Nashville at law: Appeals judges say hospitals not liable for doctors’ negligence

Sunday, April 26, 2009 at 12:53pm
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Provided that they are acting in good faith, hospitals can be granted immunity in cases of physician negligence, according to a ruling recently released by the Tennessee Court of Appeals.

In the mixed decision authored by Judge Andy D. Bennett, the court examined the case of a plaintiff suing both a Centennial Medical Center plastic surgeon and the hospital itself for having credentialed him. Central to the opinion is a statute ostensibly meant to shield hospitals from any such litigation at the hands of patients. The court ruled that the statute is proper, contrary to the claims of the plaintiff that it was unconstitutional.

Whether Centennial should be afforded such immunity, the court says, remains to be seen. Additionally, in a concurring opinion filed by Judge Frank Clement, the physician in question receives a fairly scathing review.

The original complaint arose following procedures performed by doctor Stephen Pratt, now deceased. The plaintiff claims a procedure to remove excess skin resulting from weight loss resulted in complications that included opening of the wounds, a pulmonary embolism and bleeding into the lungs as a result of blood-thinning medication prescribed to treat the prior conditions.

Christy Smith filed her malpractice lawsuit against Pratt’s estate, also naming the hospital in the claim, as the opinion says, asserting, “Centennial should not have granted surgical privileges to Dr. Pratt and should have revoked his privileges because Dr. Pratt was incompetent and dangerous.”

Centennial countered the lawsuit by filing a motion for summary judgment based on a statute meant to shield hospitals and their staff from patient damages arising from the credentialing of physicians who commit negligence. The statue adds that such credentialing decisions must have been “made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.”

The trial court denied the original motion, later saying, “Under the facts of this case, immunity for Centennial would be contrary to the central purpose of the statute, which is to encourage the medical profession to police its members without fear of being sued by physicians who are disciplined by their peers.”

The statute was raised again, leading Centennial to file an appeal asking to have the interpretation of the shielding statute examined.

Despite arguments from Smith’s attorneys, who cited various cases involving the duty owed patients by hospitals in the hiring and credentialing of physicians, the court saw little relevance and refused to rule that the statute was unconstitutional.

As far as Centennial was concerned in this case, however, the court decided it really couldn’t say and remanded the matter back “to the trial court for a determination of whether Centennial’s credentialing decision was made in good faith, without malice.”

It is on this point that the concurring opinion from Judge Frank Clement offers a bit more depth to the court’s lack of a decision concerning Centennial specifically.

Based on a great deal of evidence, Clement says it would appear that Dr. Pratt “was well known for an admitted emphasis on profits and revenues over patient care, a lack of postoperative follow-up care, and a complication rate that was significantly higher than all other surgeons practicing at Centennial Medical Center.”

If such were in fact the case, Clement would assert that Centennial deserves no immunity. But, as he notes in the next paragraph, “[w]e fully acknowledge that the evidentiary glass may only be half full, meaning that there may be countervailing evidence that will establish that Dr. Pratt had many redeeming qualities as a physician and surgeon and, thus, support a finding that the decision by the peer review committee was made in good faith.”

“This opinion will surprise a lot of lawyers in Tennessee, both those who represent patients and those who represent hospitals and doctors,” said an uninvolved local attorney who spoke with The City Paper.

The attorney noted that this was probably the closest analysis of the statute has ever received and may have pointed out some of the unintended consequences of its language, which may be flawed. But that is a problem for legislators, who the attorney opined did not likely see a scenario rising from that particular bit of legislation. For their part, the Court of Appeals judges followed the letter of the law.

Representing Pratt’s estate and Centennial are Frank Grace, of counsel with Waller Lansden as well as Brian Cummings, C.J. Gideon and Brian Manookian of Gideon & Wiseman. On the other side of the aisle are George Nolan of Leader Bulso Nolan & Burnstein and Eric Smith of Bradley Arant Boult Cummings.

3 Comments on this post:

By: idgaf on 4/27/09 at 6:06

Clement's opinion seems to contridict itself and he clearly set himself up as the jury.

Note the keyword "MAY". His job is not to guess what "may " happen in a case.

Something has to be done about these judges. They operate like gangsters/gods.

The story does not really match the headline. The dissenting opinion would have been more insightfull.

By: govskeptic on 4/27/09 at 8:44

This case obviously show that the hospitals want any immunity they can get. In this case Judge Clement seems to know the true reputation of this particular doctor in the community(which is a correct one & more), but either that was unknown to Centennial or possibly so little checking was done to care.

By: JohnSevier on 4/27/09 at 9:49

No, Iggy, Judge Clement does not contradict himself. I have not read the opinion, which was not linked to the story, but his words have to do with what the trial court or jury may do following the remand.
I have no idea who should prevail in this case, but I do know for a certainty that the medical profession has, time out of mind, sought to create special defenses for itself, unavailable to the ordinary citizen.