Georgia Court of Appeals Addresses Application of Emergency Room Statute in Infant Medical Negligence Case

As we’ve discussed before, the standard for medical malpractice liability in Georgia varies depending on whether the alleged act of medical malpractice occurs during an emergency situation. Given that the standard for liability is more stringent under Georgia’s emergency room statute, O.C.G.A. § 51-1-29.5, determining whether the statute applies is crucial for obtaining recovery against a possibly negligent medical provider. In a recent decision, Hospital Authority of Valdosta/Lowndes County v. Brinson (PDF-embedded link), the Georgia Court of Appeals looked at the application of the statute to an unfortunate but interesting set of facts, which involved the treatment of an infant who was suffering from infection requiring emergency care but whose symptoms were not immediately noticed by medical personnel.
The infant was brought to the emergency room on September 24, 2010. The infant had been born prematurely two months earlier and was treated for pneumonia only a month after birth. The infant’s mother said she brought him to the ER because he was acting fussy and had been running a fever. In addition, the infant’s baby sitter reported that the day before the infant was lethargic and cringing and experienced fever, diarrhea, and poor oral intake. At the ER, the infant was triaged by a nurse, who examined him and determined that his condition was normal but did not include the aforementioned medical history in notes. The infant was then seen by a physician’s assistant, who determined that the infant seemed pretty healthy, diagnosed the condition as either allergic rhinitis or a cold, and discharged the infant with a prescription for an oral steroid. A supervising physician later reviewed the chart, and though he testified that he would not have prescribed a steroid, concurred with the assessment and course of treatment. The mother returned three days later, as the physician’s assistant had directed her. At this time, the infant presented with a fever of 102.1, diarrhea, vomiting, and abdominal pain. After taking blood and urine samples for further testing, the pediatrician who saw the infant diagnosed the condition as a urinary tract infection and prescribed Tylenol and an antibiotic. The next day, a hospital representative called the mother and told her to bring the infant back immediately because blood test results showed the infant was suffering from a systemic infection. The call proved unnecessary, since the mother was already in transit to the hospital. Upon arrival, the baby was admitted to the hospital and, the following day, transferred to a pediatric intensive care unit at another hospital, where he was diagnosed as having streptococcus meningitis and a stroke.

Following this string of unfortunate events, the mother sued the hospital and ER personnel, arguing that when the baby first went to the ER on September 24 he was suffering from the systemic bacterial infection, and when the infection was left untreated it subsequently spread to his brain and caused permanent mental and physical injuries. The mother provided expert testimony supporting her contention that the failure to diagnose was negligent. Following discovery, both sides moved for summary judgment. The defendants argued that summary judgment was warranted because the heightened standard under O.C.G.A. § 51-1-29.5 applied, and the plaintiff failed to provide clear and convincing evidence that they were grossly negligent. The plaintiff opposed this motion and also made a motion for partial summary judgment that argued that O.C.G.A. § 51-1-29.5 should not apply to this action because the infant did not present with an emergency medical condition. The trial court denied the defendants’ motion and granted the plaintiff’s. This appeal followed.
The Georgia Court of Appeals unanimously reversed the trial court’s grant of partial summary judgment and also affirmed the trial court’s denial of the defendants’ motion for summary judgment. The court acknowledged that the factual situation presented in this case, “a stable, immunocompromised patient who comes to the ER with indications of an infection but receives no emergency care,” had not been squarely addressed in any of its prior decisions regarding O.C.G.A. § 51-1-29.5. The court held that the infant’s actual condition did not control with respect to whether the statute applies. Instead, “[i]t is whether his medical condition was manifested by acute symptoms of sufficient severity to trigger the [the statute].” This question, “whether the infant presented with symptoms that should have alerted the health care providers that he required emergency medical care,” is one of fact, and since there was conflicting evidence in this case regarding whether the health care personnel should have known of the infant’s condition, it is an issue of material fact for the jury to determine. If the infant did present with such symptoms, the statute would apply. If not, the statute would not apply, and the ordinary negligence standard would apply. Accordingly, the trial court erred by granting partial summary judgment on whether the statute applied, but it did not err in denying the defendants’ motion for summary judgment, since issues of material fact do remain for trial.
Given that proving negligence in the emergency room setting requires a showing of gross negligence by clear and convincing evidence, application of O.C.G.A. § 51-1-29.5 can have a marked impact on the outcome of a medical malpractice case. Accordingly, potential plaintiffs should be prepared to either effectively argue that the statute should not apply or be prepared to provide evidence satisfying the higher negligence standard. Doing either can be an involved undertaking, and those injured in cases of potential medical malpractice would be well-served with the assistance of knowledgeable legal counsel. The Atlanta medical malpractice attorneys at the Law Office of Terrence R. Bethune have many years of experience litigating medical malpractice claims in both state and federal court and can provide the guidance you may need. Feel free to contact us if you are interested in a free case consultation.
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