Court: Court of Appeals of Georgia; July 15, 2013; Georgia; State Appellate Court
James Wynn, M.D. and Lloyd Cook, M.D. appeal a trial court's denial of their claim for official immunity under the Georgia Tort Claims Act in a medical malpractice case. They argue that the trial court incorrectly interpreted the precedent set by Jones v. Allen, asserting that the recent ruling in Shekhawat v. Jones supports their claim for immunity. The burden of proof for official immunity lies with the party seeking it. The trial court's motion to dismiss is reviewed de novo, while factual findings are upheld if supported by evidence.
The case involves Charlotte Forrester, who underwent kidney removal surgery at the Medical College of Georgia, where her spleen was unintentionally injured, necessitating blood transfusions. The blood administered was not leukoreduced, leading to the development of antibodies that resulted in the cancellation of her scheduled kidney transplant from her sister. Subsequently, Mrs. Forrester died over a year later.
John Forrester, as executor of her estate, sued multiple parties, including the Board of Regents, Medical College of Georgia Hospitals, and the involved physicians. The amended complaint alleges that Dr. Cook and Dr. Wynn, as employees and agents of these entities, provided negligent care outside of their official duties, and that Dr. Wynn, as Medical Director, failed to implement necessary protocols for identifying transfusion needs and ensuring the provision of leukoreduced blood for transplant patients.
Defendant was found negligent for failing to establish, administer, and oversee a system that contributed to the sensitization causing Mrs. Forrester’s injuries. Expert affidavits did not accuse Dr. Wynn, Mrs. Forrester’s transplant surgeon, of direct negligence in her care; criticisms from his identified expert witnesses focused solely on his administrative role as medical director of transplant surgery. However, a third expert, Dr. Goodnough, claimed Dr. Wynn violated care standards by not providing leukoreduced blood. Dr. Cook, as Director of the Blood Bank at the Medical College of Georgia, was also deemed negligent for not overseeing a system providing leukoreduced blood for transplant patients, although his alleged negligence was confined to his administrative responsibilities since he was not Mrs. Forrester’s attending physician. Dr. Cook moved to dismiss the claims against him, while Dr. Wynn sought summary judgment based on official immunity under the Georgia Tort Claims Act. The trial court initially granted Dr. Wynn’s motion but later reversed its decision upon reconsideration, denying both Dr. Wynn’s and Dr. Cook’s motions. The parties referenced multiple contracts regarding the immunity issue, particularly the Amended Master Affiliation Agreement between MCG and MCGHI, which outlined commitments to healthcare education, comprehensive services, and research, along with provisions related to the employment and service allocation of faculty members.
The Medical College of Georgia Physicians Practice Group (PPG) is a cooperative entity under the Board of Regents responsible for billing and managing fees from member physicians' services and overseeing medical practice at MCG. All full-time MCG Hospital faculty automatically become PPG members through their employment. The PPG membership agreement clarifies that these physicians are employees of the Board of Regents—not PPG. The Board of Regents controls the allocation of faculty time to clinical and administrative roles, appoints faculty at MCG's discretion, determines compensation, and restricts PPG from compensating faculty beyond standard fringe benefits.
MCGHI pays PPG a contractual fee for faculty performing administrative roles, with PPG subsequently disbursing these funds to MCG for faculty salaries. The doctors involved assert that their actions occurred within the scope of their MCG employment as they were professors and medical directors at MCGHI, which requires full-time faculty membership. They claim MCGHI denied employing them, while MCG issued their W-2 forms and managed their employment contracts.
The plaintiff contends that the doctors' alleged negligent conduct stemmed from their roles as medical directors rather than their faculty positions, highlighting that MCGHI operates the blood bank, appointed Dr. Cook and Dr. Wynn as medical directors, and compensated them for these roles. Additionally, MCGHI provided professional liability insurance for claims related to their administrative duties and evaluated their performance annually, with provisions for addressing unsatisfactory performance. The agreement stipulates that medical services must be provided by PPG members who hold clinical privileges in their respective service areas.
MCGHI, after consulting with PPG and the Dean of the Medical College of Georgia, is responsible for appointing individuals to medical administrative positions. If MCGHI is dissatisfied with a person's performance, it must notify PPG in writing, outlining the reasons for dissatisfaction. PPG will then work with MCGHI to counsel the individual and address the issues. If dissatisfaction persists after 30 days, MCGHI can remove and replace the individual following the established appointment procedures. However, if MCGHI believes the individual’s actions negatively impact patient care, safety, or the hospital's reputation, it can remove the individual immediately, bypassing the usual procedures.
In a related legal case, the trial court found that two doctors were not acting within their official duties as medical directors while employed at the Medical College of Georgia, based on the precedent set in Jones, which was later reversed by the Supreme Court in Shekhawat. The trial court ruled that the doctors were not entitled to official immunity under the Georgia Tort Claims Act because their roles as medical directors did not align with their official faculty duties. However, following the Supreme Court's overruling of its earlier decision in Keenan and the reversal of the Jones decision, it was determined that the doctors were indeed acting within the scope of their state employment while performing their duties. Consequently, the trial court's denial of Dr. Cook’s motion to dismiss and Dr. Wynn’s motion for summary judgment was reversed, affirming their entitlement to official immunity.
MCGHI is identified as a nonprofit, tax-exempt charitable organization established to lease and operate a hospital, with authority granted to it by the board of regents to serve various patient demographics.
