Opinion ID: 2046507
Heading Depth: 3
Heading Rank: 3

Heading: Evolving Law in Other Jurisdictions

Text: In the area of hospital liability, there has been an ongoing movement by courts to use apparent or ostensible agency as a means by which to hold hospitals vicariously liable for the negligence of some independent contractor physicians. See, e.g., Clark v. Southview Hosp. & Family Health Ctr., 68 Ohio St.3d 435, 628 N.E.2d 46, 53 (1994) (terming it agency by estoppel); Gilbert v. Sycamore Mun. Hosp., 156 Ill.2d 511, 190 Ill.Dec. 758, 622 N.E.2d 788, 793-94 (1993). [10] Many of these cases employ the doctrine of apparent agency when the plaintiff was negligently injured by a physician's actions while visiting the hospital's emergency room. See Clark, 628 N.E.2d at 53-54; Gilbert, 190 Ill.Dec. 758, 622 N.E.2d at 791, 796. See generally Abraham, supra note 10, at 387. Courts, however, also have employed the doctrine of apparent agency to hold a hospital liable for assertedly negligent acts committed in non-emergency room settings, including negligent acts committed by anesthesiologists. See Seneris v. Haas, 45 Cal.2d 811, 291 P.2d 915, 917, 926-27 (1955) (discussing negligence of an anesthesiologist during the delivery of a baby); see also Williams v. St. Claire Med. Ctr., 657 S.W.2d 590, 592-93 (Ky.Ct.App. 1983) (discussing negligence of an independent contractor nurse anesthetist). [11] Courts that have held hospitals liable for the negligence of independent contractor physicians under apparent agency have sometimes referred to or adopted Section 267, [12] Section 429, [13] or both, [14] and sometimes have not referred to or adopted either Section 267 or Section 429. [15] While the language employed by these courts sometimes varies, generally they have employed tests which focus primarily on two basic factors. The first factor focuses on the hospital's manifestations and is sometimes described as an inquiry whether the hospital acted in a manner which would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. Kashishian, 481 N.W.2d at 284-85; Gilbert, 190 Ill.Dec. 758, 622 N.E.2d at 795-96 (quoting Pamperin v. Trinity Mem'l Hosp., 144 Wis.2d 188, 423 N.W.2d 848, 855-56 (1988)); see also Seneris, 291 P.2d at 927. Courts considering this factor often ask whether the hospital held itself out to the public as a provider of hospital care, for example, by mounting extensive advertising campaigns. See, e.g., Clark, 628 N.E.2d at 53; Gilbert, 190 Ill.Dec. 758, 622 N.E.2d at 796. In this regard, the hospital need not make express representations to the patient that the treating physician is an employee of the hospital; rather a representation also may be general and implied. See, e.g., Paintsville Hosp. Co. v. Rose, 683 S.W.2d 255, 256 (Ky.1985); Pamperin v. Trinity Mem'l Hosp., 144 Wis.2d 188, 423 N.W.2d 848, 856 (1988) (presuming that the hospital held itself out as a medical care provider unless the hospital expressly provided notice to the patient that independent contractors provide the care). The second factor focuses on the patient's reliance. It is sometimes characterized as an inquiry as to whether the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence. Kashishian, 481 N.W.2d at 285; Gilbert, 190 Ill.Dec. 758, 622 N.E.2d at 795 (quoting Pamperin, 423 N.W.2d at 855-56); see also Seneris, 291 P.2d at 927. Courts considering this factor sometimes ask whether, because of the hospital's manifestations, the plaintiff believed that the hospital was providing the pertinent medical care as opposed to simply acting as a situs for the physician to provide health care as an independent contractor. See, e.g., Clark, 628 N.E.2d at 53; Gilbert, 190 Ill.Dec. 758, 622 N.E.2d at 796; Kashishian, 481 N.W.2d at 285. Other courts, however, seem to employ a less subjective form of reliance or even to presume reliance absent any evidence that the patient knew or should have known that the physician was not an employee of the hospital and that it is the physician and not the hospital who is responsible for his medical care. See, e.g., Seneris, 291 P.2d at 927; Paintsville Hosp., 683 S.W.2d at 257-58; Williams, 657 S.W.2d at 596; Arthur v. St. Peters Hosp., 169 N.J.Super. 575, 405 A.2d 443, 447 (1979). An example of a situation where a patient might be in a position to know that the physician was an independent contractor may exist if the patient establishes an independent relationship with the physician or selects a particular physician in advance of going to the hospital. See Arthur, 405 A.2d at 447. Even in such circumstances, however, the courts have reasoned that the patient may not have had reason to know of the contractual arrangements between the physician and the hospital. See, e.g., Kashishian, 481 N.W.2d at 284. Central to both of these factorsthat is, the hospital's manifestations and the patient's relianceis the question of whether the hospital provided notice to the patient that the treating physician was an independent contractor and not an employee of the hospital. See, e.g., Seneris, 291 P.2d at 927; Gilbert, 190 Ill.Dec. 758, 622 N.E.2d at 796; Clark, 628 N.E.2d at 53; Pamperin, 423 N.W.2d at 856-57; Kashishian, 481 N.W.2d at 286.