The Court of Appeal, Fourth Appellate District, Division One, State of California (“California Appellate Court”) held in its unpublished opinion filed on April 15, 2019 “the Hospital could not be vicariously liable for any negligence by the on-call physicians because the physicians were independent contractors and not the Hospital’s employees or ostensible agents.”
The California Appellate Court determined that “the Hospital provided evidence showing Mother had reason to know the on-call physicians were not the Hospital’s employees or agents, and Minor and his parents did not provide countervailing evidence sufficient to raise a triable issue of material fact on this point. We further conclude Minor and his parents cannot establish the physicians were the Hospital’s employees, rather than independent contractors … Finally, we conclude Minor and his parents have forfeited any contention the physicians were the Hospital’s employees under any other potentially applicable test for distinguishing between employees and independent contractors.”
The Underlying Facts
During her pregnancy, Mother visited the Hospital on multiple occasions for prenatal stress testing. On at least nine occasions, she signed a “Conditions of Admission” form. The second paragraph on the first page of the form was headed with boldface, capital letters stating, “PHYSICIANS ARE INDEPENDENT MEDICAL PRACTITIONERS.” The paragraph itself, which Mother initialed, stated, “All physicians and surgeons providing services to me, including the radiologist, pathologist, emergency physician, anesthesiologist and others, are not employees or agents of the
hospital. They have been granted the privilege of using the hospital for the care and treatment of their patients, but they are not employees or agents of the hospital.” At the end of the form, above Mother’s signature, was a statement certifying Mother had read and received a copy of the form.
After Mother went into labor, she went to the Hospital’s labor and delivery ward, where she was registered and placed in a room. She signed and initialed another “Conditions of Admission” form with advisements identical to those described above. Because of a shift change, two on-call physicians handled Mother’s care during the labor and delivery process. One on-call physician admitted Mother to the Hospital and then transferred Mother’s care to another on-call physician, who delivered Minor. The on-call physician who admitted Mother was an employee of the women’s specialty medical group. The on-call physician who delivered Minor was one of the medical group’s members or partners.
A hospital is liable to a patient for a physician’s malpractice if the hospital employs the physician or the physician is the hospital’s ostensible agent. A physician is the ostensible agent of a hospital if the hospital intentionally or negligently causes the patient to believe the physician is the hospital’s agent. (Civ. Code, § 2300.) Accordingly, to hold a hospital liable for a physician’s negligence under an ostensible agency theory, (1) the hospital must have engaged in conduct that would cause a reasonable person to believe the physician was the hospital’s agent, and (2) the patient must have relied on the apparent agency relationship.
The first element of ostensible agency is met if the hospital holds itself out to the public as the provider of care, unless the hospital gave the patient contrary notice under circumstances in which the patient could be expected to understand and act upon the information. The second element is met if the patient looks to the hospital for services rather than to an individual physician.
The California Appellate Court stated that in the case it was deciding, the Hospital presented evidence Mother had reason to know the on-call physicians who treated her at the Hospital were not the Hospital’s employees because it gave her actual notice of this fact. Specifically, the Hospital provided Mother with and she signed and initialed multiple “Conditions of Admission” forms unequivocally advising her all physicians providing services to her at the Hospital were independent medical providers and none were employees or agents of the Hospital. As to the two on-call physicians who attended her during her labor and delivery, this evidence was bolstered by the women’s specialty medical group’s “Medical Release Form,” which Mother signed, showing the on-call physicians were affiliated with the group. Furthermore, Mother did not provide any evidence suggesting she received and signed the “Conditions of Admission” forms under circumstances in which she could not be expected to understand or act upon the information in them.
The California Appellate Court held: “we conclude Minor and his parents have not established the court erred in granting summary judgment for the Hospital.”
Source M.O. v. Palomar Health, D074410.
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