2024 IL App (1st) 221169 

SIXTH DIVISION

January 5, 2024 

No. 1-22-1169 

IN THE

APPELLATE COURT OF ILLINOIS

FIRST DISTRICT

SHAINA SOLORZANO, 

Plaintiff-Appellant, 

v. 

JASON MAGNANI, M.D.; NEIL GUPTA, M.D.; 

NANCY SIBIGTROTH, M.D.; THE MOUNT SINAI 

COMMUNITY FOUNDATION, d/b/a Sinai Medical 

Group; MOUNT SINAI HOSPITAL CENTER OF 

CHICAGO; VICTOR ROMANO, M.D.; ROMANO 

ORTHOPAEDICS, LLC, d/b/a The Romano 

Orthopaedics Center; and 

VHS WEST SUBURBAN MEDICAL CENTER, INC.

d/b/a West Suburban Medical Center, 

Defendants. 

(VHS West Suburban Medical Center, Inc., d/b/a West 

Suburban Medical Center, Defendant-Appellee). 

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 Appeal from the 

 Circuit Court of 

 Cook County 

 No. 2018 L 6332 

 The Honorable 

Catherine Schneider, 

 Judge Presiding. 

JUSTICE TAILOR delivered the judgment of the court, with opinion. 

Presiding Justice Oden Johnson and Justice Hyman concurred in the judgment and 

opinion. 

OPINION

¶ 1 In the competition for healthcare market share, hospitals today promote themselves to the 

public as centers for comprehensive medical care with teams of highly competent and 
No. 1-22-1169 

2 

compassionate physicians and ancillary care providers. But in order to limit their liability, hospitals 

employ few, if any, physicians. In the medical malpractice context, our apparent agency case law 

largely involves physicians who provide treatment to patients who have been admitted to the 

hospital, and in that instance courts have held that a disclaimer form signed by a patient 

acknowledging that the physician is an independent contractor and not employed by the hospital 

generally forecloses a malpractice claim against the hospital under apparent agency theory. In this 

instance, the patient was treated in a medical professional building located within the hospital 

medical complex but was neither asked to acknowledge in writing nor otherwise informed that her 

treating physician was not employed by the hospital. Based on the evidence in the record, we see

no theoretical or pragmatic difference in our approach here than in cases involving treatment by 

physicians in the hospital in-patient setting. For the reasons we explain below, we find that the 

circuit court erred in dismissing the claim against the hospital as the apparent agent of the physician

and reverse and remand for further proceedings. 

¶ 2 I. BACKGROUND

¶ 3 This appeal arises out of the dismissal of a medical malpractice claim against a hospital 

as the apparent agent of a physician. Shaina Solorzano brought a medical malpractice suit against

Dr. Victor Romano, VHS West Suburban Medical Center, Inc. (WSMC), and others, alleging 

that their failure to timely diagnose a cancerous tumor in her right leg resulted in the amputation 

of her leg from the pelvis down. In her complaint, Solorzano alleged that WSMC was vicariously 

liable for Dr. Romano’s conduct. WSMC denied Solorzano’s allegations and moved for 

summary judgment under section 2-1005 of the Code of Civil Procedure (Code) (735 ILCS 5/2-

1005 (West 2022)), which the circuit court granted. The following facts, which are not in 

dispute, were considered by the circuit court when it ruled on WSMC’s motion. 
No. 1-22-1169 

3 

¶ 4 In June 2015, Solorzano was involved in a car accident in Odessa, Texas. Both of her 

femurs were broken, and surgery was performed to insert rods and screws in each of her legs. 

When Solorzano returned to Illinois several months later, she went to see her primary care 

provider at PCC South (PCC) in Berwyn, Illinois, who referred her to see Dr. Jason Magnani, an 

orthopedic surgeon, at Mount Sinai Hospital. Dr. Magnani advised her that her bone was 

growing well. 

¶ 5 In August 2016, Solorzano returned to see her primary care provider at PCC after she 

began experiencing pain and swelling above her right knee. Solorzano said that her primary care 

provider referred her to “orthopedics at [WSMC]” because PCC is affiliated with WSMC, and 

that she went to see Dr. Romano because that is where her primary care provider told her to go. 

The referral order from Solorzano’s primary care physician stated the following: 

“Victor M. Romano, MD 

Victor Romano, MD 

West Suburban Hospital 

1 Erie Court, Suite 7120 

Oak Park, IL 60302” 

¶ 6 Solorzano acknowledged that she would have gone to whatever hospital and doctor her 

primary care physician recommended. She said that if her primary care physician had directed her 

back to Dr. Magnani at Mount Sinai Hospital, she would have gone to see him again. 

