Apparent Authority In Baltimore Hospitals

Apparent authority is the power of an agent to act on the behalf of a principal. When an agent acts based on apparent authority, there may not need to be any express grant of authority, as long as the agent is acting within the scope of apparent authority. However, the principal generally has to do something that gives the third party reason to believe the agent is acting on the principal’s behalf. 

What is Apparent Authority in a Baltimore Hospital and Why is it Important for a Malpractice Case?

Apparent authority, sometimes called ostensible agency, may come up in Baltimore medical malpractice cases. Many doctors and surgeons working in a hospital are independent contractors. They may not be employed by the hospital but many patients may not be aware of the difference in employment status. If a doctor makes a mistake, causing an injury to a patient, the patient may think the hospital is also responsible as the employer. 

However, a company is generally not liable for the negligent actions of independent contractors. The patient may not know the difference when they were treated by a medical professional in a hospital setting, which healthcare providers were employees of the hospital and which were independent contractors. Under apparent authority, a hospital may be liable for the actions of a 3rd party agent if a reasonable person would believe the doctor was employed by the hospital.  

In order to make a claim under apparent agency in Maryland, the plaintiff generally needs to prove 3 elements:

1. Did the apparent principal create, or acquiesce in, the appearance that an agency relationship existed? 
2. Did the plaintiff believe that an agency relationship existed and rely on that belief in seeking the services of the apparent agent? 
3. Were the plaintiff’s belief and reliance reasonable?¹

If the hospital created an appearance that the doctor was an employee; the plaintiff believed the doctor was an employee of the hospital and relied on that belief in seeking services; and the plaintiff’s beliefs were reasonable, then the hospital may be liable for the doctor’s actions as if they were an employee even if the doctor was an independent contractor. 

Example of Apparent Authority and Medical Negligence

For example, a patient goes to the emergency room at the St. Jude Baltimore Hospital. The patient was prescribed medication and picked it up at the pharmacy inside the St. Jude Baltimore Hospital. The patient noticed no signs indicating the pharmacy was not part of the hospital. The patient was injured because the pharmacist put the wrong pills in the prescription bottle causing an injury. 

The patient files a malpractice claim against the pharmacist and St. Jude Baltimore Hospital. The hospital says the pharmacy is actually operated by another company that rents space inside the hospital. However, if there was nothing to indicate to a patient that the pharmacy was a separate company, the patient believed the pharmacy was part of the hospital organization, and the belief that the pharmacy was part of the hospital was reasonable, the hospital might have been liable for the actions of the pharmacist.

Doctors and Surgeons in a Hospital

Doctors and surgeons can be an employee of the hospital or a 3rd party independent contractor, or an employee of another company. It is not always easy for patients to tell if the doctor is an employee of the hospital or not. In many cases, patients assume any doctor practicing inside a hospital is an employee. 

There are a number of doctors and surgeons and medical specialties operating in a hospital setting. The issue of apparent authority may come up after any of the independent contractors engage in medical malpractice for the following medical specialties: 

Anesthesiologist

Anesthesiologists are doctors who administer sedation and anesthesia to prevent pain and discomfort in patients undergoing invasive medical procedures. Serious complications involving anesthesia include nerve damage, epidural abscess, blood clots, heart attacks, brain damage from lack of oxygen, and death.

Anesthesiologists work in a variety of settings, including hospitals and other medical centers. Anesthesiologists may be employed by the hospital or medical center, or work as an independent contractor.

Cardiologist

Cardiologists are doctors that specialize in diagnosing, treating, and preventing conditions of the cardiovascular system including the heart and the body’s blood vessels. Cardiologists typically work in group or private practices that work through hospitals. Some cardiologists work directly for hospitals. 

Diagnosis errors were the most common malpractice claim against cardiologists, including failure to diagnose myocardial infarction (heart attack). Other claims involve improper treatment, improper management of treatment, and improper medication management. 

Colorectal Surgeon

A colorectal surgeon, sometimes called a proctologist, is a doctor that treats diseases of the intestinal tract, colon, rectum, and anal canal. Colorectal surgeons typically work in hospitals or surgical centers, either in private practices or directly for the health care centers. 

