Bradford v. Jai Med. Sys. Managed Care Org., Inc.

Jai Medical Systems Managed Care Organization, Inc. (JaiMCO) is an entity that contracts with health care providers to provide health care services to patients enrolled in the State Medicaid program. Dr. Steven Bennett participated as a specialty care provider in the network of JaiMCO. Petitioner chose Dr. Bennett to treat a bunion on her foot that was causing her pain. After Dr. Bennett performed surgery to remove the bunion Petitioner developed gangrene, and her foot had to be partially amputated. Petitioner sought to hold JaiMCO liable for Dr. Bennett’s negligence on a theory of apparent agency, asserting that JaiMCO created the appearance that Dr. Bennett was its agent and that she reasonably relied on that appearance. A jury returned a verdict in Petitioner’s favor. The court of special appeals reversed, determining that the evidence was insufficient to support the verdict. The Court of Appeals affirmed, holding (1) a managed care organization may be vicariously liable for the negligence of a network physician under a theory of apparent agency; but (2) even if Petitioner subjectively believed Dr. Bennett was an employee of JaiMCO, the belief was not reasonable under the facts of this case. View "Bradford v. Jai Med. Sys. Managed Care Org., Inc." on Justia Law