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Rodas v. SwedishAmerican Health System Corp.

January 29, 2009

GLORIA L. RODAS, ET AL., PLAINTIFFS,
v.
SWEDISHAMERICAN HEALTH SYSTEM CORPORATION, ET AL. DEFENDANTS.



The opinion of the court was delivered by: Frederick J. Kapala, District Judge

MEMORANDUM OPINION AND ORDER

Plaintiff, Gloria Rodas, individually and as administrator of the estate of the decedent infant Andrea Rodas, filed this lawsuit against defendants SwedishAmerican Health System Corporation ("SAH"), the United States of America, Dr. John Seidlin, and Dr. Ana-Maria Soleanicov, alleging medical negligence related to the delivery of the decedent on August 2, 2001. Defendants Seidlin and Soleanicov each have filed motions for summary judgment in which they argue that they are immune from liability based on the Illinois Good Samaritan Act, 745 ILCS 49/25. For the reasons stated below, the court grants defendants' motions for summary judgment.

I. BACKGROUND*fn1

On August 2, 2001, plaintiff went into labor with the decedent and was admitted to the labor and delivery floor at SAH at approximately 4:02 a.m. Up until that point, plaintiff had been receiving her prenatal care from the Crusader Central Clinic Association ("Crusader Clinic") and, therefore, did not have a primary physician. Plaintiff had been instructed, however, that for delivery services or other obstetric needs, she would be provided a physician at SAH. In addition to having an on-call family practitioner available at the hospital for its patients, Crusader Clinic also had an Agreement for Professional Services ("APS") with the University of Illinois College of Medicine at Rockford ("UIC"), whereby UIC obstetricians and gynecologists would provide back-up professional services to Crusader Clinic patients that were admitted to the labor and delivery floor at SAH. Dr. Soleanicov was the scheduled back-up obstetrician assigned to the labor and delivery floor on August 2, 2001.

Under the terms of the APS, Crusader Clinic agreed to pay UIC a set monthly fee regardless of the level of services provided. In exchange, Crusader Clinic reserved the right to bill its patients after receiving documentation of services rendered from the UIC physician, and Crusader Clinic was entitled to keep the entirety of the proceeds. As a result of this arrangement, UIC physicians did not directly bill patients to whom they provided back-up services or receive any additional compensation in the event they were asked to assist with a Crusader Clinic patient.

Plaintiff's care at SAH originally was managed by Dr. Al Saraf, a UIC resident, until approximately 7:00 a.m., at which time Dr. Alpa Boshku, a UIC resident, and Dr. William Baxter, a Crusader Clinic family practice physician, took over her care. During his deposition, Dr. Baxter testified that it was his understanding that day that if Dr. Soleanicov was not available to assist him, he could consult Dr. Seidlin if needed.*fn2 At approximately 12:05 p.m., Dr. Baxter asked a nurse to contact Dr. Seidlin because the fetal heart tones had dropped, plaintiff was not pushing effectively, and there was no progress in the descent of the baby.*fn3 Dr. Baxter did not attempt to contact Dr. Soleanicov, the scheduled back-up UIC physician, because he knew that she was in the middle of a surgery.

After Dr. Seidlin was notified about the status of plaintiff's labor, he determined that the infant should be delivered expeditiously (i.e., as soon as possible). Because Dr. Soleanicov was the scheduled back-up doctor at the time, Dr. Seidlin immediately went to the operating room where she was located and advised her about plaintiff's condition and the fact that Dr. Baxter was requesting an obstetrician to consult and evaluate his patient. After notifying Dr. Soleanicov, Dr. Seidlin was at plaintiff's bedside by 12:10 p.m. Dr. Soleanicov was able to finish her surgery within five minutes or less, and she was at plaintiff's bedside by 12:15 p.m., at which point Dr. Soleanicov assumed control over the management of the delivery of the infant and made all of the decisions throughout the delivery of the infant.

After her arrival, Dr. Soleanicov looked at the fetal monitor tracings, did a vaginal and fundal exam, and ordered oxygen by mask and increased IV fluids, at which point the infant's condition improved slightly. After approximately 10 minutes of pushing with plaintiff, however, the infant's fetal heart rate decelerated down to 90, and Dr. Soleanicov decided to attempt an instrumental-assisted delivery. According to Dr. Soleanicov's deposition testimony, it was an "emergency situation" from the moment she walked into the room and, after spending some time with plaintiff, she knew that she had to "deliver this baby as soon as possible," and that "the fastest way and most expeditious way would be to attempt an instrumental delivery." After two unsuccessful attempts at delivery with a vacuum extractor, Dr. Soleanicov next attempted to deliver the infant with forceps. After Dr. Soleanicov was unsuccessful in her attempt at a forceps-assisted delivery, Dr. Seidlin indicated that he wanted to attempt an instrumental delivery. Dr. Soleanicov disagreed with this procedure and refused to let Dr. Seidlin attempt to deliver the infant. Instead, Dr. Soleanicov decided, at 12:35 p.m., to take plaintiff for a cesarian section because "it was becoming a serious emergency." Anesthesia was commenced at 12:40 p.m., and Dr. Seidlin was Dr. Soleanicov's assistant during the cesarean delivery because no one else was immediately available to assist. The infant was delivered at 12:50 p.m. According to the allegations in the complaint, the infant died on August 14, 2001.

