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What exactly is “health care”? The Supreme Court draws the line in the wrong place.

What exactly is “health care”? The Supreme Court draws the line in the wrong place.

It seemed like a pretty simple negligence case.  Andrew Minnich, a 71 year old man, went to MedExpress complaining of shortness of breath.  He was taken to an exam room and told to “have a seat.”  The step on the exam table was not fully pulled out, causing Andrew to lose his balance.  Andrew fell backwards into his wife, then hit the floor, resulting in a brain bleed that proved fatal.

Andrew’s wife, Joyce, sued MedExpress.  Her complaint alleged that MedExpress failed to keep its premises in a reasonably safe condition.  MedExpress, however, argued that it was protected by West Virginia’s malpractice laws because it was rendering “health care” to Andrew at the time of the fall.

Unfortunately, a majority of the Supreme Court agreed.  According to the majority, the “intake” aspect of a patient’s visit is an integral part of providing medical care.  Andrew had already gone through MedExpress’s intake process and was “attempting to comply with the [staffer’s] directive” when the fall happened.  All of this “was necessarily part of the health care services MedExpress undertook to provide.”  Therefore, the more restrictive malpractice laws applied.

Justice Davis, the lone dissenter, was having none of it.  This was not a case involving health care.  This was a premises liability case.  The staffer responsible for the exam room testified that she was supposed to “make sure that the footstool is out.”  Failing to do so, she admitted, posed a safety risk to anyone using the table.  Even MedExpress’s incident report characterized Andrew’s mishap as a simple “slip and fall.”

Cutting to the heart of the matter, Justice Davis was absolutely convinced that the conduct “form[ing] the basis for this litigation is not rooted in the provision of medical care.”  To be sure, it “confounds common sense to suggest that a physician expert is required to opine on the medical professional standard of care for extending a footstool.”  The claim here was focused on “a dangerous, partially extended footstool,” and not the rendering of health care in any way, shape, or form.

Viewed in isolation, this case will not have any significant impact.  This kind of fact pattern is not likely to repeat itself and the Court did not write any new syllabus points.  That said, the case is still troubling.

For one thing, it amounts to a step backward.  Were it not for a procedural issue,  three of the justices in an earlier case were willing to say that a claim involving a bacterial infection in a hospital was not covered by our state’s malpractice laws.  Riggs v. West Virginia University Hospitals, 221 W.Va. 646, 656 S.E.2d 91 (2007).  If providing a clean, infection-free hospital is not health care, then surely providing an exam room free of any tripping hazards is not health care.

The Court’s analysis is also a bit alarming.  Its emphasis on the “intake” process that occurs before a patient visit is misplaced.  Even accepting that the intake itself is part of rendering health care, it most certainly does not mean everything after that is health care.  What if Andrew had tripped on a frayed carpet as he entered the exam room?  Or stepped in a hole in the floor?  What if Andrew’s weight had caused the exam table to collapse?  Would these routine examples of premises liability be deemed malpractice simply because they happened after the patient had gone through intake.

Line drawing is part of the Court’s job.  But its lines must be drawn using fairness, practicality, and common sense.  In this case, the Court got it wrong.  Hopefully, the Court will correct its error in the future.  However, it’s likely this case is a harbinger of things to come.  If so, that’s certainly bad news for injury victims.


Minnich v. MedExpress Urgent Care, Inc., No. 15-1148 (W.Va. 2/9/17)

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