Title: Norvin Lewis v. Physicians Insurance Company of Wisconsin
Citation: 2001 WI 60
Docket Number: 1999AP000001
State: Wisconsin
Issuer: Wisconsin Supreme Court
Date: June 13, 2001

2001 WI 60 
 
SUPREME COURT OF WISCONSIN 
 
 
Case No.: 
99-0001 
 
 
Complete Title 
of Case: 
 
Norvin Lewis and Delores Lewis,  
 
Plaintiffs-Respondents-Petitioners, 
 
v. 
Physicians Insurance Company of Wisconsin, Jay 
Seldera, M.D. and Wisconsin Patients 
Compensation Fund,  
 
Defendants-Appellants, 
Lakeland Medical Center, The Dean Health Plan, 
Inc. and Donna Shalala,  
 
Defendants.  
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
2000 WI App 95 
Reported at:  235 Wis. 2d 198, 612 N.W.2d 389 
(Published) 
 
 
Opinion Filed: 
June 13, 2001 
Submitted on Briefs: 
      
Oral Argument: 
January 4, 2001 
 
 
Source of APPEAL 
 
COURT: 
Circuit 
 
COUNTY: 
Milwaukee 
 
JUDGE: 
Michael G. Malmstadt 
 
 
JUSTICES: 
 
Concurred: 
ABRAHAMSON, C.J., concurs (opinion filed). 
 
 
BRADLEY, J., joins concurrence. 
 
Dissented: 
      
 
Not Participating:       
 
 
ATTORNEYS: 
For the plaintiffs-respondents-petitioners there 
was a brief by Timothy J. Aiken, James C. Gallanis and Aiken & 
Scoptur, S.C., Milwaukee, and oral argument by Timothy J. Aiken. 
 
 
For the defendants-appellants there was a brief 
 
2 
by Christopher P. Riordan, Marianne Morris Belke and Crivello, 
Carlson, Mentkowski & Steeves, S.C., Milwaukee, and oral argument 
by Christopher P. Riordan. 
 
 
 
 
2001 WI 60 
 
NOTICE 
This opinion is subject to further editing and 
modification.  The final version will appear 
in the bound volume of the official reports. 
 
 
No. 99-0001 
 
STATE OF WISCONSIN                    :  
  IN SUPREME COURT 
 
 
Norvin Lewis and Delores Lewis,  
 
          Plaintiffs-Respondents- 
          Petitioners, 
 
     v. 
 
Physicians Insurance Company of  
Wisconsin, Jay Seldera, M.D. and  
Wisconsin Patients Compensation Fund,  
 
          Defendants-Appellants, 
 
Lakeland Medical Center, The Dean Health  
Plan, Inc. and Donna Shalala,  
 
          Defendants. 
 
 
REVIEW of a decision of the Court of Appeals.  Affirmed.  
 
¶1 
JON P. WILCOX, J.   The issue in this case is whether 
a surgeon can be vicariously liable for the negligence of two 
hospital nurses who failed to count accurately the sponges used 
in a surgical procedure.  Because the plaintiff has not 
presented a viable doctrine for imposing vicarious liability on 
the surgeon under existing Wisconsin law and because we decline 
to adopt the "captain of the ship" theory for Wisconsin, we 
FILED 
 
JUN 13, 2001 
 
Cornelia G. Clark 
Clerk of Supreme Court 
Madison, WI 
 
 
 
 
 
No. 
99-0001 
 
 
2 
conclude that the surgeon cannot be held vicariously liable for 
the negligence of the two hospital nurses. 
¶2 
The plaintiff in this case, Norvin Lewis (Lewis), 
asserted that the defendant, Jay Seldera, M.D. (Seldera), was 
vicariously liable for the failure of two hospital nurses, 
employed by Lakeland Medical Center (Lakeland) in Elkhorn, 
Wisconsin, to count accurately the number of sponges used in 
Lewis' gallbladder surgery.  As a result of their inaccurate 
count, a sponge was left in Lewis' abdomen.  Lewis stipulated to 
the fact that Seldera was not negligent.  The Circuit Court for 
Milwaukee County, Michael D. Goulee, Judge, awarded Lewis 
$150,000, set off by $50,000 from his settlement with Lakeland. 
 The court of appeals reversed the circuit court's decision.  
For the following reasons, we now affirm the court of appeals' 
ruling.  
I 
¶3 
The parties have stipulated to the relevant facts.  
Seldera removed Lewis' gallbladder at Lakeland on November 8, 
1993.  During the surgery, Seldera packed off the gallbladder 
with laparotomy1 pads (sponges).  Nurses Patricia Vickery 
(Vickery) and Ellen Chapman (Chapman) were in charge of counting 
the sponges.  Under Lakeland's procedures, the nurses, not 
Seldera, 
were 
responsible 
for 
counting 
the 
sponges 
and 
overseeing the counting of the sponges.  Indeed, Chapman, the 
                     
1 Laparotomy is an "[i]ncision in the loin."  Stedman's 
Medical Dictionary 840 (25th ed. 1990).  Laparotomy pads are 
sponges used to pack off an area in the loin or abdomen. 
No. 
99-0001 
 
