it's fiction that many hospitals hold out that the doctors who work there are independent contractors and we have nothing to do with them they work here and they use our this is how else would the the hospital communicate that was one of the more the more aggressive consent forms that i've never seen basically said these people are not our employee don't think that they are employees i know they work here but we just gave them a place to see their patients they don't work for us plaintiff talk about the doctors and nurses working together in the reality of life and treatment you need you know an emergency room how would you take care of a patient without working with the other people who won't work yeah exactly and how is not an element of a parent agency when it is the principal that's the one who's doing the holding out because the bathroom is based on a parent agency by a scalpel is there anything in the record his demean emergency room we do have a copy of the nurse's badge and it says it was hospital it has the angles local it has the physical address you know what i'm concerned about is it's a material fact this is a fact that we're client testified in her deposition that one of the reasons she believes the defendant physicians be the age of the hospital is because she observed his badge but she didn't say what was on it we have no idea she has no many courts have recognized as a mainstream website and that that affidavit was from me and that's ragout it and all self there was evidence of holding out are completely inconsistent with the party's position in this league ation and through the back to through the death of their general counsel it's an admission it's a statement against their condition at this time and it contains reality today and this brand elevation work is a good example that i'm saying what's on the increase in the notes being independent contractors the fact that hospitals and health systems are joining together they're consolidating and they're increasing their holding on to the public as thorough systems that can provide a complete we don't think so there can be other instances and in all the cases said to defendant where i sign it was the fact of the consent form signed coupled with the absence of other additional facts that demon of what i'm saying is addition to other things and that to set the standard on summary judgment it doesn't hit it has to be some evidence even if the court would characterize the evidence that the plaintiff is set forth in this case that she thought this although she had signed multiple confession forms that were really aggressively worded thing these doctors are not our employee is first objective belief in light of having signed th the standard that the court should be looking into i'm glad you asked that your honor because there seems to have been some confusion around the trial court level but it's always been our position that it's a reasonable person standard and normal or should have known cases the defender relies on what is based on standard concrete facts and that's where the reasonable person to judge so you're right it's more of an objective standard that our plaintiff's testimony colors whether a reasonable he and so again it's not out of position that her failure to read it i view it's a fact or that the fact that they didn't explain it to are out it's fact it's the additional evidence that other court working together you asked what else were the interactions between the plaintiffs and the physician that might recently lead to it his will perception was that the child was being discharged my plaintiffs objected but also wasn't there a sign in the ers testifying to bad nurse mcmanus there were multiple signs i don't know where exactly they are i'm not entirely familiar with the footprint of the high school in my closet she said there was one definitely in the e r each night i believe so i quite didn't see him she was arrested her deposition whether she recalled i've ever seen any of those signs and she said no you know a couple of the things the fenice claim that my client's affidavit which is totally unlike the affidavits in the cases they rely on it's based on facts is conclusion worry or contentiously contradictory it's not the defendant's asked very general broad questions with regard to agency in the discovery deposition and our effort david fills in those  supportive and complimentary i think even in the cases that the defendants rely on say by implication where are the other facts there's no other facts so it's bad that has led us to conclude as a matter for that consent form is will rule the day but it certainly says and church it says to in all the other cases cited to the church it says that there certainly could be other facts outside of what i presume it would be an unambiguous consent form anything else i don't think i've ever looked at the best that clearly well you know whether it said it was in the royal hospital it does have the name of angels memorial hospital on it and he said it was front to back or he didn't was ever found in the agency disclosure to be unambiguous but then granting him to her that there were other factors that invalidated that agency disclosure and risk should not be the first case introduced himself as bad for joshi and the advertisements with no evidence that the played up had ever seen the advertisements and really no foundation for the advertisements but be that as it ma these are all innocuous and universal characteristics of every hospital against parade of t plaintiff has it backwards here the group of course mentioned the modern reality of hospital inflator for accused about the modern reality of hospitals that there are people working together and there are many factors that might give somebody the impression that maybe these doctors are employed that's not something to contradict the agency disclosures that's the reason we care for the agency disclosures we confronting the patient that the cure is provided by the independent contractors that's the language from gilbert there's two sides to it you hurt yourself as a provider for emergency care but you do it without having  patient that these people are independent contractors hospitals who made their own business decisions to have doctors who are working within their walls now playing i'm not there  rose everybody that comes to the emergency room is in some form or in some manner emergent situation and if we were told that being in pain or being being in the emergency situation could invalidate this concern for them the hospital would have to go to trial in every single case and so the for sadness quota saying there is when you have these  circumstances that exist at every hospital in every situation you can use spells to undercut the importance of the consent form because it would undercut your can importance of the consent form in every was an employee that's not the language of the court sorry the plaintiff in this is adding to the language of your opinion in addition to that and this is why i asked to reference the ms your case which i apologize i should have done earlier informing the patient that the doctor is an independent contractor and now it's bad as well do you think birth to these agencies disclosures that hospitals use now they are used to answer the call from gilbert to say you have to do something you have an affirmative obligation to inform people and what the agency disclosure does is it says it recognizes the reality yes absolutely somebody could very well there will very well thank everybody who is here works here is an employee here if the agency disclosure does this it says it creates a separation and this is prosperous second well that's a question for notion you had before you got here today about who works where and who's employed here we want to tell you it's  they're not employees they're independent contractors we write it disappear use you as whatever notion you may have developed in the past even though that notion may have been perfectly reasonable to develop your put the onus on hospitals to inform somebody that they were with the patient that these people were independent contractors and the hospice of responded appropriately by rolling out these agenc disclosures to tell people i know you might think that people look like their employees that the doctors they're not and among the modern realities of hospital care which is something goldberg tossed out and something plaintiff tossed out here among the modern realities is the hospital really have to rely on written documents and britain disclosures in order to i's and cross their t s that's the real reality here a lot of moving parts people are taken from the emergency department to the imaging to get studies done and then they're brought back and nurses come the nurses from out the hospital has to be able to say regardless of at these moving parts here we've got something and we put it in paper because it's important and it's not just agenc with with regard to the advertisements i think that they'd be the agency disclosure for a closing reliance on advertisements to believe that somebody hospital hurling itself out the second factor is the doctor holding himself out with the hospital's knowledge the first factor would be the reliance factor i don't think dr joshi didn't do i don't think it's possible to rely on the conduct of the hospital in this case or a case like this because the hospital is into a new thing to care for people the impression that this person is has t you hit the the point right on the head which is that there's no case where there was an unambiguous consent form but that there were additional facts my best case is hammered because the way i read it is that the court found those additional facts to be a fresh consideration in addition to a potentially confusing consent for i've just a couple other things you know it down you know we talked about where they were going with this and so i wanted to bring that up and in this case they're saying they seem to say there's no reliance because fact that she didn't read it and that is not the law i think what the defendants are saying is not the law because their arguments the sum total of it is that they are conclusive but the law is clear they are important but they're not determinative there's no case they rely on that says that it's not and the first district has raised eyebrows still decision where they say it's almost conclusive  i'm top of that you have these advertisements that are that occurred before that haitian even presents to the emergency room and really has no meaningful choice at that point sold i'll conclude a restaurant as have any additional questions i think the key here is that there's some evidence even if it may not be particularly compelling