William Ural v . Clifford Levy CV-01-215 06/30/03
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
William Ural, M.D., and Sue Ural
v. Civil N o . 01-215-B Opinion N o . 2003 DNH 114 Clifford M . Levy, M.D., Concord Orthopedics, P.A., Keith R. Nichols, M.D., Anesthesia Associates, P.A., R. Sanborn, C.R.N.A., and Concord Hospital
MEMORANDUM AND ORDER
The plaintiffs, Doctor William Ural and his wife, allege
that the defendants negligently administered anesthesia to D r .
Ural during spine surgery. As a result, D r . Ural contends that
he suffered irreversible damage to his vision. The plaintiffs
claim that Concord Hospital is vicariously liable for the acts of
defendants Keith R. Nichols, M.D., and R. Sanborn, C.R.N.A.
Concord Hospital moves for summary judgement, arguing that D r .
Nichols and Sanborn were not employees of the Hospital and
otherwise lacked the actual or apparent authority to act as its
agents. I grant the Hospital’s motion (Doc. N o . 1 9 ) . I. BACKGROUND1
Dr. Ural is a urologist who operated a solo practice in
Middlebury, Vermont. Apparently in need of spine surgery, D r .
Ural selected Clifford Levy, M.D., to perform the operation.
Prior to his surgery, D r . Ural met with D r . Levy to discuss the
procedure. D r . Levy proposed to perform the spine surgery at
Concord Hospital because he had staff privileges there. D r . Ural
agreed. Although the operation did indeed take place at Concord
Hospital, it is undisputed that D r . Levy is not an employee,
agent or representative of Concord Hospital, and that his office
is wholly separate and distinct from the Hospital.
Dr. Nichols and Sanborn, employees of defendant Anesthesia
Associates, provided the anesthesia services for D r . Ural’s
surgery. Anesthesia Associates and its employees provide such
services to Concord Hospital under an agreement which states that
Anesthesia Associates is an independent contractor who “ . . .
agrees that neither i t , nor any of its Providers, employees or
agents, will hold themselves out or represent to anyone that they
or any of them are agents, employees or other representatives of
1 The background facts are cast in the light most favorable to the non-moving party.
-2- the [Concord] Hospital.” D r . Ural does not recall whether D r .
Nichols or Sanborn ever held themselves out as employees or
agents of Concord Hospital. The plaintiffs do not dispute the
fact that D r . Nichols and Sanborn were not employees or actual
agents of Concord Hospital.
One day prior to surgery, D r . Ural signed a Concord Hospital
consent form that stated “I understand that many of the
physicians on staff of this hospital are not employed by the
hospital, nor are they agents of the hospital. They are
independent practitioners.” Although D r . Ural did not read the
entire consent form and could not recall its terms, he
nonetheless intended to go through with the operation “in spite
of the fact that [he] didn’t read the consent form.”
On the day of surgery, Sanborn met with Ural in the pre-
operative “holding” room. Sanborn testified at his deposition
that he did not consider himself an employee of the Hospital and
did not tell Ural that he was employed by the Hospital. However,
he also testified that he told D r . Ural that he was “a certified
registered nurse anesthetist working in the department of
anesthesia at Concord Hospital.” D r . Levy also spoke with D r .
Ural prior to the operation. D r . Levy did not recall what he
-3- told D r . Ural, but he testified that he ordinarily tells patients
that anesthesia will be provided by individuals who “work at the
hospital,” but are not employed by the hospital.
The plaintiffs’ complaint alleges that the negligent conduct
of D r . Nichols and Sanborn in providing anesthesia caused D r .
Ural’s injuries. They argue that D r . Nichols and Sanborn were
agents of the Hospital under the theory of apparent authority.
As such, they conclude that the Hospital is vicariously liable
for the acts of D r . Nichols and Sanborn.
II. STANDARD OF REVIEW
Summary judgment is appropriate only “if the pleadings,
depositions, answers to interrogatories, and admissions on file,
together with the affidavits, if any, show that there is no
genuine issue as to any material fact and that the moving party
is entitled to judgment as a matter of law.” Fed. R. Civ. P.
