Can you Sue a Hospital for Negligently Granting Your Doctor ‘Privileges’?

building_hospital_within_931281-1024x683Amid the potential chaos and life-or-death scenarios in a hospital emergency room, “negligent credentialing” might not immediately come to mind. It’s understandable; after all, numerous nightmare scenarios occupy our thoughts. However, negligent credentialing is an incredibly significant matter that hospitals face regularly.

So what is “negligent credentialing”? It all comes down to whether your doctor has the legitimate credentials to practice medicine at that hospital.

Imagine a chaotic life-or-death situation where someone you love has been rushed into the ER. Your first thought isn’t going to be, “Hm, I wonder if this doctor is board certified?” It’s assumed that if someone’s doing a professional job, they’re qualified to do it. You trust the mechanic changing your car’s oil knows what they’re doing, right? Or that your kid’s teacher has the right qualifications to teach. And your dentist—you’re pretty sure they’re qualified and accredited to poke around your mouth.

So, when you head into a hospital, it’s entirely fair for you to expect that the doctor treating you knows their stuff, that they’re qualified and accredited. But what happens if they’re not?

How the system should work

A physician may be granted certain ‘privileges’ which constitute a critical component in enabling physicians to exercise their practice within a specified hospital, even when that institution does not formally employ them. These privileges carry various degrees of authority, extending from the capacity to admit patients to the hospital and provision of medical treatment up to and including the execution of surgical procedures.

Before the acquisition of such privileges, a physician is required to undertake a stringent process of credentialing. This rigorous accreditation procedure is an exhaustive appraisal of the physician’s qualifications and competencies. The hospital scrutinizes a range of elements, encompassing the physician’s educational pedigree, professional training, the validity of their medical license, board certification status, work experience, and any medical malpractice record.

This credentialing process operates as a safeguard, ensuring that the hospital upholds a high caliber of medical care by solely conferring privileges upon those physicians who demonstrate sufficient qualification and capability, thereby prohibiting those deemed incompetent from associating with the institution. This mechanism protects the hospital’s reputation and provides a layer of protection to patients, ensuring they are shielded from substandard medical care. From this, there are two questions which become apparent:

  1. Can you sue a hospital for “negligently credentialling” a doctor?
  2. Does “negligent credentialling” fall within the auspices of the Louisiana Medical Malpractice Act.?

The lawsuit captioned Billeaudeau v. Opelousas Gen. Hosp. Auth. helps answer these questions.

Brandi, a thirty-four-year-old woman with Down syndrome, experienced a sudden collapse at her residence and was promptly transported by her parents to Opelousas General Hospital. Upon her arrival in the emergency room, Dr. Zavala diagnosed Brandi with a focal motor seizure. However, her parents believed she had experienced a stroke, leading them to request a specific treatment typically administered to stroke patients. Dr. Zavala advised them that, in her professional opinion, Brandi was not suitable for the treatment they suggested.

Subsequently, the parents requested that Brandi be moved to another medical facility. She was transferred to Our Lady of Lourdes Hospital in Lafayette, where she was initially administered the stroke treatment that her parents had initially sought at Opelousas General Hospital. As it transpired, Brandi had indeed suffered a stroke. Although she survived the incident, she incurred severe and irreversible brain damage.

Brandi’s parents proceeded to institute a medical malpractice lawsuit. Among their assertions, they contended that Opelousas General Hospital was negligent due to Dr. Zavala’s credentialing and the granting of full active privileges at the hospital, which they deemed inappropriate. Furthermore, they alleged that the hospital’s duty of care to Brandi was violated not solely through malpractice but also due to flawed hiring practices.

It was held by the Third Circuit Court of Appeal of Louisiana and later upheld by the Supreme Court of Louisiana that the trial court did not commit an error in determining that the parent’s claim, which alleged negligent credentialing of Dr. Zavala, did not fall within the purview of a medical malpractice claim governed by the Louisiana Medical Malpractice Act (LMMA), as outlined in La. Rev. Stat. Ann. § 40:1231.1 et seq. This decision had wide-ranging implications for Louisiana medical facilities.

The Relevance of the Louisiana Medical Malpractice Act to negligent credentialing.

Why is it relevant whether negligent credentialing fell inside or outside the LMMA?  It all boils down to money. The LMMA caps the total amount a plaintiff can receive in a medical malpractice case.  In order for the plaintiff to receive an amount in excess of the cap, their negligent certification claim needed its own standing rather than to fall under the LMMA.

Under the LMMA cap, the amount of money a patient can recover from a healthcare provider due to medical malpractice is set at $500,000 plus the costs of future medical care related to the malpractice.

The $500,000 cap includes all damages such as pain and suffering, lost wages, loss of enjoyment of life, and any other type of non-economic damage. This cap is applied per patient, not per defendant, which means that even if multiple healthcare providers are found at fault, the total recovery cannot exceed $500,000, excluding future medical expenses.

Effects of the Billeaudeau Decision

As a direct consequence of the ruling, medical institutions in Louisiana found themselves in a situation where they may face potential legal liability in excess of the $500,000 limit for damages previously mandated by the Medical Malpractice Act. Billeaudeau constitutes a significant shift from the established legal precedents on the subject matter, thereby paving the way for heightened exposure of hospitals to claims stemming from allegations of negligent credentialing

Navigating the labyrinth of complexities often present in medical malpractice claims, particularly those involving negligent credentialing, requires significant expertise and legal acumen. The indispensable role of an accomplished and astute attorney in such instances cannot be overstated. With their expert knowledge, they can conduct a comprehensive and scrupulous assessment of the details pertinent to your case, strategize an effective legal course of action designed to triumph over adversarial counterclaims, and relentlessly strive to secure the maximum possible financial compensation for damages.

Additional Sources: Brandi Billeaudeau v. Opelousas Gen. Hosp. Authority

Written by Berniard Law Firm Writer: Angela Mackie-Rutledge

Other Berniard Law Firm Articles on Medical Malpractice and the Bildeaudeau case: Do You Trust Your Hospital to Have Good Doctors?

Contact Information