 
3 
"circulating 
nurse" 
assigned 
to 
the 
operation, 
had 
an 
independent duty delineated in the administrative code to count 
the sponges.  See Wis. Admin. Code § HFS 124.13(7) (Oct., 2000) 
(the "'circulating nurse'" is "a registered nurse who is present 
during 
an 
operation . . . who, 
before 
the 
surgical 
procedure . . . is completed, . . . ensures that the sponge, 
needle and instrument counts have been done according to 
hospital policy").  Both Vickery and Chapman were employed by 
Lakeland, not Seldera.  According to the medical records from 
the surgery, Vickery and Chapman counted the number of sponges 
used on four occasions and they thought that the correct number 
of sponges had been collected at the end. 
¶4 
However, Lewis began to have problems and Seldera 
operated again on January 30, 1994.  During this second surgery, 
a retained sponge was discovered.  After this sponge was 
removed, Lewis recovered.  He then brought suit against Lakeland 
and Seldera. 
¶5 
Prior 
to 
trial, 
Lakeland 
agreed 
that 
it 
was 
responsible for the actions of its employees, Vickery and 
Chapman.  Because Lakeland was a county-owned hospital at the 
time of the surgery, its liability for the negligence of Vickery 
and 
Chapman 
was 
limited 
to 
$50,000. 
 
See 
Wis. 
Stat. 
§ 893.80(3)(1993-94).2  After settling with Lakeland for the 
maximum amount allowed under § 893.80(3), Lewis pursued this 
                     
2  All subsequent references to the Wisconsin Statutes are 
to the 1993-94 version unless otherwise indicated.    
No. 
99-0001 
 
 
4 
case 
against 
Seldera. 
 
In 
consideration 
for 
Seldera's 
stipulation to the above facts, Lewis dropped all claims except 
for the allegation that Seldera could be held vicariously liable 
for Vickery and Chapman's negligence.  Both parties moved for 
summary judgment on the issue of whether Seldera could be so 
held liable. 
¶6 
The circuit court issued an oral decision, finding "as 
a matter of law, that [Seldera] is, in fact, responsible and 
liable for the actions of the parties that were in the operating 
room with him and working under his supervision."  The circuit 
court maintained that the "doctor is the captain of the ship.  
That the doctor is responsible for everything."  Seldera 
appealed. 
¶7 
The court of appeals reversed the circuit court's 
ruling.  Lewis v. Physicians Ins. of Wisconsin, 2000 WI App 95, 
¶14, 235 Wis. 2d 198, 612 N.W.2d 389.  Judge Fine, writing for 
the court, rejected the argument that Seldera could be liable 
for the negligence of the nurses by distinguishing our decision 
in Fehrman v. Smirl, 25 Wis. 2d 645, 131 N.W.2d 314 (1964) 
(Fehrman II)3, which held that two doctors could be held liable 
for a single injury.  Judge Fine further observed that "[n]o 
appellate court in Wisconsin has used the 'captain of the ship' 
                     
3 The same action reached this court in two separate cases: 
 Fehrman v. Smirl, 20 Wis. 2d 1, 121 N.W.2d 255 (1963) (Fehrman 
I) and Fehrman v. Smirl, 25 Wis. 2d 645, 131 N.W.2d 314 (1964) 
(Fehrman II).  Although the underlying facts of the action were 
set forth in our Fehrman I decision, Lewis relies on our 
discussion of vicarious liability in Fehrman II. 
No. 
99-0001 
 
 
5 
doctrine to impose liability in a medical malpractice case, and 
the doctrine has generally lapsed into disuse elsewhere with the 
passage of time."  Lewis, 2000 WI App 95, ¶13.  Therefore, the 
court of appeals declined to apply that doctrine to the present 
case.  Id. 
¶8 
Lewis subsequently appealed and this court accepted 
his petition for review. 
II 
¶9 
This case is before us on a grant of summary judgment. 
 Because the parties have stipulated to the facts, this appeal 
only raises a question of law, which we review de novo.  L.L.N. 
v. Clauder, 209 Wis. 2d 674, 682, 563 N.W.2d 434 (1997). 
¶10 At the outset, we note that Lewis is not contending 
that Vickery and Chapman were employed by Seldera or that 
Vickery and Chapman were "borrowed servants."4  Nor is Lewis 
contending that Seldera was responsible for counting the 
sponges.  Instead, this case turns on whether Seldera is 
vicariously liable for the negligence of Vickery and Chapman 
under our holding in Fehrman II or whether we adopt the "captain 
of the ship" doctrine. 
¶11 It is a basic principle of law, as well as common 
sense, that one is typically liable only for his or her own 
acts, not the acts of others.5  Nevertheless, the law in certain 
                     
4 We declined to discard the "borrowed servant rule" in 
favor of the "dual liability approach" in DePratt v. Sergio, 102 
Wis. 2d 141, 147, 306 N.W.2d 62 (1981). 
5 Oliver Wendell Holmes, Jr., Agency 5 Harv. L. Rev. 1, 14 
(1891).  On this point, Holmes wrote:  
No. 
99-0001 
 
 
6 
circumstances will impose "vicarious liability" on a non-
negligent party.  Vicarious liability is "[l]iability that a 
supervisory party (such as an employer) bears for the actionable 
conduct of a subordinate or associate (such as an employee) 
because of the relationship between the two parties."  Black's 
Law Dictionary 927 (7th ed. 1999).  There is a tension, then, 
between the basic principle of individual responsibility under 
the law on the one hand and the imposition of vicarious 
liability on an innocent party for a tortfeasor's acts on the 
other hand.  Because vicarious liability is a severe exception 
to the basic principle that one is only responsible for his or 
her own acts, we proceed with caution when asked to impose 
vicarious liability on an innocent party, doing so only in 
accordance with well-settled law. 
¶12 One 
well-settled 
doctrine 
for 
imposing 
vicarious 
liability is respondeat superior, which allows a non-negligent 
employer to be held liable for an employee's actions.  See 
Shannon v. City of Milwaukee, 94 Wis. 2d 364, 370, 289 N.W.2d 
564 (1980) ("Under the doctrine of respondeat superior an 
employer can be held vicariously liable for the negligent acts 
                                                                  