¶ 7 WSMC’s website states: 

“At WSMC, our mission is to improve the quality of life for every patient who enters our 

doors. *** For more than 100 years, our patients have our caring nurses and 

compassionate physicians to keep them well and see them through their health 
No. 1-22-1169 

4 

challenges. With comprehensive services ranging from Bariatric Surgery to *** 

Orthopedics *** and more—we are here for our neighbors in Oak Park and beyond.” 

WSMC’s website says the following about its orthopedics department: 

“Your life doesn’t need to be put on hold if you’re experiencing pain from a knee, hip, or 

other joint. When conservative measures like diet, exercise, and medication can no longer 

alleviate your pain, the orthopedic specialists at WSMC may be able to help. With vast 

experience diagnosing and treating injuries and disease involving bones, joints, 

ligaments, tendons, and nerves, our team works to create a high-quality program tailored 

to you.” 

¶ 8 On August 26, 2016, Solorzano went to WSMC for an X-ray, which was interpreted by a 

radiologist. The X-ray revealed a lytic lesion, the “destruction of an area of bone due to a disease 

process, such as cancer,” on the femur. 

¶ 9 On August 29, 2016, Solorzano saw Dr. Romano for the first time. Dr. Romano is the 

manager of and is employed by Romano Orthopaedics, LLC (Romano Orthopaedics). He is not 

and has never been employed by WSMC. He has a WSMC badge, but he does not wear the 

badge. Nor does he wear a lab coat bearing the WSMC logo. If his patients ask, he informs them 

he is not employed by WSMC, but he does not routinely make a disclaimer about his 

employment status. Dr. Romano’s office is located on the seventh floor of WSMC’s professional 

building. The WSMC professional building adjoins and serves as the main entrance to the 

hospital that WSMC owns and operates. Dr. Romano has had an office in the professional 

building since 1992, and over the years he has held a number of positions at the hospital, 

including chairman of the department of orthopedics, as well as president, vice president, and 

president emeritus of WSMC’s medical staff. 
No. 1-22-1169 

5 

¶ 10 When Solorzano walked into WSMC’s professional building, she saw several large signs 

identifying it as WSMC. When she arrived at Dr. Romano’s office, she was given a consent 

form, which she signed. The consent form states at the top “ROMANO ORTHOPAEDICS, 

LLC—1 ERIE CT SUITE 7120 - OAK PARK IL 60302 - 708-848-4662.” The form states the 

following: 

 “CONSENT FOR TREATMENT: I hereby voluntarily consent to care, treatment, 

testing and all other services performed by healthcare providers at Romano Orthopaedics, 

LLC. At the same time, I do understand that I have the right to refuse consent to any 

proposed care, treatment, testing, surgery or procedure. Moreover, I have the right to ask 

questions and discuss my concerns with my healthcare provider. I acknowledge that no 

guarantees have been made to me as to the outcome of my care, examination and/or 

treatment at Romano Orthopaedics. While I understand that I am required to sign this 

consent annually or as necessary, I may revoke this consent at any time by writing to 

Romano Orthopaedics, LLC-1 Erie Ct Suite 7120 Oak Park, IL 60302 Attn: Practice 

Manager. 

RELEASE OF INFORMATION/ASSIGNMENT OF BENEFITS: I understand 

that Romano Orthopaedics shall maintain both electronic and paper-based documentation 

of the medical record. *** I am aware that data and information concerning medical 

treatment and healthcare services rendered on my behalf may be released, when 

necessary to healthcare providers in emergency situations and/or to public and private 

health insurance plans in order to receive payment for services provided by Romano 

Orthopaedics, LLC. I do hereby assign my benefits payable from my insurance plan to 

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No. 1-22-1169 

6 

Romano Orthopaedics, LLC and I authorize payment directly to them. I agree that this 

assignment cannot be revoked without Romano Orthopaedics, LLC consent.” 

The consent form says nothing about Dr. Romano’s employment status or about the relationship 

between Romano Orthopaedics and WSMC. 

¶ 11 During the August 29, 2016, appointment, Solorzano told Dr. Romano about the pain and 

swelling in her right leg. Dr. Romano examined her and reviewed her X-ray, which had been 

taken at WSMC. He acknowledged that the findings on the X-ray were indicative of a 

radiographic abnormality consistent with a tumor, but disagreed with the radiologist’s finding of 

bony destruction or a lytic lesion. Instead, he believed Solorzano’s pain was caused by 

incomplete healing or infection related to her prior surgery, so he ordered a magnetic resonance 

imaging (MRI) study to obtain additional information. He told Solorzano they would discuss the 

results of the MRI at her next visit. 