Some of the most common malpractice cases against colorectal surgeons include failure to recognize a complication in a timely manner and causing damage to surrounding tissue during a procedure.

Dermatologist

A dermatologist is a doctor who is trained to evaluate and treat both children and adults with disorders that may be either benign or malignant. Most dermatologists work in individual or group practice clinics. However, some dermatologists may be employed by a hospital medical group.  

Emergency Room Physician

Emergency room doctors are often the frontline for medical treatment in Baltimore. ER doctors provide emergency care to patients in acute and urgent care situations. ER doctors handle a wide array of medical conditions, from trauma due to serious car accidents to heart attacks. 

Most emergency rooms in Baltimore are connected to a larger hospital. However, in a confusing way, the ER may actually be operated by a 3rd party company or group of doctors not directly employed by the hospital. 

Endocrinologist

Endocrinologists are doctors who specialize in treating disorders of the glandular system including the pituitary, thyroid, adrenal, ovaries, testes, and pancreas. Most endocrinologists work in private or group practices. Endocrinologists can also work directly in hospitals or other health care facilities. Failure to diagnose or delayed diagnosis of a thyroid disorder or diabetes can have serious consequences.

Fertility Specialist

Fertility specialists, sometimes known as reproductive specialists or as specific doctors such as reproductive endocrinologists, are doctors who treat infertility in men and women and help couples conceive. Fertility specialists work in a variety of settings, including private and group practices, fertility clinics, and hospitals.

Gastroenterologist

Gastroenterologists, or GI doctors, are doctors who treat conditions of the digestive tract, also called the gastrointestinal (GI) tract. Gastroenterologists usually work out of private or group medical offices in outpatient settings. 

General and Family Practitioners

General and family practitioners provide the front lines of medical care for most patients. An important role of general and family practitioners is to know when a patient’s condition requires expertise beyond what they can offer, and these doctors refer their patients to specialists who can provide the specific care necessary.

General Surgeon

General surgeons are doctors who specialize in surgical operations for a variety of medical conditions. General surgeons can also specialize and work in specific fields of surgery, oncology, pediatrics, or plastic surgery. General surgeons can work directly for hospitals or for single or group private practices that work through a hospital.

Hepatologist

Hepatologists are doctors that treat diseases and conditions of the liver and diseases of other gastrointestinal organs related to the liver like the gallbladder, pancreas, and bile ducts. Hepatologists may work in private or group practices associated with hospitals, or may work directly for hospitals.

Hematologist

A hematologist is a doctor who specializes in the study of blood, blood-forming organs, and blood diseases. Hematologists can work in a variety of settings including private clinics, hospitals, or labs.

Hospitalist

Hospitalists are doctors who are stationed in the hospital and focus on the care of hospitalized patients. Most hospitalists are employed directly by the hospitals where they work. There are many types of physicians that can serve as hospitalists, including those who specialize in specific areas of medicine such as internal medicine or pediatrics. 

Internal Medicine Doctor

An internist, or doctor of internal medicine, is a doctor who treats diseases, infections, and other internal medical conditions and disorders. Internal medicine doctors can work out of hospitals, private practices, and nursing homes.

Intensive Care Specialist

Intensive care specialists, also known as critical care specialists or intensivists, are doctors who treat patients with a variety of critical and life-threatening conditions. Critical care doctors or intensivists usually work in hospitals in emergency departments, in intensive care units, or in general surgical units.

Medical Oncologist

Medical oncologists are doctors that specialize in the diagnosis and non-surgical treatment of cancers. Medical oncologists may work in a variety of different settings including hospitals, cancer centers, or other medical and healthcare networks.

Neonatologist

Neonatologists are specialty pediatricians that care for newborn babies, particularly for newborns that are premature, underweight, or face another complex condition. Neonatologists often work in the Neonatal Intensive Care Units (NICU) of hospitals.

Nephrologist

Nephrologists are doctors that specialize in treating pediatric and adult diseases and conditions of the kidneys. Nephrologists usually work in private practice settings that may be connected to hospitals.

