Hull v. North Val. Hospital

• Decision Date: 09 June 1972
• Docket Number: No. 12102,12102
• Citation: Hull v. North Val. Hospital, 498 P.2d 136, 159 Mont. 375 (Mont. 1972)
• Court: Montana Supreme Court
• Parties: William B. HULL, Plaintiff and Appellant, v. NORTH VALLEY HOSPITAL, Defendant and Respondent.

Page 136

498 P.2d 136

159 Mont. 375

William B. HULL, Plaintiff and Appellant, v. NORTH VALLEY HOSPITAL, Defendant and Respondent.

No. 12102.

Supreme Court of Montana.

Submitted Feb. 17, 1972.

Decided June 9, 1972.

McGarvey, Morrison, White & Hedman, Frank B. Morrison, Jr. (argued), Whitefish, for appellant.

Murphy, Robinson, Heckathorn & Phillips, Kalispell, I. James Heckathorn (argued), Kalispell, for respondent.

Chadwick H. Smith (argued), Helena, amicus curiae.

DALY, Justice.

This is an appeal from entry of a directed verdict for defendant in a negligence action brought by plaintiff William B. Hull against defendant North Valley Hospital of Whitefish, Montana. The action was brought in the district court of the eleventh judicial district, county of Flathead, to recover damages for personal injury suffered by plaintiff by reason of the negligence of his family physician, while plaintiff was a patient in defendant hospital. At the conclusion of plaintiff's case, the trial judge sustained defendant's motion to dismiss and from that judgment plaintiff appeals.

The principals involved herein are: North Valley Hospital, defendant and respondent, hereinafter referred to as 'Hospital'; William B. Hull, plaintiff and appellant; Doctor David V. Kauffman, William B. Hull's family physician; the Board of Directors of the Hospital, hereinafter referred to as 'Board of Directors'; and the private physicians practicing in the surrounding area who utilize the Hospital for patient care, hereinafter referred to as the 'medical staff'.

The Hospital is a private, nonprofit corporation operated by a Board of Directors made up of community volunteers with no paid staff of doctors or interns.

The Hospital on June 13, 1966, adopted bylaws creating a hospital structure designed to regulate the conduct of the medical staff. It was necessary to create such hospital organization to comply with the standard for hospital accreditation, more specifically the Joint Commission on Accreditation of Hospitals. In part, those bylaws are:

'ARTICLE VI MEDICAL STAFF

'Section 1. The Board of Directors shall appoint a medical and dental staff composed of physicians and dentists who are graduates of recognized medical or dental schools, legally licensed to practice in the State of Montana, a member in good standing in the local medical or dental society, and practicing in the community or within a reasonable distance of the hospital, and shall see that they are organized into a responsible administrative unit, and adopt such by-laws, rules and regulations for government of their practice in the hospital as the Board of Directors deem to be the greatest benefit to the care of patients within the hospital. In the case of the individual patient, the physician or dentist duly appointed to the medical staff shall have full authority and responsibility for the care of that patient subject only to such limitations as the Board of Directors may formally impose and to the by-laws, rules and regulations for the medical and dental staff adopted by the staff and the Board of Directors.

"* * *

'Section 4. In any case where the medical committee of the Board of Directors or the Credential Committee of the medical staff does not recommend termination of appointment, or imposes limitations with respect to the exercise of privileges requested, or where reduction of privileges is recommended, or a request for additional privileges denied, the Credential Committee of the medical staff should so notify, in writing, the physician concerned. That within ten (10) days of receipt of the above notice the physician may request, in writing, to the administrator of the hospital, reconsideration and, an opportunity to appear before the Joint Conference Committee made up of three (3) members of the medical staff and three (3) members of the Board of Directors. A decision to grant this hearing should be made within ten (10) days after the receipt of the request by the Joint Conference Committee. The Joint Conference Committee shall then, after said hearing, make their recommendation to the Board of Directors and their decision shall be final.'

'ARTICLE IV COMMITTEES OF THE BOARD OF DIRECTORS

"* * *

'Section 4. The Medical Committee shall consist of three (3) members of the Board of Directors.

'This committee shall:

'(1) Receive recommendations from the medical staff and make final recommendations to the Board of Directors on all appointments to, and assignments of responsibilities within, the medical staff of the hospital.

'(2) Recommend to the Board of Directors the types of professional work to be permitted to be done by each member of the medical staff.

