No HCLA liability under GTLA where allegedly negligent doctors were not employees of governmental entity hospital.

Where plaintiff filed an HCLA case against a hospital that was a governmental entity, but only alleged negligence by doctors who were not employees of the hospital, summary judgment under the GTLA was affirmed.

In Howell v. Chattanooga-Hamilton County Hospital Authority d/b/a Erlanger Health System, No. E2021-01197-COA-R3-CV, 2022 WL 5295794 (Tenn. Ct. App. Oct. 7, 2022), plaintiff went to defendant hospital for treatment for a laceration on his foot. Plaintiff was treated by a medical resident and a medical student, who were both under the supervision of the same physician. Neither the supervising physician, medical resident, or medical student were employees of defendant hospital.

Plaintiff filed this suit asserting negligence against the medical resident and supervising physician because the resident allegedly failed to remove fiberglass shreds from his cut before doing stitches, which led to serious medical issues.  Defendant moved for summary judgment, and after several responses and replies, the trial court granted summary judgment on the basis that “[defendant] is a governmental entity and that neither [the supervising physician] nor [the medical resident] are employees of [defendant],” so defendant “could not be held vicariously liable for the actions of [the supervising physician or medical resident] under the GTLA.” This ruling was affirmed on appeal.

Pursuant to the GTLA, a governmental entity may be liable for the “negligent actions of governmental employees acting within the scope of their employment.” (Tenn. Code Ann. § 29-20-205). The issue here, however, was that the doctors that plaintiff claimed had acted negligently were not employees of defendant hospital. The only expert testimony presented by plaintiff asserted that the supervising physician and medical resident had failed to meet the standard of care; it did not “allege that [defendant hospital] or its nurses deviated from the standard of care.”

Plaintiff argued on appeal that he could support a direct negligence claim against defendant hospital. The Court of Appeals found, however, that although “the GTLA has been interpreted to allow a direct negligence claim against a governmental entity,” in this case “Plaintiffs have not argued any negligence resulting from actions specifically by [defendant hospital] nor challenged any specific policy enacted by [defendant hospital] resulting in harm to [plaintiff].” (internal citation omitted). The Court pointed out that although plaintiff took issue with defendant allowing a “recently graduated doctor to treat patients in its hospital when they had no medical license…,” plaintiff “presented no expert proof that [defendant’s] allowing this arrangement in its emergency department fell below the standard of acceptable care for hospitals.” Further, the Court stated that the Tennessee Supreme Court has “assured that direct liability would not result in the imposition of strict liability against hospitals for injuries suffered by its patients, nor will it make hospitals a guarantor of patients’ health irrespective of individual negligence or force hospitals to regulate the medical decisions of doctors practicing in the hospital.” (internal citation and quotation omitted). The Court therefore found plaintiff’s “argument regarding direct negligence to be unavailing.”

The Court of Appeals ultimately found that plaintiff was asserting vicarious liability against the hospital based on the purported negligence of the two non-employee doctors. Because plaintiff did not allege negligence by any employee of the hospital, and because the supervising physician and medical resident were not hospital employees, summary judgment for defendant hospital was affirmed.

This case is a good example of a common issue that can arise when bringing an HCLA case against a governmental entity. The issue of who negligence is asserted against and whether that person is an employee under the GTLA can be critical in such a case.

This opinion was released five months after oral arguments in this case.

Note:  Chapter 41, Section 8 of Day on Torts: Leading Cases in Tennessee Tort Law has been updated to include this decision.

Day on Torts: Leading Cases in Tennessee Tort Law contains summaries of leading cases on over 500 topics and citations to more than 1500 additional cases.  The 500,000+ word book  (and two others, Tennessee Law of Civil Trial and Compendium of Tennessee Tort Reform Cases) is available by subscription at and is continually updated as new decisions and statutes impact Tennessee law.  Click on the link to see the book’s Table of Contents.

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