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

Saint Vincent Hospital, Worcester, Mass.
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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.