Mid-Atlantic Health Law TOPICS

Hospitals in Louisiana will not be protected by the statutory cap on medical malpractice damages if the hospital negligently credentials its physicians. A sharply divided Louisiana Supreme Court held, in Billeaudeau v. Opelousas General Hospital, that a claim for negligent credentialing does not fall within the purview of the Louisiana Medical Malpractice Law, and, therefore, is not subject to the cap on damages applicable to medical malpractice claims.

A. The Case

The case arose when the parents of a 34-year-old woman with Down syndrome took their daughter, Brandi, to Opelousas General Hospital after she collapsed at home. The emergency room physician, Dr. Zavala, diagnosed Brandi with focal motor seizure, and ordered the administration of anti-seizure medication. 

Brandi’s parents disagreed with the diagnosis. Believing their daughter had suffered a stroke, they asked Dr. Zavala to give Brandi tPA (t-plasminogen activator), a treatment for stroke victims. When Dr. Zavala refused, Brandi’s parents had her transferred to another hospital where she was given tPA over four hours after she suffered what was ultimately determined to be a stroke. Brandi survived the stroke, but suffered severe, irreversible brain damage.  

Brandi’s parents sued Dr. Zavala and Opelousas General Hospital for malpractice under the Louisiana Medical Malpractice Act, and also asserted a claim for negligent credentialing against the hospital, arguing that the hospital should never have given Dr. Zavala privileges to treat patients in the hospital’s emergency room. 

Although the malpractice claims settled, the issue of whether the negligent credentialing claim was a “malpractice claim” was ultimately decided by the Louisiana Supreme Court.  That court concluded that the hospital’s decision to grant credentials to Dr. Zavala was essentially an administrative decision, not a medical one, and therefore did not constitute “medical malpractice.”

B. The Dissenting Opinions

Three judges filed dissenting opinions, disagreeing with the majority decision. They argued that, although credentialing itself may be administrative in nature, it is inseparable from its ultimate purpose to ensure that patients receive quality medical care and treatment. Moreover, they argued, negligent credentialing alone will not result in injury to a patient unless the physician goes on to commit a negligent act. 

Under the majority’s decision, the hospital is now exposed to uncapped liability for the same capped acts of malpractice committed by Dr. Zavala. The dissenting judges argued that the majority’s decision effectively creates a back door for the avoidance of the malpractice cap on damages. The result, they warned, could undermine the legislature’s goal of reducing or stabilizing medical malpractice insurance rates, and assuring the availability of affordable medical services to the public.

Catherine A. Bledsoe, Maryland Assistant Attorney General, Higher Education Division