Gaulden v. Green

• Decision Date: 30 October 2012
• Docket Number: No. A12A1872.,A12A1872.
• Citation: 733 S.E.2d 802
• Parties: GAULDEN et al. v. GREEN et al.
• Court: Georgia Court of Appeals

733 S.E.2d 802

GAULDEN et al.

v.GREEN et al.

No. A12A1872.

Court of Appeals of Georgia.

Oct. 30, 2012.

H. Craig Stafford, Tyler Lee Randolph, for Appellants.

Matthew Scott Coles, Wiley A. Wasden III, B. Nicole Smith, Savannah, Theodore E.G. Pound, Kathleen Woodruff Simcoe, Paul E. Weathington, Atlanta, for Appellees.

BARNES, Presiding Judge.

Following the death of Deloris P. Gaulden in the emergency room of Liberty Regional Medical Center (“LRMC”), her daughter, individually and as administratrix of her estate, brought this wrongful death and survival action against several defendants, including Bobby L. Herrington, M.D., the Medical Director of the LRMC Emergency Department.¹ The trial court granted summary judgment to Dr. Herrington on the plaintiff's claim for professional negligence on the ground that he had no physician-patient relationship with the decedent and owed no legal duty to her. The trial court subsequently granted summary judgment to Dr. Herrington on the plaintiff's claim for ordinary negligence on the ground that all of the allegations against him sounded in professional negligence. For the reasons discussed below, we affirm the trial court grant of summary judgment on the ordinary negligence claim. However, we conclude that Dr. Herrington owed a legal duty to the decedent based upon the specific supervisory responsibilities that he assumed over the emergency room staff in agreeing to serve as Medical Director, and, therefore, reverse the trial court's grant of summary judgment on the professional negligence claim.

Summary judgment is proper if, and only if, the pleadings and evidence “show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” OCGA § 9–11–56(c). See Ly v. Jimmy Carter Commons, LLC, 286 Ga. 831, 833(1), 691 S.E.2d 852 (2010). On appeal from the grant of summary judgment, we view the evidence de novo, with the facts and all inferences drawn from them viewed in the light most favorable to the nonmoving party. McCaskill v. Carillo, 263 Ga.App. 890, 589 S.E.2d 582 (2003).

So viewed, the record shows that on October 17, 2008, the 64–year–old decedent was transported by ambulance to the LRMC Emergency Department after becoming dizzy and fainting at church. En route to the hospital, the decedent informed the paramedic who was riding in the ambulance that she had a history of hypertension and hypercholesterolemia. She also complained of “chest tightness,” which the paramedic reported to emergency room staff by phone on the way to the hospital and in-person once the ambulance arrived there.

The decedent was received by staff in the emergency room at 1:47 p.m. Despite her repeated complaints of chest pain following her arrival, she did not receive an anticoagulant (i.e., aspirin) until 2:45 p.m. The first 12–lead electrocardiogram (“EKG”) of the decedent, which showed that she was likely suffering from a heart attack, was not performed until 2:58 p.m. Following the EKG, the decedent went into cardiac and respiratoryarrest, and the emergency room staff called an emergency code and began CPR at 3:19 p.m. Efforts were made to revive the decedent until 6:05 p.m., when she was pronounced dead.

The administratrix of the decedent's estate subsequently commenced this wrongful death and survival action against multiple defendants, alleging that the failure to properly triage, diagnose, and treat the decedent in the emergency room caused her untimely death from a sudden cardiac event. The complaint and accompanying expert affidavits alleged that if Dr. Daniel Green (the emergency room physician who had treated the decedent), had properly recognized the decedent's symptoms of a heart attack, and if Dr. Green and Stuart Mauney (the registered nurse assigned to the decedent in the emergency room), had immediately and properly implemented the hospital's “Chest Pain Standing Orders” in response to those symptoms, the decedent would not have died from her cardiac condition.

The complaint also named as a defendant Dr. Herrington, the Medical Director of the LRMC Emergency Department. Dr. Herrington was not present or physically involved in the care and treatment of the decedent the day she presented and died at the hospital. However, according to the complaint and the expert physician's affidavit attached to it, Dr. Herrington breached his specific supervisory duties as Medical Director and was negligent in failing to take adequate steps to ensure that emergency room staff (including Dr. Green and Nurse Mauney) were properly trained on the existence of and proper implementation of Emergency Department policies and protocols, including the “Chest Pain Standing Orders.”

