373 P.3d 681
Idaho2016Background
- Decedent Ellery Navo underwent ankle surgery at Bingham Memorial Hospital (BMH) on December 20, 2008; anesthesia was administered by CRNA Ryan Sayre, an independent contractor employed by Blackfoot Anesthesia Services; Navo later died.
- Plaintiffs (Lucia, Serena, and Nicole Navo) sued BMH alleging hospital negligence and vicarious liability for Sayre’s malpractice; complaint referenced defendants and “their agents” but did not expressly plead apparent authority.
- Plaintiffs offered expert affidavit of Dr. Samuel H. Steinberg to show BMH breached the local standard of care by failing to adopt policies governing anesthesia by independent contractors; BMH moved to strike the expert for lack of foundation on local standard knowledge.
- The district court struck Dr. Steinberg’s testimony (finding inadequate proof he knew the Blackfoot/Eastern Idaho local standard or that statewide/national standards supplanted it) and granted summary judgment for BMH; it also found plaintiffs failed to plead apparent authority adequately and that the record did not create a material fact issue on apparent authority.
- On appeal, the Idaho Supreme Court affirmed the exclusion of Dr. Steinberg’s testimony but reversed the judgment as to apparent authority: it held the complaint gave sufficient notice and that genuine factual disputes existed about whether BMH’s conduct created an appearance that Sayre acted for the hospital; summary judgment was vacated and the case remanded.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of out-of-area expert (local standard knowledge) | Dr. Steinberg familiarized himself via Joint Commission standards, statutes, and consultation with state Board of Nursing — sufficient to show actual knowledge of local standard | Steinberg lacked actual knowledge of Blackfoot/Eastern Idaho standard; consultation with Judith Nagel was inadequate; national/state standards cited do not replace local standard | Court: District court did not abuse discretion excluding Steinberg — his consultation was insufficient and the cited standards did not supplant the local standard |
| Sufficiency of pleadings to raise apparent authority theory | Complaint’s negligence count plus phrase “and their agents” put BMH on notice that plaintiffs would seek vicarious liability for independent contractors | Complaint failed to specifically plead apparent authority as a separate cause of action | Court: Complaint provided adequate notice; apparent authority is a theory of agency, not a distinct cause of action; plaintiffs were not barred from asserting it at summary judgment |
| Existence of genuine fact issue on apparent authority (vicarious liability) | Facts (BMH letterhead on anesthesia consent, website listings, hospital advertising) create triable issues whether BMH ‘held out’ CRNAs and whether patient reasonably accepted services as on behalf of hospital | Admission form explicitly states physicians and anesthesiology providers are independent contractors; no evidence decedent believed Sayre acted for hospital | Court: Genuine disputes exist on both Restatement elements (holding out and patient’s reasonable belief); summary judgment improper; vacated and remanded |
| Entitlement to costs/attorney fees below and on appeal | Plaintiffs opposed fees; on appeal sought costs as prevailing party after reversal | BMH sought discretionary fees and costs below and on cross-appeal on appeal | Court: Vacated district court award of costs/fees to BMH because no prevailing party after vacatur; no appellate fees awarded; appellants awarded costs on appeal as prevailing party |
Key Cases Cited
- Mattox v. Life Care Centers of America, Inc., 157 Idaho 468, 337 P.3d 627 (Idaho 2014) (out-of-area expert may familiarize via local consultation or show statewide/national standard replaced local standard)
- Dulaney v. St. Alphonsus Reg'l Med. Ctr., 137 Idaho 160, 45 P.3d 816 (Idaho 2002) (consultation must show the local consultant actually knows local standard)
- Arregui v. Gallegos-Main, 153 Idaho 801, 192 P.3d 1000 (Idaho 2012) (out-of-area expert’s affidavit must describe the local consultant and basis for their knowledge)
- Hayward v. Jack's Pharmacy, Inc., 141 Idaho 622, 115 P.3d 713 (Idaho 2005) (state/federal regulations can replace a local standard when they govern actual patient care)
- McDaniel v. Inland Nw. Renal Care Group - Idaho, LLC, 144 Idaho 219, 159 P.3d 856 (Idaho 2007) (distinguishes organizational/regulatory rules from regulations governing physical administration of care)
- Jones v. Health S. Treasure Valley Hosp., 147 Idaho 109, 206 P.3d 473 (Idaho 2009) (hospitals can be vicariously liable under apparent authority for negligence of independent personnel assigned by the hospital)
- Frank v. E. Shoshone Hosp., 114 Idaho 480, 757 P.2d 1199 (Idaho 1988) (actual knowledge requirement for expert testimony need not be onerous; common-sense assessment applies)
- Celotex Corp. v. Catrett, 477 U.S. 317 (U.S. 1986) (summary judgment standard: nonmoving party must present evidence on elements it must prove at trial)