Bain v. Colbert Cty. Nw. Ala. Health Care Auth. — Feb. 2017 (Summary)

MALPRACTICE/AGENCY

Bain v. Colbert Cty. Nw. Ala. Health Care Auth.
1150764 (Ala. Feb. 10, 2017)

The Supreme Court of Alabama affirmed a decision by a lower court to grant a hospital’s motion for summary judgment in a malpractice action brought by a patient’s wife.  The complaint alleged that the nurses and the physician in the emergency department had breached the standard of care when they treated the patient.  With respect to the physician, the complaint alleged that he was acting within the scope of his duties as an employee or that he was an actual or apparent agent of the hospital, and thus the hospital should be held liable.

The facts leading to the claim are as follows.  After experiencing increasing pressure near the base of his skull and fatigue, the patient, a 30-year-old male, was brought to the hospital’s emergency department where he was first triaged by nurses.  There was no indication in the medical record that the nurses noted the patient’s family history, which included that his father had died of an aneurysm at age 47.  Subsequently, the ED physician examined the patient and obtained a medical history, including information that the patient’s father had an aneurysm.  Although the ED physician failed to document the history in the medical record, the patient’s wife remembered the discussion and testified about such during her deposition.

The ED physician ordered certain tests, including an x-ray, a CT, an EKG, and blood work; he  was, however, unable to determine the cause of the patient’s symptoms.  The ED physician discharged the patient approximately six hours later with instructions that the patient follow up with his primary physician.  The patient died approximately 20 days later when a 45-millimeter ascending aortic aneurysm dissected.

With respect to the claim against the hospital for the care rendered by the ED nurses, the court concluded that summary judgment in favor of the hospital was proper because there was no evidence that the nurses’ failure to obtain the patient’s family history contributed to the patient’s death.  Rather, the evidence supported that the ED physician learned through his own efforts that the patient’s father had died of an aneurysm.  The failure of the nurses to obtain and communicate this information to the ED physician did not affect the treatment provided to the patient.

With respect to the claim against the hospital for the alleged negligence of the ED physician, the court said that there had to be proof that:  (1) the hospital had acted to hold the ED physician out as its employee or agent; (2) because of the acts of the hospital, the patient reasonably believed that the ED physician was an employee or agent of the hospital; and (3) the patient actually relied on the appearance that the ED physician was an employee or agent of the hospital.  The court found that there was no proof to support these conclusions.

The court also refused to find that the hospital had a nondelegable duty to provide the patient with emergency medical physician services that met the standard of care.  While the hospital was required to properly organize, staff and equip the ED, the court found that the hospital was not required to “provide emergency physician services that are within the applicable standard of care for emergency-room physicians.”  The duty to provide care that met the standard of care rests solely with the ED physician; the hospital did not share that duty.