Georgia Supreme Court Revives Vicarious Liability Claim
July 1, 2025
By Damian D. Capozzola, Esq., and Jamie Terrence, RN
News
The Georgia Supreme Court has revived a vicarious liability claim in a medical malpractice lawsuit that raises important questions about the role of medical students and the legal responsibility of supervising physicians. The case stems from a surgical injury that occurred during a 2019 hysterectomy, in which a medical student under the supervision of two attending physicians allegedly caused harm by misplacing a surgical instrument. A trial court ruled that the physicians could not be held vicariously liable for the student’s alleged negligence, and an appellate panel affirmed that ruling, but the Supreme Court reversed, holding that key factual questions remain unresolved.
At issue was whether the supervising physicians had assumed enough control over the medical student’s actions to establish a master-servant relationship under Georgia’s respondeat superior doctrine. The lower courts relied on a written agreement between the physicians’ practice and the student’s medical school that disclaimed any employment or agency relationship. But the Georgia Supreme Court ruled that such disclaimers are not dispositive if the evidence shows the physicians, in fact, directed and controlled the student’s conduct during surgery. The decision clarifies that a physician still may be vicariously liable for a student’s conduct if they exercised real-time control, regardless of what the paperwork says.
Background
In August 2019, a patient underwent a total laparoscopic hysterectomy at a Georgia medical facility. The procedure was performed by a licensed physician and assisted by a second physician. A third participant in the surgery was a medical student who had been placed at the facility for clinical training as part of her educational program. The student’s assigned role in the surgery was to use a sponge stick to help the physicians visualize the plaintiff’s anatomy and assist with the location for incision. Specifically, under the attending physicians’ direction, she was instructed to insert the sponge stick into the patient’s vagina and lift the bladder to allow for visualization during the procedure. The supervising physicians visually confirmed the student’s initial placement of the instrument. However, at some point during the surgery, the student allegedly misplaced the device into the plaintiff’s rectum. This misplacement allegedly contributed to the patient’s rectal wall being cut during the operation, which later resulted in a rectovaginal fistula, requiring additional surgeries and ongoing care.
The patient filed suit against the two supervising physicians and their medical practice, asserting claims for professional negligence, negligent supervision, and vicarious liability for the student’s actions. Central to the claim for vicarious liability was whether the student was acting as a “servant” under the doctors’ supervision, making them legally responsible for her conduct.
The defendants moved for summary judgment, arguing that they could not be held vicariously liable because there was no legal employment or agency relationship with the student. They relied on a written agreement between the medical school and the medical practice that stated that students were not employees or agents of the facility and were not entitled to compensation or employment benefits. The agreement also reserved authority to both the school and the medical facility to remove students from clinical assignments and emphasized that students were not to provide unsupervised care.
The trial court agreed with the defendants and granted partial summary judgment, concluding as a matter of law that the physicians could not be held vicariously liable for the student’s conduct. The Court of Appeals affirmed that decision, focusing on the language of the written agreement and concluding that, because the contract disclaimed any agency relationship and there was no employment arrangement, the doctors could not be vicariously liable under Georgia law.
The Georgia Supreme Court then addressed whether the Court of Appeals erred in concluding, on summary judgment, that the physicians could not be held vicariously liable. In a unanimous opinion issued on May 13, 2025, the Supreme Court reversed the appellate ruling. The Court held that the absence of an agency or employment relationship in the contract was not dispositive. Instead, what mattered was whether the doctors exercised actual control over the student’s actions during surgery.
Citing established principles of Georgia agency law, the Court emphasized that a master-servant relationship may exist if the principal (here, the supervising physicians) either assumes or retains the right to control the time, manner, and method of the agent’s work. The Supreme Court noted that such a relationship typically is a question of fact for a jury to decide, especially when there is evidence that the physicians directed the student’s conduct during the operation.
The Supreme Court found that the evidence, including the fact that the doctors instructed the student on how to use the sponge stick, observed her work, and gave real-time direction, could support a jury finding that the doctors had assumed control. Therefore, the case should not have been resolved at the summary judgment stage. The ruling reinstated the vicarious liability claim and sent the case back for further proceedings. The patient may now present evidence that the physicians exercised the kind of control over the student’s actions that would render them legally responsible for her mistake.
What This Means for You
At the heart of this case is the legal doctrine of vicarious liability, which is a principle that allows a party to be held responsible for the acts of someone else. In the medical context, vicarious liability often determines whether an injured patient can hold not just an individual provider, but a hospital, clinic, or supervising physician liable for harm caused by someone under their supervision. The Georgia Supreme Court’s ruling clarifies when and how that doctrine applies to medical students.
