HOSPITAL

LIABILITIES

DEFINITION OF HOSPITAL
Sec.2(a), RA 4226, Hospital Licensure Act
HOSPITAL means a place devoted primarily to
the maintenance and operation of facilities for the
diagnosis, treatment, and care of individuals
suffering from illness, disease, injury or deformity,
or in need of obstetrical or other medical and
nursing care.
The term hospital shall also be construed as
any institution, building or place where there are
installed beds, cribs, bassinets for twenty-four hour
use or longer by patients in the treatment of
diseases, ..xxx.

HOSPITAL
Institution for diagnosing and treating the sick or injured,
housing them during treatment, examining patients, and
managing childbirth.
Outpatients, who can leave after treatment, come in for
emergency care or are referred for services not available in
a private doctor's office.
Hospitals may be public (government-owned) or private
(profit-making or not-for-profit)
They may also be general, accepting all types of medical or
surgical cases, or special (e.g., children's hospitals, mental
hospitals), limiting service to a single type of patient or
illness.

HOSPITAL
General hospitals usually also have specialized
departments, and special hospitals tend to
become affiliated with general hospitals.
A charitable institution for the needy, aged,
infirm, or young
an institution where the sick or injured are given
medical or surgical carea place for the care and
treatment of sick and injured animals

THREE TYPES OF HOSPITAL

Government-supported Hospitals

This group includes tax-supported hospitals for

counties, communities and cities with voluntary
hospitals (community or charity hospitals) run
by a board of citizen administrators who serve
without pay (usually by allowances).
The main objective of this type of hospital is to
provide health care for a underprivileged
citizens or underserved community or
geographic region.

THREE TYPES OF HOSPITAL

Teaching or Community Hospitals

These are hospitals that serve several purposes,

namely:
i. they provide patients for the training or
research of interns and residents;
ii. they also offer services to patients who are
unable to pay for services, while attempting to
maintain profitability.

THREE TYPES OF HOSPITAL

Proprietary Hospitals

For-profit hospitals include both general

and specialized hospitals, usually as part
of a healthcare network like Humana or
HCA, which may be corporately owned.
The main objective of proprietary
hospitals is to make a profit from the
services provided.

Primary Duties of a
Hospital:
1. To furnish a safe and wellmaintained building and ground;
2. To furnish adequate and safe
equipment;
3. To exercise reasonable care in the
selection of the hospital staff.

Hospital
Organization

A hospital organization is an organization that:

is regulated as a hospital by a state Department of Health
or its equivalent or
holds itself out to the public as a hospital or provider of
hospital based services, which means a place that is
devoted primarily to the maintenance and operation of
facilities for the diagnosis,

treatment or

care over a period exceeding twenty-four hours of two or

more nonrelated individuals suffering from illness,
injury, or deformity or a place that is devoted

primarily to the rendering over a period exceeding twentyfour hours of obstetrical

or other medical
or nursing care or files a state or Medicare
cost report intended to be filed by hospitals.

Hospital
Organization

Hospital organization takes charge of the

management of the internal organization of
the hospital.
Hospital boards of directors and executive
committees officially have responsibility for
the hospital as a whole.
The , boards facilitate fund raising and
determine the nature of hospital outputs
desired by the community.

LIABILITIES OF HOSPITAL
1. CORPORATE Liabilities
Those arising from failure of the hospital to
furnish accommodations and facilities necessary
to carry out its purpose or to follow in a given
situation, the established standard of conduct to
which the corporation should conform.
Recent decisions of the court has extended
hospital liability to patient for its failure to
make careful selection, review, and supervision
of independent physicians who are permitted to
practice in the hospital.

2. VICARIOUS Liabilities for the Acts of

Hospital Employees.

LIABILITIES OF HOSPITAL FOR ITS

ANCILLARY SERVICES

Whenever the hospital administration enters into

contract with a partnership of physicians to run the
emergency room, the medical staff therein are not
considered employees of the hospital. Consequently
liability for negligence in the emergency room is shifted
to the medical partnership.
Courts have held that even if contracts specify that
physicians will be considered independent contractors,
the hospitals are responsible for their action if they can
exercise control over them.
Patients are not bound by the secret limitations
contained in a private contract between the hospital and
the physician.

