Court Struggles With Good Samaritans in Hospitals

Debra Heanue underwent an elective dialysis catheter insertion at Swedish American Hospital in Rockford.

In the recovery room, a nurse tried to page the surgeon after a problem developed regarding the patient’s medication, but he was unavailable. The nurse then asked for the immediate assistance of another surgeon, and Dr. Leslie Edgcomb took over the treatment of Heanue, who later died.

In the ensuing medical malpractice lawsuit, the defendant cited the Good Samaritan Act, 745 ILCS 49/25, as shielding him with immunity for the care and treatment he provided because he did not charge Heanue a fee for his emergency room services. The plaintiff, however, did receive a number of bills for treatment rendered before and after the emergency care, including bills on that very day. These bills included time for the services of the defendant.

In particular, the defendant cited Section 25, which states that any person licensed under the state Medical Practice Act "who in good faith provides emergency care without fee to a person, shall not, as a result of his or her acts or omissions, except willful or wanton misconduct on the part of the person...be liable for civil damages."

The appeals court reversed the trial court and held that it was a factual question as to whether the surgeon acted in good faith or did not charge a fee so as to trigger the Good Samaritan statute. Estate of Debra A. Heanue v. Edgcomb, Ill.App.3d (No. 2-03-1297, 2d Dist., decided Feb. 8, 2005). The appeals court asked, "Is the fact that defendant [doctor] benefitted financially from his relationship with Rockford Surgical, which benefitted from conducting business with the defendant, sufficient to remove the protection that Sec. 25 provides him a doctor rendering emergency care?"

Although time and again the statute has been liberally construed, the court imposed a strict construction of the term "fee." It noted that the trial court found "defendant’s professional relationship with Rockford Surgical was ‘troubling’ in that it suggested the existence of a preexisting duty to render care to Debra," Id., but the trial court had ultimately concluded that no such duty existed.

"Troubling" is indeed a good word to describe the relationship between the doctor and hospital for the apparent purpose of avoiding liability.

Just the other day, I saw a television commercial for Rush Medical Center that showed a group of physicians talking about the care they provide through that hospital. It is difficult, indeed sometimes impossible, to determine in advance which physician is a staff physician and who is an independently contracted physician with privileges to use that hospital.

Regardless, whenever someone utilizes the services of Rush Medical Center, it is clear that economic benefits – the "fees" likely contemplated by the Legislature – would flow in these doctors if they were part of a patient’s care team. Therefore, for a doctor to deny liability for such care when working in a hospital demonstrates a lack of accountability based on a technicality.

Physicians need not worry about the courts protecting them under appropriate circumstances when they try to do good under the Good Samaritan Act. Take, for instance, the recent cases of Somoye v. Klein, 349 Ill.App.3d 209, 811 N.E.2d 196 (2d Dist.2004) and Neal v. Yang, 352 Ill.App.3d 820, 816 N.E.2d 853 (2d Dist.2004).

Somoye involved an obstetrician whose alleged negligence at delivery resulted in a newborn’s suffering cerebral palsy, seizure disorder and developmental delay. Id., at 212. The trial court entered summary judgment for the defendant. On appeal, the court found that because the defendant was not the doctor on call, he, therefore, had not monitored the mother’s condition; he had no notice of any dangers to the child and had no duty to act. The Good Samaritan Act protected him.

Similarly, in Neal v. Yang, the attending obstetrician failed to call a pediatrician in time to be present for the birth of a newborn whose heart was in fetal distress. Instead, because the obstetrician also was not immediately available, he asked that the on-call anesthesiologist assist in the neonatal resuscitation of the infant. As a result of 22 minutes of oxygen deprivation, the infant required 24-hour care and then died at a little more than one year old.

The plaintiff contended that the on-call physician was contractually obligated to provide medical care and, as such, a pre-existing duty existed to render such care. This physician was the one doctor present and, therefore, was in charge during the resuscitation. Id., at 823.

In liberally construing the act, however, the court found that a physician need not provide the absence of a preexisting duty to render aid to a patient in order for the Good Samaritan Act to apply, and that a preexisting duty or on-call status of a physician is relevant only in terms of the notice requirements under the statute. Id., at 829. A physician need only demonstrate she had no notice, provided emergency care and did not charge a fee under the act.

The court pointed out that, upon amending the act in 1998, the Legislature broadened the application to further protect Illinois doctors and "omitted the requirement that the treating physician act ‘without prior notice of the illness or injury’" Id., at 825.

Still, it is surprising that courts are applying the Good Samaritan Act to actions occurring in hospitals, something not initially contemplated by the Legislature. "While the Act was originally enacted to ‘encourage good samaritans to do the right thing on the streets of Illinois, without fear of repercussions in a court of law,’ it is clear that courts have liberally construed the plain language of the act and have applied it to emergency situations at hospitals..." Id., at 826-27.

Yet, when it comes to the definition of fees under the act, some courts seem to be turning to a strict construction. As the case of Debra Heanue points out, the law should not be twisted to avoid responsibility when negligence has occurred.