Establishing Hospital Standard of Care in North Carolina Lawsuit

skullIn a recent North Carolina appellate case, the plaintiff appealed after a lower court granted a directed verdict for a hospital on a medical negligence claim. The plaintiff claimed that the hospital’s process for X-ray over-read discrepancies wasn’t up to the professional standard of care for hospitals.

The case arose when a man came to the ER of a hospital, asking for treatment for his pain. He had sickle cell anemia. In the ER, he was treated by a doctor who gave him pain medication and a saline solution and ordered different tests.

The tests showed most of his vital signs were normal. His white blood cell count was high, but his red blood cells were normal, and his body didn’t show inflammation. The doctor found his chest x-ray to be normal and, thinking his vital signs were normal, discharged him from the hospital early in the morning and told him to come back if he got worse. The man did come back a day later, and the ER doctors decided he had acute chest syndrome, which is a complication of sickle cell anemia. He was admitted to the ICU and died early the next morning in spite of getting more treatment.

The plaintiff sued many of the treating entities, claiming they were agents or employees of the hospital and other treaters. The case was a medical malpractice case, and the plaintiff claimed that each defendant had failed to provide proper care to the decedent and that their negligence was a legal cause of the decedent’s death. The plaintiff also claimed that the hospital was liable for medical malpractice, not only because of negligent medical treatment but also because its policy to review discrepancies between an ER doctor’s X-ray interpretation and a radiologist’s interpretation didn’t meet the relevant standard of care. The plaintiff dismissed some of the claims later.

After the plaintiff presented evidence at trial, the court granted a directed verdict in favor of the hospital with regard to the individual defendants and claims of clinical malpractice. It didn’t dismiss the claim based on the hospital policy for review of discrepancies in how the X-rays read at that time, but when all of the evidence was closed, a directed verdict was granted for the hospital on that claim too.

The jury found the individual health care providers weren’t negligent. All of the claims were dismissed with prejudice. The plaintiff moved for reconsideration, but this motion was denied.

The plaintiff appealed based on the directed verdict related to the X-ray over-read discrepancies policy. The appellate court explained that the plaintiff had to establish malpractice by showing:  (1) what the standard of care was, (2) a breach, (3) proximate (legal) causation, and (4) damages. If the plaintiff couldn’t make the requisite showing on just one of these elements, he couldn’t proceed with the claim.

The plaintiff argued that the hospital should have had a better process whereby a radiologist would interpret x-rays initially interpreted by an ER doctor. The issue was whether the plaintiff submitted evidence that the policy or practice wasn’t in line with the standards among members of the same type of practice with similar training.

It found the plaintiff hadn’t offered any evidence about the standard of care or a breach of that standard. The plaintiff claimed that the hospital’s method for letting ER doctors know about a discrepancy observed by a radiologist in a subsequent “over-read” of the X-ray didn’t meet the standard of care. If a radiologist didn’t see the need for an immediate intervention, it could be a minimum of 24 hours from the ER doctor reading the X-ray to an opportunity for a doctor to compare the results of the radiologist’s reading to the initial read. The appellate court found that the plaintiff’s expert hadn’t offered testimony to establish the standard of care and hadn’t even made inquiries to decide what the practices of other hospitals were in this context. Therefore, it affirmed the directed verdict.

If you suffered injuries due to the wrongful conduct or negligence of another party, the experienced North Carolina personal injury attorneys at Maurer Law may be able to help you recover compensation. Contact us at 919-229-8359 or via our online form.

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