I assume that common-sense is opposed to making one 
man pay for another man's wrong, unless he actually 
has brought the wrong to pass according to the 
ordinary canons of legal responsibility,——unless, that 
is to say, he has induced the immediate wrong-doer to 
do acts of which the wrong, or, at least, wrong, was 
the natural consequence under the circumstances known 
to the defendant. 
Id. 
No. 
99-0001 
 
 
7 
of his employees while they are acting within the scope of their 
employment.").  Respondeat superior is perhaps the most familiar 
context in which vicarious liability is imposed.  It arises due 
to the employer's control or right of control over the employee; 
because of this control or right of control, the negligence of 
the 
employee 
is 
imputed 
to 
the 
employer 
in 
certain 
circumstances.  Arsand v. City of Franklin, 83 Wis. 2d 40, 46, 
264 N.W.2d 579 (1978); Wis JI——Civil 4030 (1994).  Indeed, in 
the present case, the hospital admitted that it could be held 
vicariously liable for the negligence of the two nurses under 
the doctrine of respondeat superior.  Lewis, however, does not 
argue that Seldera is vicariously liable for the negligence of 
Vickery and Chapman under the doctrine of respondeat superior; 
instead, he contends that Seldera is vicariously liable under 
our holding in Fehrman II or alternatively, under the "captain 
of the ship" doctrine.  We examine each of his theories for 
imposing vicarious liability on Seldera in turn.   
¶13 In Fehrman v. Smirl, 20 Wis. 2d 1, 6-7, 121 N.W.2d 255 
(1963) (Fehrman I), the plaintiff's surgeon, Smirl, asked 
another 
surgeon, 
McDonnell, 
to 
assist 
with 
treating 
the 
defendant after Smirl had removed the defendant's prostate 
gland.  The plaintiff was injured during the course of this 
treatment and filed an action against Smirl.  Id. at 1-9.  
During the jury's deliberations, it raised a question regarding 
Smirl's responsibility relative to McDonnell's responsibility.  
Fehrman II, 25 Wis. 2d at 654.  The circuit court responded that 
Smirl "would be responsible for any failure upon the part of Dr. 
No. 
99-0001 
 
 
8 
McDonnell to exercise such care and skill" and Smirl objected on 
the ground that this response may have led the jury to impose 
liability on him for negligence committed by McDonnell.  Id. at 
654-55.  Justice Gordon, writing for the majority of this court, 
but not agreeing with it on this issue, stated the majority's 
holding as such:  "under the circumstances of this case, Dr. 
Smirl either was in charge of the patient or was acting jointly 
with Dr. McDonnell."  Id. at 656.  Therefore, this court upheld 
the circuit court's response to the jury's question.  Id.  Lewis 
characterizes our holding in Fehrman II as imposing vicarious 
liability on a doctor whenever the doctor continues to actively 
care for and participate in the treatment of the patient.  His 
reading is too broad. 
¶14 We begin our analysis of Fehrman II by recognizing 
that this court's holding on the issue of vicarious liability 
was 
grounded 
in 
the 
particular 
facts 
presented. 
 
Id.  
Importantly, we did not assert a new doctrine for imposing 
vicarious liability.  Instead, we merely approved of a response 
to a question the jury raised during its deliberation regarding 
Smirl's responsibility relative to McDonnell's responsibility.  
Id. at 653-54.  We decline to stretch Fehrman II to hold that 
this court's refusal to overturn a circuit court's response to a 
jury question created a new doctrine for imposing vicarious 
liability. 
¶15 Moreover, in Fehrman II we allowed the circuit court's 
response to stand in part because it was unclear whose 
No. 
99-0001 
 
 
9 
negligence was the cause of the plaintiff's injury.6  As noted, 
Smirl was objecting "to the fact that under the court's 
instruction he was held responsible for the negligence which may 
have been chargeable to Dr. McDonnell."  Id. (emphasis added).  
Therefore, as the court of appeals commented, Fehrman II more 
closely resembles the "alternative liability" case of Summers v. 
Tice, 33 Cal.2d 80, 199 P.2d 1 (1948).  There, two hunters 
simultaneously and negligently shot in the direction of the 
plaintiff, 
but 
it 
was 
unclear 
which 
bullet 
injured 
the 
plaintiff.  Id. at 2.  Because this extraordinary fact pattern 
made it impossible for the plaintiff to identify which hunter 
caused his injury, the court determined that he could hold both 
defendants liable.  Id. at 4-5.  Thus, the "alternative 
liability" theory was born. 
¶16 Without adopting the "alternative liability" theory, 
we discussed the holding of Summers in Collins v. Eli Lilly Co., 
116 Wis. 2d 166, 342 N.W.2d 37 (1984) where the plaintiff sought 
to impose liability on 17 drug companies because she was unable 
to determine what specific drug company had made the particular 
                     
