## Facts

- Crystal Jefferson underwent multiple abdominal/pelvic CT scans at Missouri Baptist Medical Center (MBMC) after a 2005 cesarean section; earlier scans noted a soft-tissue mass and recommended follow-up.
- On January 19, 2006, radiologist Amy Mosher, M.D., interpreted a CT scan at MBMC and documented findings in Crystal’s chart; plaintiffs alleged Mosher reported resolution of fluid but failed to mention the persistent suspicious mass.
- Crystal did not seek further evaluation until 2008, when she was diagnosed with stage IV, inoperable cancer; she died in 2011.
- Crystal’s children (through their father) sued MBMC and others for medical negligence and sought to hold MBMC vicariously liable for Mosher’s alleged negligence.
- MBMC argued Mosher was not its “employee” because she was employed and paid by Midwest Radiological Associates, P.C., which contracted with MBMC to provide radiology services.
- The circuit court granted MBMC summary judgment on the ground that Mosher was not an “employee” of MBMC under Mo. Rev. Stat. § 538.210.2(3); plaintiffs appealed.

## Issues

1. Whether “employee” in Mo. Rev. Stat. § 538.210.2(3) is limited to individuals directly employed/paid by the hospital, or instead includes physicians working at the hospital through a separate contracting professional corporation when common-law agency control is shown.
2. Whether summary judgment was proper where evidence could support a finding that the hospital had sufficient right of control over the radiologist’s work to treat the radiologist as the hospital’s employee/agent under § 538.210.2(3).

## Decision

- The Missouri Court of Appeals reviewed the summary judgment ruling de novo and considered the record in the light most favorable to the non-movants.
- The court held the trial court used an erroneously narrow definition of “employee” under § 538.210.2(3) by effectively limiting the term to direct payroll employment.
- Because the statute did not define “employee,” the court applied common-law agency principles, focusing on the right of control over the manner and means of work.
- The court found the record contained evidence from which a factfinder could conclude MBMC exercised sufficient control over radiology services within its facility to treat Mosher as MBMC’s employee/agent for purposes of § 538.210.2(3).
- The court reversed summary judgment for MBMC and remanded for further proceedings.

## Legal Principles

- When a Missouri statute governing health-care liability uses “employee” without defining it, courts interpret the term using common-law agency principles rather than a formal payroll test.
- The key inquiry in distinguishing employee/agent status from independent contractor status is the alleged principal’s right to control the manner and means of the work.
- A physician may qualify as a hospital’s employee/agent for statutory allocation and vicarious-liability purposes even if the physician is formally employed and paid by a separate contracting entity, where evidence supports hospital control over the services provided.
- Summary judgment is improper where material fact disputes exist regarding the extent of the hospital’s right of control and the nature of the relationship relevant to employee/agency status.

## Conclusion

The court reversed the hospital’s summary judgment because § 538.210.2(3) did not restrict “employee” to direct payroll workers; instead, employee status turns on common-law agency control, and the evidence allowed a factfinder to treat the radiologist as the hospital’s employee/agent for vicarious liability purposes.


Jefferson v. Missouri Baptist Med. Ctr., 447 S.W.3d 701 (Mo. Ct. App. E.D. 2014)