In a medical malpractice claim, a patient who is injured because of a doctor’s mistake can seek to recover damages caused by the accident. Doctors owe their patients a duty of care and when they breach that duty, causing an injury, they may be liable for the patient’s damages. However, how does the hospital play a role in medical malpractice? In many cases, the hospital may also be liable for damages as an employer or because of the hospital’s negligence.
Is a Hospital Negligent for Medical Errors?
When a patient suffers a medical injury caused by negligence, the patient may not be sure who caused the injury or if there were multiple parties responsible for the medical error. Medical malpractice claims are very complex and can take a lot of time to investigate. However, injury victims only have a limited time to file a claim. This may result in the lawsuit naming more people and companies than may have been responsible.
It is common in a medical malpractice lawsuit to include multiple parties in the complaint, including anyone who provided medical care to the patient during the time in question. This may include naming the hospital involved, medical practice, medical clinic, nursing home, and other health care provider businesses.
During the course of discovery, documents and testimony can help clear up what occurred during the negligent care. In many cases, the hospital will continue to be named as a defendant who is alleged to be liable for the damages. Hospitals are generally liable for medical malpractice injuries in two ways:
- Vicarious liability for the negligence of employees
- Direct liability through negligent practices
Elements of a Medical Malpractice Claim
Most medical malpractice claims are based on negligence. In a negligence claim, the injury victim generally needs to prove duty, breach, causation, and harm. In a medical malpractice case, the injured patient needs to prove the following elements:
- The defendant owed the plaintiff a duty of care;
- The defendant breached the duty of care;
- The breach caused the plaintiff’s injury; and
- The plaintiff suffered harm as a result.
In a doctor-patient relationship, the doctor owes the patient of duty to act within the accepted standard of care of the medical community. A breach would involve the failure to exercise the degree of care, skill, and learning as a reasonably prudent medical professional would under the same or similar circumstances.
Causation includes cause-in-fact, where the injury could not have occurred but for the breach. The injury also has to be a foreseeable and proximate cause of the breach. Finally, the patient has to suffer some harm or damage in order to claim damages after the medical error.
Is the Hospital Liable for Negligence of the Employees?
An employer may be liable for the negligence of an employee when the employee is acting within the scope of employment. This includes a hospital’s liability for the negligence of a hospital employee. This is known as vicarious liability. In order for an injury victim to recover damages from the hospital under vicarious liability, they must establish:
- There was an employer-employee relationship; and
- The act was committed within the scope of employment.
For example, a part-time employee in the cafeteria in the hospital is carrying a pot of hot coffee up to another floor. While walking and looking at their phone, the employee bumps into an elderly patient, spilling the scalding coffee on the patient’s head and neck. The patient suffers serious burns, pain, and permanent scarring and disfigurement. A jury awards the injury victim $1 million in damages. However, the employee only has about $500 in the bank. Who should bear the liability for the accident?
Under respondeat superior, an employer is liable for the acts of employees performed in the course of their job duties. The employee may be living paycheck-to-paycheck and not have enough financial resources to even begin to cover the damages after a serious injury accident. The employer may be liable for damages because the employer is generally in a better financial position to cover the costs of damage caused by an employee.
Who Is Considered a Hospital Employee?
A hospital may have hundreds or thousands of workers performing a number of duties. However, not all of those workers may be employees. Non-employee workers in a hospital may include contractors, repair technicians, transportation services, suppliers, or independent contractors.
According to the U.S. Department of Labor, there is no single rule or test for determining whether an individual is an independent contractor or an employee. The difference between an employee and an independent contractor is based on the total activity or situation, including the following factors:
- Are the services rendered an integral part of the business?
- Can the relationship be terminated for any reason?
- What investment has the alleged contractor made in facilities and equipment?
- What control does the employer have over the worker?
- What are the alleged contractor’s opportunities for profit and loss?
- How much initiative, judgment, or foresight is required for the success of the alleged independent contractor?
- What degree of independence does the worker have from the business organization and operation?
Whether a worker is an employee or an independent contractor is very important and not just for vicarious liability. The distinction between employee and contractor makes a difference in wages and overtime, worker benefits, and payroll taxes. However, just because a business calls someone an independent contractor does not make it a fact.
Types of Hospital Employees
There are many types of hospital employees, including full-time, part-time, managers, and seasonal workers. However, most of the employees who may be involved in a medical malpractice case are healthcare professionals or medical staff. Some of the common types of medical hospital employees include:
- General practitioner
- Internal medicine doctor
- Emergency room physician
- Hospitalist
- General surgeon
- Anesthesiologist
- Oncologist
- Intensive care specialist
- Radiologist
- Pharmacist
- Physical therapist
- Occupational therapist
- Physician’s assistant
- Nurse
- Medical technologist
- Respiratory therapist
- Patient care technician
When any of these health care providers are employees of the hospital and cause a negligent injury or death, you may be able to sue the hospital for medical malpractice.
