Christian v. Wilmington General Hospital Ass'n

• Decision Date: 08 November 1957
• Citation: 11 Terry 550,135 A.2d 727,50 Del. 550
• Parties: , 50 Del. 550 Barbara Lynn CHRISTIAN, an infant, by her next friend, James A. Christian, Plaintiff Below, Appellant, v. WILMINGTON GENERAL HOSPITAL ASSOCIATION, Inc., a corporation of the State of Delaware, Defendant Below, Appellee.
• Court: Supreme Court of Delaware

Page 727

135 A.2d 727

11 Terry 550, 50 Del. 550

Barbara Lynn CHRISTIAN, an infant, by her next friend, James A. Christian, Plaintiff Below, Appellant, v. WILMINGTON GENERAL HOSPITAL ASSOCIATION, Inc., a corporation of the State of Delaware, Defendant Below, Appellee.

Supreme Court of Delaware.

Nov. 8, 1957.

Donald W. Booker, Wilmington, for appellant.

E. N. Carpenter, II, Wilmington, for appellee.

SOUTHERLAND, C. J., and WOLCOTT and BRAMHALL, JJ., sitting.

WOLCOTT, Justice.

This appeal seeks reversal of a directed verdict for the defendant at the close of the plaintiff's testimony in the trial of an action before the Superior Court against the defendant hospital, based on the alleged negligence of its agent.

The facts may be stated as follows: The plaintiff, in January, 1953, the time of the injury, was approximately sixteen months of age and, while playing in her home, fell on a glass bottle which broke and cut her hand severely. The plaintiff was taken by her parents to the Wilmington General Hospital and there treated by an intern then on duty in the emergency ward. At the time of treatment, the plaintiff was crying and struggling so that she had to be held by her parents and a student nurse then on duty.

The intern examined the wound, treated it and sewed it up and, in response to a question by the infant's father, stated that the tendons of the hand were not severed. Later, although the testimony is somewhat confused as to the exact time, the plaintiff was again taken to the defendant hospital. This subsequent visit was either four or ten days following the accident. She was again examined by the same intern who noted that a stiffness had developed in the index finger of her right hand. At this time the intern did not diagnose the stiffness as having been caused by a severed tendon, although, again on this point, the testimony is confused.

Subsequently, a third time, the plaintiff was taken to the defendant hospital and, at this time, the plaintiff's parents may have been advised that the stiffness in the index finger was caused by a severed tendon. In any event, however, in April, 1953, the plaintiff was examined at the Philadelphia Naval Hospital and her parents advised that the tendon serving the index finger of her right hand had been severed, and that an operation would be required to repair it. As of the date of trial of this cause, approximately four years following the injury, the operation has not been performed.

The plaintiff called as witnesses two doctors to testify as experts. The substance of their testimony with respect to injuries of this type and the treatment customarily followed is set out. In a child of this age the tendon leading to an index finger is approximately the size of a heavy piece of string, perhaps as much as 1/8 inch in diameter. By visual examination of the wound, it is possible to see the tendon if it has not been severed, but it is also entirely possible, in the case of a small struggling and crying child, that the tendon would not be seen. In the treatment of such a wound, it is routine practice to determine if possible whether or not tendons have been severed, but if the child is unco-operative, it is often-times impossible to determine because diagnosis requires flexion of the finger which, in turn, can be achieved only by the co-operation of the patient.

The doctors testified that when a tendon is divided an operation is invariably required to repair it since a severed tendon will not grow together of its own volition, but tends to withdraw into the wrist after having been severed. They also testified that an immediate operation for a severed tendon is not always performed. Whether or not immediate repair is made, or the operation postponed depends upon a number of factors, such as possible contamination of the wound and, also, in the case of a small child the desirability of permitting normal growth to take place to make subsequent repair by operation easier.

The doctors were agreed that immediate operation is not necessary for the repair of a severed tendon and that postponement of the operation, even for as long as four years, would not result in any permanent disability by reason of the delay. In other words, successful repair of a severed tendon can be made after the lapse of years.

The doctors also testified it was possible, at the time of the initial examination by the intern, that the tendon leading to plaintiff's right index finger was only partially severed, which would not have been discovered by examination, and that the tendon might have ruptured later after the initial treatment, which, if that were the fact, would not have been the cause of the rupture.

Upon this state of the plaintiff's evidence the trial court instructed the jury to return a verdict for the defendant on the ground that it was insufficient to establish a prima facie case in the plaintiff's favor because of two deficiencies. The first deficiency was that there was no evidence at all that the intern employed by the defendant had failed to conform to accepted standards of care and treatment prescribed for physicians in the community. And the second deficiency was that there was no evidence offered by the plaintiff that the treatment performed by the intern was the proximate cause of the injury.

Plaintiff now appeals, making two basic arguments for the reversal of the directed verdict, viz., (1) that the plaintiff did offer sufficient evidence of the failure of the intern to conform to the accepted medical standards in the community for the care and treatment of injuries of the nature suffered by the plaintiff; and (2) that in any event the case should have been submitted to...