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Illinois lawsuit could further restrict resident work hours

A postcall resident crashes while driving home. Is the hospital liable?

By Myrle Croasdale, amednews staff. March 21, 2005.

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Heather Brewster was hit by a first-year internal medical resident who was driving home after 36 hours on call. Brewster, who was 23 at the time, July 14, 1997, sustained a head injury that has left her permanently disabled and has since been deemed incompetent by the courts.

Brewster's family is suing the resident and teaching hospital, Rush University Medical Center in Chicago, on her behalf. The family says Rush should be held liable because it enforced a work schedule that left residents sleep-deprived. They have asked an appeals court to overturn a lower court ruling excluding Rush from the lawsuit on the grounds that it could not be held responsible for an employee's after-work conduct.

At stake, legal experts say, is the broader issue of resident work hours. If Rush is held responsible for the car crash, then teaching hospitals nationwide could be vulnerable to similar suits, even though residents are no longer allowed to work 36-hour stints.

Jonathan Zittrain, a Harvard law professor, explained that once a state court decides that a practice is up for examination, it sets a precedent.

"Forget the plaintiffs even winning," he said. "Even if they're permitted to press their claim, if the threshold decision is made that hospital practices in this area are subject to scrutiny, it would send the signal that you can't just do business as usual, that you can no longer only answer to internal controls in the profession for what you chose to do.

"We already know that when a construction company asks someone to work three shifts in a row, they might be held responsible for an accident. The question is whether there is any special status for hospitals and doctors."