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Understanding Negligent Credentialing Claims Against Hospitals

When medical malpractice occurs, it is common for plaintiffs to sue both the doctor and the healthcare facility where the physician treated the plaintiff. When a physician is employed by a hospital, the hospital may be liable for the negligence of its employees under the doctrine of respondeat superior. If the doctor is an independent contractor with hospital privileges, then issues of agency and ostensible agency become more complex. Regardless of the employment arrangement, plaintiffs may have a claim against the healthcare facility for negligent credentialing.

Negligent credentialing is a cause of action based on the theory that the healthcare entity is a gatekeeper with a nondelegable duty to properly screen, credential, and periodically reassess healthcare providers to whom they grant staffing privileges. If a healthcare facility fails to confirm a provider’s credentials and fitness for employment, it may be found liable for negligent credentialing. Even if a physician lied on his or her application, the hospital may still be responsible because it had a duty to verify the information and ensure the competency of a physician before credentialing their practice at the medical center.

As with any negligence claim, negligent credentialing requires proof that the hospital had a duty to the plaintiff and that it breached the duty of care resulting in harm to the plaintiff. The plaintiff must show the hospital knew or should have known the healthcare provider was not competent to treat the patient — and that but for the hospital’s negligent credentialing or peer review, the physician would not have negligently treated the patient. To meet these requirements, expert witness testimony is essential.

Hospitals have an organized process for credentialing and regular peer review. This includes a duty to be diligent when granting privileges to a physician and to act promptly when there are concerns about a physician’s competency. Hospitals must also comply with obligations imposed by licensing boards and statutory law. To protect themselves, healthcare entities must maintain detailed documentation showing that a physician was appropriately credentialed pursuant to the facility’s policies and statutory requirements. Although the details of the process and actions taken against a doctor may be confidential, credentialing experts can testify regarding general standards used by hospitals as well as whether the facility’s approach met such standards of care. Typically, such credentialing experts are hospital administrators and physicians who have served on credentialing committees. Hospital or Healthcare Administrators are part of the hospital’s Executive Leadership Team and have overarching responsibilities for patient safety. As a result, they can provide valuable insights as expert witnesses regarding proper protocols for credentialing and peer review.

It can be difficult to find expert witnesses with the appropriate background in credentialing. If you are handling a negligent credentialing claim, please contact Elite Medical Experts. We can help you find nationally recognized experts for your case.

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