The Connecticut Supreme Court recently handed down a pair of important opinions in Mills v. Hartford Healthcare Corp. and Manginelli v. Regency House of Wallingford, Inc. The opinions answered the question of whether health care providers and facilities could be civilly liable for healthcare services undertaken in support of the state’s COVID-19 response pursuant to Governor Ned Lamont’s Executive Order No. 7V. In both decisions, the court’s review included the consideration of acts and omissions undertaken due to the lack of resources that often plagued those in the medical field during the pandemic as well as examining the principles for interpreting an executive order by the Connecticut Governor.
What Protections Did Executive Order No. 7V Provide Medical Practitioners and Facilities?
In Executive Order No. 7V, the Governor cited a “compelling state interest” in rapidly and comprehensively increasing the capacity of health care professionals and facilities in response to the influx of patients during the height of the COVID-19 pandemic. Executive Order No. 7V was designed to help the state accomplish this goal.
The text applicable to the decisions at hand reads in relevant part: “…
[A]ny health care professional or health care facility shall be immune from suit for civil liability for any injury or death alleged to have been sustained because of the individual’s or health care facility’s acts or omissions undertaken in good faith while providing health care services in support of the State’s COVID-19 response, including but not limited to acts or omissions undertaken because of a lack of resources, attributable to the COVID-19 pandemic, that renders the health care professional or health care facility unable to provide the level or manner of care that otherwise would have been required in absence of the COVID-19 pandemic and which resulted in the damages at issue, provided that nothing in this order shall remove or limit any immunity conferred by any provision of the Connecticut General Statutes or other law.
The order explicitly provides healthcare providers and facilities immunity from civil liability stemming from alleged injury or death arising from acts or omissions undertaken in good faith in support of Connecticut’s COVID-19 response. This immunity extends to both common law causes of action as well as statutory causes of action. In addition, it offers protection for acts and omissions that occur due to a lack of resources or personnel caused by the circumstances of the pandemic and that render a facility unable to provide the level of care ordinarily required in the absence of the pandemic. The Executive Order does not excuse conduct involving gross negligence, criminal behavior, fraud, malice, or otherwise willful misconduct.
Mills v. Hartford Case
In Mills v. Hartford HealthCare Corp., SC 20763 (Conn. Aug. 8, 2023), the Court examined the issue of whether Hartford Healthcare could be liable for its COVID-19 response, or if it was immune pursuant to the parameters outlined in Executive Order No.7V. Cheryl Mills allegedly presented with a sore throat and headache. She also allegedly informed the medical personnel that she had a heart murmur and was in need of a heart valve replacement. The attending emergency medicine physician ran an echocardiogram and found that Mills was having a heart attack.
Normally, the protocol for this type of issue was for the patient to undergo a cardiac intervention in the cardiac catheterization lab. However, according to COVID-19 protocols in place at the time, health care professionals were asked to wait to admit patients suspected of being infected with COVID-19 to the cardiac unit until after they had tested negative for COVID-19, unless it was an emergency. The stated purpose of this protocol was to prevent the spread of COVID-19 and conserve the limited personal protective equipment available at that time. Accordingly, the doctor transferred Mills to the emergency room to receive a COVID test. The test came back negative three days later and a health care professional treating Mills ordered that she undergo a coronary angiogram in the cardiac catheterization lab the day following the negative result, but Mills died from a heart issue before ever being transferred back to the lab. The family sued the hospital claiming that its negligent treatment of Mills resulted in her death.
In assessing the family’s claim in this case, the Connecticut Supreme Court concluded that the portion of the executive order stating, “when providing healthcare services in support of the state’s COVID-19 response” was vague and felt it necessary to delve into the circumstances that the pandemic created and the reasons behind the executive order. In its opinion, the Court reminded the parties that COVID-19 was a highly contagious and potentially life-threatening virus. Despite this, it also relied on the fact that “statutes in derogation of the common law are to be strictly construed.” Based on this, the Court determined that the Governor’s executive order was limited and could only “provide immunity from suit for services directly combatting COVID-19.” Further, the Court held that the moment Mills’ COVID test came back negative, the hospital was no longer combatting COVID-19 within the parameters of the executive order and could not be shielded from liability for services that were unrelated to fighting the virus pursuant to the executive order.
Accordingly, the Court reversed the decision of the trial court granting the medical facility immunity.
Manginelli v. Regency House of Wallingford, Inc.
In this case, also before the Connecticut Supreme Court, the plaintiff, Darlene Matejek, allegedly had a plan of care in place that specifically provided that she needed assistance for bed and wheelchair transfers. Matejek fell during a wheelchair transfer and the nursing home staff at Regency House Wallingford allegedly did not report the incident to her family for two days. . Matejek was finally taken to the hospital where it was discovered that the fall had fractured both her left and right femurs. . In the weeks following, Matejek allegedly developed a heart arrythmia, atrial fibrillation, and severe anxiety. She died eight months later and the family filed suit claiming that her death stemmed from the nursing home’s negligence.
The question before the Court was whether the nursing home was shielded from liability pursuant to Executive Order No. 7V, or whether that immunity only applied to the treatment of patients with COVID-19. The nursing home argued that the lack of resources and staffing issues caused by the pandemic ultimately resulted in the gap in care for Matejek and, therefore, the incident should be included under the umbrella of protection offered by the executive order.
Although the Court agreed that the Governor’s order was meant to protect facilities that were short-staffed due to the pandemic and offer immunity from civil liability even in cases where the patient did not have COVID-19, it found that the nursing home did not provide adequate information to show that COVID directly impacted its ability to provide adequate care to the plaintiff. Specifically, although the Court held that Governor Lamont did not intend for Executive Order No. 7V “to apply only to the diagnosis and treatment of COVID-19 patients,” it also held that the defendants in this case failed to prove that a lack of resources due to COVID-19 caused the situation with the plaintiff. The Court concluded that the defendants had failed to bring sufficient evidence to establish that their acts and omissions were a result of the pandemic- imposed difficulties in the operation of their medical facility. Therefore, the Court affirmed the trial court’s denial of defendant’s motion to dismiss.
Healthcare workers and facilities should take note of these two decisions as they provide clarity on the degree and depth of immunity provided by Executive Order No. 7V. Although the executive order does provide immunity to health care professionals and facilities from liability arising from the harried and unprecedented circumstances that arose due to the pandemic to some extent, it is not a complete shield. Claims of malpractice involving patients not suffering from COVID-19 are generally not included, unless it can be shown that the surrounding circumstances of the pandemic significantly impacted the level of care that could be offered to patients, or that the efforts were somehow directly related to “combatting COVID-19” in support of the state’s response efforts.
In addition, facilities and healthcare workers claiming immunity based on circumstances surrounding COVID, such as equipment and staffing shortages, must provide sufficient evidence to show how the circumstances directly impacted the standard of care.
Finally, these cases are significant in that the Connecticut Supreme Court clearly drew a boundary on the scope of the executive orders in the state.