Opinion ID: 894688
Heading Depth: 1
Heading Rank: 1

Heading: Medical Malpractice versus Ordinary Negligence

Text: In a health care setting, the line between medical malpractice and ordinary negligence is easily blurred. As many courts have observed, the distinction between medical malpractice and negligence is a subtle one, for medical malpractice is but a species of negligence and `no rigid analytical line separates the two.' Weiner v. Lenox Hill Hosp., 88 N.Y.2d 784, 650 N.Y.S.2d 629, 673 N.E.2d 914, 916 (1996) (citation omitted), quoted in Gunter v. Lab. Corp. of America, 121 S.W.3d 636, 639 (Tenn.2003). Thus, determining the appropriate standard of care to apply to a patient's claim against a health care provider is seldom an easy task. See Gold v. Greenwich Hosp. Ass'n, 262 Conn. 248, 811 A.2d 1266, 1270 (2002). In this case, the Court parses medical malpractice from ordinary negligence in a claim involving the alleged sexual assault of a nursing home patient. See at 853. Based on this analysis, the Court concludes that all of Rubio's claims are health care liability claims under the MLIIA. Id. at 853. But every Texas court of appeals to consider the issue has held otherwise. In addition to the court of appeals in the present case, three other courts have determined that the MLIIA does not apply to claims arising out of a patient's assault of another patient because such claims were not based on medical or health care services. See Healthcare Ctrs. of Tex., Inc. v. Rigby, 97 S.W.3d 610, 621-22 (Tex. App.-Houston [14th Dist.] 2002, pet. denied); Zuniga v. Healthcare San Antonio, 94 S.W.3d 778, 782-83 (Tex.App.-San Antonio 2002, no pet.); Bush v. Green Oaks Operator, Inc., 39 S.W.3d 669, 673 (Tex. App.-Dallas 2001, no pet.). In Rigby, the court held that a claim against a nursing home arising out of a patient's assault of another patient was not a health care liability claim. 97 S.W.3d at 622. In that case, a male nursing home resident, who had a known history of sexually violent behavior, attempted to sexually assault a female resident. Id. at 614-17. The court concluded that the claim involved simple negligence in failing to take adequate safety measures to protect [the nursing home] residents from a known sexual deviant. Id. at 622; see also id. at 628 (Brister, C.J., concurring). Likewise, the Zuniga court held that the MLIIA did not apply to a claim involving a psychiatric hospital patient's allegations that she was sexually assaulted by another patient. 94 S.W.3d at 780, 783. The plaintiff in that case alleged that the hospital was negligent in failing to: protect her from abuse, take [sic] reasonable efforts to prevent actions by another person that resulted in physical injury, make reasonable efforts to prevent sexual contact, and provide her a safe environment. Id. at 782. The hospital argued that Zuniga's claims asserted, in essence, a failure to provide a therapeutic environment that would keep Zuniga safe from herself and others. Id. The court rejected the hospital's argument noting: While we agree that preventing a patient from harming herself or others is part of the treatment provided to an involuntarily committed psychiatric patient, the allegation of injury here was not Zuniga's harm to herself or to others. Instead, the allegation is another patient's assault of her while on [the hospital's] premises. Id. Finally, in Bush, the court held that a patient's claim against a hospital arising from an alleged attack by a fellow patient with a known propensity for violent behavior was not a health care liability claim under the MLIIA. 39 S.W.3d at 670, 672. Bush, the plaintiff patient, claimed that the hospital was negligent either in failing to warn her of the known danger or in failing to maintain the premises in a safe manner or both. Id. at 670-71. The hospital argued that Bush's claim was fundamentally a claim for negligent diagnosis and lack of proper treatment with respect to her assailant and thus was subject to the MLIIA. Id. at 672. The court disagreed, noting: Although [the hospital's] alleged failure to provide Bush with a reasonably safe environment may ultimately involve a determination of whether the hospital breached a standard of care with respect to [the assailant], Bush's claim, as pleaded, is not for negligence in her medical treatment. Id. Indeed, many courts analyzing similar claims under comparable statutes have held that claims involving inpatient assault sound in ordinary negligence rather than medical malpractice. See, e.g., Andrea N. v. Laurelwood Convalescent Hosp., 13 Cal. App.4th 1492, 18 Cal.App.4th 1698, 16 Cal. Rptr.2d 894, 903 (Cal.Ct.App.1993), review granted, 19 Cal.Rptr.2d 519, 851 P.2d 801, 802 (Cal.1993), and review dismissed, 27 Cal.Rptr.2d 1, 865 P.2d 632 (Cal.1994); Lauria v. West Rock Health, Inc., No. CV03082278, 2004 WL 201939, at  (Conn.Super.Ct. Jan.13, 2004); Delaney v. Newington Children's Hosp., No. CV-93-0524063, 1994 WL 228322, at -3 (Conn.Super.Ct. May 9, 1994); Robinson v. West Fla. Reg'l Med. Ctr., 675 So.2d 226, 228 (Fla.Dist.Ct.App.1996); Hicks v. Baptist Hosp., Inc., 676 So.2d 1019, 1019 (Fla. Dist.Ct.App.1996); Palm Springs Gen. Hosp., Inc. v. Perez, 661 So.2d 1222, 1223 (Fla.Dist.Ct.App.1995); Klingman v. Green, 616 So.2d 762, 763-64 (La.Ct.App. 1993); Reaux v. Our Lady of Lourdes Hosp., 492 So.2d 233, 234-35 (La.Ct.App. 1986); Afamefune v. Suburban Hosp., Inc., 385 Md. 677, 870 A.2d 592, 602-03 (2005); Borrillo v. Beekman Downtown Hosp., 146 A.D.2d 734, 537 N.Y.S.2d 219, 220-21 (N.Y.App.Div.1989); Sumblin v. Craven County Hosp. Corp., 86 N.C.App. 358, 357 S.E.2d 376, 377-79 (1987); Burns v. Forsyth County Hosp. Auth., Inc., 81 N.C.App. 556, 344 S.E.2d 839, 846 (1986). But see Dorris v. Detroit Osteopathic Hosp. Corp., 460 Mich. 26, 594 N.W.2d 455, 466-67 (1999); Smith v. Four Corners Mental Health Ctr., Inc., 70 P.3d 904, 914 (Utah 2003).