¶ 12 Solorzano underwent an MRI study on September 27, 2016, at WSMC. The radiologist 

who read the MRI stated that the “[d]ifferential includes chronic osteomyelitis, possible foreign 

body reaction to metal, and a sarcoma.” Solorzano went back to see Dr. Romano on September 

29, 2016. Dr. Romano reviewed the results of Solorzano’s MRI but did not believe that there was 

any osteosarcoma, which is a type of bone cancer, and instead thought the findings were 

indicative of a “healing fracture.” He recommended that Solorzano undergo a screw removal 

procedure and discussed the surgery with her. Because Solorzano’s insurance was set to expire at 

the end of the month, she said she would contact Dr. Romano’s office to schedule the surgery 

once she found new insurance. 

¶ 13 However, Solorzano did not return to Dr. Romano for the surgery or seek any additional 

medical care from him because he was no longer “in-network” with her new insurance provider. 
No. 1-22-1169 

7 

In 2017, she sought additional treatment for her leg from a different provider, and then, on May 

4, 2017, she was diagnosed with osteosarcoma in her right femur. Her right leg was amputated 

from the pelvis down shortly thereafter. 

¶ 14 On February 25, 2022, after reviewing the evidence and hearing argument from the 

parties, the court granted summary judgment in favor of WMSC, stating: “WSMC maintains 

[Solorzano] has not presented any evidence to show the hospital held out as the care provider or 

that [Solorzano] justifiably relied on the hospital’s conduct to provide the care. The court 

agrees.” The court added, 

“[Solorzano] has not provided any evidence of [WSMC’s] conduct that suggested to [her] 

the individual doctors were agents. [Solorzano] also testified she could not recall any 

badge or insignia on Dr. Romano’s lab coat. Thus, based on the record, the court cannot 

find [WSMC] engaged in any conduct upon which a reasonable jury could infer the 

hospital ‘held out’ Dr. Romano as its employee.” 

The court also concluded that Solorzano “has not presented any evidence of the hospital’s 

conduct upon which she relied to provide the care.” It added, “Significantly, [Solorzano] testified 

that she ‘would have gone to whatever hospital [her] physician at PCC recommended for [her].’ 

She also testified that if PCC had told [her] instead to go back to Mt. Sinai and see [a different 

doctor], she would have gone back to him instead.” The court added that although Solorzano 

submitted a screenshot of a hospital webpage listing Dr. Romano, she did not “submit[ ] any 

evidence of having viewed the webpage before the first appointment with Dr. Romano” and, 

therefore, “the screen shot does not indicate [Solorzano’s] reliance.” 

¶ 15 On Solorzano’s motion to reconsider, the court noted that Solorzano signed a consent 

form provided by Romano Orthopaedics on her first visit with Dr. Romano, not one provided by 
No. 1-22-1169 

8 

WSMC. It also noted that Dr. Romano held certain leadership positions with WSMC and that he 

has a badge with the WSMC logo on it but had “never worn the badge on his person.” The court 

conceded that it erred when it previously concluded that Solorzano would have had to have seen 

the hospital website in order to satisfy the holding out factor, noting that “[w]hether a patient 

actually observes a hospital’s advertisements is not relevant to the objective inquiry into the 

holding out factor.” However, the court concluded that even if “the hospital’s website and the 

badge create a question of fact regarding the ‘holding out’ element, Solorzano still ha[d] not 

raised a question of fact regarding the ‘justifiable reliance’ element.” The court stated that, 

“the record indicates that [Solorzano] did not rely on the hospital to seek care from Dr. 

Romano. [Solorzano] testified she went to see Dr. Romano because her primary care 

provider gave her a referral. *** Though [Solorzano] insists the primary care provider’s 

referral was generally for the orthopedics department, the referral order specifies Dr. 

Romano by name. And while the referral order listed Dr. Romano’s office address as 

[WSMC], [Solorzano] still sought care from a specific physician and not from the 

department of orthopedics generally. [Solorzano] scheduled an appointment with Dr. 

Romano rather than, for instance, seeking the next available orthopedic surgeon at 

[WSMC]. Put different, Dr. Romano was not chosen by [WSMC] to provide care to 

[Solorzano]. Accordingly, [Solorzano] has failed to present any evidence of ‘justifiable 

reliance.’ Because [Solorzano] has not established the ‘justifiable reliance’ element, she 

has not created a triable issue of fact as to the issue of apparent agency.” 

