ST. MARY'S HEALTH CARE SYSTEM, INC.
ROACH et al.
MILLER, P. J., DOYLE, P. J., and REESE, J.
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
in favor of the Appellees as the nonmoving party,
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.
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
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
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
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
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.
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.
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
Court granted the Appellant's application for
interlocutory review, and this appeal follows.
Court reviews a trial court's ruling on a motion for
summary judgment de novo. "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." With these guiding principles in mind, we
turn now to the Appellant's specific claims of error.
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