56(c). A genuine issue is one “that properly can be resolved
only by a finder of fact because [it] may reasonably be resolved
in favor of either party.” Anderson v . Liberty Lobby, Inc., 477
U.S. 2 4 2 , 250 (1986). A material fact is one that affects the
outcome of the suit. See id. at 248.
-4- In ruling upon a motion for summary judgment, I must
construe the evidence in the light most favorable to the non-
movant. See Navarro v . Pfizer Corp., 261 F.3d 9 0 , 94 (1st Cir.
2001). The party moving for summary judgment, however, “bears
the initial responsibility of informing the district court of the
basis for its motion, and identifying those portions of [the
record] which it believes demonstrate the absence of a genuine
issue of material fact.” Celotex Corp. v . Catrett, 477 U.S. 3 1 7 ,
323 (1986). Once the moving party has properly supported its
motion, the burden shifts to the nonmoving party to “produce
evidence on which a reasonable finder of fact, under the
appropriate proof burden, could base a verdict for i t ; if that
party cannot produce such evidence, the motion must be granted.”
Ayala-Gerena v . Bristol Myers-Squibb Co., 95 F.3d 8 6 , 94 (1st
Cir. 1996) (citing Celotex, 477 U.S. at 323; Anderson, 477 U.S.
at 2 4 9 ) . Neither conclusory allegations, improbable inferences,
or unsupported speculation are sufficient to defeat summary
judgment. See Carroll v . Xerox Corp., 294 F.3d 2 3 1 , 236-37 (1st
Cir. 2002).
-5- III. ANALYSIS
Apparent authority may arise when the acts and appearances
of a principal lead a reasonably prudent person to believe that
an agency relationship exists between the principal and another.
Demetracopoulos v . Strafford Guidance Ctr., 130 N.H. 209, 215-16
(1987). Such authority must be “induced by the principal’s acts
or conduct,” and not from the representations of the alleged
agent. Id. (quotation omitted); see also Daniel Webster Council,
Inc. v . S t . James Ass’n, Inc., 129 N.H. 6 8 1 , 683 (1987). In
evaluating a claim of apparent authority, a court must ascertain
whether a reasonably prudent person “in the exercise of
reasonable diligence and sound discretion, under similar
circumstances with the party dealing with the agent, and with
like knowledge,” would be justified in assuming that the actions
of the principal vested the alleged agent with the authority to
perform the act in question. Demetracopoulos, 130 N.H. at 216
(quotation omitted); Daniel Webster Council, Inc., 129 N.H. at
683; see also Restatement (Second) of Agency § 27 (1958)
(“apparent authority to do an act is created as to a third person
by written or spoken words or any other conduct of the principal
-6- which, reasonably interpreted, causes the third person to believe
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William Ural v . Clifford Levy CV-01-215 06/30/03
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
William Ural, M.D., and Sue Ural
v. Civil N o . 01-215-B Opinion N o . 2003 DNH 114 Clifford M . Levy, M.D., Concord Orthopedics, P.A., Keith R. Nichols, M.D., Anesthesia Associates, P.A., R. Sanborn, C.R.N.A., and Concord Hospital
MEMORANDUM AND ORDER
The plaintiffs, Doctor William Ural and his wife, allege
that the defendants negligently administered anesthesia to D r .
Ural during spine surgery. As a result, D r . Ural contends that
he suffered irreversible damage to his vision. The plaintiffs
claim that Concord Hospital is vicariously liable for the acts of
defendants Keith R. Nichols, M.D., and R. Sanborn, C.R.N.A.
Concord Hospital moves for summary judgement, arguing that D r .
Nichols and Sanborn were not employees of the Hospital and
otherwise lacked the actual or apparent authority to act as its
agents. I grant the Hospital’s motion (Doc. N o . 1 9 ) . I. BACKGROUND1
Dr. Ural is a urologist who operated a solo practice in
Middlebury, Vermont. Apparently in need of spine surgery, D r .
Ural selected Clifford Levy, M.D., to perform the operation.
