Question

SpencerMedical Center (The Hospital) participates in Medicare. The Hospital contracts with a physicians group, Emergency Physicians LLC (The Group) for 24 hour coverage of its emergency department. The contract between The Hospital and the Group states that the physicians of the group are not the agents or employees of the Hospital and that the hospital will not be liable for the negligence of The Group or its physicians. A sign in the emergency room states "The physicians working in our Emergency Department are physicians with Emergency Physicians LLC and are not employees or agents of Johnson City Hospital. Around 10:00 P.M., George had a splitting headache. He called a friend who drove him to the Hospital’s emergency room. George was briefly examined by the nurse and by the physician from the Group who was on duty. Hospital protocol stated that if an adult patient came to the emergency room with a splitting headache, the patient should be given a CAT scan. The nurse asked if George had insurance and called George’s HMO to verify coverage and obtain authorization for the scan. The HMO informed the nurse that they did not pay for this type of scan and advised George to call his primary physician the next day. The nurse informed the on duty physician, who discharged George with instructions to contact his primary physician in the morning. The physician did not tell George that the ordinary diagnostic procedure for his condition was a CAT scan. George could have paid for the scan with a credit card. George went home and died of an aneurysm that night. According to the autopsy report, the aneurysm was a rare type which could not have been detected with the CAT scan.

Questions to be Addressed
1. What claims could be asserted against The hospital by George’s estate. In discussing each claim be sure to discuss the elements of the claim and the likelihood of success. Do not discuss any potential claims against the Emergency Physicians or the individual health care professionals.

Answer 1

Claims against SpencerMedical Center that George's estate could assert include negligence and informed consent, yet both appear to have a low likelihood of success due to the details surrounding the case, especially the autopsy findings that the aneurysm could not have been detected with a CAT scan.

Step-by-step explanation:

A potential claim that could be asserted against the SpencerMedical Center by George's estate is one of negligence related to the failure to follow hospital protocol for patients presenting with a splitting headache by not performing a CAT scan. To establish negligence, the estate must prove that the hospital had a duty to George, that there was a breach of that duty, that the breach caused injury, and that there was an injury (damages). However, since the autopsy report indicated that George's aneurysm was a type that could not have been detected by a CAT scan, proving causation, and damages attributable to the hospital's breach may be challenging. Therefore, the likelihood of success on such a claim could be low.

In addition to negligence, George's estate might attempt to claim informed consent, arguing that George was not adequately informed about the recommended diagnostic procedure (CAT scan) for his condition, which could have influenced his decision to seek further medical help even if he had to pay for it himself. The elements for this claim would include the duty to inform, the failure to disclose necessary information, whether a reasonable person would have decided differently if properly informed, and if actual harm was caused by the failure to inform. Given the information that the estate would have trouble showing that a different decision would have prevented George's death, this claim also seems unlikely to succeed.