (ame nding I ll. Rev. St at. 1965, ch. 91, ¶ 2a).

-10-¶ 42 In 1973, section 2a wa s ex p an d ed ag ain when the leg islature substitut ed “per son” for

“victim of an acc ident at the scene of the acc ident or in the case of nuclea r attack.” Pub. Act 78-385 (eff. Aug. 28, 1973) (amendingI ll. Rev. St at. 1971, ch. 91, ¶ 2a). This a

mendment also added “without prior notice of the illness or injury” so the section protec ted a phy sician “who, in g ood faith, and without prior notice of the illness or injury
, provides emer g ency car e without fee to a person.” Pub. Act 78-385 (ef f. Aug

. 28, 1973) (ame nding I ll. Rev. Stat. 1971, ch. 91, ¶ 2a). During leg islative debate on the amendment, Senator Shaffe r explained: “This bill only g ives a doctor a safe guard that [ sic ] if he comes upon an emer gency situation if one of us falls down the stairs and rolls to the foot of the s t ai rs h ere and a doctor treats us, and this is on the spot, not in his doctor’s office or in the hospital on the

o p erat ing table
, that he has a littl e protec tion that if we have bad eff ects b ec au s e h e wasn’t able to do the things he might do in a hospital, he would be somewhat protec ted.” (Emphasis added.) 78t h I ll. Gen

. Assem., S enate Procee dings, May 22, 1973, at 49-50 (statements of Senator Shaffe r). ¶ 43 In 1996, the l eg is l at ure enac ted t he Good Samaritan Act (765 I L CS 49/1 et s eq. (West 1996)). Pub. Act 89-607 (ef f. J an 1, 1997). The leg i s l at u re also amende d the Medica l Practice Act to ref

lect that “[e]x emption from civil liability for emer g ency car e is as provided in the Good Samaritan Act.” 225 I L CS 6 0 /30 (West 1996). Thus, former section 2a of t he Medica l Practice Act bec ame se ction 25 of the Good Sama ritan Ac t. ¶ 44 A final amendment in 1998 (Pub. Act 90-742, § 40 (ef f. Aug

. 13, 1998)) eliminated the require ment that the phy si ci an h av e n o prior notice of the injury or illness, setting out the

curr ent version of t he Act. 745 I L CS 49/25 (West 2010). During legislative debate on this amendment in 1996, Represe ntative L ang asked Represe ntative Wint ers whether it was his position “that the p assag e of th[ e] [Act] would encour ag e g ood samaritans to do the rig ht thing on the streets of Illinois
, I suppose, without fea r of repe rcussions in a co u rt of law.” (E m p h as is added.) 89th I ll. Gen. Assem., House Procee dings, Mar. 25, 1996, at 1 0 0 (statements of Represe ntative L ang ). Represe ntative Wint ers responde d “that is exactly the point of the Bill.” 89th I ll. Gen. As s em

. , House Procee dings, Mar. 25, 1996, at 100 (statements of Re prese ntative Winters). ¶ 45 The prea

mble to the Act states its leg islative purpose i s t o co d i fy t h e “n u m er o u s protec tions for the g ener ous and compassionate acts of its citizens who volunteer their time and tal en t s t o help others.” (Emphasis added.) 745 I L CS 49/2 (West 2010). It direc ts that “without l i m i t ation the provisions of this Act shall be liberally construed to encour ag e persons to volunteer their time and talents.” (Emphasis added.) 745 I L CS 49/2 (West 2010). ¶ 46 One cannot be a volunt eer if one is paid for the s ervices provided, whether one is paid by the hour, the day
, the month, the y ear or the patient visit. Dr. Murphy was not voluntarily
prese nt at the hospital. He was paid by the hour to be there

. He rec eived that pay in exchang e for his service s as emerg ency room phy sician and would be paid reg ardle ss of which or how
many patients he saw or whether he saw those patients in the emer g ency room or on another floor. Dr. Murphy was compensated for the time he spent responding to the code blue called for Ander s o n

. He did not provide that emer g ency car e “without fee .” W e find that to hold otherwise w ould lead to an a bsurd re sult.

