It was in the summer 2010 that the employee crashed an ambulance, which was transporting a patient and another colleague, into a rock wall along the side of a road outside the western town of Trollhättan.
It was revealed that the driver had worked almost an entire day at the time of the wreck, Swedish Radio's local channel in Uddevalla reports.
The region was charged with breaking workplace safety laws and causing bodily harm. But, in order for the county to be found guilty, prosecutors had to demonstrate that it was running a business operation.
According to the Gothenburg district court, Västra Götaland was not operating a business since medical care is a mandatory service provided by the county and financed by taxes.