Credentialing: Can hospital be liable for docs?

June 1, 2005

Dr. Jonas, a dermatologist in a highly litigious state, has recognized the importance of procedural credentialing.

Dr. Jonas, a dermatologist in a highly litigious state, has recognized the importance of procedural credentialing.

Negligence suit filed Patient Deb recently sued him for negligence, alleging that she suffered significant cosmetic deformity and various other permanent injuries from a light chemical peel that Dr. Jonas performed.

Once this defense was supplied to plaintiff Deb's legal counsel, they amended their initial complaint to include vicarious negligence on behalf of the hospital for its negligence in credentialing Dr. Jonas.

It now appears, as the case has evolved, that Dr. Jonas' training was quite poor. He had, in fact, committed a negligent act, and the hospital had been unable, from his application, to verify the poor quality of his training. Can plaintiff Deb sue the hospital for their credentialing process, and what does this say about the process of procedural credentialing as it relates to dermasurgery?

Shedding light A recent Texas case sheds some light on this issue.

Debi Rose brought court action against James Fowler, M.D., for medical malpractice. She alleged that she suffered scarring and a variety of other injuries from cosmetic surgery that Dr. Fowler performed. In a later suit, plaintiff Rose also sued the local hospital where Dr. Fowler did some of his surgical procedures.

According to Ms. Rose, the hospital was vicariously responsible and, therefore, liable for Dr. Fowler's negligence. In addition, she contended in her court filed papers that the hospital itself was directly liable for its own negligence in credentialing him to practice at the hospital after having learned about various complaints against the physician.

Hospital wants out The case eventually found its way into the Texas Supreme Court.

The issue discussed by the court was whether the credentialing process undertaken by the hospital could become part of a malpractice case against the hospital if the credentialing of Dr. Fowler occurred well before plaintiff Rose had ever been treated at the hospital.

The hospital contended that it should be dropped from the case because the credentialing act was not "during the patient's care, treatment or confinement."

The Texas court disagreed.

The court contended that credentialing is an ongoing process that encompasses not only the initial credentialing of Dr. Fowler, but also the ongoing process of determining that he is fit to do a procedure at that institution. Furthermore, the high court suggested that a negligent credentialing claim involves a specialized standard of care that requires an expert witness opinion in order to establish liability. In that sense, an institution that provides procedural credentialing is no different than any physician in its susceptibility to medical malpractice claims.

Looking for credentialing An increasing number of physicians are looking for some way to credential their procedures, much as was done for Dr. Fowler in the Texas case and Dr. Jonas, as described in this column.