Rivers v. Katz, 67 N.Y.2d 485 (1986)
A hospital can be held liable for medical malpractice when its staff negligently fails to execute a physician’s explicit order, particularly when the task does not require independent medical judgment.
Summary
This case concerns a hospital’s liability for failing to perform a cystourethrographic test on an infant as ordered by the attending physicians. The New York Court of Appeals held that the hospital could be liable for malpractice because the failure to conduct the test, which didn’t involve medical judgment but rather the execution of a doctor’s order, contributed to the infant’s loss of kidney function and deprived him of a potential surgical correction. The court emphasized that the physicians’ subsequent decision to discharge the child, knowing the test hadn’t been performed, didn’t automatically revoke the order, as evidence suggested the delay itself was detrimental. The case was remitted to the Appellate Division to address unresolved issues concerning another defendant’s settlement.
Facts
1. Doctors ordered Massapequa Hospital to perform a cystourethrographic test on an infant patient.
2. The hospital neglected to perform the test.
3. Several days later, the doctors discharged the child, knowing the test had not been performed.
4. The infant’s kidney function significantly deteriorated between his treatment at Massapequa Hospital and his admission to New York Hospital.
5. Evidence suggested the delay in performing the test contributed to the loss of kidney function and precluded a potentially successful surgical intervention.
Procedural History
1. The case reached the Appellate Division.
2. The Appellate Division ruled against the plaintiff, finding the doctor’s decision to discharge the patient after knowing the test had not been performed, constituted a revocation of the test order.
3. The New York Court of Appeals modified the Appellate Division’s order, remitting the case for consideration of unresolved issues related to Massapequa Hospital, finding sufficient evidence to support the jury’s verdict against the hospital.
Issue(s)
1. Whether a hospital can be held liable for medical malpractice for failing to carry out a physician’s order that doesn’t require medical judgment.
2. Whether a physician’s decision to discharge a patient, knowing that a previously ordered test was not performed, constitutes an automatic revocation of the test order.
3. Whether the hospital’s failure to perform the test, contributing to a delay in diagnosis, caused or exacerbated the infant’s injury.
Holding
1. Yes, because a hospital is responsible for carrying out physicians’ orders, and failure to do so can constitute malpractice, especially when the task does not involve medical judgment (citing Toth v Community Hosp. at Glen Cove, 22 NY2d 255).
2. No, because the decision to discharge the patient was not necessarily based on a conclusion that the test was unnecessary, but rather on concerns that performing the test at that late stage might be dangerous.
3. Yes, because the jury could have found that the hospital’s failure to perform the test when directed contributed to the injury, particularly given the substantial loss of kidney function during the delay, and that the delay deprived the child of an opportunity to have the condition surgically corrected.
Court’s Reasoning
The Court of Appeals reasoned that the hospital’s responsibility to perform the cystourethrographic test was ministerial, not involving medical judgment. The court relied on the principle established in Toth v. Community Hospital, which holds hospitals accountable for failing to execute physician’s orders. The court distinguished the present situation by emphasizing that the order wasn’t followed. The court noted that the evidence did not conclusively show that the doctors’ later decision to discharge the child constituted a