6 As this court observed in its discussion of res ipsa 
loquitur, "[t]here was direct medical proof of negligence."  
Fehrman II, 25 Wis. 2d at 651.  On that count, we held that the 
defendant was entitled to an instruction on res ipsa loquitur 
where an expert testified that "'it is my opinion that this 
result would not have occurred if [Smirl and McDonnell], or 
either of them, or both, had been exercising the proper skill 
and care and diligence that is expected of them in the 
performance of this operation, suprapubic prostatectomy.'"  Id. 
 Therefore, the jury could have found that both doctors breached 
their duty of care, but only one doctor caused the plaintiff's 
injury. 
No. 
99-0001 
 
 
10
drug that caused her injuries.  Id. at 175.  Although we 
rejected the imposition of liability upon the 17 drug companies, 
our 
discussion 
of 
"alternative 
liability" 
in 
Collins 
is 
instructive.  In discussing the rule of Summers, we wrote that 
under alternative liability "when all defendants, although 
acting independently, have breached a duty of care toward the 
plaintiff but only one of them caused the injury, each defendant 
must prove that he or she did not cause the plaintiff's injury 
or be jointly and severally liable with all other defendants."  
Id. at 183.  The direct proof of negligence in Fehrman II, 
presented to the jury with the res ipsa loquitur instruction, 
indicates that both Smirl and McDonnell may have violated their 
respective duties of care to the plaintiff, but only one 
doctor's actions may have caused his injury.  25 Wis. 2d at 650-
53.  Our decision in Fehrman II then, while confined to its 
facts, is more akin to this theory of alternative liability than 
creating a "continuing active management" theory for imposing 
vicarious liability.7  Consequently, Fehrman II does not support 
Lewis' new "continuing active management" theory. 
¶17 Not only does Fehrman II fail to support Lewis' new 
theory, it is distinguishable from the instant case.  In this 
case, Seldera did not breach a duty to Lewis; instead, he 
stipulated that Seldera was not negligent.  In contrast, both 
                     
7 Given Justice Gordon's equivocal statement of the court's 
specific holding on the issue of vicarious liability in Fehrman 
II, we caution against relying on that language in the future.  
See Fehrman II, 25 Wis. 2d at 656. 
No. 
99-0001 
 
 
11
Smirl and McDonnell in Fehrman II may have breached their duties 
to the plaintiff.  Id. at 656.  Although in this case there was 
clearly a breach of duty owed to Lewis, that duty was breached 
by Vickery and Chapman, the nurses employed by the hospital.  
Their duties were defined by hospital policy, not by Seldera.  
Chapman's duty, as the circulating nurse, was also defined by 
the administrative code.  See Wis. Admin. Code § HFS 124.13(7) 
(Oct., 2000).  In further contrast to Fehrman II where Smirl 
selected McDonnell to assist with the surgery, the nurses here 
were selected by Lakeland, not Seldera.  Fehrman II, therefore, 
is distinguishable from the present case and cannot be relied 
upon to impose vicarious liability on Seldera under any theory. 
¶18 Lewis, however, seeks support for his "continuing 
active management" theory for imposing vicarious liability on 
Seldera in the two cases cited by this court in Fehrman II, 
Morrill v. Komasinski, 256 Wis. 417, 41 N.W.2d 620 (1950), and 
Heimlich v. Harvey, 255 Wis. 471, 39 N.W.2d 394 (1949).  In 
Morrill, this court confronted the issue of whether three 
doctors could be held jointly and severally liable for failing 
to diagnose a broken arm properly.  256 Wis. 2d at 426.  The 
family doctor, Dr. Komasinski, objected to being held jointly 
liable with a more experienced doctor, Dr. Bump, whom he called 
to assist with the diagnosis and treatment of the plaintiff's 
broken arm.  Id.  We held that the "evidence amply supports the 
findings of the jury."  Id.  The evidence indicated that three 
doctors, Dr. Komasinski, Dr. Bump, and a Dr. Wright, who was in 
charge of taking the X rays, "examined the X rays together and 
No. 
99-0001 
 
 
12
decided upon the treatment to be administered."  Id. at 419.  
The three doctors then "concluded that the arm should be placed 
at right angles to the body with the forearm pointing straight 
upward . . . ."  Id.  It was this diagnosis and treatment by all 
three doctors that caused the plaintiff's injury.  Id. at 425.  
Therefore, all three doctors were jointly and severally liable. 
 Id. at 426. 
¶19 The central fact that distinguishes Morrill from the 
instant case is that there the jury found negligence on the part 
of all three doctors who acted in concert whereas here Lewis has 
stipulated that Seldera was not negligent.  There was no 
imposition of vicarious liability in Morrill.  Accordingly, 
Morrill does not support the theory advanced by Lewis of 
imposing vicarious liability when the non-negligent doctor 
"continues active participation" in the patient's case.   
¶20 Likewise, Heimlich provides no assistance to Lewis.  
There, the defendant, Dr. Harvey, objected to the imposition of 
liability when the injury suffered by his patient may have been 
inflicted through the course of treatment by his employee, Dr. 
Baird, rather than by him.  Heimlich, 255 Wis. 2d 471.  Noting 
that Dr. Harvey "testified that Dr. Baird worked for him for a 
salary plus commission," we rejected Dr. Harvey's argument by 
stating that "it appears to us as well as to the jury that [Dr. 
Harvey] has completely acknowledged the acts of Dr. Baird to be 
his own, which is a very good recognition of responsibility 
under the familiar doctrine of respondeat superior."  Id. at 
474-75.  Thus, Heimlich was resolved under the well-settled law 
No. 
99-0001 
 