Neurologist

Neurologists are specialty doctors that diagnose and treat conditions of the nervous system, including the brain, spinal cord, and the peripheral nervous system. Neurologists work in hospitals, clinics, and universities.

Neurosurgeon

Neurosurgeons are doctors that diagnose and treat conditions of the nervous system, spine, and brain. Many neurosurgeons work in private practices that are often affiliated with academic facilities. 

OB/GYN

An OB/GYN, or an obstetrician and gynecologist, is a doctor that specializes in the care for women’s reproductive health and pregnancy along with many other conditions that affect women. OB/GYN doctors work in a variety of settings including private and group practices, hospitals, and clinics.

Orthopedic Surgeon

Orthopedic surgeons are doctors that specialize in treating conditions of the musculoskeletal system, including the bones, joints, muscles, ligaments, tendons, nerves, and skin. Orthopedic surgeons usually work in hospitals, outpatient surgical centers, private or group practices. 

Otolaryngologists / ENT

Otolaryngologists are doctors that treat conditions in the ears, nose, and throat along with conditions in the head and neck, also referred to as ENT (ears, nose, throat) doctors. Most otolaryngologists work out of private practices or hospital-based offices.

Palliative Care Specialist

Palliative care specialists focus on relieving the symptoms of patients with serious or terminal illnesses. Most pathologists work in large or small hospitals, with others working in rehab facilities, hospice care, or private practice. 

Pathologists

Pathologists are doctors who study the tissue and fluids of the body to help diagnose disease. Pathologists usually work out of laboratories either through private or group practices or directly for health care organizations.

Pediatrician

Pediatricians are doctors who provide general preventative health and medical care to infants, children, and teens. Pediatricians generally work out of medical offices and private practices, but may also work in hospitals

Pharmacist

Pharmacists are health care specialists responsible for preparing and dispensing medications to patients. Pharmacists work in a variety of settings including hospitals and a variety of health care facilities, in community pharmacies, and in pharmaceutical companies.

Pulmonologist

Pulmonologists are doctors that specialize in the diagnosis and treating of respiratory conditions including cancer, asthma, pneumonia, and bronchitis. Pulmonologists work in a variety of settings where patients need them including doctor’s offices in private or group practices, hospitals, and emergency rooms.

Radiologist

Radiologists are doctors that specialize in obtaining and assessing medical images to diagnose and treat health conditions. Radiologists use imaging technologies like x-rays, CT scans, MRIs, and ultrasounds. Many radiologists work out of hospitals and outpatient diagnostic centers. However, radiologists may also work in telemedicine and review images from patients around the world.

Surgical Oncologist

Surgical oncologists are doctors that specialize in the surgical treatment of cancers and other malignant diseases. Surgical oncologists often work in hospitals or cancer clinics to treat patients.

Urologist

Urologists are doctors who treat diseases of the male and female urinary tract and of the male reproductive organs. Urologists work in both private and group practice settings.

Additional Healthcare Provider Employees in a Hospital Setting

There are a number of other healthcare and service employees in a hospital setting that participate in patient care. In most cases, these people are employed by the hospital and are less often 3rd party independent contractors. When these individuals make a mistake that causes an injury, the hospital may also be liable under vicarious liability. Under vicarious liability, the plaintiff generally only has to show the employee was negligent and the employee was acting in the scope of their employment at the time of the accident. 

Some of the skilled healthcare workers that are not doctors or surgeons include:

• Nurse Anesthetist
• Nurse Practitioner
• Registered Nurse (RN)
• Nuclear Medicine Technologist
• Physician Assistants (PAs)
• X-ray Technician
• Radiation Therapist 
• MRI Technician

Each of these workers has a scope of care they can provide. Some providers, including Physician Assistants (PAs) and Nurse Practitioners (NPs), may be able to do things like prescribe medication or diagnose conditions. Other providers may need to be under the supervision of doctors, supervisors, or other healthcare providers. 

