Smith v. Hardy Wilson Mem'l Hosp.

Citation300 So.3d 991
Decision Date20 August 2020
Docket NumberNO. 2018-CA-01448-SCT,2018-CA-01448-SCT
Parties William H. "Skip" SMITH, Jr., Individually and on Behalf of the Wrongful Death Beneficiaries of Carolyn Smith, Deceased, and the Estate of Carolyn Smith v. HARDY WILSON MEMORIAL HOSPITAL
CourtUnited States State Supreme Court of Mississippi

ATTORNEY FOR APPELLANTS: WILLIAM C. GRIFFIN

ATTORNEYS FOR APPELLEE: GAYE NELL CURRIE, D. JASON CHILDRESS

BEFORE RANDOLPH, C.J., COLEMAN AND CHAMBERLIN, JJ.

CHAMBERLIN, JUSTICE, FOR THE COURT:

¶1. The estate and wrongful-death beneficiaries of Carolyn Smith1 appeal the Copiah County Circuit Court's grant of summary judgment in favor of Hardy Wilson Memorial Hospital, now known as Copiah County Medical Center. The trial court found that the Smiths failed to produce sufficient evidence showing that Carolyn Smith's injuries or death were caused by any alleged negligence of Hardy Wilson's nursing staff. After review, we affirm.

FACTS AND PROCEDURAL HISTORY

¶2. On Friday, December 31, 2015, Carolyn Smith fell outside her home, injuring her shoulder and sustaining a small laceration above her right eye. Carolyn presented to Hardy Wilson Memorial Hospital's emergency department that day at 2:21 p.m. The nursing staff at Hardy Wilson recorded Carolyn's initial vital signs in preparation for the emergency-room physician, Dr. James Johnson, to evaluate Carolyn. Carolyn's initial vitals showed, among other things, a respiration rate of eighteen and an oxygen-saturation

rate of ninety-five. Carolyn's records show that Dr. Johnson had evaluated her and had issued orders by 2:55 p.m. Dr. Johnson ordered that Carolyn be administered four milligrams of Zofran and two milligrams of Dilaudid to relieve her pain. Dr. Johnson also ordered an X-ray and CT scan ; the X-ray showed that Carolyn had a broken shoulder, and the CT scan appeared normal.

¶3. After Dr. Johnson's assessment of Carolyn, he called and consulted with Dr. Todd Smith—Carolyn's son and an orthopedic specialist. Dr. Smith recommended that Dr. Johnson discharge Carolyn and that she follow up with an orthopedic specialist in Jackson, Mississippi, the following Monday. At approximately 4:30 p.m., Dr. Johnson made the decision to discharge Carolyn. Shortly after Dr. Johnson had ordered the discharge, Carolyn complained of increased pain. As a result, Dr. Johnson ordered that Carolyn be administered two milligrams of Ativan

and two more milligrams of Dilaudid. Pursuant to Dr. Johnson's orders, the nurses began to administer the medication at around 4:45 p.m. while rechecking Carolyn's vital signs. The nurse recorded Carolyn's vital signs, which showed, among other things, a respiration rate of twelve and an oxygen-saturation rate of eighty-two. Because the monitor obtaining the vital-sign readings had the potential to give false readings, the nurse made sure that Carolyn was properly situated and took an additional reading to ensure the readings were accurate.

¶4. At around 5:10 p.m. or 5:20 p.m., the nursing staff began to administer oxygen to Carolyn to stabilize her oxygen levels. At the same time, a member of the nursing staff informed Dr. Johnson of Carolyn's worsening vital signs. Dr. Johnson instructed the nurse to check the vital signs again to ensure they were accurate due to potentially false readings from the monitor. The nurse checked Carolyn's vital signs again, confirmed that they were accurate and informed Dr. Johnson of Carolyn's confirmed vital signs.

¶5. Despite the information that the nurse provided, Dr. Johnson maintained his earlier decision to discharge Carolyn and sent her home at approximately 5:30 p.m. At discharge, members of the nursing staff assisted Carolyn into the vehicle that her husband was driving. In an answer to an interrogatory, Carolyn's husband averred that at some point after Dr. Johnson's decision to discharge Carolyn, "one or both of the nurses at the Hospital said something to the effect that they did not agree with Dr. Johnson's decision to discharge Carolyn when he did."2 When Carolyn was placed into the vehicle, she was asleep, and the nurses explained to Carolyn's husband that he may have a hard time waking her up. Carolyn's husband drove to the pharmacy to have her prescriptions filled and then continued home. Carolyn was still sleeping when she and her husband arrived at their home. As a result, Carolyn's husband remained in the vehicle with her anticipating that she would eventually wake up. But instead of waking up, Carolyn stopped breathing, and an emergency call was placed for an ambulance. Approximately five hours after being discharged, the ambulance transported Carolyn back to Hardy Wilson. Carolyn was pronounced dead on arrival at Hardy Wilson.

