Defense secures verdict in wrongful death case at St. Louis casino

An EMT company obtained a defense verdict that its attorney says showcases the limits of emergency aid in public spaces after a 54-year-old died of an asthma attack at a casino.

Tropicana St. Louis, represented by Jared D. Howell and V. Scott Williams of Hamilton Weber in St. Charles, prevailed in the medical malpractice and wrongful death case following the death of Kimberly Douglas at the Horseshoe Casino.

Douglas, who had a history of severe asthma attacks, suffered an asthma attack after using the restroom at the casino in the early morning hours of March 9, 2021, Howell told Missouri Lawyers Media.

“Upon being alerted of the attack, an on-site EMT Tropicana employee called 911 and started care,” Howell said. “However, Ms. Douglas worsened, losing consciousness. City EMS arrived shortly thereafter, took over care, and moved her to an ambulance, where cardiac arrest struck.”

She was pronounced dead at the hospital shortly after.

“After initially claiming that the asthma attack was brought on by defendant’s improper use of cleaning chemicals, plaintiff later abandoned that theory and instead argued that defendant’s EMT breached the standard of care by failing to timely intervene with a bag-valve-mask,” Howell said. “Plaintiff’s experts — EMT R. Knight Galloway, who faulted the transition timing and emergency medical doctor Joshua Helman, who said earlier advanced ventilation of the bag-valve-mask would have saved her life — painted the event as avoidable due to errors in a pressured setting.”

Howell said the defense countered this by “stressing protocol compliance against overwhelming biology, via two top experts. John B. Everlove, MS, NRP — a nationally recognized paramedic instructor — affirmed that the EMT’s actions aligned with EMT standards, particularly where rapid decision-making under duress is paramount.”

Another defense expert, Dr. John P. Kress, MD, FCCP, analyzed the autopsy and discovered that to save Douglas’ life would have required hospital-grade intervention, something far beyond the scope of the EMT’s on-site care.

“The jury’s defense verdict vindicated Tropicana while highlighting key issues: the inherent limitations of emergency response in non-clinical venues and the efficacy of robust causation defenses,” Howell wrote in a description of the defense. “This outcome offers useful examples in future litigation, underscoring the need for nuanced expert analyses in bridging the gap between lay perceptions of ‘what could have been’ and the harsh realities of medical inevitability.”

The plaintiff’s attorney did not respond to a request for comment.

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Amount of verdict, judgment or settlement: Defense verdict

Type of action: Wrongful death

Venue: St. Louis City Circuit Court

Case Number/Date: 2222-CC0039 / 07/02/2025

Judge: Theresa Counts Burke

Plaintiffs’ Experts: R. Knight Galloway Jr. NREMT-Paramedic Shift Supervisor & Joshua B. Helman, MD, FAAEM

Defendants’ Experts: John B. Everlove, MS, NRP, Battalion Chief-EMS Operations

Injuries: Death

Caption: Maurice D. Douglas v. Tropicana St. Louis, LLC

Plaintiffs’ Attorneys: Richard J. Zalasky & Kristine H. Bridges of Brown & Crouppen (St. Louis, MO)

Defendants’ Attorneys: Jared D. Howell & V. Scott Williams of Hamilton Weber (St. Charles, MO)