Prior to his surgery, D r . Ural met with D r . Levy to discuss the
procedure. D r . Levy proposed to perform the spine surgery at
Concord Hospital because he had staff privileges there. D r . Ural
agreed. Although the operation did indeed take place at Concord
Hospital, it is undisputed that D r . Levy is not an employee,
agent or representative of Concord Hospital, and that his office
is wholly separate and distinct from the Hospital.
Dr. Nichols and Sanborn, employees of defendant Anesthesia
Associates, provided the anesthesia services for D r . Ural’s
surgery. Anesthesia Associates and its employees provide such
services to Concord Hospital under an agreement which states that
Anesthesia Associates is an independent contractor who “ . . .
agrees that neither i t , nor any of its Providers, employees or
agents, will hold themselves out or represent to anyone that they
or any of them are agents, employees or other representatives of
1 The background facts are cast in the light most favorable to the non-moving party.
-2- the [Concord] Hospital.” D r . Ural does not recall whether D r .
Nichols or Sanborn ever held themselves out as employees or
agents of Concord Hospital. The plaintiffs do not dispute the
fact that D r . Nichols and Sanborn were not employees or actual
agents of Concord Hospital.
One day prior to surgery, D r . Ural signed a Concord Hospital
consent form that stated “I understand that many of the
physicians on staff of this hospital are not employed by the
hospital, nor are they agents of the hospital. They are
independent practitioners.” Although D r . Ural did not read the
entire consent form and could not recall its terms, he
nonetheless intended to go through with the operation “in spite
of the fact that [he] didn’t read the consent form.”
On the day of surgery, Sanborn met with Ural in the pre-
operative “holding” room. Sanborn testified at his deposition
that he did not consider himself an employee of the Hospital and
did not tell Ural that he was employed by the Hospital. However,
he also testified that he told D r . Ural that he was “a certified
registered nurse anesthetist working in the department of
anesthesia at Concord Hospital.” D r . Levy also spoke with D r .
Ural prior to the operation. D r . Levy did not recall what he
-3- told D r . Ural, but he testified that he ordinarily tells patients
that anesthesia will be provided by individuals who “work at the
hospital,” but are not employed by the hospital.
The plaintiffs’ complaint alleges that the negligent conduct
of D r . Nichols and Sanborn in providing anesthesia caused D r .
Ural’s injuries. They argue that D r . Nichols and Sanborn were
agents of the Hospital under the theory of apparent authority.
As such, they conclude that the Hospital is vicariously liable
for the acts of D r . Nichols and Sanborn.
II. STANDARD OF REVIEW
Summary judgment is appropriate only “if the pleadings,
depositions, answers to interrogatories, and admissions on file,
together with the affidavits, if any, show that there is no
genuine issue as to any material fact and that the moving party
is entitled to judgment as a matter of law.” Fed. R. Civ. P.
56(c). A genuine issue is one “that properly can be resolved
only by a finder of fact because [it] may reasonably be resolved
in favor of either party.” Anderson v . Liberty Lobby, Inc., 477
U.S. 2 4 2 , 250 (1986). A material fact is one that affects the
outcome of the suit. See id. at 248.
-4- In ruling upon a motion for summary judgment, I must
construe the evidence in the light most favorable to the non-
movant. See Navarro v . Pfizer Corp., 261 F.3d 9 0 , 94 (1st Cir.
2001). The party moving for summary judgment, however, “bears
the initial responsibility of informing the district court of the
basis for its motion, and identifying those portions of [the
record] which it believes demonstrate the absence of a genuine
issue of material fact.” Celotex Corp. v . Catrett, 477 U.S. 3 1 7 ,
323 (1986). Once the moving party has properly supported its
motion, the burden shifts to the nonmoving party to “produce
evidence on which a reasonable finder of fact, under the
appropriate proof burden, could base a verdict for i t ; if that
party cannot produce such evidence, the motion must be granted.”
Ayala-Gerena v . Bristol Myers-Squibb Co., 95 F.3d 8 6 , 94 (1st
Cir. 1996) (citing Celotex, 477 U.S. at 323; Anderson, 477 U.S.
at 2 4 9 ) . Neither conclusory allegations, improbable inferences,
or unsupported speculation are sufficient to defeat summary
judgment. See Carroll v . Xerox Corp., 294 F.3d 2 3 1 , 236-37 (1st
Cir. 2002).
