Opinion ID: 1974424
Heading Depth: 1
Heading Rank: 2

Heading: corporate negligence

Text: Count 2 of plaintiff's complaint alleges a theory of corporate negligence against the hospital. The doctrine of corporate negligence imposes liability upon a hospital that has failed to exercise reasonable care in selecting or renewing the staff privileges of an unfit physician. Corporate negligence differs from the vicarious nature of respondeat superior in that it imposes on the hospital a nondelegable duty owed directly to the patient that is independent of the doctor-hospital relationship. Although this court has not yet addressed the doctrine of corporate negligence, we have previously recognized an analogous cause of action known as negligent hiring. In Welsh Manufacturing, Division of Textron, Inc., supra, we ruled that a security-guard company could be held liable for the failure to exercise reasonable care in hiring one of its security guards. In so holding, the Welsh court stated that our reasoning that the employer may be directly liable for wrongful acts of its negligently hired employee comports with the general torts principles of negligence long espoused by this court. 474 A.2d at 440. The court reasoned that [l]iability of the employer is premised on its failure to exercise reasonable care in selecting a person who the employer knew or should have known was unfit or incompetent for the employment, thereby exposing third parties to an unreasonable risk of harm. Id. Because the corporate-negligence doctrine mirrors this reasoning, we deem it a natural progression to extend the negligent-hiring doctrine to the hospital setting. Accordingly we adopt the doctrine of corporate negligence as a theory of hospital liability in this jurisdiction. We now turn to an examination of the procedures utilized by the hospital in renewing the staff privileges of Dr. Issenberg. According to Dr. Robert Hopkins, the individual primarily responsible for reviewing the privileges of staff physicians, each physician seeking reappointment in 1984 had to fill out an application for the renewal of staff privileges. The application solicited such information as whether any changes had occurred in the physical and mental health of the applicant, whether any adverse claims had been brought against the applicant, and whether the applicant's privileges had been reduced at other medical institutions. Doctor Hopkins reviewed Dr. Issenberg's application with Dr. Mendel Robinson, director of the hospital's otolaryngology department. After discussing Dr. Issenberg's application and qualifications, Dr. Hopkins and Dr. Robinson agreed to renew Dr. Issenberg's staff privileges. Following standard procedure, Dr. Hopkins mailed a letter to Dr. Issenberg notifying him of his staff privileges for the years July 1, 1984, through June 30, 1986. The letter listed twelve privileges accorded to Dr. Issenberg, one of which was the right to perform tracheotomies. [1] The letter also provided that [i]f there are any additions or corrections in this list, please feel free to call upon [Dr. Hopkins] at any time. Dr. Issenberg accepted the delineated privileges by signing the following acknowledgment: I understand and accept the above to be my privileges as a member of The Miriam Hospital Active Staff, in the Department of Surgery, from July 1, 1984, through June 30, 1986. Both Dr. Hopkins and Dr. Robinson testified that, other than the renewal-of-privileges application, they made no attempt to further investigate Dr. Issenberg's clinical activities. They admitted that the hospital's process of reappointing staff physicians revolved primarily around the honor system, wherein the applicants were expected to notify the hospital if they were no longer performing any of the listed procedures. The plaintiff asserts that the reappointment procedure utilized by the hospital in 1984 did not conform with the standards delineated by the hospital bylaws. The relevant portion of the hospital's bylaws provides that Biennial re-appointment shall follow an appraisal of clinical activity, professional performance an[d] a re-assessment of the extent of clinical privileges to be granted. Bylaws of the Miriam Hospital Staff Association, art. I, B, sec. 2(e). The plaintiff avers that an in-depth appraisal of Dr. Issenberg's clinical activities would have revealed that Dr. Issenberg had not performed a tracheostomy in recent years. Armed with this information, plaintiff claims that the hospital could have reasonably inferred that Dr. Issenberg might be incapable of or might refuse to perform a tracheostomy. The plaintiff contends that, in viewing the evidence in the light most favorable to her, reasonable minds could conclude that the hospital was negligent in renewing Dr. Issenberg's staff privileges based solely on the honor system. We disagree. It is important to point out that before a hospital can be held liable under the theory of corporate negligence, it is necessary to show that the hospital had actual or constructive knowledge of the defect    which created the harm. Thompson v. Nason Hospital, 527 Pa. 330, 341, 591 A.2d 703, 708 (1991); see Fridena v. Evans, 127 Ariz. 516, 519, 622 P.2d 463, 466 (1980). A hospital will be charged with constructive knowledge of any facts that it would have acquired if it had exercised the requisite care in renewing a physician's staff privileges. Thus, in the case at hand, plaintiff must show that the hospital would have discovered Dr. Issenberg's reluctance or inability to perform tracheostomies if it had performed the recommended and customary investigation into his previous clinical activities. Our review of the trial record leads us to conclude that plaintiff has not met this burden. The plaintiff has failed to produce any evidence indicating that a further probe into Dr. Issenberg's clinical activities would have dissuaded the hospital from renewing his staff privileges. Even if Dr. Hopkins and Dr. Robinson had explored all available information regarding Dr. Issenberg's activities at the hospital and his activities at Roger Williams General Hospital, where he was chief of otolaryngology, there is nothing that would have put them on notice that Dr. Issenberg might refuse to perform a tracheostomy. There had been no complaints or adverse actions taken against Dr. Issenberg, nor had he refused to perform such a procedure in the past. We disagree with the plaintiff's assertion that, because Dr. Issenberg had not performed a tracheostomy in many years, Dr. Hopkins and Dr. Robinson could have reasonably inferred that Dr. Issenberg might be incapable of performing, or might refuse to perform, a tracheostomy. We find such an inference to be unreasonable. Physicians are trained to do a variety of procedures that they are not called upon to perform on a regular basis. Simply because a physician has not performed a particular procedure within a certain, unspecified period does not support an inference that the physician is incapable of performing, or might refuse to perform, the procedure when requested. Accordingly we are of the opinion that information of Dr. Issenberg's lack of tracheostomy activity would not have adversely influenced the hospital's decision to renew Dr. Issenberg's staff privileges. For all the above-stated reasons we affirm the trial justice's granting of the defendant's motion for a directed verdict. The plaintiff's appeal is hereby denied and dismissed, and the papers in the case are remanded to the Superior Court.