 
13
of respondeat superior and did not involve the creation of a new 
doctrine for the imposition of vicarious liability.8 
¶21 As a result, Lewis has not presented a viable doctrine 
for imposing vicarious liability on Seldera under existing 
Wisconsin law.9 
III 
¶22 Alternatively, Lewis asks this court to follow the 
circuit court's lead and adopt the "captain of the ship" 
                     
8 We observe that the evidence presented could have led the 
jury to conclude that Dr. Harvey was jointly liable with Dr. 
Baird because he followed Dr. Baird's injection with another 
injection at the next visit.  Heimlich v. Harvey, 255 Wis. 471, 
472, 39 N.W.2d 394 (1949).  The expert testimony indicated that 
the injections were the cause of the defendant's injury.  Id. at 
473.  
9 Lewis cites Bailey v. Sturm, 59 Wis. 2d 87, 93 n.4, 207 
N.W.2d 653 (1973), as approving of his interpretations of 
Fehrman II, Morrill v. Komansinski, 256 Wis. 2d 417, 41 N.W.2d 
620 (1950), and Heimlich.  He reads too much into this 
collecting of cases, which does not create a new theory for 
imposing vicarious liability on an innocent party.  Furthermore, 
in brief parentheticals, we characterized Fehrman II and Morrill 
as joint liability cases and Heimlich as a case of respondeat 
superior.  Bailey 59 Wis. 2d at 93 n.4.  Thus, our cursory 
description of these three cases in Bailey is in accord with our 
in-depth discussion above. 
No. 
99-0001 
 
 
14
doctrine in order to impose vicarious liability on Seldera.10  
Similar to respondeat superior, "captain of the ship" is another 
theory that allows a party to invoke vicarious liability, but it 
has never been recognized in Wisconsin and, as the court of 
appeals 
acknowledged, 
has 
fallen 
into 
disfavor 
in 
other 
                     
10 The concurrence breezily suggests that we avoid the 
possible danger of running aground through analysis of the 
"captain of the ship" theory for imposing vicarious liability.  
Concurrence at ¶¶29-31.  We agree that other jurisdictions have 
wrestled with this theory for imposing vicarious liability, 
which now lacks a solid agency law foundation due to the demise 
of the charitable immunity doctrine.  See Majority op. at ¶¶22-
24.  Because of the difficulties presented by "captain of the 
ship", we also agree that it would be much easier, as the 
concurrence seems to propose, to ignore this outdated theory and 
engage in an unencumbered search for another theory to impose 
vicarious liability on surgeons.  Concurrence at ¶31.  However, 
as a court, we are confined to issues and arguments presented in 
the case before us.  Accordingly, it is necessary to address 
"captain of the ship" because the circuit court premised 
Seldera's liability on it and Lewis argued it before us as an 
alternative theory for imposing vicarious liability on Seldera. 
 We 
further 
agree 
with 
the 
concurrence 
that 
there 
are 
hypotheticals——with the right facts——where vicarious liability 
might perhaps be imposed through a theory of agency law such as 
respondeat superior or borrowed servant.  See Concurrence at 
¶¶33-37.  However, the present case is not such a hypothetical——
with the right facts——where vicarious liability might perhaps be 
imposed on an individual through a theory of agency law such as 
respondeat superior or borrowed servant.  This court only 
decides cases with real disputes arising from events that 
actually took place. 
No. 
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15
jurisdictions.11  Lewis, 2000 WI App 95, ¶13.  Because "captain 
of the ship," which enabled plaintiffs to recover in the face of 
a hospital's "charitable immunity," is an antiquated doctrine 
                     
11 Pennsylvania, which first raised the "captain of the 
ship" doctrine in McConnell v. Williams, 65 A.2d 243 (Pa. 1949), 
has since rejected it in Tonsic v. Wagner, 329 A.2d 497, 499-501 
(Pa. 1974), and Thomas v. Hutchinson, 275 A.2d 23, 27-28 (Pa. 
1971), because of the demise of charitable immunity.  Other 
jurisdictions declining to adopt the doctrine or abrogating it 
include:  Iowa in Tappe v. Iowa Methodist Med. Ctr., 477 N.W.2d 
396, 402-403 (Iowa 1991) (noting that "captain of the ship" is 
not in accord with modern practice and refusing to adopt it); 
New Jersey in Sesselman v. Muhlenberg Hosp., 306 A.2d 474, 476 
(N.J. Super. Ct. App. Div. 1973) (rejecting "captain of the 
ship" doctrine); North Dakota in Nelson v. Trinity Med. Ctr., 
419 N.W.2d 886, 892 (N.D. 1988) (overruled by statute on other 
grounds) (limiting "captain of the ship" to cases where the 
doctor has "direct control" over the nurses actions); Ohio in 
Baird v. Sickler, 433 N.E.2d 593, 595 (Ohio 1982) (refusing to 
"breathe[] new life into that now prostrate doctrine"); Oregon 
in May v. Broun, 492 P.2d 776, 780-81 (Or. 1972) (acknowledging 
that changes in the operating room have made it impossible for 
the surgeon to directly supervise all personnel and therefore 
concluding that "captain of the ship" is no longer viable with 
the demise of charitable immunity); Tennessee in Parker v. 
Vanderbilt Univ., 767 S.W.2d 412, 415 (Tenn. Ct. App. 1988) 
(asserting that the term "captain of the ship" is confusing and 
unnecessary); Texas in Sparger v. Worley Hosp., Inc., 547 S.W.2d 
582, 585 (Tex. 1977) (disapproving of "captain of the ship" as a 
"false special rule of agency"); and West Virginia in Thomas v. 
Raleigh Gen. Hosp., 358 S.E.2d 222, 224-25 (W. Va. 1987) 
(observing 
that 
the 
"majority 
of 
states 
which 
are 
now 
considering the captain of the ship doctrine are rejecting it" 
and rejecting the doctrine for West Virginia).  See also Stephen 
H. Price, J.D., The Sinking of the "Captain of the Ship":  
Reexamining the Vicarious Liability of an Operating Surgeon for 
the Negligence of Assisting Hospital Personnel, 10 J. Legal Med. 
323, 331-47 (1989) (reviewing the abandonment of the "captain of 
the ship" doctrine in light of a more modern view of the 
hospital as a health care provider rather than a mere "conduit 
for delivery of medical services"). 
No. 
99-0001 
 
