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New Jersey Appellate Court Rules, Gynecologist Not Covered by Hospital Insurance

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New Jersey Gynecologist Malpractice Case

Claims against gynecologists for negligence can happen anywhere in New Jersey, including in Essex County. When a gynecologist is determined to be negligent, meaning he or she fails provide an adequate standard of care, the patient who suffers injury may pursue legal action through medical malpractice litigation. Recovering damages for medical malpractice often provides desperately needed financial compensation for individuals bearing the costs of medical care now and in the future, as well as the emotional toll inflicted as a result of their injuries.

If you experienced an injury as a result of suspected medical negligence or you believe you may have grounds for a medical malpractice claim against a gynecologist or another provider in New Jersey, contact our offices at 973-435-4551 for a free consultation with a New Jersey medical malpractice attorney. 

Gynecologist Malpractice in Essex County NJ

In a recent medical malpractice case brought before a New Jersey Appellate Court, the three-judge panel ruled that a hospital’s insurance coverage did not extend to a gynecologist and his practice, as they did not qualify as hospital employees.

This case began when the plaintiff, Keyko Gil, underwent an emergency C-section at Clara Maass Medical Center in Belleville, New Jersey in 2004. Gil alleged that the Cesarean, performed by Dr. Huseyin Copur, caused birth injuries in her son Kenneth. She filed a medical malpractice claim in 2011, naming the hospital, its covering insurance companies, and FirstChoice OB-GYN LLC, Dr. Copur’s practice, in the lawsuit.

As the case proceeded, a trial judge first limited the hospital’s liability to $250,000 because it is subsumed under the Catholic health network and as such, qualifies under the New Jersey Charitable Immunities Act. The plaintiff then pursued damages from FirstChoice OB-GYN LLC and the hospital’s insurers. The insurers were granted a summary judgement, which prompted Gil to appeal the decision. The question brought before the Appellate Division was: should the hospital’s insurance cover Dr. Copur and his practice, First Choice OB-GYN LLC, which had an ongoing services agreement with the hospital?

Notably, the hospital’s insurance policies specifically limited coverage to hospital employees. In other words, independent contractors are not included in policy provisions. The Appellate panel was then left to decide if Dr. Copur met the criteria of an “employee” per the definition under the hospital’s insurance policies. The policies defined an employee in a variety of ways, but requirements included: being on hospital payroll, having an assigned work schedule, or being paid directly by Clara Maass.

The next significant component of this decision involved whether or not the specific insurance policies, or the common law definition of an employee, should be the primary determinant for coverage. The court then examined the precedential test for employee versus independent contractor, which was outlined in the New Jersey Supreme Court case of Lowe  v. Zarghami in 1999. The established test for employees under New Jersey law involves four factors:

  • The degree of control exercised by the employer over the means of completing the work;
  • The source of the worker’s compensation;
  • The source of the worker’s equipment and resources;  and
  • The employer’s termination rights

If the aforementioned questions are answered in the affirmative, a subsequent test, known as the “relative nature of the work” test, may be used to confirm the relationship. The relative nature of the work test asks the “the extent of the economic dependence of the worker upon the business he serves and the relationship of the nature of his work to the operation of that business.” (Marcus v. Eastern Agricultural Ass’n, 58 N.J.Super. 584, 603, 157 A.2d 3 (App.Div.1959)(Conford, J. dissenting), rev’g on dissent, 32 N.J. 460, 161 A.2d 247 (1960).

Ultimately, the Appellate Panel ruled that Dr. Copur did not meet the criteria for an employee under the common law definition, and that the specific terms of the insurance policies were paramount when determining liability. This decision is significant for medical malpractice victims in New Jersey, as it indicates the inclination of the courts to prioritize insurance policy provisions as they apply on a case-by-case basis.

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