Hospital's radiology contractor must answer negligence claim over patient death, per third-party doctrine

Saint Vincent Hospital, Worcester, Mass.
Terageorge~commonswiki via Wikimedia Commons CC BY-SA 4.0

A hospital's radiology contractor may be on the hook for failure to provide emergency medical treatment to a patient who died, the Massachusetts Appeals Court ruled last week.

The decision offers a solid analysis of third-party beneficiary doctrine in tort law. Under the doctrine, a duty in common law tort can arise from a contract that benefits a third party. So if B and C contract for the protection of A, an injured A may sue C for for its failure under the contract, even though C had no contract with A and would not otherwise have owed any common law duty to A.

In the instant case, Saint Vincent Hospital (SVH) in Worcester, Massachusetts, had contracted with Saint Vincent Radiological Associates, Inc., (SVRA) for radiology services for SVH patients. The plaintiff-decedent was an SVH patient suffering from an acute gallbladder infection requiring an emergency procedure. SVH did not have staff to do the procedure and transferred the patient to another hospital. The patient died before the procedure could be completed. 

The plaintiff-representative discovered later that an SRVA physician on call for SVH was able to do the procedure. The representative sued SVH and SVRA. The representative settled with SVH, but the representative's negligence claim against SVRA was dismissed for want of duty.

The trial court erred, the Appeals Court decided. Ordinarily, an SVRA doctor might have owed no duty to an SVH patient, any more than any doctor who was a stranger to the patient. However, SVRA had contracted with SVH for the benefit of third parties, namely, patients, such as the decedent. The plaintiff therefore could pursue a negligence claim against SVRA, the Appeals Court agreed, remanding and reinstating the claim.

There remains a question of fact in the case, which might have confused the issue in the trial court, over whether the SVH-SVRA contract provided for SVRA doctors to do emergency procedures, if needed, more than mere radiology consultations. If the scope of the contract was so limited, then there is no basis in the contract for the duty to perform the procedure that could have saved the patient's life. The parties had settled contract claims in the case below, so the courts never had occasion to opine on the scope of the contract.

Another question that will have to be resolved on remand, if the case is tried, is whether the defendant was negligent, that is, breached the standard of care. Even breach of contractual obligation, if that were the case, is not negligence per se under the third-party beneficiary doctrine.

In working out its conclusion, the Appeals Court noted an important additional feature of the doctrine, which is that a contract can only support a duty familiar to common law, assuming there were a social-contractual link between A and C. If a contract imposes some exotic obligation, then the only remedy for breach arises between the contracting parties, B and C, in contract law. Here, though, this requirement is not an impediment. C is a doctor, and A is a patient. The duty relationship is easily recognizable once the contract bridges the social gap.

The case is Brown v. Saint Vincent Radiological Associates, Inc., No. 23-P-771 (Oct. 24, 2024). Justice Gregory I. Massing wrote the opinion of the unanimous panel, which also comprised Justices Shin and D'Angelo.

Hospitals may track patients online and sell their data without violating state wiretap law, high court rules

Mike MacKenzie (via Flickr) CC BY 2.0

State wiretap law does not prevent hospitals from tracking patients on the web and selling their data, the Massachusetts Supreme Judicial Court ruled last week.

The plaintiff is a patient at two hospitals in the Beth Israel Lahey Health network. As the court explained the facts, the plaintiff "reviewed information available to the public on the hospitals' websites regarding doctors (including their credentials and backgrounds) and medical symptoms, conditions, and procedures." Without her consent, the hospitals shared the plaintiff's browsing data with third parties to generate revenue from targeted advertising.

The plaintiff sued under state wiretap law and got some traction in the lower courts, where the theory has bubbled up in other cases, too. The high court ended the trend, though, ruling that the state wiretap law, which threatens criminal penalties such as imprisonment, while reaching interpersonal communications such as telephone calls and email and text exchanges, was not intended to reach persons' interactions with websites.

The 47-page majority opinion by Justice Scott L. Kafker, drew a vigorous and almost as lengthy dissent from Justice Dalila Argaez Wendlandt, who accused the hospitals of lying to patients in their pledges of confidentiality and argued that the alleged misconduct falls squarely within legislative intent in prohibiting the interception of electronic communication.

I won't belabor the back and forth, as ample commentary already has been published about the case (e.g., JD Supra, Commonwealth Beacon, Bloomberg, National Law Review, Law360 (subscription), Massachusetts Lawyers Weekly (subscription)), and there is plenty more to come. Rather, I will comment only that the decision reflects the sorry state of privacy law in the United States.

The majority and dissent both make defensible arguments. I come down with the dissent on the technical merits of what the wiretap law was designed to prevent, i.e. "the spirit of the law," regardless of whether the legislature could have foreseen web surveillance. At the same time, the majority is right that the legislature likely would not have wanted to imprison every actor engaging in the kind of web surveillance that has become pervasive in our online society.

The missing link between the two positions is the meaningful data protection law that the United States still doesn't have, and which Americans want and expect, while almost three decades have passed since the European Union Data Protection Directive. The later General Data Protection Regulation (GDPR) has been in force for six years.