-11-¶ 47 Fur ther, Heanue ’s o n e- s i d ed d ef i n i tion of “fe e” could result in a disparity of leg al

re medies between the aff luent and the less-privileg ed. S ee Be n Bridge s, Comment s , Cu r b Y our Immunity: The Improper Expansion of Good Samaritan Protection in Illinois
, 34 S. I ll. U. L .J

. 373, 391 (2010). I f a hospital phy sician paid by t h e h o u r n egli g ently provided

emer g ency car e to an affluent patient and the patient or the patient’s insurer was billed for that car e, the doctor would not be immune under the Act. Bridge s, supra , at 391. I f the same doctor provided neg lige nt emer g ency car e to an indige nt uninsured patient and the hospital did not bill the patient beca use it would not be able to collect pay ment, the doctor would be immune under the Act

. Bridge s, supra , at 391. The affluent patient would be able to file a
neg lige nce action ag ainst the phy sician and the indige nt patient w ould not. Br idge s, supra , at 391. The phy sician could arguably provide substandard car e to all poor, uninsured patients beca use those patients would have no leg al rec ourse ag ainst him. Br idge s, supra , at 391. The leg islature ca

nnot have intende d such a r esult. ¶ 48 We a gree with Hensleethat a rea sonable definition of “fe e” in se ction 25 encompa sses

a situation “in which either a doctor is paid for his service s or the client pay s a bill for those service s.” (Emphase s in orig inal.) Henslee
, 373 F. Supp. 2d at 812. “Unde r this interpre tation of the Act, a ‘fe e’ exis ts when a doctor is paid for the emer g ency services h e rende rs.” Henslee
, 373 F. Supp. 2d at 812. “B y using the term[ ] ‘volunteer ’, the leg islature seems to also contemplate the sec ond part of a fee transaction–the doctor beingpaid. It follows that a doctor who is beingpaid to work at an eme rg ency fac ility is neither a voluntee r nor is he rende ring‘eme rg ency

car e without fee .’ ” Henslee , 373 F. Supp. 2d at 813. ¶ 49 As Henslee points out, billing for m ed i ca l s er v i ces is no longe r a simple transac tion betwee n two parties. Henslee
, 373 F. Supp. 2d at 813. It ty pically involves contra cts betwee n hospitals, doctors, prac tice g roups and insurers. Doctors rar ely bill patients direc tly and are seldom compensated direc tly by their patients, making it difficult to link a char g e for service s to a pay ment rec eived from a patient. Henslee
, 373 F. Supp. 2d at 814. There fore
, a definition of “fe e” that includes both the doctor’s compen s at i on and the patient’s eventua l pay ment circ umvents the possibili ty that doctors or their employ ers will att em p t to “eng ineer immunit y ,” such as by avoiding itemiz ed billing or waiting to bill until threat of litigation has passed. Henslee , 373 F. Supp. 2d at 814. ¶ 50 “The Good S amar itan Act was meant to protec t volunteers; it was never meant to be a shelter for pract i cing phy sicians who, acting in the scope of their employ ment, rec eive
pay ment for their emer g ency service s.” Henslee , 373 F. Supp. 2d at 814. As the leg islative history and prea

mble make clea

r, the Act is intended to protec t phy sicians who step into the brea ch when coming upon an emerg ency , without aid of the usual equipment and service s at t heir dispos al and without though t o f co ntrac tual duty or pay

. The Act should not apply
to phy sicians who provide emer g ency service s in a hospital wher e they have been hired and paid to work, such as a staff member, an employ ee, an independe nt contra ctor or an on-ca ll phy sician. These doctors ar e not providingtheir ser vices “ without fee.” ¶ 51 Def

endants ’ in

te r p r e ta ti o n of the statute, taken toge ther with modern billing prac tices and the facts that a majority

of eme rg ency

room phy sicians ar e indepe ndent contractors or in a phy sicians’ g roup, are compensa ted for their time and must respond to code blue calls as part of their job, leads to a situation wher e most co d e b l u e responses by phy sicians would be

-12-immuniz ed under the Act. This wa s not the intent of the Act. Nowher e in the leg islative

history of the Act is it ever stated that the intent of the Act was to immuniz e emer g ency room phy sicians who ar e paid f or their time. ¶ 52 We do not find that the Act ca n neve r apply in a hospi tal setting. The deter mination of whether emer g ency

car e wa s provided “w ithout fee” is not dependent on the geography of wher e that car e was provi d ed

. W e m erely state t hat, on these facts, as a matter of l aw, Dr. Mu rp h y re ce i v ed “a fee ” for his emer g ency car e of Ander son and thus did not provide

emer g ency car e “without fee ” as contemplated by the Act. Dr. Murphy is not immune from liability under the Good Samaritan A ct. Summary judgme nt on this basis i s reve rsed.

¶ 53 2. Deviation F rom the Standard of Care ¶ 54 Plaintiffs lastly argue that there is no merit to Dr. Murphy ’s alternate basis for summary judgme nt, in which he asser ted that, as a matter of law, he had not deviated from the standard of car e. The trial court did not addre ss this theory beca use it found Dr. Murphy immune from liability under the Act. We leave it to the trial court to addre s s t h i s al t er nate basis for
summary judgme nt on remand.

¶ 55 CONCLUSI ON ¶ 56 For

the re asons stated a

bove, we reve rse a

nd rema nd the dec ision of the trial court.

¶ 57 Reverse d and re manded.

-13-