For billing purposes, whenever a UIC physician provided services to a Crusader Clinic patient, a billing form listing the various diagnostic codes associated with the services performed would be prepared and submitted to the Crusader Clinic. For labor and deliveries, it is usually the delivery physician who handles the paperwork. On the billing form for plaintiff, Dr. Soleanicov circled the code "59515," which referred to "Cesarean delivery with postpartum care," and submitted this information to the Crusader Clinic's billing clerk. The form made no mention of an assistant, and Dr. Seidlin did not independently submit a billing form for his services. Based on the forms received, the billing clerk generated a "Hospital Encounter Route Sheet," which reflects, among other things, Dr. Soleanicov's code number of 142, the same procedure code of 59515, and a charge of $1936.00. The billing clerk testified that this was the "standard rate" for that specific procedure code if the bill was to go to Public Aid.*fn4 The parties have failed to demonstrate to the court who determined the amount of this standard rate for this type of delivery. Moreover, the court notes that this amount appears to cover the entirety of plaintiff's labor and delivery, and therefore, seems to also include whatever charges were generated for the care plaintiff received both before and after Dr. Soleanicov's delivery services.

On August 23, 2001, Crusader Clinic issued a bill to a third-party payer, Medicaid, in the amount of $1936.00 for the delivery services provided to plaintiff. Plaintiff's account history next reflects a "Medicaid write-off" in the amount of $803.00, as well as a payment by Medicaid to Crusader Clinic for the remaining balance of $1133.00. Because the Crusader Clinic was entitled to collect on the bill and keep the entirety of the proceeds according to the terms of the APS, plaintiff was never billed directly from UIC, Dr. Seidlin, or Dr. Soleanicov for their delivery services. Moreover, Dr. Seidlin and Dr. Soleanicov each received their full salary and compensation from UIC that day, and this amount would have been the same regardless of whether they provided any professional services to plaintiff.

II. DISCUSSION

In their motions for summary judgment, both Dr. Seidlin and Dr. Soleanicov argue that they are entitled to immunity from plaintiff's claims of medical negligence pursuant to the Illinois Good Samaritan Act, 745 ILCS 49/25. In order to decide these motions, which depend on an interpretation of state law, the court must predict how the Illinois Supreme Court would decide this case if it were presented to it. See Konradi v. United States, 919 F.2d 1207, 1213 (7th Cir. 1990). When, as here, there are no decisions on point from the state's highest court, the "decisions of the state appellate courts control, unless there are persuasive indications that the state supreme court would decide the issue differently." Allstate Ins. Co. v. Tozer, 392 F.3d 950, 952 (7th Cir. 2004) (quotation marks omitted); see also Liberty Mut. Fire Ins. Co. v. Statewide Ins. Co., 352 F.3d 1098, 1100 (7th Cir. 2003) (explaining that, when applying state law, "the rulings of state appellate courts must be accorded great weight, unless there are persuasive indications that the state's highest court would decide the case differently" (quotation marks omitted)).

The Illinois Good Samaritan Act provides, in relevant part, that a licensed physician "who, in good faith, provides emergency care without fee to a person, shall not, as a result of his or her acts or omissions, except willful or wanton misconduct on the part of the person, in providing the care, be liable for civil damages." 745 ILCS 49/25. The Act's stated purpose is to provide "numerous protections for the generous and compassionate acts of [Illinois] citizens who volunteer their time and talents to help others," and its provisions are to be "liberally construed to encourage persons to volunteer their time and talents." 745 ILCS 49/2.

Illinois courts require a doctor seeking to invoke the protections of the Good Samaritan Act to prove two things: "(1) that he or she provided emergency care and (2) that he or she did not charge a fee." Estate of Heanue v. Edgcomb, 355 Ill. App. 3d 645, 648 (2005). The Act also requires that the doctor act "in good faith." See id. The Act applies even where the emergency occurs within a hospital. See Johnson v. Matviuw, 176 Ill. App. 3d 907, 917 (1988). In addition, a doctor does not have to prove the absence of a pre-existing duty to render aid to the patient in order to receive the protections of the Act. Neal v. Yang, 352 Ill. App. 3d ...


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