Brayboy v. Advocate Health & Hospitals Corp.
2024 IL App (1st) 221846 (2024)
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Rule of Law:
A hospital may be held vicariously liable under the doctrine of apparent agency for the negligence of an independent contractor physician if the hospital's conduct would lead a reasonable patient to believe the physician was an employee, and the patient relied on the hospital for care, especially when a disclaimer of independent contractor status is not presented in a meaningful way or at a meaningful time that allows for an informed choice.
Facts:
- In the late evening of March 25, 2019, Christina Brayboy took her three-year-old son, Benjamin Mathis, to the emergency room at Advocate Good Samaritan Hospital due to severe flu-like symptoms, including a 102-degree fever, chills, vomiting, and lethargy.
- Benjamin was officially admitted to the emergency room at 9:27 p.m. and began receiving treatment from a male nurse and a female physician’s assistant, including Tylenol, Motrin, IV fluids, and blood tests that revealed a "significantly elevated" procalcitonin level of 11.51.
- At approximately 10:18 p.m., Dr. Michael Antoniolli was assigned to care for Benjamin in the emergency room.
- At 10:59 p.m., after Benjamin had already received some treatment and Dr. Antoniolli had been assigned to his care, Christina was presented with a three-page, single-spaced "Health Care Consent" form, which contained a section stating that non-employed physicians were independent contractors; Christina signed the form because she was told treatment would not continue otherwise.
- Around 2:00 a.m. the following morning, Dr. Antoniolli discharged Benjamin from the hospital, despite the on-duty charge nurse, Brittany Wheeler-Hagberg, informing Dr. Antoniolli that Benjamin's Procalcitonin test came back abnormal at 11.51, a critical value indicative of severe sepsis or bacterial shock.
- Christina Brayboy was never informed of Benjamin's elevated Procalcitonin result, and when she called Advocate the next day to report Benjamin's returned fever, hospital staff informed her it was consistent with his virus diagnosis.
- Three days later, on March 30, 2019, Benjamin collapsed at home and was subsequently transported to Advocate via ambulance, where he was pronounced dead due to streptococcus pneumonia.
Procedural Posture:
- Christina Brayboy, individually and as independent administrator of Benjamin Mathis's estate, filed a medical malpractice action against Advocate Health and Hospital Corporation, Dr. Michael Antoniolli, and DuPage Emergency Physicians, Ltd., in the Circuit Court of Cook County.
- Advocate filed a motion for partial summary judgment on the issues of actual and apparent agency regarding Dr. Antoniolli's actions.
- Christina Brayboy did not oppose the actual agency claim but opposed the apparent agency claim.
- The Circuit Court granted Advocate's motion for partial summary judgment on both actual and apparent agency.
- Christina Brayboy moved for reconsideration, which the Circuit Court denied.
- The Circuit Court granted Christina Brayboy's request for an Illinois Supreme Court Rule 304(a) finding, allowing for an immediate interlocutory appeal.
- Christina Brayboy appealed to the Appellate Court of Illinois, First District, as the Plaintiff-Appellant, with Advocate Health and Hospital Corporation as the Defendant-Appellee.
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Issue:
Does a hospital's presentation of a consent form disclaiming an emergency room physician's agency status, given after a patient has begun receiving treatment and under exigent circumstances, automatically negate the 'holding out' and 'reliance' elements of an apparent agency claim against the hospital, thereby entitling the hospital to summary judgment?
Opinions:
Majority - Justice Lavin
No, a hospital's presentation of a consent form disclaiming an emergency room physician's agency status, given after a patient has begun receiving treatment and under exigent circumstances, does not automatically negate the "holding out" and "reliance" elements of an apparent agency claim, and genuine issues of material fact preclude summary judgment. The court agreed with persuasive authority from other jurisdictions that a notice or consent form, to be effective, must be given when the patient still has a reasonable opportunity to obtain treatment elsewhere if he or she chooses not to sign the form. Here, the form was presented nearly two hours after Christina's arrival, after Benjamin had been admitted and partially treated, and after Dr. Antoniolli was assigned, all while Christina was attending to her severely ill child and another young child, rendering any "choice" to leave illusory. Furthermore, Advocate's extensive marketing campaign, which promoted the hospital's "good reputation" and frequently depicted doctors as employees or agents, contributed to the "holding out" element, and Christina explicitly testified she chose Advocate due to its reputation. The hospital's discharge instructions also contradicted the disclaimer by thanking Christina for choosing the hospital and referring to "Our physicians and clinical staff." These factors create a triable issue of fact regarding both the "holding out" and "justifiable reliance" elements of apparent agency, making summary judgment inappropriate.
Analysis:
This decision significantly clarifies the application of apparent agency in Illinois, particularly regarding the timing and effectiveness of independent contractor disclaimers in hospital settings. By emphasizing the "meaningful time" and "meaningful way" standard for notice, the ruling makes it more challenging for hospitals to rely solely on boilerplate consent forms signed under duress to avoid vicarious liability for their emergency room physicians. The court's consideration of a hospital's broader marketing efforts and contradictory discharge instructions provides a more holistic view of how the "holding out" and "reliance" elements should be assessed, potentially leading to more medical malpractice cases proceeding to trial on apparent agency theories rather than being resolved at summary judgment.
