Liability of Public Hospital Where Allegations Related to Non-Employee Doctors

In Gilreath v. Chattanooga-Hamilton County Hosp. Authority, No. E2015-02058-COA-R3-CV (Tenn. Ct. App. June 15, 2016), the Court of Appeals affirmed summary judgment for defendant hospital in a Tennessee health care liability  (formerly called “medical malpractice” case.

Plaintiff went to defendant hospital complaining of certain symptoms and allegedly told the medical providers there that her chiropractor had diagnosed her with cauda equina syndrome. Plaintiff was treated at the hospital by two doctors who “failed to recognize her symptoms as suggestive of cauda equina syndrome.” She was discharged with a diagnosis of possible impacted kidney stone, but was later correctly diagnosed at a different hospital after her condition worsened significantly. In this action, plaintiff sued defendant hospital based on the alleged inadequate treatment and diagnosis she received.

Defendant hospital moved for summary judgment on the basis that plaintiff’s expert could not support the claim against it, and that the hospital was not vicariously liable for the alleged negligence of the two physicians because the hospital was a government entity that fell under the GTLA and the physicians were not employees of the hospital pursuant to the terms of the Tennessee’s Government Tort Liability Act (“GTLA”). The trial court granted summary judgment, and the Court of Appeals affirmed.

In analyzing this case, the Court first pointed out that plaintiff had attempted to couch her claims as a contract claim and an ordinary negligence claim, but in reality the entire complaint sounded in health care liability. The Court found that “the complaint and responsive pleadings allege specific acts of negligence, namely the failure to order an MRI or other diagnostic test and a neurological or neurosurgical consult…These allegations sound in medical malpractice[.]”

Having determined that this was a health care liability action, the Court then looked at the errors alleged by plaintiff. First, plaintiff asserted that the hospital was vicariously liable for the negligence of the two physicians she saw. The defendant hospital was a governmental entity, so the suit filed against it was governed by the GTLA. While the GTLA provides immunity to governmental entities, it removes immunity when an “injury is caused by the negligence of a governmental employee acting within the scope of his or her employment.” In this case, plaintiff conceded that the two physicians were not employees under the GTLA, but she argued that the hospital was liable under the loaned servant doctrine. The loaned servant doctrine “provides that an employee of one employer may become the servant of another and shift the liability for his negligent acts to the second employer.” (internal citation and quotation omitted). The Court rejected this argument, though, finding that the GTLA “provides that a person ‘shall not be considered an employee of a governmental entity’ unless certain requirements are met,” and that those requirements were not met here. (citing Tenn. Code Ann. § 29-20-107(a)).

Next, the Court looked at plaintiff’s argument that defendant hospital could be held liable under the doctrine of res ipsa loquitur. The Court stated that “[a]pplication of the doctrine is precluded in cases where evidence of a specific act of negligence is introduced at trial,” and that here the plaintiff was alleging specifically that the hospital was negligent because an MRI or other test was not done and the hospital failed to “provide adequate treatment, instruments, and facilities fit for the intended use.” Because plaintiff was clearly alleging specific incidents of negligence, the Court held that res ipsa loquitur could not be used in this case.

Finally, the Court analyzed plaintiff’s “direct negligence claim” against the hospital. To survive summary judgment under the HCLA, plaintiff was required to produce expert testimony establishing the appropriate standard of care, “that the defendant acted with less than or failed to act with ordinary and reasonable care in accordance with such standard,” and that plaintiff’s injuries were proximately caused by defendant’s negligence. Regarding this claim, the Court found:

Other than conclusory references to [hospital’s] failure to provide adequate treatment, instruments, and facilities fit for the intended use, Plaintiffs did not set forth any specific facts to establish that [hospital] acted with less than or failed to act with reasonable care or that such failure proximately caused [plaintiff’s] injuries. To the contrary, Plaintiffs repeatedly asserted that [plaintiff’s] injuries were proximately caused by physician omissions, namely the failure to order a neurological or neurosurgical consult or an MRI or other diagnostic test. …However, these allegations do not establish [hospital’s] direct negligence as a hospital.


Essentially, the Court ruled that allegations only against the doctors could not support the claim against the non-employer hospital. Having rejected all of plaintiff’s arguments, summary judgment was affirmed.

This case really came down to the wrong defendant being named. Plaintiff’s specific allegations all related to the two physicians who treated her, yet the suit was against the hospital. This case serves as a reminder to think carefully about the defendants you name in a suit, how your allegations relate to those defendants, and whether a statute such as the GTLA will have an impact on your action.

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