The court denied Solorzano’s motion to reconsider on June 30, 2022. 
No. 1-22-1169 

9 

¶ 16 On July 11, 2022, the court ruled that, pursuant to Illinios Supreme Court Rule 304(a) 

(eff. Mar. 8, 2016), its February 25, 2022, order was a final judgment as to WSMC, and that 

there was “no just reason to delay either enforcement or appeal or both.” 

¶ 17 II. ANALYSIS

¶ 18 We have jurisdiction over this appeal under Rule 304(a), which permits an appeal to be 

taken from a final judgment “as to one or more but fewer than all of the parties or claims only if 

the trial court has made an express written finding that there is no just reason for delaying either 

enforcement or appeal or both.” Id. The trial court made such a finding here, and Solorzano 

timely appealed. 

¶ 19 As an initial matter, we note that WSMC filed a motion to strike portions of the 

“improper argument” in the statement of facts section of Solorzano’s brief as well as certain 

pages of her attached appendix, which WSMC contends violate Illinois Supreme Court Rule 341 

(eff. Oct. 1, 2020) and Rule 342 (eff. Oct. 1, 2019). We decline to strike any portion of 

Solorzano’s brief or appendix and instead will “simply disregard” any portions of the brief and 

appendix we find to be in violation of the rules. In re Marriage of Milne, 2018 IL App (2d) 

180091, ¶ 22, n.4. 

¶ 20 The sole issue in this case is whether the trial court properly granted summary judgment 

to WSMC on the basis that it could not be held liable under the doctrine of apparent authority. 

Under section 2-1005 (c) of the Code (735 ILCS 5/2-1005(c) (West 2022)), summary judgment 

is properly granted when “the pleadings, depositions, and admissions on file, together with the 

affidavits, if any, show that there is no genuine issue as to any material fact and that the moving 

party is entitled to a judgment as a matter of law.” To determine whether a genuine issue of 

material fact exists, the court must construe the facts strictly against the moving party and 
No. 1-22-1169 

10 

liberally in favor of the nonmoving party. Gilbert v. Sycamore Municipal Hospital, 156 Ill. 2d 

511, 518 (1993). “A triable issue exists where there is a dispute as to material facts or, when the 

facts are not in dispute, where reasonable persons might differ in drawing inferences from those 

facts.” Scardina v. Alexian Brothers Medical Center, 308 Ill. App. 3d 359, 363 (1999). Because 

summary judgment is a “drastic means to dispose of litigation,” it should be granted only where 

“the movant’s right is clear and free from doubt.” Prutton v. Baumgart, 2020 IL App (2d) 

190346, ¶ 22. We review the trial court’s grant of summary judgment de novo. Williams v. 

Tissier, 2019 IL App (5th) 180046, ¶ 25. 

¶ 21 A hospital can be held “vicariously liable for the negligent acts of a physician providing 

care at the hospital, regardless of whether the physician is an independent contractor, unless the 

patient knows, or should have known, that the physician is an independent contractor.” Gilbert, 

156 Ill. 2d at 524. For a hospital to be liable under the doctrine of apparent authority, a plaintiff 

must show that: 

“ ‘(1) the hospital, or its agent, acted in a manner that would lead a reasonable person to 

conclude that the individual who was alleged to be negligent was an employee or agent of 

the hospital; (2) where the acts of the agent create the appearance of authority, the 

plaintiff must also prove that the hospital had knowledge of and acquiesced in them; and 

(3) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent 

with ordinary care and prudence.’ ” Id. at 525 (quoting Pamperin v. Trinity Memorial 

Hospital, 423 N.W.2d 848, 855-56 (Wis. 1988)). 

“To survive a defendant hospital’s motion for summary judgment on a claim of apparent agency, 

a plaintiff must present at least some evidence to satisfy each of the Gilbert factors.” LambRosenfeldt v. Burke Medical Group, Ltd., 2012 IL App (1st) 101558, ¶ 25. 
No. 1-22-1169 

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¶ 22 A. A Genuine Issue of Material Fact Exists on the “Holding Out” Element

¶ 23 Solorzano asserts that either Dr. Romano’s or WSMC’s actions would lead a reasonable 

person to conclude that Dr. Romano worked for WSMC because the hospital’s website promoted 

its physicians and its orthopedics department, Dr. Romano’s office was located on WSMC’s 

campus, Dr. Romano was issued a WSMC badge and held a number of leadership positions at 

the hospital, and neither Dr. Romano nor the consent form he presented to Solorzano expressly 

disclaimed an employment relationship with WSMC. 

¶ 24 “The first two Gilbert elements are frequently grouped together and have been referred to 

as the ‘holding out’ factor.” Id. ¶ 26. The focus of the “holding out” element is whether “the 

patient knows, or should have known, that the physician is an independent contractor.” 