 
16
that fails to reflect the emergence of hospitals as modern 
health care facilities, we decline to adopt it now. 
¶23 The "captain of the ship" doctrine is an outgrowth of 
the largely defunct "charitable immunity" 
doctrine, 
which 
granted immunity to most hospitals prior to 1940.12  See Kojis v. 
Doctors Hosp., 12 Wis. 2d 367, 372, 107 N.W.2d 131 (1961) 
(discarding the "charitable immunity" doctrine in Wisconsin).  
To provide some form of recovery for plaintiffs in the face of 
"charitable immunity," the "captain of the ship" doctrine 
enabled them to hold a doctor liable for the negligence of 
assisting hospital employees.  Courts reasoned that charitable 
hospitals of the late nineteenth century and early twentieth 
century lacked the financial wherewithal to survive a negligence 
action against their employees relative to the doctors who 
conducted surgery on their premises.13 
¶24 But now, as numerous commentators have observed, 
modern health care facilities are in a better position to 
protect patients against negligence from their employees and 
                     
12 Kenneth S. Abraham & Paul C. Weiler, Enterprise Medical 
Liability and the Evolution of the American Health Care System, 
108 Harv. L. Rev. 381, 385 (1994)(explaining the advent of the 
charitable immunity doctrine and heralding its demise).  
13 See 1 Barry R. Furrow et al., Health Law 379 (2d ed. 
2000) (recounting that the reasoning supporting charitable 
immunity was that "a single large judgment could destroy a 
hospital" and that "[l]iability insurance was not generally 
available to cover a hospital's risk exposure"). 
No. 
99-0001 
 
 
17
insure 
against 
the 
corresponding 
liability.14 
 
See 
id. 
(acknowledging that modern charitable hospitals "are now larger 
in size, better endowed, and on a more-sound economic basis" and 
that "[i]nsurance covering their liability is available and 
prudent management would dictate that such protection be 
purchased").  Over the last 60 years, hospitals have become 
increasingly vital facilities for the delivery of health care.  
We recognized this shift in Kashishian v. Port, 167 Wis. 2d 24, 
38-39, 481 N.W.2d 277 (1992), where we confronted the issue of 
whether a hospital could be held vicariously liable under the 
doctrine of apparent authority for the allegedly negligent acts 
of a doctor working at a hospital as an independent contractor. 
 In so doing, we observed that "[m]odern hospitals have spent 
billions of dollars marketing themselves, nurturing the image 
with the consuming public that they are full-care modern health 
facilities."  Id. at 38.  As full-care modern health facilities, 
hospitals are no longer "'mere structures where physicians 
treated and cared for their patients.'"  Id. at 42 (citations 
omitted).  We acknowledged the important role hospitals have in 
our health care system and their advent as full-care modern 
health care facilities when we stated: 
 
In essence, hospitals 
have become 
big 
business, 
competing with each other for health care dollars.  As 
the role of the modern hospital has evolved, and as 
                     
14 See Stephen H. Price, J.D., The Sinking of the "Captain 
of the Ship":  Reexamining the Vicarious Liability of an 
Operating Surgeon for the Negligence of Assisting Hospital 
Personnel, 10 J. Legal Med. 323, 343-48 (1989).  
No. 
99-0001 
 
 
18
the image of the modern hospital has evolved (much of 
it self-induced), so too has the law with respect to 
the hospital's responsibility and liability towards 
those it successfully beckons.  Hospitals not only 
employ physicians, surgeons, nurses, and other health 
care 
workers, 
they 
also 
appoint 
physicians 
and 
surgeons to their hospital staffs as independent 
contractors. 
Id. at 38-39.  We recognize the development of the modern 
hospital as a health care delivery facility and the attendant 
responsibilities this transition has entailed.  Simply put, 
"captain of the ship" has lost its vitality across the country 
as plaintiffs have been able to sustain actions against full-
care modern hospitals for the negligence of their employees.15   
 
¶25 Accordingly, we decline to resurrect the anachronistic 
"captain of the ship" doctrine or create a new theory to enable 
Lewis to impose vicarious liability on Seldera.  Lewis, under 
the current negligence law in Wisconsin, had a viable cause of 
action against Lakeland. 
 
