## Facts

- Terence Williams suffered severe injuries in a May 3, 2014 motor vehicle crash in Prince George’s County, Maryland.
- EMS transported Williams to Prince George’s Hospital Center, a state-designated Level II trauma center operated by Dimensions Health Corporation.
- Upon arrival, Williams was intubated and became unconscious, leaving him unable to review or sign the hospital’s standard consent form disclaiming that physicians were hospital employees or agents.
- Dr. Montague Blundon, the on-call orthopedic surgeon staffing the trauma center, treated Williams.
- Williams alleged Dr. Blundon negligently failed to meet the standard of care for trauma treatment, causing additional harm, including eventual bilateral leg amputations.
- Williams testified he understood he was being taken to a trauma center and relied on the hospital, not a particular physician, for emergency care.

## Issues

1. Whether sufficient evidence permitted a reasonable jury to find that the trauma-center orthopedic surgeon was the hospital’s apparent agent, making the hospital vicariously liable for the surgeon’s negligence.

## Decision

- The trial jury found Dr. Blundon negligent and found the hospital vicariously liable based on an agency/apparent agency theory.
- The circuit court granted the hospital’s motion for judgment notwithstanding the verdict (JNOV) for insufficient evidence of agency.
- The intermediate appellate court affirmed.
- The Maryland high court reversed, holding there was ample evidence supporting apparent agency and remanded with instructions to reinstate the jury’s verdict imposing vicarious liability on the hospital.

## Legal Principles

- Apparent agency permits vicarious liability when: (1) the principal represents, or acquiesces in the appearance, that another is its agent; (2) the third party relies on that appearance to the third party’s detriment; and (3) the reliance is reasonable under the circumstances.
- In emergency/trauma care, a hospital may be vicariously liable under apparent agency for negligence by providers staffing its emergency facility even if those providers are formally independent contractors.
- A hospital’s trauma-center designation and required staffing can constitute manifestations supporting a finding that on-call trauma surgeons are held out as part of the hospital’s emergency care team.
- Disclaimers in forms or signage do not defeat apparent agency unless notice is timely and meaningful; lack of meaningful notice to an unconscious emergency patient supports the reasonableness element.

## Conclusion

The court held that evidence of the hospital’s trauma-center status, its staffing of on-call surgeons to satisfy regulatory obligations, Williams’s reliance on the hospital for emergency trauma care, and the absence of timely and meaningful notice of independent-contractor status was sufficient for a jury to find apparent agency and impose vicarious liability on the hospital.


Williams v. Dimensions Health Corp., 480 Md. 24, 279 A.3d 954 (Md. 2022)