Menzer v. Catholic Health Initiatives

MATTHEW MENZER, as Litigation Guardian Ad Litem of KJM, a minor, Appellant, v. CATHOLIC HEALTH INITIATIVES, a foreign corporation; FRANCISCAN HEALTHSYSTEM, a Washington corporation; and SAINT JOSEPH MEDICAL CENTER, Respondents.

No. 53972-1-II

Court of Appeals of Washington, Division 2

August 10, 2021

UNPUBLISHED OPINION

SUTTON, J.

Matthew Menzer, as litigation guardian ad litem for KJM, a minor sued Catholic Health Initiatives (CHI), Franciscan Health System (FHS), and Saint Joseph Medical Center (St. Joseph). CHI is the parent corporation of FHS and FHS owns St. Joseph. KJM alleged that CHI failed to adopt specific procedures requiring FHS and St. Joseph to screen newborns for a rare genetic disorder that KJM was later diagnosed with after his birth at St. Joseph. At the time of his birth, the Department of Health did not mandate this newborn screening test in acute care hospitals in Washington State although other states did.

KJM claims that CHI, a corporate entity, owed him a duty because it directed health care decisions regarding his care and it directed health care decisions to its subsidiaries in other states' hospitals throughout the United States. KJM argues that CHI meets the definition of a Washington "health care provider" because it employed one licensed doctor in Washington. KJM argues that CHI can be sued for damages for injuries to KJM occurring as a result of health care under chapter 7.70 RCW. Alternatively, if CHI is not a health care provider, KJM argues that we should expand RCW 7.70.020's definition of health care provider to include "persons engaged in the healing arts," which would then include CHI. KJM also argues that CHI, as a principal, is vicariously liable for FHS's and St Joseph's actions based on their apparent authority to act for CHI. Thus, KJM argues that the superior court erred by granting summary judgment dismissal to CHI.

We hold that because CHI is not a health care provider under RCW 7.70.020, CHI does not owe a duty to KJM and even assuming a duty is owed, KJM fails to prove causation as a matter of law, and no duty exists under common law. We decline to expand the definition of health care provider and we hold that CHI is not vicariously liable for FHS or St. Joseph. We also decline KJM's invitation to apply Washington's definition of health care provider in a way that assumes CHI directed health care decisions in this matter as KJM provided no evidence that was the case. We affirm.

FACTS

I. BACKGROUND

A. CHI, FHS, AND ST. JOSEPH

CHI is a nonprofit parent corporation formed in 1996 and incorporated in Colorado. CHI's purpose is to "promote and support, directly or indirectly, by donation, loan, or otherwise, the interests and purposes" of its "sponsored organizations." Clerk's Papers (CP) at 109-10. By 2005, CHI was the parent corporation of several subsidiary corporations that independently owned and operated hospitals in other states.

CHI describes itself as a "national health care institution." CP at 50. CHI's mission, "[a]s one of the nation's largest nonprofit health care systems," is to "go beyond the provision of quality health care to help protect the vulnerable; to encourage participation in the political process; and to safeguard the environment." CP at 278. CHI has 64 hospital facilities and 50 long-term care and residential-care facilities in 19 states.

FHS was formed in 1981. CHI was created when FHS and two other Catholic health care systems merged, but they continued to exist as separate subsidiary corporations. FHS owns and operates St. Joseph. The FHS Board of Directors was the governing body for St. Joseph. FHS was responsible for appointing medical staff, approving clinical privileges for medical staff, ensuring St. Joseph and its staff carried out peer review activities and other quality assurance activities in accordance with RCW 70.41.200, approving contracts with physicians to perform specific activities, and providing general oversight and supervision of the hospital.

In August 2005, when KJM was born, no person employed by CHI had been granted privileges as a member of St. Joseph's medical staff. In August 2005, the corporate operations of CHI and FHS were separate and distinct. Both St. Joseph and FHS were subject to oversight by the CHI Board of Directors, including subject to the approval of or removal by CHI.

CHI "did not have any involvement in the clinical decision-making or treatment of patients at St. Joseph." CP at 102. When KJM was born at St. Joseph in August 2005, CHI employed 46 people who "[had] an office, workspace, or were otherwise associated with working in Washington State." CP at 103.

