EMAIL TO A FRIEND COMMENT

 

ER Medical Director Not Liable for Staff’s Failure to Implement Chest Pain Protocol


A woman suffered cardiac arrest and died in the emergency room. The woman’s daughter, individually and as administrator of the mother’s estate, sued the medical director of the emergency department, alleging that her mother could have been saved, if only her treating physician and nurse had promptly and properly implemented a chest pain protocol that the hospital had adopted. The daughter alleged that the medical director owed a duty to supervise the training of the physician and nursing staff with respect to this protocol, but he negligently failed to ensure that they were adequately trained in that respect. The Liberty County State Court granted summary judgment in favor of the medical director.

 

The Court of Appeals affirmed in part and reversed to the extent that the claim against the medical director sounded in professional negligence. The Court of Appeals reasoned that the medical director had assumed a responsibility to supervise the training of emergency department physicians and nurses, and as a result, he owed a legal duty to the mother to see to it that their training was sufficient to ensure that the physicians and nurses were adequately informed of and knowledgeable about hospital policies, including the chest pain protocol.

 

The Supreme Court of Georgia reversed holding that the fact that the medical director did not treat the patient precluded the imposition of liability for medical malpractice, and the medical director did not affirmatively increase the risk of harm to the patient and thus could not be held liable for negligent performance of an undertaking.

 

The court held that the medical director could not be held liable when the director did not treat the patient or direct the method and manner of care rendered by those who did treat the patient. To make out a case of medical malpractice, the plaintiff usually must prove that the plaintiff was, in fact, a patient of the defendant-physician. This rule has a few recognized exceptions. The court clarified that the exception upon which the appellate court relied was limited to incidents where the defendant undertook not only to supervise the staff, but also to direct the method and manner of care rendered by the staff. The court held that this exception did not apply to the medical director because the director had no responsibility or authority to control or direct the method and manner of care rendered to the mother by the treating physician and nurse.

 

The court also held that the medical director did not affirmatively increase the risk of harm to the mother and thus could not be held liable under section of the Restatement (Second) of Torts governing liability to third persons for negligent performance of an undertaking. The appellate court specifically relied on a section of the Restatement (Second) of Torts that stated that one who undertakes to render services to another which he or she should recognize as necessary for the protection of a third person or that person’s things, is subject to liability to the third person for physical harm resulting from the failure to exercise reasonable care to protect this undertaking, if the failure to exercise reasonable care increases the risk of such harm. The court noted that this section of the Restatement (Second) of Torts applies when a nonhazardous condition is made hazardous through the negligence of a person who changed its condition or caused it to be changed. Liability does not attach for failing to decrease the risk of harm. The court found no evidence in the record that the risk to the mother was escalated by the medical director's alleged failure to adequately supervise the training of emergency department physicians and staff. At most, the medical director might have been said to have failed to resolve a misunderstanding of the physicians and staff about the precise requirements of the chest pain protocol, which was a misunderstanding that was not of the director’s own making.

 

See: Herrington v. Gaulden, 2013 WL 6157338 (Ga., November 25, 2013) (not designated for publication).

 

See also Medical Law Perspectives, November 2013 Report: Diagnosis and Treatment of Heart Attacks: Liability Issues

 

See also Medical Law Perspectives, December 2012 Report: When Urgency Leads to Errors: Liability for Emergency Care

 

 

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