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Keywords

contractplaintiffappealtestimonysummary judgmentcontractual obligation

contractplaintiffappealtestimonymalpracticeregulation

Related Cases

Hiser v. Randolph, 126 Ariz. 608, 617 P.2d 774

Facts

Bonita Hiser was taken to the emergency room at Mohave County General Hospital in a semi-comatose state due to acute hyperglycemia. The on-call physician, Dr. Randolph, refused to treat her, stating that the nurse should contact her regular physician, Dr. Arnold, who also declined to come to the hospital. After a delay of 40 minutes, Dr. Lingenfelter, the Chief of Staff, arrived and began treatment, but Mrs. Hiser died the following morning. The refusal of Dr. Randolph to treat Mrs. Hiser was disputed, with suggestions that it may have been based on personal animosity rather than medical justification.

The emergency room nurse, after viewing Mrs. Hiser, immediately contacted Dr. Randolph, the 'on call physician' at that time. Upon being advised as to who the patient was, Dr. Randolph stated to the nurse, at 11:50 p.m., that he would not attend or treat Mrs. Hiser, and that the nurse should call Dr. Arnold.

Issue

1) Whether a physician paid by a hospital to render emergency room services has a duty to render care to anyone presenting themselves to the hospital for emergency care; 2) Whether the plaintiff has raised a factual issue that proximate cause exists between the failure to render care and the subsequent death of the patient.

In this medical malpractice case, two issues are presented for resolution: (1) Whether a physician paid by a hospital to render emergency room services has a duty to render care to anyone presenting themselves to the hospital for emergency care; and (2) under the facts presented here, whether plaintiff has raised a factual issue that proximate cause exists between the failure to render care and the subsequent death of the patient.

Rule

A physician has a contractual obligation to treat emergency patients to the best of their ability when they are on call, and the plaintiff must show by expert testimony that the delay in treatment probably caused the patient's death.

The plaintiff, while conceding the validity of this basic rule, contends that because of the contractual relationship between Dr. Randolph and Mohave General Hospital and the bylaws of the staff of that hospital, the doctor has obligated himself to treat all emergency patients.

Analysis

The court determined that Dr. Randolph, by accepting the role of the on-call physician and the associated payment, had a contractual obligation to provide care to emergency patients. The court also noted that the plaintiff needed to demonstrate through expert testimony that the 40-minute delay in treatment was likely the cause of Mrs. Hiser's death. Although the expert testimony did not categorically state that the delay caused the death, it indicated that immediate treatment was crucial and that the delay increased the risk of death.

In our opinion, Dr. Randolph, by assenting to these bylaws, and rules and regulations, and accepting payment from the hospital to act as the emergency room doctor 'on call,' personally became bound 'to insure that all patients … treated in the Emergency Room receive the best possible care,' and agreed to insure 'in the case of emergency the provisional diagnosis shall be started as soon after admission as possible.'

Conclusion

The Court of Appeals reversed the summary judgment in favor of Dr. Randolph, concluding that there were genuine issues of material fact regarding his duty to treat and the causation of the patient's death, and remanded the case for further proceedings.

The judgment is reversed and the cause is remanded for further proceedings consistent herewith.

Who won?

The decedent's spouse prevailed in the appeal because the court found that there were substantial factual issues regarding the physician's duty to treat and the causation of the patient's death, which precluded summary judgment.

The Court of Appeals, Jacobson, J., held that (1) physician was obligated by contract between physician and hospital to treat patient to best of his ability; (2) spouse of deceased patient had burden to show by expert testimony that patient probably died as a result of 40-minute delay in testing and treatment occasioned by physician's refusal to attend her.

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