Williams v. Tissier
2019 IL App (5th) 180046 (2021)
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Rule of Law:
A hospital may be held vicariously liable for the negligent acts of an independent contractor physician under the doctrine of apparent agency if the hospital 'holds out' the physician as its agent and the patient justifiably relies on the hospital's conduct to provide medical care, unless the patient knew or should have known the physician was an independent contractor.
Facts:
- In June 2007, Crystal Williams, then 26 years old and pregnant with twins, experienced contractions and was instructed by a physician from Dr. Tissier's office to go to St. Elizabeth’s Hospital.
- On June 4, 2007, Dr. Bradley J. Tissier delivered Williams' twins at St. Elizabeth’s, where Twin A was delivered without difficulty, but Twin B (Jerrin) was in a persistent transverse lie.
- Dr. Tissier attempted to rotate Jerrin in utero and then performed a vaginal footling breech extraction, during which Jerrin’s umbilical cord became compressed, leading to serious permanent injuries including cognitive deficits, movement disorders, and seizure disorders.
- Dr. Tissier was a member of OB GYN Care, LLC, and not an employee of St. Elizabeth’s Hospital.
- Dr. Tissier's office was located in 'St. Elizabeth’s Medical Park,' a building which displayed an exterior sign with St. Elizabeth’s Hospital's logo and color scheme, also listing 'OB-GYN Care and Bradley J. Tissier, M.D.' without distinguishing their relationship to the hospital.
- In May 2007, St. Elizabeth's Hospital's website advertised itself as 'the hospital of choice' for a 'family-centered maternity experience with the added assurance of a specialized staff and advanced equipment,' promoting 'quality care to pregnant women and their families throughout the birthing process,' and listed a board-certified neonatologist on staff with a Level II special care nursery.
- Dr. Tissier recommended that Crystal Williams deliver her twins at St. Elizabeth's, assuring her it was a good hospital with a good birthing center.
- Crystal Williams conducted an Internet search of St. Elizabeth's, reviewed its website, and, based on Dr. Tissier's recommendation and the website information, believed Dr. Tissier was an employee of the hospital; no one from the hospital or Dr. Tissier's office informed her otherwise.
- During her hospital admissions, Williams signed multiple consent forms generated by St. Elizabeth's; only one of these, a general 'Consent for Treatment/Guarantee And Assignment' form, included an 'independent contractor' disclosure, which was printed in small, 8-point font, was ambiguously worded, and was 'buried' within the document.
Procedural Posture:
- Crystal Williams, individually and as parent and next friend of Jerrin K. Williams, filed a medical negligence action in the circuit court of St. Clair County (trial court) against Dr. Bradley J. Tissier and OB GYN Care, LLC.
- Williams was granted leave to file an amended complaint, adding St. Elizabeth’s Hospital of the Hospital Sisters of the Third Order of St. Francis as a defendant, alleging vicarious liability for Dr. Tissier’s negligence under theories of actual or apparent agency.
- St. Elizabeth’s Hospital filed a motion for summary judgment, asserting there were no genuine issues of material fact and it was entitled to judgment as a matter of law on the issues of actual and apparent agency.
- The circuit court of St. Clair County (trial court) issued an order granting summary judgment in favor of St. Elizabeth’s on the issues of both actual and apparent agency.
- Crystal Williams filed a timely appeal to the Illinois Appellate Court, Fifth District, challenging the circuit court's grant of summary judgment for St. Elizabeth’s on the issue of apparent agency (St. Elizabeth's Hospital being the appellee).
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Issue:
Does a genuine issue of material fact exist as to whether St. Elizabeth’s Hospital 'held out' Dr. Tissier as its apparent agent and whether Crystal Williams 'justifiably relied' on St. Elizabeth's for medical care, thereby precluding summary judgment on the issue of apparent agency, even when the patient signed a consent form containing an independent contractor disclosure?
Opinions:
Majority - Justice Cates
Yes, genuine issues of material fact exist as to whether St. Elizabeth’s Hospital 'held out' Dr. Tissier as its apparent agent and whether Crystal Williams justifiably relied on St. Elizabeth's to provide quality maternity and delivery services, thus precluding summary judgment. The court found that the 'independent contractor' disclosure in St. Elizabeth’s consent form was not clear and concise like those found dispositive in cases like Lamb-Rosenfeldt or Wallace. It was printed in a small, 8-point font, ambiguously worded by not explicitly stating Williams' personal physician was an independent contractor, and was 'buried' within a multi-paragraph document. Furthermore, other consent forms signed by Williams for specific procedures did not contain any independent contractor disclosures. The court emphasized that a signed consent form is an important factor but not dispositive, especially when additional facts create a triable issue. The hospital's online marketing materials from May 2007 promoted it as 'the hospital of choice' for maternity services, touting a 'specialized staff and advanced equipment,' 'quality care to pregnant women,' a board-certified neonatologist, and a Level II special care nursery. St. Elizabeth's website also listed Dr. Tissier as one of its doctors. Additionally, Dr. Tissier's office was located in 'St. Elizabeth’s Medical Park,' which was prominently branded with St. Elizabeth’s logo and colors on exterior signage that also listed Dr. Tissier and OB GYN CARE, LLC, without differentiation. These facts, viewed in a light most favorable to Williams, could reasonably lead a trier of fact to conclude that St. Elizabeth’s held Dr. Tissier out as its agent. Regarding 'justifiable reliance,' Williams testified that Dr. Tissier recommended St. Elizabeth's, praising its birthing center, and that she researched the hospital's website and its specialized services for twins, which would be reasonable for a mother expecting twins. Citing York, the court reiterated that a patient's reliance on a chosen physician does not preclude also relying on the hospital for care. The court concluded that Williams' testimony and the hospital's marketing materials created a material issue of fact regarding her reliance on St. Elizabeth's for quality maternity and delivery services. The court distinguished Yarbrough because that case involved an unrelated independent clinic that did not use the hospital's branding, unlike the circumstances presented here. Therefore, summary judgment was inappropriate.
Analysis:
This case significantly clarifies the application of apparent agency in medical malpractice claims, particularly concerning the weight given to 'independent contractor' disclosures in hospital consent forms. It establishes that such disclosures are not singularly determinative and will be scrutinized for clarity, prominence, and specificity. The ruling broadens the scope of evidence plaintiffs can introduce to prove 'holding out' and 'justifiable reliance,' emphasizing the cumulative impact of a hospital's branding, advertising, physical facility integration, and patient-physician interactions. For hospitals, this means a more comprehensive approach to disclaimers is necessary, extending beyond a mere mention in a single document. For patients, it potentially offers greater protection by allowing claims where hospitals create an overall impression of integrated care, even if individual physicians are technically independent contractors, especially in specialized medical fields where patients rely on institutional capabilities.
