Mejia v. Community Hospital of San Bernardino
2002 Daily Journal DAR 7848, 99 Cal. App. 4th 1448, 122 Cal.Rptr.2d 233 (2002)
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Rule of Law:
A hospital can be held vicariously liable for the negligence of an independent contractor physician under the doctrine of ostensible agency if the patient sought treatment at the hospital and had no reason to know that the physician was not a hospital agent.
Facts:
- In April 1997, Maria Del Carmen Mejia felt something pop in her neck while moving boxes, causing intermittent pain.
- On May 3, 1997, Mejia awoke with severe neck pain and her head twisted to one side.
- That night, a neighbor took Mejia to the emergency room at Community Hospital of San Bernardino.
- An emergency room physician examined Mejia, ordered X-rays, and prescribed medication.
- The ER physician sent at least one X-ray to an on-call radiologist for evaluation, and Mejia never met or knew of the radiologist.
- The radiologist reported seeing only a congenital fusion and nothing else of concern.
- Based in part on the radiologist's misinterpretation, the ER physician discharged Mejia, telling her she only had a twisted neck.
- The following morning, Mejia awoke to find she was paralyzed, as her neck had actually been broken.
Procedural Posture:
- Maria Del Carmen Mejia (plaintiff) filed a medical malpractice suit in a California trial court against Community Hospital of San Bernardino, an ER physician, a radiologist, and their respective medical groups.
- The case proceeded to a jury trial.
- After the close of the plaintiff's case, the trial court granted a motion for nonsuit in favor of Community Hospital, dismissing it from the lawsuit.
- The jury returned a verdict finding the radiologist and his employer negligent, but exonerated the ER physician and his employer.
- Mejia (appellant) appealed the judgment of nonsuit granted in favor of Community Hospital (respondent) to the California Court of Appeal.
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Issue:
Is a hospital potentially liable under the doctrine of ostensible agency for the negligence of an independent contractor radiologist when the patient sought treatment at the hospital's emergency room and had no reason to know the radiologist was not a hospital employee, even if the patient never personally met or knew of the radiologist's involvement?
Opinions:
Majority - McKinster, Acting P. J.
Yes. A hospital is potentially liable under the doctrine of ostensible agency because when a patient seeks treatment at a hospital, an agency relationship is inferred unless the patient knew or should have known the physician was an independent contractor. The evolution of the modern hospital from a mere facility to a comprehensive provider of medical care has created a public perception that the hospital itself is the provider of services. Therefore, the central factual issue is whether the patient had reason to know the physician was not a hospital agent. A patient's reliance is presumed when they look to the hospital for care, and the hospital holds itself out as a provider simply by operating an emergency room open to the public. The fact that the patient never met or knew about the radiologist is irrelevant, as emergency patients cannot be expected to inquire into the employment status of every medical professional involved in their care. The patient only needs to show they sought treatment at the hospital to create a triable issue of fact for the jury on ostensible agency.
Analysis:
This decision significantly strengthens the doctrine of ostensible agency as applied to hospitals in California, making it very difficult for a hospital to defeat a medical malpractice claim on a motion for nonsuit by arguing its physicians are independent contractors. The ruling creates a strong presumption of agency when a patient seeks care at a hospital, especially in an emergency context. It effectively shifts the burden to the hospital to demonstrate that it provided clear notice to the patient that a physician was not its agent. The case clarifies that the patient's subjective awareness of a specific physician's role is not necessary to establish reliance on the hospital for care.
