Buman v. Gibson (Summary)

Supervision of Allied Health Practitioners

Buman v. Gibson, No. W2013-01867-COA-R3-CV (Tenn. Ct. App. Aug. 11, 2014)

A man sought treatment from a physician’s assistant (“PA”) for foot ulcers. For almost three months, the PA treated the patient. During this time, the PA was monitored by a supervising physician, who never personally treated the patient, but who reviewed 30% of the PA’s charts. Eventually, the PA referred the patient to a vascular surgeon. Unfortunately, the patient’s leg eventually had to be amputated below the knee. The patient and his wife filed a motion in which they alleged that the PA was negligent in not referring him to a specialist sooner. The patient passed away soon thereafter, due to unrelated causes, and the executrix was substituted as the plaintiff. The executrix then filed an amended complaint, alleging that the PA’s supervising physician was negligent in not properly ensuring that the patient received effective treatment. Before the trial court date, the supervising physician filed a motion for summary judgment, stating that no expert testimony obtained during depositions could link his alleged negligence with the loss of the patient’s leg. In response, the executrix filed a motion to amend her complaint and “more clearly plead” a claim of vicarious liability against the supervising physician. The trial court granted summary judgment to the supervising physician and denied the executrix’s motion to amend her complaint.

The court found that the trial court was correct in finding the supervising physician fulfilled his responsibilities in monitoring the PA’s behavior. The court held that the supervising physician had sufficiently proven his active and continuous overview of the PA. A supervising physician, who is only statutorily required to review 20% of a PA’s charts, is not expected to determine which charts need special attention over others. Rather, the court held, there is an implied duty on the PA to bring the charts in need of special attention to the supervising physician’s attention. Therefore, the court could find no basis in which to find the physician liable.

The trial court did not err in ruling that there was no claim for vicarious liability, as it is not the court’s job to impose additional responsibilities on supervising physicians that the legislature chose not to enumerate in statute.

The court recognized that the trial court had denied the executrix’s motion to amend the complaint due to timeliness, as the motion to amend was filed two years into the lawsuit and only a few weeks before the trial date. The court found that no abuse of discretion had been shown to rebut this reasoning.