Connecticut Supreme Court Narrows Scope of Physicians’ Immunity from Civil Liability During COVID

The Connecticut Supreme Court recently determined that the executive order by Gov. Ned Lamont granting medical professionals and healthcare facilities immunity from any medical malpractice actions related to care delivered during the state’s COVID-19 response did not apply in two medical malpractice cases.

The first case, Mills v. Hartford HealthCare, involved the alleged wrongful death of patient Cheryl Mills at a hospital affiliated with the Hartford HealthCare System. Mills presented at the hospital in March 2020 complaining of a sore throat and headache. Her medical history detailed a heart murmur and the need for a heart valve replacement, and an electrocardiogram indicated rapid atrial fibrillation. The emergency room staff suspected Mills was experiencing a heart attack.

The standard of care for a heart attack involves admitting the patient to a cardiac catheterization lab, but the hospital had modified its protocols in response to the pandemic. Patients suspected of COVID-19 infection could not be admitted to the hospital’s catheterization lab until they tested negative for COVID-19 unless physical symptoms dictated emergency catheterization.

Believing that Mills could be suffering from COVID-related myocarditis or myopericarditis rather than a heart attack, an interventional cardiologist ordered her to be tested for COVID-19 and her admission to the catheterization lab to be deferred pending a negative result. Diagnostic testing was administered, and three days later the result came back negative. Mills was immediately scheduled to undergo a coronary angiogram in the catheterization lab but died of a heart attack before the procedure could be administered. Mills’ estate filed medical malpractice actions against the four physicians who treated her and Hartford Hospital.

The defendants moved to dismiss the claims, arguing immunity from civil liability under Gov. Lamont’s executive order, which conferred immunity from suit for civil liability to any healthcare professional or healthcare facility “for any injury or death alleged to have been sustained because of the individual’s or healthcare facility’s acts or omissions undertaken in good faith while providing healthcare services in support of the state’s COVID-19 response, including but not limited to acts or omissions undertaken because of a lack of resources, attributable to the COVID-19 pandemic, that renders the healthcare professional or healthcare facility unable to provide the level or manner of care that otherwise would have been required in the absence of the COVID-19 pandemic.”

The Supreme Court determined that the phrase “while providing healthcare services in support of the state’s COVID-19 response” was ambiguous and that the circumstances surrounding the executive order must be considered. The justices considered the challenges that necessitated the executive order and ultimately concluded the immunity conferred applies only to services directly combating COVID-19. As such, after Mills’ COVID test came back negative, the services rendered were no longer directly tied to combatting COVID-19. The court granted the motions to dismiss the claims involving the defendants’ acts or omissions occurring before the receipt of Mills’ negative COVID-19 test result but denied the motion to dismiss the wrongful death claim involving acts or omissions occurring after that time. The court remanded the wrongful death claim back to the trial court.

The second case, Manginelli v. Regency House of Wallingford, involved a nursing home patient, Darlene Matejek, who had a care plan specifying she required assistance during wheelchair transfers. Matejek fell during a wheelchair transfer in April 2020. No one reported the incident to her family or treated her pain for two days. When Matejek was taken to the hospital, she was diagnosed with two fractured femurs. She suffered a heart arrhythmia, atrial fibrillation and severe anxiety post-fall. Matejek died eight months after the fall, and her estate filed a malpractice claim against the nursing and rehabilitation center.

Regency House filed a motion to dismiss, arguing Gov. Lamont’s executive order specifically immunized healthcare facilities when the pandemic created a lack of resources that rendered the facility unable to provide the level or manner of care that otherwise would have been required.

The Supreme Court determined the language of Gov. Lamont’s executive order required healthcare facilities to establish that a pandemic-induced lack of resources existed and that the lack of resources caused the acts or omissions for which the facility is seeking immunity. And while the defendant did present evidence that there existed a lack of specific resources attributable to the pandemic, no evidence was presented that the lack of resources caused the defendant’s failure to implement a plan of care for Matejek prior to her fall or that it caused the failure to obtain her treatment immediately after her fall. The court refused to dismiss and remanded the case back to the trial court.

With its Mills and Manginelli rulings, the Connecticut Supreme Court set borders to the applicability of immunity under Gov. Lamont’s executive order conferring immunity from civil liability upon healthcare workers and healthcare facilities delivering care during the COVID-19 pandemic. The justices made clear that immunity does not apply to all acts or omissions that coincide with the effective period of the declared public health emergency but does apply when the acts or oversights can be tied to the healthcare provider’s services supporting the state’s response to COVID-19.

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