Of the CHI employees who were associated with working in Washington State, Dr. Gregory Semerdjian was the only one who was "a licensed health care provider." CP at 103. Dr. Semerdjian was CHI's Vice President of Medical Operations, a member of the Clinical Services Group, and a member of CHI's Physician Leadership Council. He attended the 2004 Genetics Advisory Summit and the 2005 meeting of the Genetics Advisory Committee. Dr. Semerdjian did not provide health care services to KJM. Dr. Semerdjian has not practiced clinical medicine since 1991. Dr. Semerdjian was employed as a remote Vice President of Medical Operations to work with rural hospitals in North Dakota, Minnesota, Kansas, and Kentucky, not in Washington State. He did reside in Tacoma, Washington, but his work required him to travel out of state to the facilities CHI assigned him. He had a cubicle in an office space owned by FHS, but he did not work with any FHS facilities, or work at St. Joseph, and had no role related to making health care decisions about KJM.

B. SUPPLEMENTAL NEWBORN SCREENING AND KJM'S BIRTH

In August 2005, KJM was born at St. Joseph in Tacoma. At that time, St. Joseph did not include a newborn screening test for Glutaric Acidemia type 1 (GA-1) in its supplemental newborn screening (SNS) panel. The pediatrician who attended to KJM at St. Joseph was not named in the lawsuit, but could have ordered individual genetic testing if necessary. No other acute care hospitals licensed in Washington State offered the test at that time. The Department of Health required acute care hospitals in the state to conduct newborn screening for nine genetic disorders in August 2005, but did not mandate newborn screening for metabolic disorders such as GA-1.

KJM was diagnosed with GA-1 when he was 11 months old. By the time he was diagnosed, KJM had developed brain damage due to GA-1. KJM's mother said she would have gotten the additional screening test at St. Joseph if it had been offered.

Prior to KJM's birth, other states^[1] had mandated testing for GA-1 in the SNS panel. In 2005, hospitals in Colorado and Pennsylvania voluntarily included the GA-1 test in their SNS panel despite it not being mandatory in those states.

KJM's mother noticed the CHI logo on the admission paperwork she filled out upon arriving at St. Joseph to give birth, which was "important" to her.

C. CHI'S KNOWLEDGE OF SNS

Dr. John Anderson, CHI's Chief Medical Officer from 2004 to 2008, explained that CHI's Clinical Services Group did not have a pediatrician because CHI did not include a children's hospital; the hospitals in its subsidiaries provided adult care. CHI provided best practice resources in the form of "practice bundles" to its subsidiaries. "Practice bundles" include all of the resources that would be necessary to implement a practice change, but they do not mandate a particular course of testing or treatment.^[2] Dr. Anderson explained that SNS was not a priority at that time. CHI did not provide a practice bundle to its subsidiaries relating to SNS. Baylor University's Institute for Metabolic Disease, the institution Anderson previously worked at, ensured that all of its hospitals offered SNS before any state mandate.

II. PROCEDURE

In March 2017, KJM filed a negligence suit against FHS d/b/a/ St. Joseph for alleged negligence in August 2005, and it alleged that FHS owned and operated St. Joseph. Later, KJM amended his complaint to allege that CHI owed an independent duty to KJM for its failure to conduct SNS tests that he alleged would have detected GA-1 and for its failure to inform KJM's parents of the material facts relating to KJM's care and treatment. CHI denied that it employed or credentialed medical providers at St. Joseph and denied it owed a duty to KJM.

CHI moved for summary judgment dismissal of KJM's claims against it because it did not employ or credential any licensed health care provider at St. Joseph-who allegedly caused damages to KJM. CHI argued that (1) CHI was not a health care provider as defined in RCW 7.70.020, nor was any employee of CHI involved in KJM's care and treatment, (2) no common law duty exists, and (3) CHI was not vicariously liable for FHS or St. Joseph under the corporate medical negligence doctrine.

KJM argued in response that CHI is a health care provider under Washington law that owes a duty to the participants in its system because CHI was "registered to do business in Washington as a corporation whose purpose was to 'provide, conduct, and administer health care and related services,' in Washington." CP at 251 (boldface type omitted). KJM also argued that CHI had a common-law duty to patients of its health care system and CHI had voluntarily assumed a duty owed to KJM. In opposition to CHI's motion for summary judgment KJM filed the declaration of its expert Dr. Leslie Selbovitz. She was the Chief Medical Officer and Senior Vice President for Medical Affairs at Milford Regional Medical Center in Milford, Massachusetts. She stated that "KJM was not diagnosed until after he was approximately 11[ ]months old which was too late, as by then h...