¶6. On June 20, 2016, the Smiths filed suit against several of Carolyn's medical providers, including Hardy Wilson. As part of its claim against Hardy Wilson, the Smiths alleged that Hardy Wilson's negligence, by and through its nursing staff, caused or contributed to Carolyn's death. On July 20, 2016, Hardy Wilson answered, denying fault and asserting that the complaint failed to state a cause of action against Hardy Wilson. Hardy Wilson propounded interrogatories and received responses on October 4, 2016.

¶7. On August 20, 2018, more than two years after the complaint was filed, Hardy Wilson moved for summary judgment. Hardy Wilson argued, among other things, that "[p]laintiffs have failed to designate any expert testimony that any member of the nursing or other nonmedical staff was negligent in their care and treatment of Carolyn Smith and that such negligence caused or contributed to her death." Citing Vicksburg Healthcare, LLC v. Dees , 152 So. 3d 1171, 1173 (Miss. 2014), Hardy Wilson contended that "[w]ithout such expert testimony, any such claim fails as a matter of law."

¶8. In response to Hardy Wilson's summary-judgment motion, the Smiths offered three expert affidavits. A nursing care expert, Irish Patrick-Williams, R.N., opined that Hardy Wilson's nursing staff breached the standard of care applicable to nurses in their care of Carolyn and that such breaches caused or contributed to Carolyn's death. Nurse Patrick-Williams's affidavit, in relevant part, stated that

the attending nurses knew (or should have known) Carolyn Smith should have been monitored for significantly longer than the 25 minutes for which she was monitored, and she should not have been discharged after only 25 minutes following the doses of Dilaudid

and Ativan together, and with the no apparent effect of oxygen therapy on her, and particularly with her deteriorating medical condition.

....

Nurses are trained to know and should know the side effects or adverse reactions with administering Dilaudid alone, and especially accompanied by Ativan, include sedation and respiratory depression, and Carolyn Smith experienced both of these effects. Her resulting medical condition after medication clearly showed she should not have been discharged when she was discharged and in her condition when discharged, and the nurses in the ED at Hardy Wilson on December 31, 2015, providing care to her knew or should have known this.

The attending nurses who participated in Carolyn Smith's discharge, particularly including Joyce Schimmel, who reported the final vital signs of Carolyn Smith's deteriorated condition, should have considered the objective vital signs and taken affirmative action for Carolyn Smith to be kept in the emergency room with continuous monitoring, rather than being discharged, despite physician orders. If there was any problem whatsoever in retaining Carolyn Smith with continuous monitoring in the ED, based on her taken and recorded vital signs, the attending nurses, again particularly including Joyce Schimmel, should have sought supervisory authority and/or consultation from another physician, such as a physician on-call.

....

The nurses’ participation in the discharge of Carolyn Smith, without objection or without seeking supervisory intervention, and without use of a calibrated, correctly functioning and accurate monitor, particularly for oxygen saturation rate, constituted clear medical negligence on their part, and the

treatment of Carolyn Smith was in breach of the applicable standards of care for the nurses providing care to her in the ED on December 31, 2015.
To a reasonable degree of medical probability, if the nurses in the ED at Hardy Wilson Memorial Hospital had acted within the applicable standards of care, Carolyn Smith would not have been discharged when she was discharged in the condition she was in, and she would not have died because of any continued respiratory depression

, or even respiratory arrest or cardiac arrest could have been addressed and treated immediately in the hospital.

¶9. The Smiths also submitted the affidavits of Dr. Robert Dale, Jr., and Dr. Michael O. Stodard. Both doctors opined that

[a]s shown by the records, the attending nurse reported Carolyn Smith's deteriorated medical condition, as shown by her vital signs, to the emergency physician, Dr. Johnson, but Dr. Johnson failed to take corrective action or delay discharge under the existing circumstances, and the attending nurse also failed to take any further action despite the oxygen saturation rate of 82% as taken and recorded by monitor for Carolyn Smith at discharge.
....
To a reasonable degree of medical probability, but for the discharge by Dr. Johnson of Carolyn Smith with depressed respiratory function and altered mental state, Carolyn Smith would not have died.
Dr. Johnson breached the applicable standards of care in his treatment of Carolyn Smith by discharging her with the vital signs which were taken and recorded at the time of discharge per the records, by failing to take action to obtain additional monitor readings from correctly functioning equipment and/or obtain arterial blood gases to confirm her oxygen saturation

level, and by failing to take corrective action to address her deteriorated medical condition and altered mental state as shown by the...

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