Wiretap law was once the stuff of political intrigue, à la Watergate. The Massachusetts statute characteristically dates to the 1960s. Just as the advent of the internet made media law again hotly relevant to society, so wiretap law found new life in the electronic era. Courts had little difficulty transposing the law of wired telephone surveillance to wireless cell phones and electronic communication media such as email and texts. Even the U.S. Supreme Court got in on the action.

That's why I think Wendlandt has the better argument on the technical merits, by the way. The majority's distinction of interaction with a person or a website, when there are persons receiving surveillance data from the website, seems meaninglessly formalistic.

With electronic communication burgeoning in the internet era and electronic interception easier to accomplish without the need for specialized hardware, wiretap laws have been repurposed to do more work than they were designed for, becoming a key tool in the personal privacy arsenal.

The problem in tort law, to oversimplify modestly, always has been what Professor Daniel Solove termed "the secrecy paradigm." The common law of privacy torts, which also emerged largely in the 1960s, was not designed to handle the nuances of an online world. Rather, tort law, like the Fourth Amendment right against search and seizure, focused on secrets kept. A person might resort to the law to protect an intimate secret shared with a spouse. But the person who discloses financial information to a bank has forfeit legal privacy. 

Intimate space is not the theory of privacy that animates data protection in Europe and most of the rest of the world. In the theory abroad, the human right of privacy flows forward with personal data as they are handed off from person to person and corporation to corporation. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) provides a modicum of privacy protection in this vein, but the circumstances in which it pertains are extremely narrow—web activity is not protected health information, and a web host is not a healthcare provider—and it authorizes no private right of action for violation.

In the absence of a legal model of downstream privacy preservation in the United States—notwithstanding a perplexing emerging plethora of competing state laws, if usually limited to commercial contexts; Massachusetts has been working on joining the pack, but has not yet—wiretap law has been unexpectedly instrumental to protect personal privacy in a narrow class of cases, because wiretap law focuses on the misconduct of clandestine surveillance rather than on the purportedly private nature of the intercepted content.

To be fair to the Massachusetts majority, though, such use of anachronistic wiretap law takes us down a road of ever more speculative application as the electronic avatar increasingly becomes an embodiment of personal identity. Electronic tools such as Google Analytics watch our every word. And we don't necessarily want to stop that wholesale. The other day, I watched a dated TV movie that Amazon thought I would like, and it was right. Time travel, Ireland, and Jane Seymour? Drop everything.

Notwithstanding which side in the instant case has the better argument in statutory interpretation, the legal response to the problem presented, that is, surveillance of web usage for the relatively innocuous if mercantile purpose of advertising, would arise better from business regulation than from common law or statutory torts.

Alas, if I had the magic potion that would make our broken Congress favor consumer protection over corporate profits, I would be running for President.

The case is Vita v. New England Baptist Hospital, No. SJC-13542 (Mass. Oct. 24, 2024).

Transparency never goes out of style

This autumn, I am privileged to serve as a new member of the Freedom of Information Act (FOIA) Advisory Committee, a U.S. federal entity constituted under the Federal Advisory Committee Act (FACA) and administered by the Office of Government Information Services (OGIS), within the National Archives and Records Administration (NARA).

If that alphabet soup has your head spinning, then you have some sense of what it's been like for me to get up to speed in this role. That said, I'm thrilled to have the opportunity and humbled by the expertise of the committee members and OGIS staff with whom I'm serving.

I'll have more to say in time, as we have accomplishments to report. Meanwhile, though, a bit of parody art. At a meeting yesterday of the Implementation Subcommittee, ace OGIS compliance officer and former journalist Kirsten B. Mitchell related an anecdote.

A youthful person had wondered aloud that Fresca is quite old, perhaps dating to the 1980s! And Mitchell said she felt compelled to note that it is even older. In fact, the niche-beloved Coca-Cola Co. soft drink dates to the same year the FOIA was signed into law: 1966. That modest revelation prompted me to generate the above art, based on a contemporary Fresca ad that capitalizes on the drink's age ("Delicious Never Goes Out of Style"). (Above art by RJ Peltz-Steele CC BY-NC-SA 4.0 with no claim to underlying work of Coca-Cola Co.)

The inaugural public meeting of the 2024-2026 FOIA Advisory Committee, at NARA in September, is posted on YouTube.

Niagara conference on workplace mobbing examines failure of academic freedom to prevent abuse

NCWM participants at Niagara University in July
© used with permission

With colleagues from around the world, I participated, as chair of the scientific committee, in the inaugural Niagara Conference on Workplace Mobbing (NCWM) on July 22-24, 2024, at Niagara University in New York (Savory Tort, Feb. 27, 2024).

Videos from the conference are now posted on a new NCWM YouTube channel and NCWM 2024 playlist.

Here is my introduction to the program, moderating the opening session.

For reasons investigated in the literature, academic workplaces are especially prone to mobbing. Here is my own presentation on academic freedom relative to workplace mobbing.

Here is another contribution to the academic freedom panel from my friend and colleague, Prof. Robert Ashford, Syracuse Law (pictured).

And here is the panel Q&A with Prof. Frances Widdowson (Woke Academy), Prof. Ashford, and me.

I will feature more programs from the conference in subsequent posts.