Jones v. Chicago HMO Ltd. of Illinois

In 1987 Shelia Jones (plaintiff) enrolled in a health plan operated by Chicago Health Maintenance Organization Ltd. of Illinois (Chicago HMO) (defendant). Chicago HMO assigned Jones’s daughter, Shawndale, to physician Robert A. Jordan, with whom Chicago HMO had contracted to provide medical care for its enrollees. Jones was not given an opportunity to choose Shawndale’s physician. In 1991 Jones called Jordan to inform him that Shawndale was constipated, irritable, and warm. As an enrollee, Jones was required to call medical personnel prior to obtaining medical care. Jordan instructed Jones to give Shawndale castor oil. The next day, Shawndale continued to exhibit symptoms, and Jones took her to a hospital emergency room. A hospital physician properly diagnosed Shawndale with bacterial meningitis. Shawndale ended up with permanent disabilities because she did not receive immediate medical care when Jones first called Jordan. Jones filed an action in state court against Jordan and Chicago HMO. Jones argued that Chicago HMO was negligent under an institutional-negligence theory by assigning Jordan as Shawndale’s physician although Jordan had an excessive patient load and by adopting the policy requiring an enrollee to call prior to obtaining medical care. The trial court granted summary judgment in Chicago HMO’s favor on the ground that Chicago HMO could not be liable for negligence under an institutional-liability theory. The matter was appealed. The appellate court affirmed. The matter was appealed to the Illinois Supreme Court.