Young v. Kamath: Hospital Must Prove Private Physician Selection to Defeat ER Vicarious-Liability Exception; Robust Documentation Can Defeat Informed-Consent Claims on Summary Judgment

1. Introduction

Case: Young v Kamath, 2026 NY Slip Op 01091 (Appellate Division, Second Department, Feb. 25, 2026).
Parties: Plaintiff (Dolores Young, executor and spouse of decedent John J. Young) versus, among others, cardiologist Ganesh S. Kamath, electrophysiologist Eric R. Uyguanco, hospitalist Jeetinder K. Gujral, and Southside Hospital.
Claims: Medical malpractice, wrongful death, loss of services (derivative), lack of informed consent (as to Uyguanco), and vicarious liability of Southside Hospital for Kamath.

The decedent had a long history of thromboembolic disease and chronic anticoagulation with Coumadin (warfarin). After pacemaker implantation and later pacemaker lead revision, his anticoagulation management and monitoring became central to the litigation. He developed deep vein thrombosis, underwent thrombolysis, suffered a hemorrhagic stroke, and died.

Key issues on appeal: Whether defendants were entitled to summary judgment on malpractice/wrongful death; whether Southside could obtain summary judgment dismissing vicarious-liability allegations for the on-call cardiologist; and whether the informed-consent claim against Uyguanco should be dismissed.

2. Summary of the Opinion

The Second Department modified the Supreme Court’s order. It held:

  • Malpractice and wrongful death: Although both defendant groups made prima facie showings, plaintiff’s expert raised triable issues of fact regarding anticoagulation management (including discharge with subtherapeutic anticoagulation and lack of ensuring therapeutic INR). Summary judgment was therefore properly denied as to these causes of action.
  • Loss of services: Because it is derivative, it survived wherever malpractice/wrongful death survived.
  • Southside’s vicarious liability for Kamath: Southside failed to show, prima facie, that the decedent sought treatment from a privately selected physician rather than from the hospital; thus dismissal was properly denied.
  • Informed consent (Uyguanco): The appellate court held the claim should have been dismissed on summary judgment because the defense proof (records, written consents, deposition testimony, and expert affirmation) established adequate disclosure and that a reasonably prudent patient would not have declined the procedure; plaintiff failed to raise a triable issue.

3. Analysis

3.1. Precedents Cited

A. Medical malpractice summary judgment framework

  • Kunwar v Northwell Health (229 AD3d 528) (quoting Mendoza v Maimonides Med. Ctr., 203 AD3d 715) and Torres v Yakobov (222 AD3d 692): These authorities supply the core elements of malpractice—deviation from accepted practice and proximate cause— and anchor the panel’s recitation of the governing test.
  • Vargas v Lee (207 AD3d 684) (quoting Carradice v Jamaica Hosp. Med. Ctr., 198 AD3d 863): Used for the rule that a defendant moving for summary judgment must establish either no departure or no causation. (The opinion also repeats the requirement that the moving defendant meet the “initial burden” before the plaintiff must respond.)
  • Wiater v Lewis (197 AD3d 782) and Ciceron v Gulmatico (220 AD3d 732): Cited for the proposition that the movant must address and rebut the specific malpractice allegations pleaded (complaint and bill of particulars), reinforcing that generalized expert assertions are insufficient if they fail to meet the pleaded theories.
  • Lee v South Nassau Communities Hosp. (231 AD3d 807) (quoting Khutoryanskaya v Laser & Microsurgery, P.C., 222 AD3d 633): Emphasizes that summary judgment is inappropriate where facts are disputed, conflicting inferences arise, or credibility issues exist—particularly salient where competing expert narratives explain the same clinical timeline differently.
  • Gilmore v Mihail (174 AD3d 686) (quoting Feinberg v Feit, 23 AD3d 517) and Fairchild v Lerner (229 AD3d 506): These cases supply the familiar rule that conflicting medical expert opinions typically create triable issues, directly supporting denial of summary judgment once plaintiff produced a competing expert affirmation on standard of care and causation.

