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Saturday, May 4, 2024

Hospital liable for malpractice by 'apparent agent' in $6.1 million case

State Supreme Court
Surgery

ANNAPOLIS, Md. (Legal Newsline) - Maryland’s highest court expanded the liability of hospitals by ruling a patient treated by a doctor working as an independent contractor in the emergency room was entitled to a $6.1 million jury verdict against the hospital as well under the theory the physician was an “apparent agent” of the facility.

Tort law usually shields defendants against liability for actions by independent contractors, but in Maryland the doctrine of apparent agency allows plaintiffs to prove they thought the contractor was an actual employee. 

In this case, Terence Williams was injured in a car crash in 2014 and brought to a hospital owned by Dimensions Health Corp. Emergency medical personnel took him to Dimensions because it was the nearest Level 2 trauma center. He was treated by several physicians including surgeon Dr. Montague Blundon.

The doctors tried to save Williams’ legs but several days later, they had to be amputated above the knees. Williams sued Dr. Blundon and the hospital for malpractice. A jury awarded Williams $6.1 million from Dr. Blundon and the hospital.

The hospital requested a judgment notwithstanding the verdict, arguing there wasn’t any evidence Williams thought Dr. Blundon was a hospital employee and thus an apparent agent of Dimensions. The trial court agreed, as did an appeals court. 

Maryland’s Court of Appeals disagreed, reversing the decision in a July 28 opinion. 

“A court may not overturn a jury verdict if there is sufficient evidence, however slight and viewed in the light most favorable to the prevailing party, to support the verdict,” the state’s highest court ruled. “In this case, there was ample evidence introduced at trial that, if credited by the jury, supported the jury’s finding that the surgeon was the apparent agent of the hospital.”

The doctrine of apparent agency prevents defendants from gaining the advantages of using independent contractors but then shielding themselves from liability when it is convenient, the court said. A 1977 decision by the Court of Appeals, Mehlman v. Powell, was one of the earliest nationwide to hold a hospital liable for the actions of independent contractor physicians. 

The hospital argued there was no evidence Williams would have made any choice about being treated by Dr. Blundon based on his employment status, so no reasonable jury could have concluded otherwise. The court disagreed, saying patients who arrive in the emergency room have “no time to either choose among individual physicians or make fine distinctions on their precise contractual relationship with the facility.”

Williams appeared to mark with an "x" a consent form explaining the doctor was not a hospital employee, although Wiliams testified he never saw it. The consent form was unclear, the court went on, and a lay reader would be unlikely to understand it as a disclaimer of responsibility. 

In dissent, Judge Joseph Getty said that with this decision the court changed the definition of apparent agency to include people “acting in the patient’s interest” who believe the doctors are hospital employees. The new standard is one step short of strict liability, he wrote, making hospitals liable for anything that happens within their four walls. 

”No other Maryland entity, such as businesses, schools, and religious organizations, is subject to this approach to apparent agency liability,” the judge wrote, joined in dissent by Jonathan Biran.

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