## Facts

- Sixteen-year-old Brett Jackson suffered severe injuries after falling from a cliff and was airlifted to Fairbanks Memorial Hospital (FMH), arriving at the emergency room shortly after midnight on May 22, 1981.
- Dr. John Power, an emergency room physician on duty, examined Jackson and noted significant trauma, including facial and scalp lacerations, lumbar contusions and lacerations, broken vertebrae, and gastric distension suggesting possible internal injury.
- Power ordered several tests but did not order certain procedures that could have identified kidney-related vascular injury.
- Jackson had damage to the renal arteries and veins; the injury went undetected for approximately 9–10 hours and ultimately resulted in loss of both kidneys.
- Jackson and his mother, Linda Estrada, sued alleging negligence in Jackson’s diagnosis, care, and treatment at FMH.

## Issues

1. Whether FMH could be held vicariously liable for Dr. Power’s alleged negligence under an enterprise liability theory.
2. Whether FMH could be held vicariously liable under apparent authority based on whether it held out Dr. Power as its agent and whether Jackson relied on that appearance.
3. Whether a licensed general acute-care hospital operating an emergency department has a non-delegable duty to provide non-negligent emergency-room physician care, making it vicariously liable for negligence of an independent-contractor emergency physician.

## Decision

- The Alaska Supreme Court agreed that FMH could not be held liable under an enterprise liability theory.
- The court held that apparent-authority liability depended on disputed facts and therefore was not resolvable in Jackson’s favor on summary judgment.
- The court held, as a matter of law, that FMH had a non-delegable duty to provide non-negligent physician care in its emergency room and therefore could be vicariously liable for Dr. Power’s alleged negligence despite his independent-contractor status.
- The case was remanded for further proceedings consistent with recognizing the hospital’s potential vicarious liability under the non-delegable duty doctrine.

## Legal Principles

- A hospital generally is not vicariously liable for negligence of independent contractors under ordinary respondeat superior principles, absent an applicable exception.
- Enterprise liability was not adopted as a basis for imposing hospital vicarious liability in this context.
- Apparent authority may support hospital vicarious liability for a physician’s negligence when the hospital holds the physician out as its agent and the patient reasonably relies on that appearance; whether these elements are satisfied is typically a fact question.
- A licensed hospital operating an emergency department has a non-delegable duty to provide non-negligent physician care in the emergency room; delegating emergency physician services to an independent contractor does not relieve the hospital of vicarious liability for negligent performance of that duty.
- Statutory, regulatory, and public-policy considerations concerning emergency services and patient expectations can render emergency-room care a core hospital obligation that cannot be shifted to independent contractors to avoid tort responsibility.

## Conclusion

The Alaska Supreme Court recognized that a hospital’s obligation to provide competent emergency-room physician services is non-delegable, allowing vicarious liability for negligent ER care even when the treating emergency physician is an independent contractor, while leaving apparent-authority liability to be determined on the facts.


Jackson v. Power, 743 P.2d 1376 (Alaska 1987)