Medical Malpractice Case Summary: Understanding Vicarious Liability and Ostensible Agency in Healthcare

Summary of Nos. 360424 and 361005 Oakland Circuit Court opinion

ESTATE OF JACQUELINE M. GRZYWACZ, by GEORGE GRZYWACZ, Personal Representative, Plaintiff-Appellant,





This court opinion involves a medical malpractice or wrongful-death case where the plaintiff, George Grzywacz, representing the Estate of Jacqueline M. Grzywacz, appeals the trial court’s orders granting summary disposition in favor of the defendant-appellee, Ascension Providence Rochester Hospital (formerly known as Crittenton Hospital Medical Center). The case was heard in the Michigan Court of Appeals and was decided on June 29, 2023.


Factual Background:

On December 4, 2016, Jacqueline Grzywacz was taken to the emergency department at Henry Ford Macomb Hospital, complaining of chest pain and elevated blood pressure. After initial treatment at Henry Ford Macomb, she was transferred to Ascension Providence Rochester Hospital (the Hospital) to be treated by her cardiologist, Dr. Samer Kazziha, an independent physician with staff privileges at the Hospital. Dr. Sindhu Koshy, another independent physician with staff privileges at the Hospital, evaluated Jacqueline at the Hospital on December 5, 2016, diagnosed her with unstable angina, and scheduled further procedures to be performed by Dr. Kazziha. On December 6, 2016, Dr. Kazziha completed a cardiac catheterization procedure, but she displayed stroke symptoms during discussions with Jacqueline’s family. The on-call hospitalist, Dr. Sarwan Kumar, assessed her condition and suspected a stroke. The on-call neurologist, Dr. Cesar D. Hidalgo, ordered a CT scan, which ruled out a hemorrhagic stroke. However, Jacqueline’s condition deteriorated, eventually dying on June 22, 2017.

Plaintiff’s Claims:

The plaintiff filed a medical malpractice lawsuit against various healthcare providers involved in Jacqueline’s care, including Drs. Hidalgo, Kazziha, Koshy, and Kumar, University Physicians Group, and Cardiovascular Consultants, PC. The plaintiff also sued the Hospital, alleging that it had vicarious liability for the malpractice of Drs. Koshy and Hidalgo claimed that Dr. Hidalgo was an actual agent of the Hospital and that Dr. Koshy and Dr. Hidalgo were the Hospital’s ostensible agents.

Court’s Ruling:

The trial court granted the Hospital’s motion for summary disposition regarding the vicarious liability claims involving Drs. Hidalgo and Koshy concluded that Dr. Hidalgo was not an actual agent of the Hospital and that Drs. Hidalgo and Koshy were not the Hospital’s ostensible agents. The plaintiff appealed this ruling.

Standard of Review:

The Michigan Court of Appeals reviewed the trial court’s ruling on the motion for summary disposition de novo. A motion for summary disposition under MCR 2.116(C)(10) tests the factual support for a claim, and summary disposition is appropriate if the proffered evidence fails to establish a genuine issue of material fact, entitling the moving party to judgment as a matter of law.


The plaintiff argued that Dr. Hidalgo was an actual agent of the Hospital because he testified that he was “employed by” the Hospital. However, the Court found that Dr. Hidalgo’s use of the term “employed by” the Hospital was an everyday, shared use of the term and not a legal definition encompassing every aspect of his conduct at the Hospital. The Court determined that the evidence indicated that Dr. Hidalgo was an independent contractor providing medical services for his patients at the Hospital, as his contract concerned administrative services only. It expressly disclaimed the Hospital’s control over its practice of medicine and patient treatment.

Regarding the apparent agency claim, the Court clarified that the critical issue is whether the plaintiff “looked to” the Hospital for medical treatment and not merely as a location where the plaintiff’s physician would render treatment. In this case, the evidence showed that Jacqueline did not look to the Hospital for medical treatment but was explicitly transferred to the Hospital to be treated by her cardiologist, Dr. Kazziha, with whom she had a preexisting patient-physician relationship. The Court also noted that the Hospital’s consent form, which Jacqueline signed before receiving any medical treatment, explicitly stated that physicians in the Hospital worked independently and billed separately for their services.


Based on the evidence presented, the Michigan Court of Appeals affirmed the trial court’s decision, finding no genuine issue of material fact regarding whether Drs. Hidalgo and Koshy were ostensible agents of the Hospital. The Court determined that Jacqueline did not have a reasonable belief that these physicians practiced medicine under the Hospital’s control, and no act or omission of the Hospital generated a proper view of ostensible agency to impose liability on the Hospital. Therefore, the Hospital was not vicariously liable for the actions of Drs. Hidalgo and Koshy, and the summary disposition in favor of the Hospital was affirmed.

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