(Emphasis added.) Gilbert, 156 Ill. 2d at 524. This is not a subjective test; instead, a hospital will 

prevail on the “holding out” element if “the patient is in some manner put on notice of the 

independent status of the professionals with whom he might be expected to come into contact.” 

(Internal quotation marks omitted.) York v. Rush-Presbyterian-St. Luke’s Medical Center, 222 

Ill. 2d 147, 182 (2006); Wallace v. Alexian Brothers Medical Center, 389 Ill. App. 3d 1081, 1087 

(2009) (as long as a patient is “placed on notice of the independent contractor status of [her] 

doctors, ‘it would be unreasonable’ for her to assume that they were employed by [the hospital] 

and, thus, she could not sustain an apparent agency claim against [the hospital]”). However, “no 

requirement exists that a plaintiff must make a direct inquiry into the status of physicians 

working in a hospital. Instead, the burden is on hospitals to put their patients on notice of the 

independent status of the professionals with whom the patients might be expected to come in 

contact.” Kane v. Doctors Hospital, 302 Ill. App. 3d 755, 762 (1999). 
No. 1-22-1169 

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¶ 25 To determine whether a hospital held a physician out as its agent, courts consider a 

number of factors, including whether the hospital’s advertising creates the appearance of an 

agency relationship. See, e.g., McCorry v. Evangelical Hospitals Corp., 331 Ill. App. 3d 668, 

671-72 (2002) (finding that the evidence could support a finding that the hospital held itself out 

as the principal for its agents when the hospital’s advertisements said that its staff included 

hundreds of “highly qualified physicians” and referred to them as “ ‘our physicians’ ”); Prutton, 

2020 IL App (2d) 190346, ¶¶ 12, 48 (finding that the hospital’s website, which displayed a 

doctor’s photo and said she “ ‘recently joined the medical staff’ ” “could, if viewed in isolation, 

create a question of material fact as to whether there was an employer-employee relationship 

between the hospital and [the doctor]” (emphasis in original)). It does not matter whether the 

patient ever saw these advertisements or not; the inquiry is an objective one. See, e.g., Yarbrough 

v. Northwestern Memorial Hospital, 2016 IL App (1st) 141585, ¶ 57 (“Whether a patient 

actually observes a hospital’s advertisements is not relevant to the objective inquiry into the 

‘holding out’ factor under Gilbert.”), rev’d on other grounds, 2017 IL 121367. 

¶ 26 Here, the record establishes a genuine issue of material fact on the “holding out” element.

On its website, WSMC held itself out as the principal for its physicians because it referred to the 

“orthopedic specialists at WSMC” as “our team” and “our *** compassionate physicians” and 

included no disclaimers about its relationship with them. Although WSMC argues on appeal that 

the website evidence was obtained from The Wayback Machine (a digital archive of the World 

Wide Web) and lacks foundation, it forfeited that argument by not objecting to it in the trial 

court. See People v. Johnson, 238 Ill. 2d 478, 484 (2010) (where a party “fails to object to an 

error at trial *** he forfeits ordinary appellate review of that error.”). The fact that WSMC issued 

a badge to Dr. Romano, even if he never wore it, and the fact that Dr. Romano held a number of 
No. 1-22-1169 

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leadership positions at the hospital over the years, including most notably as chairman of 

WSMC’s orthopedics department and president of WSMC’s medical staff, also support 

Solorzano’s argument that WSMC held Dr. Romano out as its agent. Indeed, given his position 

as president of WSMC’s medical staff, one may be hard-pressed to find a physician who is a 

greater personification of WSMC than Dr. Romano. See Lamb-Rosenfeldt, 2012 IL App (1st) 

101558, ¶ 31 (considering doctor’s status as chief of staff at the hospital when assessing the 

“holding out” element). 

¶ 27 Another factor courts consider when analyzing the “holding out” element is whether the 

patient signed a consent to treatment form containing independent contractor language. When the 

language in the consent forms is clear and unambiguous, courts have found them “almost 

conclusive” in determining whether a hospital can be held liable for the medical negligence of its

independent contractor physicians. Steele v. Provena Hospitals, 2013 IL App (3d) 110374, 

¶ 131; see Williams, 2019 IL App (5th) 180046, ¶ 33 (whether a consent form contains an

unambiguous “independent contractor” disclaimer is an “important fact to consider in evaluating 

the ‘holding out’ element”). 

