Goff, J.
In response to the COVID-19 pandemic, our state and federal governments declared a state of emergency to prevent the spread of the virus. To protect healthcare workers at the frontlines, the legislature enacted statutes to immunize them from civil liability in certain cases where a patient’s injury arose from actions taken in response to COVID19. Here, a patient was medically immobilized and placed on a ventilator as part of his COVID-19 treatment. He developed a bed sore and ultimately died from the wound. His estate filed a proposed complaint under the Medical Malpractice Act (MMA) against over eighty Healthcare Providers (or just the Providers), alleging negligence. In response, the Providers argue they are immune from liability under statute. The issues here are (1) whether the trial court can make a preliminary determination on immunity without expert opinion from a medical-review panel, and (2) whether the Providers are entitled to statutory immunity. Concluding that the court can make a preliminary determination on immunity and that Providers are immune here, we affirm the trial court’s entry of summary judgment for the Providers.
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Asserting the affirmative defense of immunity “assumes negligence but denies liability.” Putnam Cnty. Sheriff v. Price, 954 N.E.2d 451, 453 (Ind. 2011). By arguing they are immune, the Providers, for purposes of the preliminary determination, admit the Estate’s essential allegation that Elmer died from negligent treatment of an infected bed sore and related complications. Assuming Elmer died from the bed sore, there is no need for expert opinion to determine whether Providers’ treatment of the bed sore was related to COVID-19. See Haggerty v. Anonymous Party 1, 998 N.E.2d 286, 292 (Ind. Ct. App. 2013) (holding the trial court had jurisdiction to preliminarily determine the issue of immunity where expert opinion was not necessary to the determination); Ashley v. Anonymous 1, 245 N.E.3d 658, 2024 WL 4142508, * 3 (Ind. Ct. App. Sep. 11, 2024) (mem.) (holding that, given the admission a patient developed bed sores while being treated for COVID-19, “no expert opinion was required to determine whether [the patient’s] injury was related to the actions taken by [p]roviders (i.e., placing him on a ventilator for an extended period of time) to treat him for complications of COVID-19”), trans. denied. In other words, while expert opinion would have been necessary if the Immunity Statutes required COVID-19 to be the cause of Elmer’s death, no expert opinion is needed here to determine if treatment of the bed sore was related to COVID-19. See infra Section II. So, expert opinion from the medical review panel is not needed, and the court can interpret the relevant statutes to make a preliminary determination on immunity.
Having concluded that a court can make a preliminary determination on immunity here, we turn to the Immunity Statutes.
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The Healthcare Immunity Act was enacted as part of broader legislation to insulate and protect areas of public life at risk from the COVID-19 pandemic. See Mellowitz v. Ball State Univ., 221 N.E.3d 1214, 1218–19 (Ind. 2023). The Healthcare Immunity Act provides in pertinent part that a healthcare provider “may not be held civilly liable for an act or omission relating to the provision or delay of health care services or emergency medical services arising from a state disaster emergency declared under IC 10-14-3-12 to respond to COVID-19.” I.C. § 34-30-13.5- 1(b)(1) (emphases added). Damages arising from a state disaster emergency means an injury or harm “caused by or resulting from an act or omission performed in response to a state disaster emergency declared under IC 10- 14-3-12 to respond to COVID-19,” and “arising from COVID-19.” I.C. § 34- 6-2.1-13 (formerly codified at I.C. § 34-6-2-10.5 (2022)) (emphasis added). “Arising from COVID-19” means an injury or harm caused by “services, treatment, or other actions performed for COVID-19.” I.C. § 34-6-2.1- 14(b)(2) (formerly codified at I.C. § 34-6-2-10.4(b)(2) (2022)). This immunity applies “during a period of a state disaster emergency declared under IC 10-14-3-12 to respond to COVID-19, if the state of disaster emergency was declared after February 29, 2020, and before April 1, 2022.” I.C. § 34-30-13.5-1(b).
Furthermore, the Premises Immunity Act protects healthcare providers from civil liability for providing services during the COVID-19 pandemic. Under the Premises Immunity Act, “a person is immune from civil tort liability for damages arising from COVID-19: (1) on the premises owned or operated by the person” or “(2) on any premises on which the person or an employee or agent of the person provided property or services to another person.” I.C. §§ 34-30-32-6(1), (2) (2022). Damages “arising from COVID-19” means “an injury or harm caused by or resulting from: (1) the actual, alleged, or possible exposure to or contraction of COVID-19” or “(2) services, treatment, or other actions performed for COVID-19.” I.C. § 34- 30-32-2 (2022) (emphases added). Although it expired on December 31, 2024, the Premises Immunity Act applies to causes of action that accrued on or after March 1, 2020. I.C. §§ 34-30-32-1, -11 (2022).
