C074810Whitlow v. Rideout Memorial Hospital
237 Cal. App. 4th 631
| Cal. Ct. App. | 2015Background
- Decedent arrived at Rideout Memorial Hospital ER at ~1:00 a.m. in severe pain, vomiting, and with progressively worsening headache; she signed a hospital "Conditions of Admission" form while distressed and unable to read it according to her son.
- The admissions form and posted signage stated ER physicians were independent contractors and not hospital agents; the admitting registration clerk offered no recollection of explaining the form to decedent.
- Dr. Robert Martin (wearing insignia identifying him with a private emergency physician group) diagnosed a muscle-tension headache and discharged decedent; she later suffered a massive left temporal hemorrhage and died.
- Plaintiffs (decedent’s children) sued for wrongful death alleging the treating ER physician was an ostensible agent of the hospital; the trial court granted summary judgment for the hospital based principally on the signed admissions form, signage, insignia, and hospital custom.
- The Court of Appeal reversed, holding that triable issues of fact exist about whether the patient could understand/relied on the supposed notice, whether she entrusted herself to the hospital, whether the hospital selected the physician, and whether the patient reasonably believed the physician was the hospital’s agent.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the ER physician was an ostensible agent of the hospital | The patient sought treatment at the hospital, was incapable of understanding the admissions disclaimer, and reasonably relied on the hospital for care | The admissions form, posted signs, physician insignia, and customary practices gave notice that physicians are independent contractors | Reversed summary judgment — ostensible agency is a factual question; the disclaimer did not conclusively negate agency |
| Whether pre-admission notice (form/signs) conclusively defeats ostensible agency | Notice was ineffective in an emergency; form signed under distress and not read/explained | Boilerplate admissions form and signs provide conclusive notice as a matter of law | Notice via boilerplate form and signage may be insufficient in emergency settings; jury must weigh adequacy and timing of notice |
| Whether plaintiffs established reliance/entrustment and hospital selection of physician | Decedent entrusted herself to the hospital and did not choose the physician; hospital assigned/oversaw ER staff | Hospital lacks authority to employ/control physicians and thus cannot have imposed vicarious liability via nondelegable duty | Reliance, entrustment, and hospital selection are factual issues for the jury |
| Whether a nondelegable duty should be imposed on hospitals for ER care | Plaintiffs suggested public policy may support nondelegable duty for ER patients | Hospital argued statutory and policy reasons counsel against creating a judicial nondelegable duty (corporate practice of medicine concerns) | Court declined to adopt a nondelegable-duty rule; unnecessary because ostensible-agency issues resolve the case |
Key Cases Cited
- Mejia v. Community Hospital of San Bernardino, 99 Cal.App.4th 1448 (Cal. Ct. App.) (ostensible-agency in hospital context; prior notice often insufficient in ER cases)
- Clark v. Southview Hosp. & Family Health Ctr., 68 Ohio St.3d 435 (Ohio 1994) (ER patients cannot usually make an informed choice; notice must come at a meaningful time)
- Simmons v. Tuomey Regional Medical Center, 341 S.C. 32 (S.C. 2000) (refused to allow hospitals to escape liability by last-minute disclaimer in ER; public-perception and commercialization rationale)
- Wolbers v. Finley Hosp., 673 N.W.2d 728 (Iowa 2003) (ER patients rely on hospital; liability may arise from apparent agency even if doctors are independent contractors)
- Renown Health, Inc. v. Vanderford, 235 P.3d 614 (Nev. 2010) (declined absolute nondelegable duty but extended ostensible-agency inquiry where hospital selects the ER physician)
- Tunkl v. Regents of University of California, 60 Cal.2d 92 (Cal. 1963) (public policy limits enforcement of adhesion releases against hospital patients)
- Hansell v. Santos Robinson Mortuary, 64 Cal.App.4th 608 (Cal. Ct. App.) (analogous treatment of independent contractors where the defendant lacked custody/control and statutory authority)
- Jacoves v. United Merchandising Corp., 9 Cal.App.4th 88 (Cal. Ct. App.) (hospitals liable for malpractice where physician is actual employee or ostensible agent)