All healthcare providers have a limited scope of practice that is supposed to frame what the provider can and cannot do with regards to patient care. Going outside the scope of practices or violating the duty of care that causes a patient injury could be negligence and the injury victim may have a cause of action for damages. If the healthcare provider is an employee of the hospital, the hospital may be vicariously liable to the injury victim for damages. 

Baltimore Hospitals

There are a number of Baltimore-area hospitals that may be involved in medical malpractice, causing injury or death for patients because of improper care. Some of the major Baltimore hospitals include: 

Grace Medical Center (formerly Bon Secours Hospital)

2000 West Baltimore St
Baltimore, MD 21223
410-362-3000

Formerly Bon Secours Hospital Baltimore, LifeBridge Health has taken over as Grace Medical Center, a 69-bed facility. Services include behavioral health; emergency services; mammograms; obstetrics and gynecology; pharmacy; physical therapy; primary care; radiology and imaging; renal dialysis; specialty care; surgical services; vascular; and wound care.

Good Samaritan Hospital of Maryland

5601 Loch Raven Blvd
Baltimore, MD 21239
443-444-8000

Part of Medstar Health, the 246-bed facility features a burn reconstruction center, cancer center, emergency services, general surgery and medicine, heart care, neurology and neurosurgery, orthopedics, plastic surgery, rehabilitative services, urology, thoracic surgery, vascular care, women’s health, and wound care.

Harbor Hospital

3001 South Hanover St
Baltimore, MD 21225
410-350-3200

Part of Medstar Health, Harbor Hospital is a 164-bed facility with services including arthritis and osteoporosis center, cancer center, cardiology, diabetes, emergency room, intensive care unit, pediatrics, pharmacy, women’s health unit, and an orthopedic center for treatment of sports injuries, the back, spine, and arthritis.

Johns Hopkins Bayview Medical Center

4940 Eastern Ave
Baltimore, MD 21224
410-550-5000

The Johns Hopkins Bayview Medical Center is a 527-bed facility, with services including emergency care, primary care, audiology, bariatric surgery, cancer services, cardiology, clinical nutrition, dermatology, endocrinology, neurology and neurosurgery, orthopedics, head and neck surgery, and plastic surgery. It also features a breast center, burn center, and vascular lab. 

Johns Hopkins Hospital

1800 Orleans St
Baltimore, MD 21287
410-955-5000

Johns Hopkins is the largest hospital in Baltimore and one of the most well-known hospitals in the country. The 1192 bed facility offers a number of medical and surgical services, including emergency care, children’s care, pharmacy, audiology, breast center, cancer services, cardiology, diabetes, endocrinology, gastroenterology, OB/GYN, imaging and radiology, infections diseases, neonatology, neurology, ophthalmology, orthopedic surgery, otolaryngology, plastic surgery, psychiatry, rehabilitation, rheumatology, sleep medicine, surgery, urology, and vein center. 

Kennedy Krieger Institute

707 North Broadway
Baltimore, MD 21205
443-923-9200

The Kennedy Krieger Institute is a 70-bed facility specializing in child medical care, including care for children with developmental disabilities and special needs, including autism, brain injury, cerebral palsy, Down’s syndrome, feeding disorders, learning disorders, muscular dystrophy, spina bifida, and Sturge-Weber Syndrome.  

Levindale Hebrew Geriatric Center & Hospital

2434 West Belvedere Ave
Baltimore, MD 21215
410-601-2400

This center is a 330-bed facility with an emphasis on quality of life for patients, with services including cardiology, dentistry, ENT, geriatric medicine, internal medicine, ophthalmology, podiatry, psychiatry, pulmonology, and radiology. 

Mercy Medical Center

345 St Paul Place
Baltimore, MD 21202
410-332-9000

Mercy Medical Center is a 229-bed facility focused on short-term acute care. The facility offers a number of services including bone/joint/orthopedic, cancer center, GI/digestive tract center, women’s health, surgery, and emergency care. 