-5- III. ANALYSIS
Apparent authority may arise when the acts and appearances
of a principal lead a reasonably prudent person to believe that
an agency relationship exists between the principal and another.
Demetracopoulos v . Strafford Guidance Ctr., 130 N.H. 209, 215-16
(1987). Such authority must be “induced by the principal’s acts
or conduct,” and not from the representations of the alleged
agent. Id. (quotation omitted); see also Daniel Webster Council,
Inc. v . S t . James Ass’n, Inc., 129 N.H. 6 8 1 , 683 (1987). In
evaluating a claim of apparent authority, a court must ascertain
whether a reasonably prudent person “in the exercise of
reasonable diligence and sound discretion, under similar
circumstances with the party dealing with the agent, and with
like knowledge,” would be justified in assuming that the actions
of the principal vested the alleged agent with the authority to
perform the act in question. Demetracopoulos, 130 N.H. at 216
(quotation omitted); Daniel Webster Council, Inc., 129 N.H. at
683; see also Restatement (Second) of Agency § 27 (1958)
(“apparent authority to do an act is created as to a third person
by written or spoken words or any other conduct of the principal
-6- which, reasonably interpreted, causes the third person to believe
that the principal consents to have the act done on his behalf”
by the purported agent).
The plaintiffs have failed to present a genuine issue of
material fact that Concord Hospital vested D r . Nichols and
Sanborn with apparent authority. Based on the record before m e ,
there is no evidence that Concord Hospital performed any act or
maintained any appearances which would lead a reasonable person
to conclude that Anesthesia Associates and its employees had the
apparent authority to provide services at the behest of the
Hospital.
The only evidence presented that D r . Nichols and Sanborn
were agents of the Hospital flows from the statement of Sanborn
that he worked “in the department of anesthesia at Concord
Hospital.” Of course, apparent authority must flow from the acts
or appearances of the principal (Concord Hospital), not the
alleged agent (Sanborn). See Demetracopoulos, 130 N.H. at 216;
Daniel Webster Council, Inc., 129 N.H. at 683. Also, D r . Ural
does not recall Sanborn’s statement. His reason for believing
that Anesthesia Associates and its employees were “related” to
-7- Concord Hospital is based solely on an unsupported assumption,
not any particular act or appearance of the Hospital. Aside from
mere assumption, there is no evidence in the record indicating
what caused D r . Ural to believe that the Hospital consented to
have the anesthesia services provided on its behalf by D r .
Nichols and Sanborn.
Furthermore, D r . Ural selected D r . Levy, who is not an
employee or agent of the Hospital, to perform the surgery. Dr.
Levy proposed that the operation be performed at Concord Hospital
because he had privileges there. D r . Ural met with D r . Levy at
his office, not at the Hospital, and discussed the operation and
its risks. D r . Levy testified that he most likely informed D r .
Ural that the individuals that assist him with operations were
not employed by the Hospital, but that he trusted them and
recommended their services. Lastly, D r . Levy had D r . Ural sign a
consent form that indicated that many of the physicians on staff
at the Hospital were not its employees or agents. Under the
circumstances, a reasonably prudent person “in the exercise of
circumstances . . . and with like knowledge,” would not be
-8- justified in assuming that the actions of the Hospital vested D r .
Nichols or Sanborn with the authority to perform the act in
question. Demetracopoulos, 130 N.H. at 215-16; Daniel Webster
Council, Inc., 129 N.H. at 683.
IV. CONCLUSION
For the reasons stated above, Concord Hospital did not vest
Dr. Nichols or Sanborn with apparent authority. Accordingly, I
grant the Hospital’s motion for summary judgment (Doc. N o . 1 9 ) .
SO ORDERED.
Paul Barbadoro Chief Judge
June 3 0 , 2003
cc: Leslie C . Nixon, Esq. Mark Hoffman, Esq. Lawrence S . Smith, Esq. Robert M . Larsen, Esq. Christine Desmarais-Gordon, Esq.
-9-