'(3) Recommend to the Board of Directors all rules and regulations for the government of the medical staff, or amendments thereto, necessary to assure the proper care of the patients.

'(4) Receive and make recommendations to the Board of Directors respecting any communications, requests or recommendations presented by the medical staff through its duly authorized representatives.

'(5) Together with an equal number of representatives from the medical staff, constitute the Joint Conference Committee a liaison group, which, with the administrator, will discuss medical administrative matters and be the official point of contact among the Board of Directors, administrator, and medical staff.

'(6) Receive and consider all reports on the work of the medical staff and make such recommendations to the Board of Directors in respect thereto as the committee considers to be the best interests of the hospital and its patients.'

Within the medical staff itself, there are various committees including: (1) the executive committee consisting of the president, vice-president, and secretary of the medical staff; and (2) the record review committee which regularly reviews the charts of the various doctors. Discrepancies in the charts may either be called to the attention of the doctor responsible or, in instances requiring further action, the matter may be referred to the executive committee. In serious matters, the entire medical staff is consulted to decide if the situation warrants disciplinary action or restriction privileges. In such cases, the executive committee or the medical staff would make formal recommendation to the Board of Directors.

The ultimate authority for granting or revoking privileges rests with the Board of Directors. The administrator of the Hospital acts as the liaison officer between the medical staff and the Board of Directors. Information relative to doctors' qualifications to have certain privileges comes from an investigation made by the medical records review committee. Privileges extended to doctors practicing in the Hospital, subject to annual review before renewal, are: (1) surgical, (2) medical, and (3) obstetrical.

Doctor David V. Kauffman is a licensed physician practicing in Whitefish, and during all times pertinent herein was a member of the medical staff of the Hospital. Since 1964 or 1965, Dr. Kauffman has been the family physician for William B. Hull, plaintiff herein, who in July 1969 injured his left knee when he tripped over an air hose at his automotive repair shop. On July 28, 1969, Hull consulted with Dr. Kauffman who initially treated the knee with heat treatments, but after consultation with Dr. W. F. Bennett surgery was recommended to repair the knee. On August 12, 1969, plaintiff was hospitalized at the Hospital, in Whitefish.

On August 13, 1969, surgery was performed by Dr. Kauffman and Dr. Bennett. The operation consisted of removal of cartilage from inside the left knee joint. Following surgery, plaintiff spent four days in the Hospital and was discharged on August 17. Two days later plaintiff returned to Dr. Kauffman's office to have surgical stitches removed and pus was then draining from the knee. Dr. Kauffman administered penicillin salve to counteract the draining. Plaintiff testified at trial that throughout the last two weeks of August 1969, Dr. Kauffman administered antibiotics which had no apparent effect in improving plaintiff's condition.

On September 2, 1969, plaintiff was readmitted to the Hospital by Dr. Kauffman and X-ray on the knee was done by Dr. Bennett. Dr. Bennett was listed on the Hospital case records as an associate with Dr. Kauffman, and it is conceded in the record that Dr. Bennett is competent and skilled. On September 3, Dr. Kauffman, unassisted by Dr. Bennett or other medical staff, performed a second operation on plaintiff's knee. This operation was termed a 'debridement'.

At trial a description of the second operation was given by witness Dr. Theodore Sanford as:

'* * * the findings: stitch reaction, draining infected wound. What was done: the skin wound was opened, all of the old stitches removed, debridement of the wound edges. Debridement means removal of dead tissue-debridement of wound edges and then repaired with number thirty-two wire, stainless steel wire. The skin was closed with four oh nylon subcutaneous, that's just underneath the skin. * * *'. (Emphasis supplied)

Witness Sanford further testified that 'stitch reaction' as diagnosed by Dr. Kauffman, differed from a general infection of the joint, subsequently found to be the correct diagnosis.

It was established that this misdiagnosis, treatment, or lack of proper treatment, eventually caused plaintiff's injuries. We find it unnecessary to pursue this matter in detail as plaintiff claims that defendant Hospital is liable in allowing Dr. Kauffman to practice in the Hospital. It is not claimed that any employee of Hospital was negligent in the course of treatment nor that any relationship exists between Dr. Kauffman and Hospital that would make Hospital vicariously liable for his acts.

Dr. Kauffman's negligence is admitted and the record reflects a settlement of plaintiff's claim against him prior to trial of the instant case.

The record discloses that during the 1960's...