Parker v. Vanderbilt University

Court of Appeals of Tennessee
767 S.W. 2d. 412, 1988 Tenn. App. LEXIS 734 (1988)

ELI5:

Rule of Law:

A surgeon's vicarious liability for the negligence of other medical personnel in an operating room is determined by traditional master-servant principles, requiring proof that the surgeon controlled the specific means and method of the subordinate's work, rather than by the broad 'Captain of the Ship' doctrine.

Facts:

On June 17, 1984, Richard O. Parker was shot in the back and taken to Nashville General Hospital for surgery.
The surgical staff was furnished by Vanderbilt University, while the anesthesia services were provided by Sandra Conner, a nurse anesthetist employed by the hospital, and Rebecca Murphy, a student nurse anesthetist.
During the procedure, Murphy inserted an endotracheal tube, which allegedly entered Parker's esophagus instead of his trachea.
The Vanderbilt surgeons present in the operating room did not select the anesthetists, the drugs used, or direct the specific procedure of intubation.
The hospital's anesthesia protocols, developed by Dr. Alcantara who was not present, governed the work of the nurse anesthetists and allowed them to follow their own judgment over a surgeon's preference in non-emergency situations.
As a result of the alleged misplacement of the tube, Parker was deprived of oxygen for approximately twelve minutes and suffered severe, irreversible brain damage, leaving him in a coma.

Procedural Posture:

Richard Parker's guardian filed a medical malpractice action in the Circuit Court of Davidson County (trial court) against multiple defendants, including Vanderbilt University and four of its doctors.
The trial court granted Dr. Alcantara's motion for summary judgment on October 8, 1986.
The trial court granted a motion for summary judgment in favor of Vanderbilt University and the four Vanderbilt doctors on June 9, 1987.
The plaintiffs subsequently filed a notice of voluntary dismissal as to all remaining defendants, which made the summary judgment orders final and appealable.
The plaintiffs filed a motion for a new trial challenging the summary judgments, which the trial court overruled.
The plaintiffs, as appellants, then appealed the trial court's grant of summary judgment to the Court of Appeals of Tennessee.

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Issue:

Is a surgeon vicariously liable for the negligence of a hospital-employed nurse anesthetist when the surgeon does not control the specific means and methods of administering anesthesia?

Opinions:

Majority - Cantrell, Judge

No. A surgeon is not vicariously liable for the negligence of a hospital-employed nurse anesthetist where the surgeon does not exercise control over the means and method of the anesthetist's specialized tasks. The court rejects the 'Captain of the Ship' doctrine as confusing and holds that a surgeon's liability must be analyzed under traditional master-servant and agency principles. The determinative factor is whether the surgeon had the right to control not just the 'result' of the work, but the actual 'means and method' used. Here, the nurse anesthetists were highly trained specialists operating under hospital protocols, not the direct control of the surgeons. The surgeons did not select the anesthetists or direct the manner of intubation. Therefore, the nurse anesthetists were not the servants of the surgeons for the specific act in question, and the surgeons cannot be held vicariously liable for their alleged negligence. The court also found no evidence of direct personal negligence, as the plaintiffs failed to establish a standard of care requiring surgeons to supervise the placement of an endotracheal tube.

Analysis:

This decision significantly narrows the scope of surgeon liability in Tennessee by rejecting the broad 'Captain of the Ship' doctrine, which could impose almost absolute liability on a surgeon for any negligence in the operating room. By grounding vicarious liability in traditional master-servant principles, the court requires a fact-specific inquiry into the surgeon's actual control over the 'means and method' of the negligent act. This precedent makes it more difficult for plaintiffs to hold surgeons liable for the malpractice of other highly specialized professionals, such as anesthetists, reinforcing the idea of a healthcare 'team' where each member has independent responsibilities.

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