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But assuming the facts alleged in the complaint are true— Elmer developed a bed sore and then died—Elmer’s treatment still arose from COVID-19, making the Providers immune under the state immunity statutes.
At least two decisions from the Court of Appeals support our conclusion. In Ashley, the Court of Appeals held that medical providers were immune from liability when the patient developed bed sores during his treatment for COVID-19. 2024 WL 4142508 at *1–*2. The court concluded that the patient’s injuries arose from services provided for COVID-19 because he developed the bed sores while medically immobilized for an extended period of time to be placed on a ventilator as part of his COVID-19 pneumonia treatment. Id. at *4. And in Fluhr v. Anonymous Doctor 1, the Court of Appeals held that medical providers were immune from liability under the Healthcare Immunity Act when they delayed treating the patient’s stroke to conduct COVID-19 isolation procedures. 234 N.E.3d 912, 915, 917, 918 (Ind. Ct. App. 2024), trans. denied. Even though the patient did not have COVID-19, the delay in treatment arose from measures taken to limit the spread of COVID-19. Id. at 917.
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Still, the Estate argues that the Healthcare Immunity Act does not apply because the state disaster emergency expired before Elmer died. The Governor first declared the state disaster emergency on March 6, 2020, and Elmer began treatment at Anonymous Hospital 1 on January 27, 2022, during the emergency. The Governor then rescinded the state disaster emergency on March 3, 2022, and Elmer died later that month on March 29, 2022. Although Elmer died after the emergency expired, the Providers’ care still arose in response to and during the state disaster emergency. That some of the Providers’ care extended beyond the expiration of the emergency does not change the fact that their services still arose during the emergency. Therefore, the civil immunity afforded by the Healthcare Immunity Act could “appl[y] to medical services provided either before or after the actual disaster emergency declaration from the Governor.” 2017 Ind. Op. Att’y Gen. No. 8, at 6 (Dec. 4, 2017). And even if the Healthcare Immunity Act no longer applied, the Premises Immunity Act still applied because it did not expire until 2024, after Elmer’s death.
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The PREP Act authorizes the HHS to issue a declaration in the event of a public-health emergency. See 42 U.S.C. § 247d(a). Once the declaration is issued, the PREP Act immunizes “covered person[s]” from “suit and liability under Federal and State law with respect to all claims for loss caused by, arising out of, relating to, or resulting from the administration to or the use by an individual of a covered countermeasure” to respond to the emergency. 42 U.S.C. § 247d-6d(a)(1) (emphases added). In other words, the PREP Act preempts claims under state law, such as negligence, as it relates to the administration of covered countermeasures. A “covered countermeasure” includes a “qualified pandemic or epidemic product.” 42 U.S.C. § 247d-6d(i)(1)(A). A medical device is a “qualified pandemic or epidemic product” when it is used “to diagnose, mitigate, prevent, treat, or cure a pandemic or epidemic” or “to limit the harm such pandemic or epidemic might otherwise cause,” and is “authorized for emergency use” by the FDA. 42 U.S.C. § 247d-6d(i)(7)(A)(i); 42 U.S.C. § 247d-6d(i)(7)(B)(iii). And a “covered person” includes those qualified to administer countermeasures. 42 U.S.C. § 247d-6d(i)(2)(B)(iv).
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The federal public-health emergency under the Public Health Service Act ended in May 2023, with some PREP immunity extending even longer, meaning the entirety of Elmer’s treatment and death occurred while PREP immunity was in effect. 89 Fed. Reg. at 99876, 99882. What’s more, Elmer’s injuries were “caused by, ar[ose] out of, relat[ed] to, or result[ed] from” the provision of a covered countermeasure—a ventilator—in response to COVID-19. Elmer’s ventilator was a covered countermeasure because it was used to treat COVID-19, and ventilators were authorized by the FDA for emergency use.
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Although the Estate argues Elmer’s death arose from a bed sore, not COVID-19, the “chain of events cannot be separated from the administration of a covered countermeasure.” See Cowen v. Walgreen Co., No. 22-CV-157-TCK-JFJ, 2022 WL 17640208, at *3 (N.D. Okla. Dec. 13, 2022). Elmer would not have developed the bed sore and needed a ventilator as a treatment had he not suffered respiratory failure from COVID-19.
Conclusion
Our lawmakers chose as a matter of policy to immunize healthcare providers working the frontlines in response to the COVID-19 emergency. Assuming the patient here died from his bed sore rather than COVID-19, his bed sore still arose from treatment he was receiving due to his COVID19. Therefore, the Providers’ services here fall within the Immunity Statutes. We affirm.
Chief Justice Rush and Justices Massa, Slaughter, and Molter concur.