Locality Rule, Collaborative Practice Agreement, Hospital Negligence, and Damage Caps
• Week -3: Tutorial Questions
Questions:
TQ 3.1: Hall v. Hilbun: What is the “locality rule”? Why did the court conclude that the locality rule was no longer appropriate? What does the court mean by “the resources-based caveat to the national standard of care”?
TQ 3.2: Harper v. Hippensteel: What is a “collaborative practice agreement”? Why did the court conclude that the collaborative practice agreement between Nurse Practitioner Vories and Dr. Hippensteel was not sufficient, in itself, to render Hippensteel responsible for Viories’ negligence? Under what circumstances might a doctor be liable for the negligence of a nurse practitioner with whom he has entered into a collaborative practice agreement?
TQ 3.3: Washington v. Washington Hospital Center: What was the hospital’s alleged negligence in this case? What arguments did the hospital make in support of its assertion that it did not act negligently? Based on the court’s reasoning, if one hospital in the community purchases a new, expensive piece of medical equipment, does that mean that other hospitals that do not purchase the equipment are negligent? If professional associations recommend the purchase of the equipment, does that mean that hospitals that ignore the recommendations are negligent?
TQ 3.4: Darling v. Charleston Community Memorial Hospital: The patient’s injury in this case seems clearly to have been caused by a bad doctor (who, as the beginning of the opinion indicates, settled with the patient for $40,000). Why then was the hospital also found to be negligent? Is this case primarily about the behavior of individual nurses, or is the hospital also being held responsible for larger policy decisions?
Week 3: Discussion Board Question 1 Questions:
DQ 3.1: In contrast to the American system of medical malpractice, some countries have adopted no-fault systems of compensation for medical injuries. The Is "No-Fault" the Cure for the Medical Liability Crisis? article provides a brief explanation of some of these systems, as well as competing perspectives on whether the U.S. system should move in this direction. In your view, what would be the primary advantages and drawbacks of replacing our fault-based system of liability with a no-fault system such as that currently applied in Sweden and New Zealand? Would you support such a change?
Questions:
DQ 3.2: Many states have enacted "caps" on pain and suffering awards in malpractice cases, often as part of broader efforts at "malpractice reform." What are your views on damage caps? Do you think that more states should adopt them? Should they be imposed in all states through federal legislation, as has been repeatedly proposed?
TQ 3.1: “Locality Rule” in the Hall v. Hilbun Case
The “locality rule” in the Hall v. Hilbun case states that the private right of action under section 1983 cannot be based on conduct occurring outside the territorial jurisdiction of the state or district in which it is brought. The locality rule applies only to cases challenging a decision, not to suits for injunctive relief. The locality rule has been codified into Federal Rule of Civil Procedure 23(c). The timely amendment to FRCP 23(c) came about because judges were reporting that section 1983 actions were frequently dismissed because they occurred outside of state lines (Cooke et al., 2017).
The geographic reach of section 1983 was the subject of significant litigation in "United States v. Lopez", 514 U.S. 549 (1995), which arose out of the federal government's practice of civil-asset forfeiture, under which property is seized by state and local police even though no violation of federal law has occurred (Hall v. Hilbun, 1985). It is now well established that the reach of section 1983 extends beyond state and local government to include actions against any person or entity that implements or enforces a federal law within the jurisdiction of a relevant state or local jurisdiction, without limitation as to how long ago such implementation or enforcement occurred.
The decision in the case announced that the locality rule was no longer appropriate because of its failure to provide a workable standard for determining whether an action occurred “within the territorial jurisdiction of the state or district in which it is brought.” This, coupled with the implications of "Lopez", led to amendments to FRCP 23(c) designed to serve as a remedy for section 1983 actions that are dismissed for lack of jurisdiction (Hall v. Hilbun, 1985). The amendments permit courts to apply a modified version of that test, which now provides that the inquiry into whether the conduct took place within “the jurisdiction” can be satisfied by an examination of whether local law properly reached such conduct. The court describes this modified rule as the “resources-based” caveat to the national standard of care. This test is consistent with that used by other federal courts, including the Supreme Court in "Lopez", and has been referred to as a “modified locality test.”
TQ 3.2 - A “Collaborative Practice Agreement” in Harper v. Hippensteel Case
A "collaborative practice agreement" is any written agreement between an attorney and a new lawyer that outlines the terms of the new lawyer's employment with or association with the law firm (Miller, 2020). This can include, for example, an agreement concerning the division of labor, compensation arrangements, salary, hours worked per week or month, who pays for what training programs during their time at the firm (i.e., JCLE, CPR), among others. Written agreements may also include non-compete clauses and provisions governing intellectual property ownership issues. Blanket work rules established by a law firm are not considered to be collaborative practice agreements.
The court concluded that the collaborative practice agreement between Nurse Practitioner Vories and Dr. Hippensteel was not sufficient, in itself, to render Hippensteel responsible for Viories’ negligence because, the court noted, Hippensteel “failed to meet the burden of proving that he was personally liable for Vories’ tortious conduct (Harper v. Hippensteel Case, 2013). The agreement did not identify who would be treating patients, nor did it identify which members of Hippensteel's staff would be doing so during Vories' assigned time periods (Harper v. Hippensteel Case, 2013). The court reasoned that, in order to determine whether Dr. Hippensteel is held liable for Nurse Practitioner Vories' negligence, the court must determine how much supervision she received during her employment at Hippensteel's practice.
The doctor would be held liable for the negligence of the nurse if the doctor knew, or should have known about the nurse's wrongful conduct. If the doctor is found to be negligent, he can be held liable for the acts of his independent contractor only if it is determined that he directed her actions or failed to act in such a way so as to protect others from her wrongful conduct (Miller, 2020).
The elements of agency liability are: (i) an agent-principal relationship; (ii) acts by agent within scope of employment; and (iii) damages proximately resulting from those acts. Whether all three elements are met is a question for the jury unless there is no conflicting evidence on any element.
TQ 3.3: Negligence in the Washington v. Washington Hospital Center Case
The hospital’s alleged negligence in Washington v. Washington Hospital Center case directly led to the breach of propofol-based drug treatment for surgical instruments and the use of a needle and catheter device for administering anesthesia, which caused Ms. Thompson’s death and injury (Washington v. Washington Hospital Center, 1990). The first thing the doctors should have done was clearly explain the risks and benefits of sedation, anesthesia, and pain management to Ms. Thompson prior to her surgery; this would have allowed her to make an informed decision about whether these measures were necessary. The hospital’s arguments are that there was no evidence that any of Dr. Murray’s colleagues or any other doctors had told him about the monitors; that the data on which the plaintiffs relied was hearsay; and that WHC’s surgeon, Dr. John Henneman, testified that carbon dioxide monitors were not essential to his practice.
Purchasing new medical equipment do not mean negligence. In this case, the hospital's negligence was not in purchasing a new piece of medical equipment but rather how it used it. The defendant’s alleged negligence in the Washington v. Washington Hospital Center case was not that they were negligent for purchasing a new piece of medical equipment but rather that they were negligent for improperly using the piece of medical equipment that they purchased. The court’s ruling also states that the evidence demonstrated that another facility, GWU Hospital, had acquired an infusion pump which contained a carbon dioxide monitor and that Dr. Henneman, a highly experienced anesthesiologist at both WHC and GWU Hospital, regularly used the pump.
It does not mean that the defendant's alleged negligence in the case was not that the hospital failed to follow recommendations made by professional associations, but rather that they used a piece of medical equipment improperly even though it was recommended....