Hospital and Apparent Authority for Medical Errors
Apparent authority is the power of an agent to act on the behalf of a principal. Also called ostensible agency, this is another legal issue that may come up for a hospital in a medical malpractice case. As mentioned above, a hospital may not be liable for the actions of an independent contractor. Many doctors and surgeons are independent contractors of the hospital. However, patients may not know the difference.
For example, when a doctor who is an independent contractor comes in to treat the patient and later a doctor employed by the hospital comes in, how is the patient supposed to know the difference? Based on their work status, it may make a big difference in who will be liable for damages and who can afford to pay for the victim’s injuries. 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 an employee of the hospital.
Proving apparent authority may depend on state law. For example, in Pennsylvania, under the MCARE Act, “A hospital may be held vicariously liable for the acts of another health care provider through principles of ostensible agency only if the evidence shows that:
- A reasonably prudent person in the patient’s position would be justified in the belief that the care in question was being rendered by the hospital or its agents; or
- The care in question was advertised or otherwise represented to the patient as care being rendered by the hospital or its agents.”
In Maryland, there are 3 elements to show ostensible agency, based on whether:
- The apparent principal created, or acquiesced in, the appearance that an agency relationship existed.
- The plaintiff believed that an agency relationship existed and relied on that belief in seeking the services of the apparent agent.
- The plaintiff’s belief and reliance were reasonable.
Negligent Actions of Hospital Administrators
Even though a hospital may be a corporation or non-profit company, the hospital still owes a duty of care to patients. The hospital includes the actions or decisions of the hospital representatives, managers, administrators, or corporate officers. The hospital’s policies, practices, and business decisions come from people and their decisions can make the hospital liable for harmful outcomes. Ways a hospital could be directly liable for negligence include:
- Negligent training
- Failure to supervise
- Allowing dangerous doctors to continue practicing
- Failure to address a pattern of patient harm
- Understaffing
- HIPAA violations
- Hospital-acquired infections (HAIs)
Negligent Training
Most employees and staff working in a hospital have to undergo special training to be able to perform their jobs as required by hospital policy, state law, federal law, or local authority. Hospital training can include proper sanitation, responding to codes or alarms, and patient privacy. When an employee is not properly trained, it can increase the risk of an accident or injury. If an employee was never trained on how to protect patient health, the employer responsible for recruiting and approving the worker may be liable for the employee’s lack of training.
Failure to Supervise
Different medical personnel have different scopes of practice. A doctor can diagnose a patient but a certified nursing assistant (CNA) cannot make a diagnosis. Some nurses can make a diagnosis but have to be under the supervision of a doctor. If the doctor does not have time to supervise all the nurses that the doctor is in charge of overseeing, the nurses may not be properly supervised. If a nurse makes a diagnostic error and the error is responsible for causing the injury, the damage may have been caused by the failure to properly supervise hospital employees.
Allowing Dangerous Doctors to Continue Injuring Patients
Patients in a medical malpractice case may be surprised to learn that their doctor had a long history of making similar medical errors. Even after many findings of medical negligence, doctors may continue to work in the hospital. In some cases, the hospital keeps a dangerous doctor because the doctor brings in a lot of money through volume treatment. If a hospital knew of the dangerous history of a doctor and continued to let the doctor keep practicing, the hospital may share some of the responsibility for the damage.
Pattern of Medical Errors
A medical error can happen but when the same types of errors keep happening, it is up to the hospital to make changes. If a hospital is aware of a continuing problem that causes patients to suffer unnecessary injuries but does not do anything, the hospital may be complicit in the medical injuries.
Understaffing
Understaffing is common in health care. In most cases, hospitals, nursing homes, and other care facilities are understaffed because of money. Health care corporations may be putting profit over patient safety, and cutting corners just to please their shareholders. Some medical facilities have a mandatory requirement for the number of healthcare providers and hours of service. If the hospitals are violating those requirements, they may be facing statutory penalties. If a patient is injured because of understaffing, the hospital should be held responsible.
HIPAA Privacy Violations
Patient privacy is an important part of good medical care. Under the Health Insurance Portability and Accountability Act (HIPAA), hospitals and health care providers have strict requirements for handling private medical information. If a patient suffered a breach of privacy through a HIPAA violation, the patient may be able to file a legal action.
Hospital-Acquired Infections
Hospital-acquired infections (HAI), or healthcare-associated infections, are infections that a patient does not have at the time of admission. These are acquired infections that can come from catheters, tainted surgical instruments, or bacteria in the hospital. It may be difficult to show exactly how an infection was transmitted to a patient inside the hospital. However, if the patient did not have the infection before admission and got a serious infection after admission, there is a good chance it was acquired in the hospital.
How Can a Medical Malpractice Lawyer Help?
An experienced medical malpractice attorney can review your injury claim, have a medical expert review your medical file, and help you understand your legal options to file a claim against the hospital and other caregivers. Contact experienced personal injury trial attorneys who have successfully represented medical error victims and their families to recover financial compensation. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.