¶ 28 However, when hospital consent forms fail to inform patients that doctors are not hospital 

employees, or the language in the consent forms is ambiguous, courts have found them 

insufficient to defeat “holding out” claims. In Butkiewicz v. Loyola University Medical Center, 

311 Ill. App. 3d 508, 512 (2000), for example, the court found that the plaintiff satisfied the 

“holding out” element because “[n]othing would have alerted [the patient] to the fact that [the 

radiologist] was not a hospital employee” because the radiologist’s only office address was at the 

hospital, the reports he authored were on hospital letterhead and “[t]here was no written notice 

on admittance or consent forms that the doctors were not hospital employees nor were signs to 
No. 1-22-1169 

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that effect posted on the hospital property.” See McCorry, 331 Ill. App. 3d at 672 (noting that the 

hospital’s consent form included no indication that Christ Hospital did not employ its surgeons 

and physicians and concluding that “[n]othing in *** the forms the hospital presented to 

plaintiffs showed that [the doctor] did not act as the hospital’s agent”). 

¶ 29 Here, the consent form Solorzano signed when she arrived at Dr. Romano’s office states 

at the top “ROMANO ORTHOPAEDICS, LLC-1 ERIE CT. SUITE 7120-OAK PARK, IL 

60302-807-848-4662.” The “consent for treatment” section states, “I hereby voluntarily consent 

to care, treatment, testing and all other services performed by healthcare providers at Romano 

Orthopaedics, LLC. *** I acknowledge that no guarantees have been made to me as to the 

outcome of my care, examination, and/or treatment at Romano Orthopaedics. *** I may revoke 

this consent at any time by writing to Romano Orthopaedics, LLC.” The form also states, “I 

hereby assign my benefits payable from my insurance plan to Romano Orthopaedics, LLC, and I 

authorize payment directly to them.” Solorzano concedes that she read the consent form and 

signed it, but argues that the form was inadequate to put her on notice that Dr. Romano was not a 

hospital employee because “[t]here is no disclaimer of agency with or employment by WSMC” 

and the consent form “did not inform [her] that Dr. Romano was an independent contractor of 

WSMC.” WSMC argues in response that Solorzano should have known that the care she 

received when she saw Dr. Romano was provided by employees of Romano Orthopaedics based 

on the consent form she signed and that there was no reason for the form to mention WSMC 

because Solorzano was receiving medical care at Romano Orthopaedics, not WSMC. 

¶ 30 We are not persuaded by WSMC’s argument. Although the consent form states that 

treatment would be “provided by healthcare providers at Romano Orthopaedics, LLC,” it notably 

does not state who employs these healthcare providers or expressly disclaim any employment 
No. 1-22-1169 

15 

relationship with WSMC. We also question whether an average consumer would understand that 

an “LLC” is an acronym for limited liability company and that an LLC is a legal entity similar to 

a corporation through which business is conducted. While the employment relationship may be 

obvious to Dr. Romano and WSMC, patients like Solorzano are entitled to disclosure of essential 

facts about the relationship between their healthcare providers and should not be left to speculate 

about corporate ownership structures and employment relationships. For these reasons, we find 

that the consent form Solorzano signed was at least ambiguous and thus cannot defeat her

“holding out” claim. When we consider the evidence presented, including WSMC’s

advertisements; the WSMC badge issued to Dr. Romano; the number of senior levels positions 

Dr. Romano held at the hospital over the years, including chairman of the WSMC’s orthopedics 

department and president of its medical staff; the referral form Solorzano received from PCC

(who Solorzano believed was affiliated with WSMC) stating that Dr. Romano’s office address 

was “West Suburban Hospital”; Dr. Romano’s office was located inside the WSMC professional 

building; the professional building is in the same physical structure as the hospital; the entrance 

Solorzano used to access Dr. Romano’s office was also the entrance to the hospital; the 

professional building contains WSMC signs but none of them inform patients that physicians 

like Dr. Romano who work there are independent contractors; and Dr. Romano did not tell

Solorzano that he was not employed by WSMC, we conclude that it was sufficient to create a 

genuine issue of material fact as to the “holding out” element of the Gilbert test. Cf. Prutton, 

2020 IL App (2d) 190346, ¶ 55 (concluding that the signed consent forms, which “clearly and 

unambiguously informed plaintiff that the physicians at the hospital *** were independent 

contractors,” were sufficient to defeat the plaintiff’s “holding out” argument despite the fact that 

the hospital’s advertisements “initially could have been seen to create a genuine question of 
No. 1-22-1169 

16 

material fact on the issue of whether [the hospital] held [the doctor] out as an employee or 

agent”).

