Emergency medical care provided in hospital emergency rooms is different from medical care provided in other settings. This has been acknowledged in Georgia by both the judiciary and the legislature. To help promote the availability of quality health care services, in 2005, the legislature enacted an emergency medical care statute establishing a standard of care and a burden of proof that reduces the potential liability of the providers of such emergency care. The constitutionality of this statute has been upheld by the Supreme Court of Georgia, and the statute has been applied and interpreted in several cases. A recent interpretation of this statute by the Georgia Court of Appeals sheds some light on the type of protection this statute provides to emergency care physicians. Relying upon the standard and burden provided by the statute, the Court of Appeals affirmed a trial court’s grant of summary judgment in favor of the defendants in Johnson et al. v. Omondi et al., a case in which the plaintiffs filed suit against a physician after their son died from a pulmonary embolism two weeks after being treated by the physician.
In Johnson, the plaintiffs brought their son to a hospital emergency room (“ER”) due to his complaints of pain on the left side of his chest that was worse in a recumbent position. The ER physician was made aware that the patient had undergone arthroscopic knee surgery eight days earlier. The physician reviewed a triage nurse’s record and findings, inquired about past medical and family history (including any past diagnoses of pulmonary embolism or pneumonia), conducted several different examinations of the patient’s systems, and interpreted chest x-ray and EKG results. The test results came back normal and none were suggestive of pulmonary embolism as the cause of the patient’s pain. Furthermore, the evidence showed that the physician considered the fact that the patient responded positively to Toradol. Because the Toradol completely resolved the patient’s pain, and because Toradol is an anti-inflammatory that would not treat pain from a pulmonary embolism, the physician concluded that this was further evidence that there was no blood clot in the patient’s lungs. The physician concluded that the patient was suffering from pleurisy, and he prescribed Naprosyn, an anti-inflammatory medication for pain, and discharged the patient. Two weeks later, the patient died from a bilateral pulmonary embolism.
The plaintiffs argued that the physician’s care and treatment of their son deviated from the appropriate standard of care and thus proximately caused of his death. Their experts stated several ways in which they believed that the physician deviated from the appropriate standard of care, including his taking of the patient’s history, conducting the physical exam, and also in his interpretation of the chest x-ray and EKG. They further contended that he failed to rule out a pulmonary embolism, order a chest CT scan, or order an ultrasound of the patient’s surgical leg.
The Court of Appeals disagreed with the plaintiffs and affirmed summary judgment in favor of the defendants. The court explained that the emergency medical care statute “clearly distinguishes the actions of emergency department physicians from other healthcare providers in negligence cases, including medical malpractice cases not involving emergency department care, by mandating (1) a higher evidentiary standard (clear and convincing evidence), and (2) a lower standard of care (gross negligence).” The court held that while the plaintiffs’ experts criticized the care rendered to the patient, they never opined that the doctor failed to exercise even a slight degree of care. The Court went on to say that “even if some of the [plaintiffs’] allegations of negligence could somehow be construed as approaching gross negligence, any such allegations fall far short of providing evidence that is ‘substantially higher’ than a preponderance of the evidence.”