When you walk into a Hospital for a surgery, you might reasonably assume that the Hospital would share some responsibility if you are injured as a result of medical negligence during that surgery. However, given the modern healthcare system, this may not be the case. This state of affairs is clearly illustrated by the recent decision by a panel in the First District Appellate Court in the tragic case of Delegatto v. Advocate Health and Hospitals, et al, 2021 IL App (1st) 200484 No.1-20-0484.
The Complaint in the case claims that Tracy Delegatto began treating with Dr. Anthony Rinella at his private practice for back pain in 2015, before being recommended for surgery. It was decided that the surgery would be performed at Silver Cross Hospital, which Dr. Rinella was affiliated with and where he had admitting privileges. As part of the lead-up to the surgery, Tracy signed a number of consent forms, one of which read:
I UNDERSTAND THAT ALL PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS FURNISHING SERVICES TO ME, INCLUDING EMERGENCY DEPARTMENT, RADIOLOGISTS, ANESTHESIOLOGISTS, PATHOLOGISTS, AND THE LIKE, ARE INDEPENDENT CONTRACTORS AND ARE NOT EMPLOYEES OR AGENTS OF THE HOSPITAL.
Immediately prior to the surgery she also signed two other substantially similar forms. It is unknown whether Tracy understood the import of these forms, because she passed away shortly after the surgery, resulting in a lawsuit against the doctors involved as well as the hospitals.
Now, it is pretty clear that Dr. Rinella actually was an independent contractor for Silver Cross. While it was where he performed his surgeries, he did not report to anyone at Silver Cross, they did not assert any control over his actions, he was not paid anything by Silver Cross in connection with Tracy’s care, and all of his business documents (records and bills) and signage in his office were actually listed under the name of his private practice.
What complicated the matter in this case was the Plaintiff (Tracy’s Husband) argued that Silver Cross had created and agreed to an apparent agency relationship with Dr. Rinella. This is a legitimate argument— for decades Illinois courts have recognized explicitly that, because of the complicated nature of employment in healthcare, patients may rely on the reputation of a Hospital generally, without having knowledge that the doctors who are treating them don’t actually have any kind of employer-agent relationship with it. Because of this, in the medical context specifically, a hospital is liable even for independent contractors when
(1) the hospital, or its agent, acted in a manner that would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital;
(2) where the acts of the agent create the appearance of authority, the plaintiff
must also prove that the hospital had knowledge of and acquiesced in them; and
(3) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.
Gilbert v. Sycamore Municipal Hospital, 156 Ill. 2d 525 (1993).
Unfortunately, in this case the court found that the three consent forms signed by Tracy defeated the claim against Silver Cross. Although the Plaintiff was able to cite to cases involving consent forms that went the other way, the court found that the language in this case was unambiguous enough that a reasonable person would have concluded from the forms that none of the doctors in the hospital were agents of the hospital itself. It also found that Dr. Rinella had never presented himself, from his office signs to his business letterhead to his bills, as anything other than an employee his own business, and thus the hospital could not have acquiesced to anything.
Although it is extremely important to read and understand documents before singing off on them, this case does emphasize that the rules about things like consent forms are not as hard and fast as one might think. The Plaintiffs argument here, although unsuccessful, weren’t unreasonable—language, as well as the specific details, matter a great deal when it comes to things like this.
Attorney Travis Dunn