Vicarious liability exists because, in many professional relationships, one party directs and benefits from the actions of another. In law, if a person (the “servant”) is acting under the direction and control of another (the “master”) while carrying out duties that benefit the master, then the master may be held legally responsible for the servant’s negligence. This is often referred to as the doctrine of “respondeat superior,” Latin for “let the master answer.”
For plaintiffs, establishing vicarious liability can be a crucial goal. Individual medical students, trainees, or even junior employees may have limited assets and little to no malpractice coverage. If they make a mistake that causes serious harm, suing only them may offer little hope of meaningful compensation. But if the plaintiff can show that a more senior provider or institution was legally responsible for overseeing that person’s work, they may be able to hold a deeper-pocketed defendant accountable. In that way, vicarious liability is not just a legal formality — it can determine whether a judgment is collectible.
In this case, the issue was whether two attending physicians could be held liable for the alleged negligence of a medical student who assisted during surgery. The defense argued that the doctors could not be vicariously liable because the student was not their employee, and they pointed to a written agreement that disclaimed any agency relationship. But the Georgia Supreme Court rejected the notion that a contract alone could settle the question. Instead, the Court emphasized that what matters is whether the doctors actually directed and controlled the student’s actions in the operating room.
This distinction is important. If the legal standard for vicarious liability hinged only on formal paperwork, supervising physicians and institutions could avoid responsibility by drafting contracts that disavow any employment relationship. But the law recognizes that real-world control, rather than just contractual language, determines whether a party is acting as a servant. If the physicians were guiding the student’s every move, then they may be held accountable for what happened, even if the contract said otherwise.
The Court also clarified that the “borrowed servant” doctrine does not create liability. It is used defensively by a general employer to argue that another party should be responsible instead. In other words, a plaintiff cannot use the borrowed servant theory as a stand-alone path to liability. Instead, the proper analysis remains rooted in respondeat superior: whether the supervising party has the right to control, or did they in fact control, the actions that led to the harm.
The Court’s opinion also reinforces that the existence of a master-servant relationship generally is a question for the jury. It is not something that usually can be decided by a judge at the summary judgment stage, unless the facts are completely undisputed. Here, the evidence showed that the physicians observed the student, directed her use of surgical tools, and provided real-time instructions. This was enough to at least let a jury decide whether they had assumed sufficient control to justify vicarious liability.
This decision has implications for medical professionals and institutions. Doctors who supervise students, residents, or other trainees may find themselves liable for mistakes if they are directing those individuals in a hands-on way. It does not matter whether the trainee technically is employed by someone else. What matters is whether the supervisor had the authority and control to prevent the harm. That supervisory role brings with it legal responsibility.
For patients, the ruling affirms that accountability does not end with the person who made the mistake or committed the malpractice. If someone else was calling the shots or directing the procedure, they may share in the blame. This is especially important in settings like teaching hospitals or training rotations, where less-experienced practitioners often work under the oversight of more senior professionals.
Going forward, parties to medical malpractice cases in Georgia should expect more careful scrutiny of supervisory roles. Defense lawyers may continue to cite written contracts, but those contracts will not be the last word. Courts and juries will look at how much control was actually exercised. And that means more factual questions about who said what, who did what, and who ultimately was directing the care.
It also is important to remember that medical students are not physicians. A surgical resident and an intern are students who require supervision by attending physicians, but that supervision can be at a variety of levels from direct observation and instruction to being immediately available should an issue or concern arise. A medical student can observe a surgical procedure if the patient has given written consent to allow the student to do so. Beyond that, any hands-on involvement by a medical student in a surgical procedure not only requires the written consent of the patient but also the direct, immediate, real-time instruction oversight and observation of the attending physician. Anything less than that may well be negligent, even if things go well. Additionally, the medical board of the facility or organization that the attending physician uses to provide care must approve of the level of supervision provided to the students. The educational program the medical student is enrolled in should also be reviewed and approved by the medical board that oversees the attending physician’s practice. Putting the patient first in this process goes a long way to assure all involved parties that the risk potential is reduced to the lowest possible level and that both patient and physician are aware and informed of those risks.
Finally, note that the issues discussed in this case study may well be state-specific. It always is important to consult with experienced counsel in the jurisdiction of your situation.
Reference
- Decided on May 13, 2025, in the Supreme Court of Georgia, Case No. S24G0842.
Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles
Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles
The Georgia Supreme Court has revived a vicarious liability claim in a medical malpractice lawsuit that raises important questions about the role of medical students and the legal responsibility of supervising physicians. The case stems from a surgical injury that occurred during a 2019 hysterectomy, in which a medical student under the supervision of two attending physicians allegedly caused harm by misplacing a surgical instrument.
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