Hospitals and other health care providers who hire independent contractors for patient care should heed the ruling in a recent Illinois appeals court case that affirmed a negligence claim.

In Spiegelman v. Victory Memorial Hospital, 392 Ill.App.3d 826 (1st Dist. 2009), the Fifth District Illinois Appellate Court affirmed a circuit court decision holding that a hospital was not entitled to relief from a jury verdict that found the hospital liable for the negligence of a physician who was an independent contractor.

In Spiegelman, the plaintiff arrived at the hospital emergency room with a headache, pain in the left ear, congestion, dizziness, occasional double vision, and nausea. An independent contractor physician was the first to examine the plaintiff and incorrectly diagnose her. Although the independent contractor physician admitted the plaintiff due to her worsening condition, it was not until later the next day that the plaintiff was diagnosed with bacterial meningitis. As a result of the bacterial meningitis, the plaintiff sustained a permanent brain injury that left her wheelchair bound and in need of assistance for all her daily functions. The plaintiff sued the hospital and several physicians, including the independent contractor emergency room physician, to recover for the injuries she sustained as a result of an initial misdiagnosis.

The case centered on several important facts concerning a consent form signed by the plaintiff. Prior to receiving treatment at the emergency room, the plaintiff signed a multi-part, one-page consent form entitled, “Consent for Emergency Treatment.” By signing the consent form, the plaintiff consented to voluntary emergency department treatment and acknowledged that the professional services received by emergency room physicians would be provided by independent contractors and not agents or employees of the hospital. The consent form also contained other disclaimers and statements, including a statement about charges for services, a consent for the disposal of tissue or body parts, and a release for responsibility for valuables. The signature line of the consent form was beneath the section labeled, “Release for Responsibility for Valuables.”

Despite these facts, the court held that the hospital was vicariously liable based upon a principal-agency relationship between the hospital and physician. For a hospital to be liable under apparent authority, a plaintiff must show that: (1) the hospital or its agent acted in a manner that would lead a reasonable person to conclude that the negligent individual was an employee or agent of the hospital; (2) where the acts of the agent created the appearance of authority, the plaintiff must also prove that the hospital had knowledge or acquiesced to 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.

The Spiegelman court held that a reasonable person could conclude that the independent contractor was an employee or agent of the hospital because the consent form was confusing. The court reasoned that the consent form was in a multi-part format that contained various provisions unrelated to the independent contractor disclaimer. The court also noted that the title of the consent form did not reference the independent contractor disclaimer, but instead only referred to consent for emergency treatment. Further, the court reasoned that the signature line was beneath a separate numbered paragraph concerning the release of property. The court held that a jury could infer that the plaintiff was confused as to which doctors were employees of the hospital and which were independent contractors. The court also suggested that because the plaintiff complained of dizziness and vision problems, and there was evidence of her rapidly deteriorating condition, a jury could reasonably conclude that the consent form was ambiguous and confusing to the plaintiff and failed to adequately inform her of her the physician’s independent contractor status.