On or about February 15, 1990, Ms. Persuad was referred to Dr. Freeman for consu

Question

On or about February 15, 1990, Ms. Persuad was referred to Dr. Freeman for consultation and treatment of infected gallstones. Dr. Freeman recommended that Ms. Persaud undergo a laparoscopic laser cholecystectomy.

On February 16, 1990, Dr Freeman requested and was granted temporary privileges to perform the procedure. He submitted a certificate of completion of a laparoscopic laser cholecystectomy workshop, which he had taken on February 10, 1990, assisted by Dr. Thomas.

A complaint by the administrator of the patients estate, supported by an experts affidavit. Alleged that the cholecystectomy was negligently performed, causing the patient to bleed to death. The complaint charged the hospital with negligence in permitting Dr. Freeman, assisted by Dr. Thomas, to perform the procedure on the decedent without having instituted any standards, training requirements, protocols, or otherwise instituting any method for judging the qualifications of a surgeon to perform the procedure. The complaint also alleged the hospital knew or reasonably should have known that it did not have a credentialing process that could have assured the hospital of the physicians education, training, and ability to perform the procedure.

The trial court denied the hospitals motion for summary judgement on the ground that the plaintiffs evidence was sufficient to raise a question of fact regarding whether a surgical permit should have been issued by the hospital to Dr. Freeman. The hospital appealed.

The court of appeals held that there was a material issue of fact as to whether the hospital was negligent in granting the specific privileges requested, thus precluding summary judgement.

The hospital argued that there is no cause of action against a hospital based solely on the issuance of a surgical permit for a specific procedure to an independent surgeon already duly and properly appointed to its active surgical staff. The plaintiff in Joiner v. Mitchell County Hosp. Auth., 125 Ga. Ct. App. 1, 2(1), 186 S.E.2d. 307 (1971), aff’d, 229 Ga. 140, 189 S.E.2d 412 (1972), “who had brought her husband into the hospital for emergency treatment, alleged that the negligence of the treating physician who was on the staff of the hospital resulted in her husbands death. She also sought to hold the hospital liable, not under the doctrine of respondeat superior or principal and agent, but rather upon the doctrine of independent negligence in permitting the alleged negligent physician to practice his profession in the hospital when his incompetency was known.” 229 Ga. at 141, 189 S.E.2d 412. “Joiner identified negligence as failing to investigate and require satisfactory proof of the physicians qualifications and as failing to exercise care in determining his professional competency.” Id. At 777.

The Court of Appeals found that the question “in this case is whether this authority recognized by the supreme court in Joiner gives rise to a duty which the hospital owes to a patient when: (1) the patient rather than the hospital selected the independent staff surgeon to perform the procedure at issue, and (2) the hospital was allegedly negligent, not in its grant to him of privileges to practice a procedure which he allegedly was not qualified to perform.” Id. at 777.

The court interpreted Joiner as authority to support the proposition that a hospital has a direct and independent responsibility to its patients to take reasonable steps to ensure that staff physicians using Hospital facilities are qualified for privileges granted. The hospital owed a duty to the plaintiffs decedent to act in good faith and with reasonable care to ensure that the surgeon was qualified to practice the procedure that he was granted privileges to perform. While there was no evidence of Dr. Freemans curtailment or denial of staff privileges at other hospitals, the hospital did not dispute that there was a material issue of fact on the question of whether it was negligent in its granting of the staff privileges requested.

3. What credentialing issues are evident in this case? Patient Care Case Law, George D. Pozgar Chapter 10, page 372, question

Explanation / Answer

The issue of risk is one that backs its head each day at wellbeing offices. On the one hand, patients put their trust in the wellbeing office in general. They come there expecting that the hardware and staff will have the capacity to guarantee their wellbeing. They additionally anticipate that the facility will just utilize individuals who are qualified in their professions. Since patients can't promptly check each staff-part's accreditations, they depend on the office. In such manner, doctor's facilities and other wellbeing offices have an obligation to check the capabilities and certifications of staff. Then again, there are occurrences where staff will confer offenses for which the office can't be considered capable. It is the duty of administrative bodies and the courts to decide obligation when grievances are made. For the situation under survey, the office seems to have been careless in checking the doctor's credentials. Credentialing issues First is the topic of whether the accreditation set for this situation was pertinent to the benefit that the specialist was given. There are numerous parts of a doctor's activity that require exceptional benefits and the capabilities he or she has ought to dependably be considered. For instance, anyway splendid a neurosurgeon is, one can't give him or her heart medical procedure benefits considering that by itself. In this manner, the certification must be straightforwardly identified with the benefit that a doctor looks for (Deutsch and Mobley, 1999). That is an issue that ought to be set up by the doctor's facility overseers before approving any activity. For this situation, the doctor displayed a declaration that demonstrated that he finished a laparoscopic laser cholecystectomy workshop. The task he requested the benefit to perform and the one he performed was to be sure a cholecystectomy. On that score, the certification qualified as applicable to the benefit and procedure. The other issue is whether the program was adequate to allow the doctor the aptitudes to play out the system effectively.

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