Attendance to emergency cases in hospitals

Sec. 1 RA 6615 substantially states
that xxx hereby required to render
immediate emergency medical
assistance and to provide facilities and
medicine within its capabilities to
patients in emergency cases who are in
danger of dying and/or who may have
suffered serious injuries.

Liability in the emergency room may arise

from the following:

Failure to admit;
Failure to examine and/or treat;
Negligence
in
the
application
management procedures.

of

Two Aspects of Emergency Care

Examination of the patient to determine his

condition and need for emergency medical
procedures
Performance of the specific medical or surgical
procedure which are required without delay to
protect the patients health.

Detention of patient for non-payment of bill

A patient cannot be detained in a hospital for
non-payment of the hospital bill. The law
provides a remedy for them to pursue by filling
the necessary suit in court for the recovery of
such fee or bill.
A hospital any legally detain a patient against
his will when he is detained or convicted
prisoner, or when the patient is suffering from a
very contagious disease wherein his release is
prejudicial to public health, or when the patient
is mentally ill, that his release will endanger
public safety.

Hospital Liability
Doctrines

Hospital Liability Doctrines

1. Apparent Authority or Holding Out" Theory or Doctrine
of Ostensible Agency or Agency by Estoppel.
. It imposes liability, not as the result of the reality of a
contractual relationship, but rather because of the

actions of a principal or an employer in

somehow misleading the public into believing that
the relationship or the authority exists.

. The concept is essentially one of estoppel and has been explained

in this manner: "The principal is bound by the acts of
his agent with the apparent authority which he
knowingly permits the agent to assume, or which he holds the
agent out to the public as possessing.

Hospital Liability Doctrines

2. Doctrine of Corporate Negligence or Corporate
Responsibility.
Direct liability of a hospital entity is premised upon the

hospitals non-delegable duties.

Those duties generally include the following:

(1) the duty to use reasonable care in the maintenance of safe and adequate
facilities and equipment;
(2) the duty to select and retain only competent physicians and staff;
(3) the duty to oversee all persons who practice medicine within its facility
as to patient care; and
(4) the duty to formulate, adopt and enforce adequate rules and policies to
ensure quality of care.
Corporate liability applies equally regardless of

the status of the physician.

Hospital Liability Doctrines

3. Doctrine of Respondeat Superior
ART. 2180. The obligation imposed by Article 2176 is demandable not
only for ones own acts or omissions, but also for those of persons for
whom one is responsible.
The owners and managers of an establishment or enterprise are
likewise responsible for damages caused by their employees in the
service of the branches in which the latter are employed or on the
occasion of their functions.
Employers shall be liable for the damages caused by their
employees and household helpers acting within the scope of their
assigned tasks even though the former are not engaged in any
business or industry.

Hospital Liability Doctrines

3. Doctrine of Respondeat Superior
The responsibility treated of in this article shall cease when the
persons herein mentioned prove that they observed all the
diligence of a good father of a family to prevent damage.
For the purpose of allocating responsibility in medical negligence
cases, an employer-employee relationship in effect exists
between hospitals and their attending and visiting physicians.
Private hospitals hire, fire and exercise real control over their
attending and visiting consultant staff. While consultants are
not, technically employees, the control exercised, the hiring, and
the right to terminate consultants all fulfill the important
hallmarks of an employer-employee relationship, with the
exception of the payment of wages.

Hospital Liability Doctrines

4. Captain of the Ship Rule
A principle of medical-malpractice law, holding
a surgeon liable for the actions of assistants
who are under the surgeon's control but who
are employees of the hospital, not the surgeon.
The surgeon as "the captain of the ship," is
directly responsible for an alleged error or act of
alleged negligence because he or she controls
and directs the actions of those in assistance,
whose duty is to obey his orders.
This common law doctrine is often used in
operating room situations.

Hospital Liability Doctrines

5. The "Schloendorff Doctrine" (Schloendorff v.
Society of New York Hospital)

Hospitals are exempt from the application of the

respondent superior principle for fault or negligence
committed by physicians in the discharge of their profession.
It has been said that medical practice strictly involves highly
developed and specialized knowledge,such that physicians
are generally free to exercise their own skill and
judgment in rendering medical services sans interference.
Hence, when a doctor practices medicine in a hospital
setting, the hospital and its employees are deemed to
sub serve him in his ministrations to the patient and his
actions are of his own responsibility.

THANK
YOU!!!