Problem: WHAT COMMON SENSE MADE EVIDENT

Hospitals are expected to notify specialty on-call physicians when their particular skills are required in the emergency department. An on-call physician who fails to respond to a request to attend a patient can be liable for injuries suffered by the patient because of his or her failure to respond. In Thomas v. Corso, 11 a Maryland court sustained a verdict against the hospital and physician. The patient had been brought to the hospital emergency department after he was struck by a car. A physician did not attend to him even though he had dangerously low blood pressure and was in shock. There was some telephone contact between the nurse in the emergency department and the physician who was providing on-call coverage. The physician did not act on the hospital's call for assistance until the patient was close to death, and the patient did die. The court reasoned that expert testimony was not even necessary to establish what common sense made evident: that a patient who had been struck by a car may have suffered internal injuries and should have been evaluated and treated by a physician. Lack of attention in such cases is not reasonable care by any standard. The concurrent negligence of the nurse, who failed to contact the on-call physician after the patient's condition had worsened, did not relieve the physician of liability for his failure to come to the emergency department at once. Rather, under the doctrine of respondeat superior, the nurse's negligence was a basis for holding the hospital liable as well.

Ethical and Legal Issues

1. Describe how both the physician and nurse failed in their ethical responsibilities to the patient.

2. Describe what actions the hospital can take to prevent future occurrences of this nature.

3. What are the legal concerns for the physician, nurse, and hospital?