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Appeals Court Revives Hospital Defense in Infant Malpractice Case

Medical malpractice can have a devastating impact on anyone, but especially infants. Medical personnel should always be vigilant when treating their tiniest patients, but unfortunately, sometimes the standard of care falls below accepted medical norms. Georgia law can complicate malpractice cases, however, by requiring a higher standard of proof when the personnel work for an emergency room or emergency department. A recent decision by the Georgia Court of Appeals illustrates the difficulties plaintiffs face in such cases.

Hospital Authority of Valdosta/Lowndes County v. Brinson

This case began with the premature birth of a baby boy in 2010. About a month after the child’s birth, he was hospitalized and treated for pneumonia. Several weeks after that, his mother brought him to the emergency room of a local hospital. She said he was presenting a number of symptoms, including an unusual level of crying and a fever.

An emergency room nurse performed an initial examination of the child. She determined he was a “non-urgent” case and did not take note of his prior hospitalization or premature birth. A physician’s assistant conducted a second examination, determined the child had a cold and prescribed an oral steroid. Several hours later, a physician reviewed the child’s chart and, while later testifying he would not have prescribed the oral steroid, nonetheless signed off on the chart.

Three days later, the mother took her son to a pediatrician. At this point he was running a fever of over 102 degrees. The pediatrician diagnosed the child with a urinary tract infection and prescribed additional medication. The next day, the hospital informed the mother her son actually had a “systemic infection” and needed to be hospitalized right away. Ultimately, the hospital determined the child had meningitis and suffered a stroke resulting in partial paralysis and significant brain damage.

The mother sued the hospital and the emergency room personnel who initially treated her son. She argued their failure to diagnose her son’s systemic infection on the first emergency room visit led to his stroke and subsequent injuries. The hospital argued it was not liable under Georgia law, which holds medical personnel are not liable for malpractice arising from “emergency medical care” unless there is “clear and convincing evidence” of “gross negligence.”

Here, the plaintiff presented testimony from a medical expert (a pediatric emergency room physician) who said the hospital should have discovered and treated the systemic infection right away. Instead, the child was improperly “fast tracked” by emergency department personnel and diagnosed with a simple cold. The plaintiff’s expert said premature children are especially vulnerable to infection due to their underdeveloped immune systems and should be treated with greater care.

The hospital moved for summary judgment, arguing that the expert’s report was not enough to meet the heightened “gross negligence” standard required by Georgia’s emergency care law. The plaintiff responded with her own summary judgment motion, arguing the emergency care law did not apply here, because her son “did not present with an emergency condition” on the first hospital visit and therefore never received any emergency care as defined in the statute.

The trial court agreed with the plaintiff on this point. But in a November 21st decision, the Georgia Court of Appeals reversed. The plaintiff may continue her case, the appeals court said, but there is a still a disputed issue over whether the emergency care law applies. The court explained, “The question is whether [the child] presented with symptoms that should have alerted the health care providers that he required emergency medical care.”