How they shaped the outcome: The court applied this framework in a two-step way. First, it credited defendants’ prima facie showings based on expert proof (including arguments that the decedent’s noncompliance with a 5 mg Coumadin instruction broke causation). Second, it held plaintiff’s expert created fact issues by focusing on prolonged subtherapeutic anticoagulation and alleged failures to ensure a therapeutic INR at discharge—thus triggering the “conflicting expert opinions” rule.

B. Derivative loss-of-services/consortium claims

  • Buzeska v Crystal Run Healthcare Physicians, LLP (234 AD3d 656) and Many v Lossef (190 AD3d 721): Cited for the principle that loss of consortium/services is derivative. The court used them mechanically: because primary tort claims survived, the derivative claim did too.

C. Hospital vicarious liability for non-employee physicians (respondeat superior and ER exception)

  • Russell v River Manor Corp. (216 AD3d 827), citing Hill v St. Clare's Hosp. (67 NY2d 72): Reaffirms the general rule: hospitals are vicariously liable for employees acting within scope, but not for independent physicians.
  • Fuessel v Chin (179 AD3d 899), quoting Muslim v Horizon Med. Group, P.C. (118 AD3d 681): Provides the key exception: when a patient comes to the emergency room seeking treatment from the hospital itself rather than a particular chosen physician, the hospital may face vicarious liability (often described as “apparent agency” or “holding out” principles in ER settings).
  • Malcolm v Mount Vernon Hosp. (309 AD2d 704): Used alongside Fuessel to support denial of dismissal where the hospital’s proof does not establish the patient selected the physician privately.

How they shaped the outcome: The Southside defendants established Kamath was not Southside’s employee, but the court held that was not enough. To win summary judgment, Southside needed evidence showing the decedent sought care from a privately selected physician rather than the hospital. Because Southside’s motion papers did not establish that point prima facie, the vicarious-liability theory remained for trial.

D. Informed consent elements and summary judgment dismissal

  • Ciceron v Gulmatico (220 AD3d 732), quoting Cox v Herzog (192 AD3d 757), and Pirri-Logan v Pearl (192 AD3d 1149): These cases articulate the three elements of lack of informed consent: (1) failure to disclose reasonably foreseeable risks/alternatives that a reasonable practitioner would disclose, (2) a reasonably prudent patient would have declined the treatment if fully informed, and (3) proximate cause. They also support granting summary judgment where records and expert proof show adequate disclosure and no rational patient would have refused.
  • Zuckerman v City of New York (49 NY2d 557): Cited for the general opposition standard on summary judgment: the opponent must produce admissible evidence sufficient to raise a triable issue; conclusory assertions will not suffice.

How they shaped the outcome: Applying these elements, the court found the South Bay defendants’ submissions—deposition testimony, contemporaneous medical records, signed consent forms, and expert affirmation—established, prima facie, legally adequate disclosure and defeated the “reasonable patient would have declined” element. Plaintiff’s opposition did not raise a triable factual dispute under Zuckerman, requiring dismissal of the informed-consent claim against Uyguanco.

3.2. Legal Reasoning

A. Why malpractice and wrongful death survived summary judgment

The court accepted that both defendant groups initially showed entitlement to judgment as a matter of law through expert affirmations endorsing their Coumadin management and disputing causation—particularly by pointing to the decedent’s alleged nonadherence (being directed to take 5 mg but returning home to 7.5 mg). The case turned, however, on plaintiff’s competing expert theory: the decedent remained subtherapeutic “for a prolonged period” and defendants allegedly failed to ensure he was properly anticoagulated—especially at discharge—allowing clot formation culminating in DVT and ultimately death.

The court treated this as a classic “battle of experts” with disputed inferences about anticoagulation strategy, monitoring, and discharge safety—precisely the type of conflict that Gilmore v Mihail and related cases deem inappropriate for resolution on summary judgment.

B. Why Southside could not eliminate vicarious liability for Kamath at the summary judgment stage

The reasoning is significant in its procedural rigor: Southside could not rely solely on Kamath’s non-employee status. Under the ER exception described in Fuessel v Chin, the hospital needed to establish that the patient sought treatment from a “particular physician of the patient’s choosing.” The court found the motion record did not, prima facie, prove such private selection, so the exception remained potentially applicable.