We are 
mindful 
of 
the 
harsh 
consequence Lewis must endure because Lakeland, at the time of 
the negligent sponge count, was a county hospital and therefore 
its liability was capped at $50,000, which was insufficient to 
                     
15 We also note that the "captain of the ship" doctrine is 
at odds with the corresponding diminishment of an individual 
doctor's control of the modern operating room that is caused by 
increasing specialization and division of responsibility.  See 
Stephen H. Price, J.D., The Sinking of the "Captain of the 
Ship":  Reexamining the Vicarious Liability of an Operating 
Surgeon for the Negligence of Assisting Hospital Personnel, 10 
J. Legal Med. 323, 340-41 (1989) (discussing the operating 
surgeon's loss of control over the operating room due to the 
increase in hospitals providing essential medical services and 
increasing sophistication and specialization of both medical 
personnel and equipment, which improves patient care). 
No. 
99-0001 
 
 
19
cover his damages of $150,000.  See Wis. Stat. § 893.80(3).  
While this is a troubling deficiency, it is the result of a 
legislative policy decision, which may be supported by broader 
considerations.16  These broader considerations include providing 
full-care modern health care facilities to service citizens who 
might otherwise not have access to such a facility.17  If we 
circumvented this statute in order to impose liability on 
Seldera, we would discourage doctors from working at government-
owned hospitals because they would incur the liability of the 
hospital's assisting employees, whom they had no hand in 
selecting.  To attach this nondelegable liability to doctors 
                     
16 In Sambs v. City of Brookfield, 97 Wis. 2d 356, 377, 293 
N.W.2d 504 (1980), we commented on the need for legislative 
balancing in the context of caps on liability for municipal 
governments.  There we wrote: 
It is the legislature's function to evaluate the 
risks, the extent of exposure to liability, the need 
to compensate citizens for injury, the availability of 
and cost of insurance, and the financial condition of 
the governmental units.  It is the legislature's 
function to structure statutory provisions, which will 
protect the public interest in reimbursing the victim 
and in maintaining government services and which will 
be fair and reasonable to the victim and at the same 
time will be realistic regarding the financial burden 
to be placed on the taxpayers. 
Id. 
 
17 See 
John 
Danaher, 
M.D., 
Health 
Care 
Perform:  
Constituencies Necessary for Change, 3 Stan. L. & Pol'y Rev. 
155, 157 (1991) (recognizing that the cost of health care for 
the 
37 
million 
Americans 
who 
are 
uninsured 
is 
borne 
predominantly by county hospitals or private hospitals as 
uncompensated care or charity). 
No. 
99-0001 
 
 
20
utilizing government-owned health care facilities would create a 
disturbing dichotomy between government hospitals and private 
hospitals, which do not attach such nondelegable liability to 
doctors utilizing their facilities.18  Thereby we would induce 
doctors to practice only at private hospitals, which are liable 
for the full amount of damages a negligent employee may inflict 
upon a patient. 
¶26 Of course, patients can hold government-owned health 
care facilities liable for the negligence of their employees 
under respondeat superior, but, as noted, the legislature has 
capped that liability at $50,000 per occurrence.  In accordance 
with principles of judicial restraint, we leave it to the 
legislature to make any necessary policy adjustments.  See 
Doering v. WEA Ins. Group, 193 Wis. 2d 118, 132, 532 N.W.2d 432 
(1995) 
(acknowledging 
"that 
drawing 
lines 
and 
creating 
distinctions to establish public policy are legislative tasks"). 
Therefore, while recognizing the unfortunate result in this 
case, 
we 
must 
also 
remain 
cognizant 
of 
the 
legislative 
balancing, which weighs the costs of individual unfairness 
against the benefits of having government-owned health care 
                     
18 We take judicial notice of the fact that there are 
currently 156 general and special hospitals in Wisconsin.  
General and Special Hospitals Directory, Department of Health 
and Family Services (2001).  Excluding special psychiatric 
hospitals, currently there are only three government-owned 
facilities in Wisconsin at the present time:  Memorial Hospital 
of Lafayette County (id. at 12), Rusk County Memorial Hospital 
(id. at 26), and University of Wisconsin Hospital and Clinic 
Authority (id. at 29).  Lakeland is now a voluntary nonprofit 
corporation (id. at 14).   
No. 
99-0001 
 
 
21
facilities where doctors are willing to provide health care to 
all segments of the population.  As a result, we believe it 
would be shortsighted for this court to engage in judicial 
lawmaking so that Lewis could impose vicarious liability on 
Seldera and recover beyond the statutory maximum. 
IV 
 
¶27 In conclusion, we hold that Seldera cannot be held 
vicariously liable for the negligence of Vickery and Chapman 
under either Fehrman II or "captain of the ship." 
 
By the Court.—The decision of the court of appeals is 
affirmed. 
 