¶ 31 B. A Genuine Issue of Material Fact Exists on the Justifiable Reliance Element 

¶ 32 To meet the justifiable reliance element, a plaintiff must establish that she “ ‘acted in 

reliance upon the conduct of the hospital or its agent, consistent with ordinary care and 

prudence.’ ” Gilbert, 156 Ill. 2d at 525 (quoting Pamperin, 423 N.W.2d at 855-56). A plaintiff 

may satisfy the reliance element if she can show that she relied upon the hospital, rather than a 

specific physician, to provide medical care. Williams, 2019 IL App (5th) 180046, ¶ 54; see York, 

222 Ill. 2d at 193 (noting that the “critical distinction is whether the patient relied upon the 

hospital for the provision of care or, rather, upon the services of a particular physician” 

(emphasis in original)). “[O]ne must consider whether the patient in a sense placed himself in the 

‘hands’ of the hospital and looked to it to furnish the medical personnel, including doctors, 

essential for treatment.” Scardina, 308 Ill. App. 3d at 365. 

¶ 33 In Scardina, this court reversed the trial court’s grant of summary judgment to the 

hospital after finding that the evidence was sufficient to raise a triable issue of fact regarding the 

plaintiff’s justifiable reliance. Id. at 368. The evidence showed that the plaintiff went to Alexian 

Brothers Hospital at the direction of his family physician, was not given a choice of hospitals to 

visit, never met with the doctor charged with allegedly negligent conduct before arriving at the 

hospital, did not select this particular doctor to provide his treatment, and believed the doctor 

was a hospital employee because the doctor never disclosed his employment status with the 

hospital to him. Id. at 362. The court noted that “a showing that the plaintiff would have *** 

gone to a different hospital, had he been aware of the status of his treating physician as an 

independent contractor is not necessary to satisfy the reliance element,” and reasoned that the 
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“mere fact” that plaintiff was directed to the hospital by his family physician did not establish 

that he did not rely upon the hospital to provide his care. Id. at 366-67. 

¶ 34 Similarly here, we find that genuine issues of material fact exist regarding whether 

Solorzano justifiably relied on WSMC to provide her with orthopedic services as opposed to Dr. 

Romano or his employer, Romano Orthopaedics. Solorzano testified that she was referred “to 

orthopedics at [WSMC]” and that she went to see Dr. Romano because her primary care provider 

referred her to him. Solorzano said she “did not know of Dr. Victor Romano or Romano 

Orthopaedics” before she went to see him in August 2016, that she “did not specifically select 

Dr. Romano as a care provider,” and that she “assumed that Dr. Romano was an employee of the 

hospital.” Similarly, Dr. Romano testified that Solorzano came to him “out of the blue.” 

Solorzano said she would have gone to whatever doctor or hospital her primary care provider 

referred her to. She further averred in her affidavit that she relied on WSMC for her medical 

treatment. Based on the record before us, a reasonable fact finder could conclude that Dr. 

Romano was selected for Solorzano by PCC—who Solorzano understood was an affiliate of 

WSMC—because he was in WSMC’s network of physicians, not that Solorzano selected Dr. 

Romano to treat her. For this reason, Solorzano’s case is distinguishable from those where 

patients followed their personal physicians to specific hospitals for follow-up care. See, e.g., 

Lamb-Rosenfeldt, 2012 IL App (1st) 101558, ¶¶ 33-35 (finding that the patient relied on a 

specific physician, not the hospital, to provide her medical care, where testimony established that 

the patient had a preexisting relationship with her doctor and had seen her doctor several times at 

the doctor’s office prior to her hospital visit, and the hospital “was merely the location from 

which [the patient] received continued services from [her doctor]”). 
No. 1-22-1169 

18 

¶ 35 “[T]he relevant inquiry with respect to the reliance element is not whether the plaintiff 

reported to the hospital at the direction of another person but, rather, whether the plaintiff looked 

to the hospital to furnish all that is essential for treatment, including supporting medical 

personnel.” York, 222 Ill. 2d at 191. Solorzano received a referral from her primary care 

provider, PCC, for an “Orthopedic Consult” with “Victor Romano, MD[,]” which stated his 

office was at “West Suburban Hospital[.]” Solorzano averred in her affidavit that she understood 

at the time that PCC was affiliated with WSMC, and there is no evidence in the record indicating 

that PCC and WSMC are not affiliated entities. Solorzano had previously gone to WSMC for 

physical therapy based on a referral order she believed came from PCC. PCC’s order also 

referred Solorzano to WSMC for an X-ray study, which was performed at WSMC. When 

Solorzano went to see Dr. Romano, she entered through WSMC’s main entrance to get to his 

office. No signs or disclaimers from WSMC, Dr. Romano, or his staff put Solorzano on notice 

that Dr. Romano was not a hospital employee. After this visit, Solorzano had an MRI study 

performed at WSMC, pursuant to Dr. Romano’s referral order. Then she went to her second 

appointment at Dr. Romano’s office within the WSMC medical complex. After Solorzano 

received her X-rays and an MRI as WSMC, those radiological study results were sent directly to 

Dr. Romano without any action on Solorzano’s part, additional indicia that Solorzano justifiably 

relied on WSMC for her medical care. 

