Doctrine of liability: Is it applicable to hospitals?

By Larry D. Hal, JD, and William W. Large, JD

Adams, Hill, Reis, Adams, Hall & Schieffelin

Orlando, FL

The doctrine of strict liability is designed to protect the public in its use of consumer goods. Essentially, the doctrine imposes liability without fault on the seller of a defective product if the product is deemed unreasonably dangerous to the consumer, and if the seller is engaged in the business of selling the product.

The basis for applying strict liability to retailers is that, like manufacturers, they are engaged in the business of distributing goods to the public. Thus, retailers are an integral part of the overall producing and marketing enterprises that should bear the costs of injuries resulting from defective products.

Another basis for applying strict liability is to ensure that the costs of injuries resulting from defective products are borne by the manufacturers and retailers who put such products on the market, rather than by the injured people who are powerless to help themselves, and to further ensure that defective products are removed from the market. But many jurisdictions have refused to extend strict liability to hospitals and physicians who use a product that is incidental to their primary function of providing medical services.

Patient sues for defective prosthesis

In this case, the plaintiff underwent implantation of a mandibular prosthesis, known as the Vitek Propalst TMJ prosthesis, and subsequently sued the surgeon and hospital upon discovering that the prosthesis was defective. The issue was whether a physician or hospital who regularly provides, sells, and charges for prosthetic implants can be liable under the doctrine of strict liability for selling a defective product.

The court rejected the strict-liability claim against the hospital and the physician for injuries sustained by the allegedly defective prosthesis. The court reasoned that the health care providers were consumers of the prosthesis that they provided to the patient, incidental to their medical services. Thus, the court reasoned that the health care providers' positions were more analogous to that of the user of the product, rather than of a retail distributor.

[Cafazzo v. Central Medical Health Svs., aff'd. 64 L.W. 2378 (Pa. Sup. Ct., Nov. 1995).]


Generally, courts have been reluctant to apply product-liability principles to what ordinarily would be conventional malpractice actions against physicians and hospitals, offering several reasons for refusing to apply the doctrine of strict liability to health care providers. The most frequently cited reason is that a physician or hospital is not in the business of selling products, but rather in the profession of providing medical services.

Simply put, hospitals and physicians are primarily devoted to the care and healing of the sick. Supplying a device or medicine is entirely subordinate to the paramount function of furnishing trained personnel and specialized facilities in an endeavor to restore a patient's health. Medicine and devices are simply aids or instruments used to accomplish the objectives of treatment and cure. The patient who enters a hospital does not go there to buy medicine or pills. Rather, the patient goes there to obtain a course of treatment.

This does not mean a health care provider will never be found strictly liable for a defective product. A number of decisions have allowed recovery on the basis of strict liability where the injury was due to a defective product related to mechanical or administrative functions. For example, a Texas court held a hospital strictly liable for a defective hospital gown that ignited and caught on fire. This decision is a limited exception to the general rule that a patient may not bring a strict liability action against a hospital or physician for the use of a defective medical implement.

Across the country, hospitals are not considered to be ordinarily engaged in the business of selling products or equipment, and strict liability will not be imposed when an injured party alleges that professional services connected with the use of the product, rather than the product itself, were defective. Risk managers should be aware, however, that hospitals have a continuing duty to diligently examine those products related to the mechanical or administrative functions of a hospital. *