In a decision that aims to quell a long history of conflicting rulings on the topic, the California Supreme Court has adopted a wide view of when an accident in a hospital should be considered medical professional negligence instead of ordinary negligence.
Catherine Flores was a hospital patient who was injured when the rails on her hospital bed collapsed. The rails had been raised on a physician's order following a medical assessment of Ms. Flores' condition. She sued the hospital, claiming that it negligently failed to inspect and maintain the equipment. The timing of that suit, however, led to a dispute between the plaintiff and the defendant hospital as to the actual nature of the allegation.
In Flores v. Presbyterian Intercommunity Hospital, the state's highest court ruled that because the plaintiff's injury resulted from alleged negligence in the use and maintenance of equipment needed to implement the doctor's orders, her claim falls into the category of professional, rather than ordinary, negligence.
Under MICRA, medical professional negligence is defined as "a negligent act or omission to act by a health care provider in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death, provided that such services are within the scope of services for which the provider is licensed and which are not within any restriction imposed by a licensing agency or licensed hospital."
Ms. Flores' attorneys argued that the term "professional services" does not apply because the maintenance of hospital equipment and premises requires no "specialized education, training or skill." Counsel for the hospital countered that "the test is not whether the situation calls for a high or low level of skill . . . but rather the test is whether the negligent act occurred in the rendering of services for which the health care provider is licensed."
The Supreme Court unanimously ruled that the law on professional medical services does not apply only to those specific tasks that require advanced medical skills and training.
"A hospital's failure to prevent a patient from becoming separated from an oxygen ventilator, for example, occurs in the 'rendering of professional services' regardless of whether the separation was caused by an ill-considered decision of a physician or the accidental bump of a janitor's broom."
"Thus, if the act or omission that led to the plaintiff's injuries was negligence in the maintenance of equipment that, under the prevailing standard of care, was reasonably required to treat or accommodate a physical or mental condition of the patient, the plaintiff's claim is one of professional negligence... ," the court said.
But the court also explained that "professional negligence" does not extend to maintenance of equipment and premises that are merely convenient for, or incidental to, the provision of medical care to a patient.
The court pointed out that hospitals maintain tables, toilets, televisions, and the like that primarily provide comfort and convenience of patients and visitors but play no part in the patient's diagnosis or treatment.
"Although a defect in such equipment may injure patients as well as visitors or staff, a hospital's general duty to keep such items in good repair generally overlaps with the obligations that all persons subject to California's laws have and thus will not give rise to a claim for professional negligence."
Gordon Ownby is CAP’s General Counsel. Comments on Case of the Month may be directed to gownby@CAPphysicians.com.gownby@CAPphysicians.com