¶ 36 The physical therapy, X-ray study, MRI study, and orthopedic care were all provided to 

Solorzano at WSMC’s medical campus, making Solorzano’s “snow globe” analogy a particularly 

apt device to explain why a fact finder could reasonably conclude that Solorzano relied on 

WSMC for her medical treatment. In Solorzano’s depiction, the snow globe represents the 

WSMC health care system, the figurines inside the globe represent the physicians and health care 
No. 1-22-1169 

19 

providers associated with the WSMC health care system, and the snowflakes represent the 

patients being treated by the WSMC health care system. All of Solorzano’s medical care 

providers were within the WSMC snow globe, consistent with a comprehensive medical care 

provider business model. Solorzano went from one health care provider to another health care 

provider within the WSMC health system. Yet, like a muted figurine in the snow globe, Dr. 

Romano, who referred Solorzano to other specialists and treatment providers within the WSMC 

health care system, did not inform her that he was not employed by WSMC. A reasonable fact 

finder could conclude under these circumstances that Solorzano relied on WSMC for her health 

care, not Dr. Romano. 

¶ 37 WSMC, however, argues that Solorzano’s reliance is defeated by the fact that she said 

she did not understand the relationship between Dr. Romano and WSMC. In the WSMC “snow 

globe” that she found herself in, we are not surprised that Solorzano lacked this understanding. 

As Dr. Romano testified in his deposition, he would only tell a patient that he was not employed 

by WSMC if he was specifically asked, and the consent form Solorzano signed said nothing 

about Dr. Romano’s relationship with WSMC. Therefore, Solorzano’s statement—that she did 

not understand the relationship between Dr. Romano and WSMC—is not necessarily 

inconsistent with her testimony that she assumed that Dr. Romano was employed by WSMC and 

relied on WSMC for her care. WSMC then argues that Solorzano’s statement in her affidavit that 

she relied on WSMC for her care is self-serving, but what party affiant does not provide selfserving evidence. See Hill v. Tangherlini, 724 F.3d 965, 967 (7th Cir. 2013) (“Deposition 

testimony, affidavits, responses to interrogatories, and other written statements by their nature 

are self-serving. [Citation.] As we have repeatedly emphasized over the past decade, the term 

‘selfserving’ must not be used to denigrate perfectly admissible evidence through which a party 
No. 1-22-1169 

20 

tries to present its side of the story at summary judgment.”). Finally, WSMC makes much ado

about Dr. Romano’s office being located at 1 Erie Court and the hospital being located at 3 Erie 

Court. However, WSMC’s website directed visitors to “expert orthopedic care” at “3 Erie 

Court,” the address of the hospital. Moreover, because the professional offices and the hospital 

are located in the same building or adjoining buildings (the record is not clear on this point) and 

are accessed through a shared main entrance, we are at a loss to see how Solorzano’s reliance

argument is defeated by the difference in addresses. 

¶ 38 Taken together, we find that a genuine issue of material fact exists as to whether 

Solorzano justifiably relied upon WSMC, not Dr. Romano or Romano Orthopaedics, to provide 

her with healthcare. We therefore conclude that the trial court’s grant of summary judgment was 

error. 

¶ 39 III. CONCLUSION

¶ 40 For the foregoing reasons, the circuit court’s grant of summary judgment to WSMC is

reversed and this case is remanded for further proceedings consistent with our decision. 

¶ 41 Reversed and remanded. 
No. 1-22-1169 

21 

Solorzano v. Magnani, 2024 IL App (1st) 221169

Decision Under Review: Appeal from the Circuit Court of Cook County, No. 2018-L-6332; 

the Hon. Catherine Schneider, Judge, presiding.

Attorneys

for

Appellant:

Michael Murphy Tannen and Timothy Ryan Meloy, of Tannen 

Law Group, P.C., and John G. Kelly and Greg R. Ignoffo, of Kelly 

& Ignoffo Law Group, P.C., both of Chicago, for appellant.

Attorneys

for

Appellee:

Michael Resis, Ellen L. Green, and Jennifer K. Stuart, of 

Amundsen Davis, LLC, of Chicago, for appellee.