Horton v. Niagara Falls Memorial Medical Center

• Decision Date: 13 February 1976
• Citation: 380 N.Y.S.2d 116,51 A.D.2d 152
• Parties: Willard B. HORTON and Gertrude Horton, Respondents, v. NIAGARA FALLS MEMORIAL MEDICAL CENTER, Appellant.
• Court: New York Supreme Court — Appellate Division

Page 116

380 N.Y.S.2d 116

51 A.D.2d 152

Willard B. HORTON and Gertrude Horton, Respondents, v. NIAGARA FALLS MEMORIAL MEDICAL CENTER, Appellant.

Supreme Court, Appellate Division, Fourth Department.

Feb. 13, 1976.

Findlay, Hackett, Reid & Wattengel, Niagara Falls, for appellant (Paul H. Reid, Jr., Niagara Falls, of counsel).

Grossman & Levine, Niagara Falls, for respondents (Terry D. Smith, Buffalo, of counsel).

Before SIMONS, J.P., and DILLON, GOLDMAN and WITMER, JJ.

SIMONS, Justice Presiding.

Defendant appeals from a judgment awarding compensatory and derivative damages to plaintiffs for personal injuries resulting from Willard Horton's fall from defendant's second-story hospital window. On the day before the fall Mr. Horton had been admitted to the hospital, suffering from a 'fever of undetermined origin' (subsequently diagnosed as pneumonitis) and observed to be acutely ill, 'lacking in co-ordination' and suffering from blurred vision.

He was placed in a private room which had a single window opening onto a small balcony which was encircled by a railing two to three feet high. The nurses' notes on the day of the accident indicated that the patient 'appears weak and dizzy, is unable to focus, left side of face twitching, confused at times.' Mrs. Horton visited her husband that morning and found him vague, confused and unresponsive to her questions. Mrs. Horton's mother stayed with him until he was given a hypo about 2:00 p.m. and testified that he was uncommunicative and restless. Mr. Horton has no recollection of the events in the hospital prior to his fall.

At about 3:30 p.m. Mr. Horton was observed by some construction workers below his room. He was standing in his pajamas on the balcony outside his room and calling to them for a ladder. The workers notified the hospital personnel who returned the patient to his room and placed a posey belt and cloth wristlets on him as mild restraints. The incident was logged in the nurses' notes with the statement 'patient confused'.

The charge nurse on the floor called Mr. Horton's attending physician to advise him of the incident. The doctor's recollection was that he told the nurse to keep an eye on the patient, to keep him restrained, and that if the patient caused any more trouble, he would have to be put in a 'quiet' (secured) room. The charge nurse then called Mrs. Horton at her place of work in Lewiston, a village about 20 minutes' drive from Niagara Falls, and suggested that she come to sit with Mr. Horton because none of the hospital staff were free to do so. Mrs. Horton said that she would call her mother who lived only five to ten minutes distance from the hospital and ask her to go to the hospital immediately. She asked that someone watch Mr. Horton until her mother arrived, but the nurse advised that the hospital was understaffed and 'we can't possibly do that'. Mrs. Horton called her mother, who hurried the four or five blocks from her home to the hospital and arrived there just in time to see a group of construction workers and spectators surrounding something on the ground near the hospital building. She discovered later that the object of their attention was Mr. Horton, and that he had fallen from the second-story window of his room.

The rule requires that a private hospital is required to exercise reasonable care and diligence in safeguarding a patient, measured by the capacity of the patient to provide for his own safety (Robertson v. Charles B. Towns Hospital, 178 App.Div. 285, 165 N.Y.S. 17; see also Santos v. Unity Hospital, 301 N.Y. 153, 93 N.E.2d 574; Hendrickson v. Hodkin, 276 N.Y. 252, 11 N.E.2d 899; Murray v. St. Mary's Hospital 280 App.Div. 803, 113 N.Y.S.2d 104; 27 N.Y.Jur., Hospitals and Asylums, § 74; 2B Warren on Negligence, Hospitals, § 2, pp. 221--22; and see generally Anno. Hospital's Liability for Suicide of Patient, 60 A.L.R.3d 880).

Generally, a hospital is entitled to act upon the doctor's orders for his patient in medical matters (Toth v. Community Hospital at Glen Cove,22 N.Y.2d 255, 264--265, 292 N.Y.S.2d 440, 449, 239 N.E.2d 368, 374; Mulligan v. Wetchler, 39 A.D.2d 102, 105, 332 N.Y.S.2d 68, 72; app. dsmd. 30 N.Y.2d 951, 355 N.Y.S.2d 701, 287 N.E.2d 391; Garzione v. Vassar Bros. Hosp., 36 A.D.2d 390, 392, 320 N.Y.S.2d 830, 832, affd. 30 N.Y.2d 857,355 N.Y.S.2d 293, 286 N.E.2d 731; cf. Hendrickson v. Hodkin, supra) and, as defendant notes, the use of restraints is usually considered to be a medical decision (Mossman v. Albany Medical Center, 34 A.D.2d 263, 264, 311 N.Y.S.2d 131, 132; Wendover v. State, 63 Misc.2d 368, 313 N.Y.S.2d 287; cf. Haber v. Cross County Hospital, 37 N.Y.2d 888, 372 N.Y.S.2d 644, 334 N.E.2d 594). Relying upon this rule, defendant contends that since plaintiff's attending physician approved the posey belt and wristlets and since no damage was observed during periodic checks of the patient for temperature taking at 4:00 p.m. and by nurses passing his room during rounds, the actions of the hospital employees were reasonable under all the circumstances. However, while the fact that the hospital staff followed the instructions of the patient's attending physician on the use of restraints may protect the hospital from liability on that issue (assuming the physician was fully informed and that the hospital had no reason to believe that the care provided was inadequate), it is not conclusive in matters in which the hospital has a separate and independent duty to the patient. The duty of the hospital to supervise the patient and prevent him from injuring himself remained, even after the physician's instructions were given, and the court's charge properly instructed the jury on this responsibility.

The question then is what reasonable care was required in the way of supervision, considering the nature of the hospital and its facilities, the personnel available either by way of staff, private duty nurses or relatives, and the knowledge the hospital had of the patient's propensities to inflict injury upon himself (and even though, as defendant contends, the patient's conduct may not have been suicidal (see Van Patter v. Charles B. Towns Hospital, 246 N.Y. 646, 159 N.E. 686; Robertson v. Charles B. Towns Hospital, supra; Anno. 60 A.L.R.3d 880, supra, § 11(a), (b))). Competent proof of the general standards of hospital care common in the community under these circumstances was properly received as evidence of defendant's negligence (Hnat v. Nyack Hospital, 33 N.Y.2d 985, 353 N.Y.S.2d 741, 309 N.E.2d 139; Judd v. Park Ave. Hospital, 37 Misc.2d 614, 235 N.Y.S.2d 843, affd. 18 A.D.2d 766, 235 N.Y.S.2d 1023; Liebrecht v. Gotham Sanitarium, Inc., 284 App.Div. 781, 134 N.Y.S.2d 762; Anno. Hospital--Care Standard--Locality Rule, ...