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Inc. v. Roach

Court of Appeals of Georgia, Second Division

March 2, 2018

ROACH et al.

          MILLER, P. J., DOYLE, P. J., and REESE, J.

          Reese, Judge.

         The Appellant, St. Mary's Health Care System, Inc. d/b/a St. Mary's Hospital, appeals from the trial court's order denying its motion for summary judgment in a negligence suit brought by Fredrick and Jacqueline Roach ("the Appellees") for the death of their son, Bryan Roach, following a visit to and discharge from the Appellant's emergency department in Athens, Georgia. The Appellant primarily contends that the Appellees' claim sounds in professional negligence which necessitates the filing of an expert affidavit. For the reasons set forth, infra, we reverse.

         Viewed in favor of the Appellees as the nonmoving party, [1] the record shows that Bryan Roach, accompanied by the Appellees, arrived at the Appellant's emergency department at 10:36 p.m. on November 8, 2013, with complaints of chest pain, nausea, and fever. Chest x-rays were ordered and read by Dr. Elizabeth Smith, an emergency medicine physician on duty at the time. She reviewed the chest x-rays, finding an "enlarged heart, no obvious infiltrate[.]" Roach was discharged about two hours after he had arrived with a diagnosis of acute febrile illness and atypical chest pain. The record shows that the family was instructed to "follow up with [Roach's] primary care physician [the following] week" and to contact the emergency department if symptoms worsened.

         At 7:51 a.m. on November 9, 2013, a radiologist interpreted the x-ray images of Roach, and in his report noted "[h]eart size appears normal but there is opacity in the suprahilar region on the right." The radiologist recommended a "chest CT . . . done with IV contrast. If the patient has had prior chest CTs that might demonstrate this finding they should be obtained prior to obtaining . . . a chest CT[.]" At 11:44 a.m. on the same day, less than 12 hours after being discharged, emergency response personnel received a call that Roach collapsed at home. Upon arrival of emergency response personnel, Roach was transported, via ambulance, to the Appellant's hospital. Efforts to revive him were unsuccessful, and Roach was declared deceased at 1:39 p.m. An autopsy report listed Roach's cause of death resulting from "[h]emopericardium secondary to asending aortic dissection[.]"

         The Appellees initially filed a medical malpractice action against Athens-Clarke Emergency Specialists, P. C., Dr. Smith, and a physician assistant, and attached an expert affidavit to the complaint, pursuant to OCGA § 9-11-9.1. According to the affidavit, Roach's "aortic dissection would have been visible on a contrast CT scan at any point after his arrival" at the Appellant's hospital.

         Later, the Appellees amended their complaint to add the Appellant. In their amended complaint, the Appellees alleged that the Appellant's imaging interpretation system provided that x-rays ordered after 11:00 p.m. on a Friday night would not be interpreted by a radiologist until the next morning, unlike those ordered during regular hours. The Appellees did not attach an additional expert affidavit addressing the Appellant's alleged negligence claims to their amended complaint.

         The record shows that, in 2009, the Appellant entered into a "Radiology Service Agreement" with Athens Radiology Services, P.C., a group practice of physicians, specializing in radiology ("Radiology Group"). The agreement specifically provided that its purpose was to serve "the best interests of quality patient care" and to ensure the "effective and efficient delivery of health care at the Hospital[.]" The parties agreed to the following: (1) the Radiology Group would provide in-person or on-call services 24 hours per day, 365 days a year; (2) the Radiology Group could contract with a teleradiology group or physician to preliminarily interpret "CT, MRI, and Ultrasound studies" between the hours of midnight and 7:00 a.m. Monday through Thursday and 11:00 p.m. through 8:00 a.m. Friday through Sunday [;]" (3) the Radiology Group would have an on-call radiologist who would also be available during those times; and (4) the on-call radiologist would be available for a consultation whenever it was requested by a medical staff physician, with the consultation being conducted either via teleradiology or by the radiologist physically returning to the hospital if the circumstances so required.

         The Appellant filed a motion to dismiss, arguing that the Appellees' claims against it were based on professional negligence and thus, required an expert affidavit pursuant to OCGA § 9-11-9.1. The trial court denied the Appellant's motion to dismiss, and discovery ensued.

         In her deposition, Dr. Smith confirmed that the Appellant's radiology policy provided that every x-ray image would be reviewed and interpreted by a radiologist, although, as in this case, x-rays performed after hours would not be reviewed until the next day. She also testified that she could have gotten a radiology consultation in Roach's case on the night of his emergency room visit by contacting the on-call radiologist to have the x-rays interpreted immediately. She explained, however, that she did not seek the consult because she felt "comfortable" with her ability to accurately read and interpret Roach's chest film.

         The Appellant filed a motion for summary judgment asserting that: (1) the Appellees' claims against it were based on professional negligence; (2) there was no evidence that the Appellant's services were "unreasonable"; and (3) the Appellees failed to show that any act or omission by the Appellant caused Roach's death. After a hearing, the trial court denied the Appellant's motion for summary judgment, ruling that the Appellees' claims against the Appellant sounded in ordinary negligence, because the Appellant's radiology policy at issue "was the product of business negotiations between the [Appellant] and Athens Radiology to provide exclusive radiology services" and the resulting contract showed "no indication that physicians were involved in the contract negotiations."

         This Court granted the Appellant's application for interlocutory review, and this appeal follows.

         This Court reviews a trial court's ruling on a motion for summary judgment de novo.[2] "To prevail at summary judgment under OCGA § 9-11-56, the moving party must demonstrate that there is no genuine issue of material fact and that the undisputed facts, viewed in the light most favorable to the nonmoving party, warrant judgment as a matter of law."[3] With these guiding principles in mind, we turn now to the Appellant's specific claims of error.

         1. The Appellant contends that the trial court erred in finding that the Appellees' claims against it sound in ordinary, not professional, negligence, whereas the Appellees argue that entering the "Radiology Services Agreement" by the Appellant sounded in ordinary negligence. We agree that the trial court erred in finding that the Appellees' claims fall ...

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