Dr. Herrington filed a motion for summary judgment, contending that the evidence did not support a claim of professional negligence against him because he did not have a physician-patient relationship with the decedent and owed no legal duty to her. The trial court granted the motion, but reserved ruling on any claims asserted against Dr. Herrington for ordinary negligence. Dr. Herrington then filed a second motion for summary judgment as to any claim for ordinary negligence, asserting that the uncontroverted evidence showed that his duties in supervising the Emergency Department involved medical questions demanding the exercise of professional judgment and skill, such that the claims against him fell outside the realm of mere ordinary negligence. The trial court granted the second motion for summary judgment, leading the plaintiff to file this appeal.

1. The plaintiff challenges the trial court's order granting summary judgment to Dr. Herrington on the professional negligence claim. In seeking summary judgment, Dr. Herrington argued that the uncontroverted evidence showed that no physician-patient relationship existed between him and the decedent, and thus that no legal duty was owed by him to her. The plaintiff asserts that the trial court's order can be affirmed only if it is true that “claims of professional negligence can never stand against a physician who does not establish a direct, in-person doctor-patient relationship.” According to the plaintiff, Dr. Herrington owed a legal duty to the decedent based on the explicit, written duties set forth in his contract to serve as Medical Director, “as well as those implied through his position as Director of the Emergency Department.” We agree with the plaintiff that summary judgment on the professional negligence claim was inappropriate under the particular facts of this case.

To maintain a claim for professional negligence, “a plaintiff must prove the following elements: (1) a legal duty to conform to a standard of conduct; (2) a breach of this duty; (3) a causal connection between the conduct and the resulting injury; and (4) damage to the plaintiff.” (Punctuation and footnote omitted.) Pattman v. Mann, 307 Ga.App. 413, 417, 701 S.E.2d 232 (2010). “In the absence of a legally cognizable duty, there can be no fault or negligence.” Ford Motor Co. v. Reese, 300 Ga.App. 82, 84(1)(a), 684 S.E.2d 279 (2009).

In a “classic” medical malpractice case, the plaintiff must come forward with evidence of a physician-patient relationship to succeed on a claim of professional negligence against the physician. See Medical Center of Central Ga. v. Landers, 274 Ga.App. 78, 84(1)(b), 616 S.E.2d 808 (2005); Peace v. Weisman, 186 Ga.App. 697, 698(1), 368 S.E.2d 319 (1988). “In such cases, ... doctor-patient privity is essential because it is this relation which is a result of a consensual transaction that establishes the legal duty to conform to a standard of conduct.” (Citation omitted.) Landers, 274 Ga.App. at 84(1)(b), 616 S.E.2d 808.

Privity is not required, however, if there is some independent basis for the existence of a legal duty—apart from the “consensual transaction” between physician and patient—that arises out of the unique circumstances of the case. See Bradley Center v. Wessner, 250 Ga. 199, 201–203(1), 296 S.E.2d 693 (1982) (plurality opinion). This follows from the general principle that “[a] breach of different duties ... gives rise to separate and distinct claims.” (Citations and punctuation omitted.) Blier v. Greene, 263 Ga.App. 35, 39(2), 587 S.E.2d 190 (2003).

Under Georgia law, the failure to adequately supervise emergency room staff “can result in liability for any damages resulting from such failure by one whose responsibility it is to provide such supervision.” Gray v. Vaughn, 217 Ga.App. 872, 874(1), 460 S.E.2d 86 (1995) (defendant “was contractually obligated to provide supervision of the triage nurses” and could be held liable for injury to patient resulting from failure to supervise them properly). There is evidence in the record that Dr. Herrington, in serving as Medical Director of the LRMC Emergency Department, assumed an independent duty to supervise and monitor the training of emergency room physicians and nursing staff to ensure that they were adequately informed of and knowledgeable about the existence of and proper implementation of Emergency Department policies and protocols, including the “Chest Pain Standing Orders” at issue in this case. Given this independent duty, the plaintiff was not required to prove that a physician-patient relationship existed between Dr. Herrington and the decedent.

Specifically, the record reflects that since August 2000, Dr. Herrington has worked as a staff physician in the LRMC Emergency Department. Beginning in June 2008, he also assumed the role of Medical Director of the LRMC Emergency Department in return for additional compensation, termed a “Medical Director Stipend,” and signed an agreement entitled “Medical Director Agreement–Emergency Department.” (the “Medical Director Agreement”) ² Under the Medical Director Agreement, Dr. Herrington agreed to “substantially perform and carry out the typical duties of a dedicated, fully functional...