North Carolina Lawyers Weekly
Wood v. United States (Lawyers Weekly No. 003-013-16, 23 pp.) (Thomas Schroeder, J.) 1:14-cv-01004; M.D.N.C.
Holding: The forecast of evidence shows that, after plaintiff’s decedent’s quadruple bypass surgery, the process of moving him from the operating table to a transport bed was a complicated medical procedure in its own right; therefore, plaintiff’s wrongful death claim sounds in medical malpractice rather than ordinary negligence.
Defendant’s motion for summary judgment is granted without prejudice to plaintiff refiling her original medical malpractice action and its N.C. R. Civ. P. 9(j) certification.
Background
After the decedent’s quadruple bypass at a Veterans Administration hospital, he had multiple lines and tubes connecting him to various devices. When a medical team moved the decedent from the operating room table to a transport bed, the central line in the decedent’s internal jugular vein came out.
Although the flow of medication was apparently restored within seconds, the decedent nearly simultaneously developed abnormally low blood pressure. Despite the team’s response with doses of epinephrine and open cardiac massage, the decedent died 14 days later.
Plaintiff’s Standard Form 95 (SF-95) claimed medical malpractice based on the disconnection of the decedent’s central line during the bed transfer. Her original complaint contained the certification required by Rule 9(j).
However, after discovery, plaintiff amended her complaint to delete her medical malpractice claim and to allege, instead, ordinary negligence and premises liability.
Discussion
Plaintiff’s SF-95 alleged that VA agents failed to ensure that the decedent’s central line stayed intact during his transfer from the OR table to the transport table. Any trained legal reader would be aware that the SF-95 could state a claim under either medical malpractice or ordinary negligence, depending on whether or not the decedent’s transfer from the OR table to the transport table involved the provision of professional health care services. This was sufficient to permit the agency to assess its liability and to investigate the claim. Defendant is not entitled to summary judgment on the basis of insufficient notice.
A premises liability claim requires some evidence that the property owner failed to exercise reasonable care in the maintenance of its premises. But here all evidence is directed at the treatment of the patient and not at the maintenance of the VA facility. Accordingly, defendant is entitled to summary judgment on plaintiff’s premises liability claim.
In support of her ordinary negligence claim, plaintiff contends that the labor or skill involved in transferring her decedent from the OR table was predominantly physical or manual. Yet this case involves much more than physical movement.
At the end of the decedent’s surgery, he was connected to an array of medical devices. To safely conduct a transfer, each of the lines connecting the patient to the anesthesia monitors in the OR needs to be disconnected from its accompanying monitoring device so that they can be reconnected to the transport monitor. Chest tubes/drains, pacemaker, foley catheter, pressure transducers, and infusion bags are also connected and must move with the patient, all while the patient remains connected to various medication infusion pumps via the central line or IV lines.
Plaintiff’s allegation that VA agents “fail[ed] to use reasonable care to monitor [the decedent’s] central line during the transfer in order to be aware that the central line was at risk to be ‘pulled out,’” must be evaluated in light of the complexity of the environment in which the transfer and monitoring took place. Managing this complexity and prioritizing tasks, all necessary for a safe transfer, require an understanding of the purpose and interaction of the various medical devices such that the required skill and knowledge is predominantly mental or intellectual.
The court notes that non-medical personnel are not involved in such transfers. That the transfer also requires the physical or manual skills of moving the patient’s body is not determinative because these skills do not predominate.
The fact that evaluating liability for the transfer will require the resolution of issues related to the standards of medical care supports the conclusion that this action sounds in medical malpractice.
Plaintiff may not rely on the doctrine of res ipsa loquitur. This is not the rare medical malpractice case where a layperson’s common knowledge is sufficient to understand that negligence occurred. Unlike anesthesiologist professionals, whose experience and training permits them to understand the interaction and significance of various medical devices, a layperson could not appreciate this complexity without the assistance of expert testimony.
Motion granted without prejudice to plaintiff timely filing a new medical malpractice claim.
