Page 15 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

C A S E S T U DY

In Cooke, a patient visited an urgent care clinic on several

occasions to be treated for respiratory problems and
extreme fatigue. The urgent care clinic was owned by a

physician assistant, and the physician assistant provided
all care to the patient. The supervising physician did

not render any care at the clinic and did not have any
ownership interest in the clinic. After the patient’s condition

worsened, the physician assistant referred the patient to
an unaffiliated pulmonologist. The patient received care

from several other providers and was ultimately diagnosed
with cardiomyopathy for which she underwent mitral

valve repair and mitral valve replacement surgery. The
patient filed a suit against the clinic and the supervising

physician for the physician assistant’s failure to diagnose
the patient with cardiomyopathy.

Because the patient sued the supervising physician and
not the physician assistant, the Cooke court was tasked

with determining whether the supervising physician
could be held liable for negligence of the physician

assistant. The court determined that, yes, the supervising
physician could be held liable under Tennessee law even

though the physician assistant was not an employee and
the supervising physician did not have any ownership

interest in the clinic.

The court found that: “Tennessee statutory provisions
and the board rules convince us that, as a general matter,

a physician assistant stands in an agency relationship
with his or her supervising physician when the physician

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