Opinion ID: 2514015
Heading Depth: 4
Heading Rank: 1

Heading: The Jackson decision

Text: In Jackson, we held that Fairbanks Memorial Hospital (FMH) had a non-delegable duty to provide non-negligent physician care in its emergency room. [4] We concluded that the law imposed a duty on FMH to provide emergency care physicians on a twenty-four-hour basis. [5] FMH voluntarily assumed a broader duty by seeking accreditation by the Joint Committee on the Accreditation of Hospitals, whose standards mandated certain policies and procedures for FMH's emergency room. [6] FMH's bylaws also provided for maintenance and supervision of an emergency room. [7] Based upon these factors, we concluded that it cannot seriously be questioned that FMH had a duty to provide emergency room services and that part of that duty was to provide physician care in its emergency room. [8] We then decided that having assumed the duty to staff an emergency room, FMH should [not] be allowed to avoid responsibility for the care rendered therein by claiming that the physicians it provides are not its employees. [9] We suggested that the criterion for determining which duties are non-delegable is that the responsibility is so important to the community that the employer should not be permitted to transfer it to another. [10] Non-delegable duties include the duty of a carrier to transport its passengers in safety, of a railroad to fence its tracks properly or to maintain safe crossings, and of a municipality to keep its streets in repair; the duty to afford lateral support to adjoining land, to refrain from obstructing or endangering the public highway, to keep premises reasonably safe for business visitors, to provide employees with a safe place to work; the duty of a landlord to maintain common passageways, to make repairs according to covenant, or to use proper care in making them, and no doubt others. [11] We concluded that patients ... receiving treatment at a hospital emergency room are as deserving of protection as ... airline passengers, deemed a hospital's duty to provide emergency room physicians to be as important to the community as a common-carrier's duty for the safety of its passengers, and noted parallels between the regulatory schemes of airlines and hospitals. [12] We determined that the hospital regulatory scheme and the purpose underlying it (to `provide for the development, establishment, and enforcement of standards for the care and treatment of hospital patients that promote safe and adequate treatment' AS 18.20.010), coupled with the statutory definition of a hospital, (an institution devoted primarily to providing diagnosis, treatment or care to individuals, AS 18.20.130(3)), made clear the legislature's recognition that it is the hospital as an institution which bears ultimate responsibility for complying with the mandates of the law. [13] Because the hospital had to ensure compliance with the regulations, it was the hospital that had to bear final accountability for the provision of physicians for emergency room care. [14] Therefore, we held that a hospital such as FMH may not shield itself from liability by claiming that it is not responsible for the results of negligently performed health care when the law imposes a duty on the hospital to provide that health care. [15] We observed that there was no reason that liability should be based on technical employment status; regardless of how the hospital provides emergency room physicians, it will be responsible for the care rendered by physicians it has a duty to provide. [16] Finally, we emphasized the limited nature of our holding. We did not extend our holding to situations where the patient is treated by his or her own doctor in an emergency room provided for the convenience of the doctor. Such situations are beyond the scope of the duty assumed by an acute care hospital. [17] Rather, we limited our holding of vicarious hospital liability to those situations where a patient comes to the hospital, as an institution, seeking emergency room services and is treated by a physician provided by the hospital. [18]