C. Why the informed-consent claim against Uyguanco was dismissed

Unlike the malpractice claims, the informed-consent cause of action was resolved through documentary and testimonial proof aimed at the disclosure elements. The court emphasized that signed consent forms and medical records—paired with the physician’s testimony and expert support—can be sufficient to establish, as a matter of law, that reasonably foreseeable risks/alternatives were disclosed and that a reasonably prudent patient would not have declined the pacemaker procedure. Without a concrete, admissible rebuttal creating a factual dispute on these elements, plaintiff could not proceed.

3.3. Impact

A. ER vicarious liability: a clarified evidentiary burden for hospitals on summary judgment

This decision underscores a practical litigation point: to obtain summary judgment dismissing vicarious liability for an on-call or non-employee emergency-room physician, a hospital must submit evidence addressing the patient’s expectations and choice—i.e., proof that the patient affirmatively selected a private physician. Absent that, non-employee status alone may not defeat the ER exception at the prima facie stage.

B. Malpractice: anticoagulation management remains highly fact-driven

Anticoagulation cases frequently turn on timing, therapeutic targets, monitoring practices, discharge planning, and patient compliance. Young v Kamath illustrates that even where defendants identify apparent noncompliance, a plaintiff may still reach a jury by framing the departure as a systems-level failure to ensure therapeutic anticoagulation (and safe discharge parameters) rather than solely a dosing dispute.

C. Informed consent: how defendants can win early

The ruling also shows a path to early dismissal of informed-consent claims: comprehensive consent documentation, records reflecting discussions of risks and alternatives, consistent provider testimony, and expert support can establish prima facie entitlement to judgment. Plaintiffs must respond with specific, admissible evidence (not general allegations) to raise a triable issue.

4. Complex Concepts Simplified

  • Coumadin (warfarin): A blood thinner used to prevent dangerous clots. Its effect must be monitored because too little increases clot risk and too much increases bleeding risk.
  • INR (International Normalized Ratio): A standardized measure of how quickly blood clots. Many patients on warfarin need an INR in a target “therapeutic range.” “Subtherapeutic” means INR is too low (higher clot risk).
  • AV block / sick sinus syndrome: Heart rhythm conduction problems that may require a pacemaker.
  • Catheter-directed thrombolysis: A procedure delivering clot-dissolving medication directly to a clot; it can raise bleeding risk, including risk of hemorrhagic stroke.
  • Summary judgment: A pretrial ruling where the court decides there is no genuine factual dispute requiring a trial. In malpractice cases, competing expert opinions often prevent it.
  • Prima facie burden: The moving party’s initial obligation to show entitlement to judgment as a matter of law; only then must the opposing party produce evidence raising a factual issue.
  • Proximate cause: A legally sufficient connection between alleged negligence and the injury.
  • Respondeat superior / vicarious liability: An employer (including a hospital) may be responsible for an employee’s negligence within the scope of employment. Hospitals are generally not liable for independent physicians, but the ER exception can apply when the patient seeks treatment from the hospital rather than a chosen doctor.
  • Informed consent: A claim focusing not on technical negligence but on inadequate disclosure of risks/alternatives, and whether a reasonable patient would have declined the procedure if properly informed.
  • Derivative claim (loss of services/consortium): A spouse’s claim dependent on the success of the underlying injury/wrongful death claim.

5. Conclusion

Young v Kamath delivers two practical, precedent-grounded takeaways. First, in emergency-room contexts, a hospital seeking to avoid vicarious liability for a non-employee physician must do more than show independent-contractor status; it must also make a prima facie showing that the patient privately selected the physician rather than seeking care from the hospital. Second, informed-consent claims can be resolved on summary judgment when contemporaneous records, signed consents, testimony, and expert proof establish adequate disclosure and defeat the “reasonable patient would have declined” element—and when the plaintiff fails to meet the evidentiary standard required by Zuckerman v City of New York.

The broader significance lies in how the court separates fact-intensive clinical negligence disputes (often jury questions due to conflicting experts) from disclosure-based informed-consent claims that may be amenable to early disposition with strong documentation.