No. 99-0001.ssa 
 
1 
 
¶28 SHIRLEY S. ABRAHAMSON, CHIEF JUSTICE (concurring).  I 
agree with the mandate because this case has come to us on 
summary judgment based on stipulated facts.  I write separately 
because I am concerned that rules of law might be mistakenly 
drawn from the broad language in the majority opinion.  
¶29 First, it is a mistake for the majority opinion to 
rely on the "captain of the ship" metaphor.  This phrase has 
taken on various meanings beyond the cases that spawned it.  
¶30 The majority opinion defines the "captain of the ship" 
doctrine merely as a theory of vicarious liability that is 
"similar to respondeat superior."19  The majority opinion does 
not explain precisely what theory of liability it is rejecting 
when it rejects a "captain of the ship" doctrine.  
¶31 "Captain of the ship" cases can be analyzed as 
applying 
traditional 
agency 
concepts 
of 
the 
surgeon's 
supervision 
and 
control.20 
 
Let's 
forget 
the 
picturesque 
language, look at the facts of each case, and apply traditional 
principles of tort and agency law.21 
                     
19 See majority op. at ¶22. 
20 See, e.g., Franklin v. Gupta, 567 A.2d 524, 537 (Md. Ct. 
App. 1990) (concluding that a careful analysis of "captain of 
the ship" cases generally reveals that courts have applied 
traditional agency concepts).  
21 See Sparger v. Worley Hosp., Inc., 547 S.W.2d 582, 584 
(Tex. 1977) (quoting Justice Frankfurter writing that "A phrase 
begins life as a literary expression; its felicity leads to its 
lazy repetition; and repetition soon establishes it as a legal 
formula, 
undiscriminatingly 
used to 
express 
different and 
sometimes contradictory ideas."). 
No. 99-0001.ssa 
 
2 
¶32 Second, it is a mistake to conclude from the decision 
that a surgeon can never be held liable for the negligence of a 
hospital nurse.  This issue is not before the court.  The 
majority opinion carefully states what Lewis is and is not 
contending.  In particular, it states that Lewis is not relying 
on the "borrowed servants" doctrine.22  The majority opinion's 
conclusion that "the surgeon cannot be held vicariously liable 
for the negligence of the two hospital nurses" applies only to 
the stipulated facts and narrow issues presented in this case.23  
¶33 A surgeon can be vicariously liable for the negligence 
of hospital nurses if the nurses are under the surgeon's control 
and supervision.  Whether hospital nurses are under the 
surgeon's control and supervision would ordinarily be a question 
of fact for the fact-finder.  The stipulation is silent about 
the surgeon's supervision and control of the hospital nurses in 
the present case.  The facts of each case would determine 
whether the surgeon has exercised supervision or control over 
the hospital nurses. 
                     
22 See majority op. at ¶10. 
The court of appeals concluded that the surgeon did not 
employ as borrowed servants those hospital nurses who were 
negligent.  The majority opinion makes no similar declaration.  
If the hospital nurses were "borrowed employees" of the surgeon, 
the surgeon was vicariously liable for their negligence.  See 
Borneman v. Corwyn Transp., Ltd., 219 Wis. 2d 346, 580 N.W.2d 
253 (1998) (setting forth law of borrowed employees). 
23 See majority op. at ¶¶1, 3, 9, 10, 19. 
No. 99-0001.ssa 
 
3 
¶34 Third, it is a mistake to conclude from the decision 
that a hospital procedure or the administrative code controls 
the law of negligence or liability.  
¶35 The majority opinion appears to rely on the hospital 
procedure that the nurses have responsibility for counting and 
overseeing 
the 
count 
of 
laparotomy 
pads 
and 
on 
the 
administrative code that the circulating nurse ensures that the 
counts have been done according to hospital procedure to absolve 
the surgeon from liability.  Reference to the hospital procedure 
and administrative code may be misleading. 
¶36 Regardless 
of 
what 
hospital 
procedure 
or 
the 
administrative code says about a hospital nurse's obligations, a 
surgeon's failure to exercise supervision and control over 
hospital nurses might constitute negligence, and the nurses' 
negligence might then be imputed to the surgeon.  Under certain 
circumstances, a fact-finder might conclude that a surgeon 
should have, or did exercise, control or supervision.  Hospital 
procedure and the administrative code might constitute customary 
medical practice, but customary medical practice does not 
necessarily constitute reasonable due care in an action for 
medical malpractice.24  
                     
24 The standard of reasonable care for a physician is that 
degree of care, skill, and judgment that reasonable specialists 
would exercise in the same or similar circumstances having due 
regard for the state of medical science at the time the plaintiff 
was treated.  A doctor who fails to conform to this standard is 
negligent.  See Wis JI——Civil 1023 (1998).  Evidence of the usual 
and 
customary 
conduct 
of 
other 
physicians 
under 
similar 
circumstances is ordinarily relevant and admissible as an 
No. 99-0001.ssa 
 
4 
¶37 Furthermore, an issue raised at oral argument was 
whether the duty to put in and remove the pads was a 
nondelegable duty of the surgeon.  The concept of nondelegable 
duty is that the surgeon's duty of due care cannot be delegated 
and that the surgeon is liable for the negligence of the 
hospital nurse even though the surgeon has done everything that 
could be reasonably required of the surgeon.  If the duty is 
nondelegable, 
the 
person 
with 
the 
nondelegable 
duty 
is 
vicariously liable.25  The parties have not briefed or argued 
this theory of liability, and the majority opinion does not 
directly address this issue.  
¶38 For the reasons set forth, I write separately. 
¶39 I am authorized to state that Justice ANN WALSH 
BRADLEY joins this opinion. 
 
                                                                  
indication of what is reasonable care.  See Nowatske v. Osterloh, 
198 Wis. 2d 419, 438, 543 N.W.2d 265 (1996). 
 
25 W. Page Keeton, et al., Prosser and Keeton on the Law of 
Torts § 71, at 511-12 (5th ed. 1984).