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“Just when I thought I was out, they pull me back in!” –Michael Corleone, The Godfather Part III

Al Pacino probably doesn’t know it, but his iconic line from The Godfather Part III encapsulates the plight of hospitals pulled into medical malpractice suits due to negligent credentialing claims. That’s because plaintiffs sometimes assert this claim when they cannot prove a deviation from the standard of care on the part of any hospital employee or agent—so even if a hospital thinks that it’s out of the suit, plaintiffs can sometimes pull it back in by alleging that it negligently credentialed the accused doctor.

Because it can be an effective tool for ensnaring hospitals in medical malpractice suits, plaintiffs frequently assert negligent credentialing claims. However, these claims rarely make it to a jury verdict; an appeal is rarer still. Therefore, Illinois’ case law on this claim is surprisingly scant. To better understand negligent credentialing and how courts actually construe it, it’s necessary to examine five cases that explain negligent credentialing.

Frigo v. Silver Cross Hosp. & Med. Ctr.

 Prior to 2007, Illinois courts had not addressed negligent credentialing as a distinct cause of action. This changed when the Appellate Court of Illinois, First District handed down its decision in Frigo v. Silver Cross Hosp. & Med. Ctr..

The Frigo court set forth the following three elements that a plaintiff must prove to succeed on a negligent credentialing claim:

(1) the hospital failed to meet the standard of reasonable care in the selection of the physician it granted medical staff privileges to whose treatment provided the basis for the underlying medical malpractice claim;

(2) the physician breached the applicable standard while practicing pursuant to negligently granted medical staff privilege; and

(3) the negligently granted credentials were the proximate cause of their injury.

The court’s analysis in Frigo centered on the first element. The court explained that ‘reasonable care’ in this context means “that degree of care, skill and judgment usually exercised under like or similar circumstances by the average hospital.” The court held that by proving the hospital granted privileges to a doctor who did not meet the hospital’s own credentialing requirements, the plaintiff proved the hospital breached the standard of reasonable care, thereby satisfying the first element.

 Longnecker v. Loyola Univ. Med. Ctr.

The First District followed up Frigo with Longnecker v. Loyola Univ. Med. Ctr. in 2008. The court explained that negligent credentialing claims require an underlying medical malpractice claim. The court reasoned that without medical malpractice by the treating doctor, there would be no causal connection between the hospital negligently granting privileges to that doctor and the plaintiff’s injuries. Without this causal connection, plaintiffs cannot satisfy the third element in Frigo.

Helfers-Beitz v. Degelman

In 2010, the Third District tried its hand at analyzing a negligent credentialing claim in Helfers-Beitz v. Degelman. Similar to Longnecker, the Helfers-Beitz court found that the plaintiff had not asserted any underlying medical malpractice claim. Unlike the First District, the Third District reasoned that without the underlying medical malpractice claim, plaintiffs could not satisfy the first element, which specifically mentions an “underlying medical malpractice claim.” In so holding, the Third District reinforced the idea that the medical malpractice claim isn’t merely incidental to a negligent credentialing claim.

Blutcher v. Roseland Cmty. Hosp.

In the 2011 case Blutcher v. Roseland Cmty. Hosp., the First District once again addressed negligent credentialing. This case emphasizes two points: (1) failing to verify a doctors’ credentials can constitute a breach of the standard of care, and (2) once the plaintiff proves the first two elements, the third element does not necessarily require any additional evidence to prove proximate causation. This comports with Longnecker, which dictates that the underlying medical malpractice claim helps establish proximate causation.

Essig v. Advocate BroMenn Med. Ctr.

In a more recent case, Essig v. Advocate BroMenn Med. Ctr., the Fourth District gave a truncated negligent credentialing analysis. Because the plaintiffs supported their negligent credentialing claim with nothing more than conclusory statements and assertions, the court of appeals found that the plaintiffs had not proven any of the elements. Therefore, an in-depth analysis of the Frigo factors was not necessary.

Despite the shortened analysis, the court did give clues as to what evidence courts may want to see from plaintiffs. The court specifically mentioned evidence of the doctor’s performance history or peer-review assessments—the sort of materials that would have put the hospital on notice that the doctor was unqualified, negligent, or otherwise unsuitable to exercise the privileges granted.

The Takeaways

Despite its popularity among plaintiffs, Illinois’ negligent credentialing case law spans relatively few cases over the last 13 years. However, the above five cases leave two big takeaways: (1) the majority of courts’ analyses will focus on whether the hospital breached its standard of care by permitting an unqualified doctor to practice on their premises, and (2) the underlying medical malpractice claim is crucial to all parts of negligent credentialing analysis.

 Summer Associate Nick Scholz contributed to this post.