Wilmington General Hospital v. Manlove
174 A.2d 135, 54 Del. 15, 4 Storey 15 (1961)
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Rule of Law:
A private hospital that maintains an emergency ward and holds itself out to the public as a place offering emergency care has a duty to provide aid in an unmistakable emergency. Liability may be imposed if a patient is refused service during such an emergency and their condition is worsened by the denial of aid.
Facts:
- On January 4, 1959, four-month-old Darien E. Manlove developed a fever and diarrhea.
- Over the next two days, his parents consulted with their pediatricians, Dr. Hershon and Dr. Thomas, who prescribed medication, but the infant's condition did not improve.
- On the morning of January 7th, with the infant's fever at 102 degrees, the Manloves took him to the emergency ward of the Wilmington General Hospital because their doctors' offices were closed.
- Mr. and Mrs. Manlove explained the infant's symptoms to the nurse on duty and showed her the prescribed medications.
- The nurse refused to have the infant examined or treated, stating that hospital policy forbade treating a patient already under a private physician's care unless there was a 'frank indication of emergency.'
- The nurse did not physically examine the infant, take his temperature, or otherwise assess his condition; she attempted unsuccessfully to contact the infant's doctors and suggested the parents return to a clinic the next day.
- The Manloves returned home, and their infant died of bronchial pneumonia later that afternoon.
Procedural Posture:
- The infant's father, as administrator of the estate (Plaintiff), filed a wrongful death lawsuit against Wilmington General Hospital (Defendant) in a state trial court.
- After discovery, the defendant hospital moved for summary judgment, arguing it had no duty to treat the infant.
- The trial court denied the hospital's motion for summary judgment, reasoning that the hospital had a 'quasi-public' status and that a factual dispute existed as to whether there was an emergency.
- The defendant hospital (appellant) appealed the trial court's denial of its motion for summary judgment to the state's highest court.
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Issue:
Does a private hospital that maintains a public emergency ward have a duty to provide treatment to an individual who presents for care in what may be an unmistakable emergency?
Opinions:
Majority - Southerland, C. J.
Yes, a private hospital that holds itself out as providing emergency services has a duty to provide medical aid in an unmistakable emergency. The court rejected the trial court's reasoning that the hospital's receipt of public funds made it a 'quasi-public' entity. The general rule remains that a private hospital has no duty to accept any patient it does not desire. However, the court established an exception for emergency services. By maintaining a public emergency ward, a hospital creates a public reliance on the availability of aid. A refusal of service in an unmistakable emergency could worsen a patient's condition due to the loss of critical time spent seeking aid there. This reliance creates a duty on the hospital to provide care in such situations, analogous to the tort liability for negligent termination of gratuitous services. The court concluded that while the record was insufficient to determine if an 'unmistakable emergency' existed, the case should proceed to determine whether the nurse, based on her training and the presented symptoms, was negligent in failing to recognize an emergency.
Analysis:
This landmark decision established a significant exception to the common law rule that private hospitals have no duty to treat patients. By grounding the duty in the principle of public reliance, the court recognized the unique role emergency rooms play in the community. This case paved the way for the modern legal understanding of a hospital's duty to provide emergency care, influencing subsequent legislation, most notably the federal Emergency Medical Treatment and Active Labor Act (EMTALA). The ruling shifted the legal focus from the hospital's private status to its public function in offering emergency services.