Mt. Washington Pediatric Hospital

1708 West Rogers Ave
Baltimore, MD 21209
410-578-8600

Mt. Washington Pediatric Hospital is a 102-bed children’s hospital. Services include autism spectrum center, balance clinic, behavioral health, complex care, concussion, dermatology, developmental evaluation, diabetes, endocrinology, feeding disorder program, gastroenterology, infant specialty care, lead treatment, learning assessment, neurodevelopmental care, nutrition, nutritional rehabilitation, orthopedic care, outpatient health services, pulmonary care, rehabilitation, sleep center, and videofluoroscopy. 

St. Agnes Hospital

900 Caton Ave
Baltimore, MD 21229
410-368-6000

Part of Ascension Maryland, St. Agnes Hospital is a 296-bed facility with services including a cancer institute, orthopedic and spine institute, cardiovascular institute, metabolic instituted, plastic surgery and reconstructive surgery center, and emergency care. 

Sinai Hospital of Baltimore

2401 West Belvedere Ave
Baltimore, MD 21215
410-601-9000

Part of LifeBridge Health, Sinai Hospital of Baltimore is a 483-bed facility and a teaching hospital for more than 140 residents and 400 medical students. Medical services include anesthesia, dialysis access center, emergency medicine, allergy and immunology, cardiology, anticoagulation clinic, cancer/medical oncology, dermatology, endocrinology and metabolism, family medicine, gastroenterology, general internal medicine, geriatric medicine, hematology/medical oncology, infectious diseases, nephrology, pulmonary and critical care medicine, rheumatology, neurology, neurosurgery, OB/GYN, ophthalmology, oral and maxillofacial surgery and dentistry, otolaryngology, pathology, pediatrics (Children’s Hospital at Sinai), pharmacy, physical medicine and rehabilitation, psychiatry, radiation oncology, radiology, sleep center, surgery, and urology. 

Union Memorial Hospital

201 E University Pkwy
Baltimore, MD 21218
855-633-0199

Part of MedStar Health, Union Memorial is a 223-bed hospital facility, with services including cancer care, diabetes care, ENT, emergency care, urgent care, a trauma center, gastroenterology, heart care, mental health, pediatrics, sports medicine, stroke, the Curtis National Hand Center, vascular care, and a women’s health center.

University of Maryland Medical Center

22 South Greene St
Baltimore, MD 21201
410-328-8667

One of the largest healthcare centers in Maryland, the UMMC facility has 772 beds with a number of services, including trauma center, a children’s hospital, cancer center, heart and vascular center, comprehensive stroke center, critical care resuscitation unit, lung rescue unit, and emergency services.

University of Maryland Medical Center, Midtown

827 Linden Ave 
Baltimore, MD 21201
410-225-8000

The UMMC Midtown Campus is a 187-bed facility with a number of services, including addiction medicine, ALS, behavioral health, cancer, chemical dependency, diabetes and endocrinology, ENT, emergency and urgent care, gastroenterology, heart, imaging, infectious diseases, kidney care, neurosciences, ophthalmology, orthopedics, pediatrics, post-acute specialty care, primary care, rehabilitation, sleep disorders, transplant, vascular, weight management, women’s health, and wound care. 

VA Maryland Healthcare System

10 North Greene St
Baltimore, MD 21201
410-605-7000

Part of the Veteran’s Administration, the Baltimore facility offers a number of healthcare services for military veterans, including emergency services, acute medical and surgical care, outpatient, inpatient, and primary care. 

After an Injury in a Baltimore Hospital

At Gilman & Bedigian, we will use our experience, knowledge, and dedication to investigate injuries caused by negligent care in a hospital setting. The hospital may have been aware of past mistakes and errors involving the same providers who caused the injury in your treatment and should be held responsible for their actions. 

A malpractice or negligence claim against the healthcare provider may make the hospital liable for the negligence of their employee and the hospital will be financially responsible for your damages. Our aggressive trial lawyers have helped our clients recover millions of dollars in compensation related to Baltimore hospital injuries. Contact us online or call our law office at (800) 529-6162 for a free consultation.

1. Bradford v. Jai Med. Sys. Managed Care Orgs., Inc., 439 Md. 2, 18-19 (2014)