Buu Nguyen v. IHC Medical Services, Inc.
288 P.3d 1084
Utah Ct. App.2012Background
- Nguyen sued Intermountain Health Care (IHC) and others after PCMC used a portable sales-demo ventilator on Nguyen’s critically ill son during transport for a CT scan.
- Dr. Madeline Witte, PCMC’s PICU physician and Life-Flight Medical Director, participated in testing the ventilator and sought parental consent under a committee protocol.
- The ventilator was a loaner/demo device not part of routine care, tested under an IHC committee-approved protocol for use on moderately ill children, not the critically ill patient in question.
- The committee included IHC personnel, including Tammy Bleak, and a vendor representative; testing/approval procedures and an informed-consent document were in place, but not specifically followed for Nguyen’s son.
- During transport, the ventilator failed and Nguyen’s son died; investigation attributed the failure to a hardware short, with no evidence of provider misuse.
- NguyenI held that a duty to obtain informed consent existed generally; the case was remanded for proceedings on whether PCMC/IHC owed an independent duty to obtain consent for unfamiliar equipment used outside normal procedures.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Law of the case compliance | Nguyen asserts IHC is bound by Nguyen I’s duty ruling. | IHC argues mandate allowed remand to address duty anew; law of the case not controlling. | Not mandated; remand permissible to test IHC duty on PCMC. |
| Independent duty of hospital to obtain informed consent | Hospital duty extends to IHC/PCMC for consent when unfamiliar equipment is used. | Duty remains with treating physician; hospital typically not liable for informed-consent breach. | Hospital may owe independent duty in special circumstances involving unfamiliar, loaned equipment used outside normal care. |
| Statutory duty under Utah Code § 78B-3-406 | Statutory duty applies to hospital as health-care provider. | Statutory duty is not automatically imposed on hospitals; requires separate analysis. | Statute supports potential duty, but depends on context; not automatic. |
| Foreseeability and capacity to avoid injury | IHC could have obtained consent; foreseeability supports duty. | Capacity to avoid loss rests with hospital, but standard physicians have primary duty. | When hospital actively involves itself with unfamiliar equipment, foreseeability supports imposing a duty. |
| Breach and proximate cause considerations | Breach occurs if consent was not obtained for testing equipment. | Breach/causation require case-specific fact-finding. | Duty exists; breach/proximate cause to be determined in context on remand. |
Key Cases Cited
- Jeffs v. West, 2012 UT 11 (Utah 2012) (duty is a law/determinable issue; distinction from breach/proximate cause)
- Halladay v. Cluff, 739 P.2d 643 (Utah Ct. App. 1987) (trial court guidelines on mandate and remand)
- Lenahan v. University of Chicago, 808 N.E.2d 1078 (Ill. Ct. App. 2004) (hospital may bear informed-consent responsibility in experimental context)
- Kus v. Sherman Hosp., 644 N.E.2d 1214 (Ill. Ct. App. 1995) (hospital/physician liability for informed consent in specialty cases)
- Giese v. Stice, 567 N.W.2d 156 (Neb. 1997) (hospital not automatically liable for patient consent)
- Ward v. Lutheran Hosp. & Homes Soc’y of Am., 963 P.2d 1031 (Alaska 1998) (hospital involvement in care affects informed-consent duty)
- Sherwood v. Danbury Hosp., 896 A.2d 777 (Conn. 2006) (physician vs. hospital duty for risks disclosure)
- Anderson v. Thompson, 248 P.3d 981 (Utah 2010) (standard for reviewing mandate compliance on appeal)
- Thurston v. Box Elder County, Not provided (Utah 1995) (mandate and compliance principles for lower courts)