Howard v. Research Hospital & Medical Center, Inc.

Decision Date27 February 1978
Docket NumberNo. KCD,KCD
PartiesRuth HOWARD, Respondent, v. RESEARCH HOSPITAL AND MEDICAL CENTER, INC., Appellant. 28842.
CourtMissouri Court of Appeals

John M. Kilroy and W. James Foland, Kansas City, for appellant; Shughart, Thomson & Kilroy, Kansas City, of counsel.

M. Randall Vanet, Kansas City, for respondent.


PRITCHARD, Presiding Judge.

Respondent, having had the verdict of a jury against her, was granted a new trial because of error in giving Instruction No. 5 upon her contributory negligence in failing to call nurse assistance to get out of bed, and in ripping off a "Posey" (a restraining device), in that it omitted the element of whether or not she was in a confused or disoriented condition at the time of her fall.

Appellant contends that respondent failed to make a submissible case of its negligence, as submitted, that it failed properly to restrain respondent or failed to provide her with adequate nursing supervision. The evidence bearing upon that submission is as follows:

Respondent, being then 76 years old and weighing 100 pounds, was admitted to appellant hospital on October 8, 1973. She testified that she had no recollection of arriving at the hospital, and her doctor testified that her blood loss made her pale, weak and dizzy. At 10:45 p. m. that day, she was given 500 mgs. of Doriden, a sleeping medication which takes 4 to 8 hours to wear off. At 9:30 p. m. on the following day, respondent was given an additional 500 mgs. of Doriden. Prior to the latter time, respondent was visited by nurses, Mary Ellsberry and Edna Foster, for about 15 minutes, at which time Mary testified that respondent was very tired, sleepy and listless. At about 11:30 p. m., respondent's bed was placed in the low position, its wheels were locked in place, and the side rails were put up at about midnight, at which time her vital signs were taken, the nurse's entry showing that she appeared quite sleepy. At 12:30 a. m., October 10, 1973, respondent was found on the floor next to her bed, and she told the nurse that she was going to the bathroom. Respondent was then placed back in bed and upon a bedpan, and she was found asleep by a nurse thereon at 12:45. She was awakened at 1:10 a. m. to remove the bedpan, which did not contain any blood or stool. At that time the nurse told respondent to call for assistance if she needed to go to the bathroom, and a Posey restraint, a nurse's decision, was applied. The head nurse, who placed the Posey on respondent, could not recall if she put it on tightly or loosely, which is also a nurse's decision if put on loosely, it serves as a reminder not to get out of bed; if tied tightly, it would prevent the patient from getting out of bed. If the Posey is too loose, the patient gets out of it.

Respondent's doctor testified further that respondent must have been confused when she was found out of bed (on the floor) at 12:30 a. m. Nurse Reynolds testified that the reason respondent was told to call for assistance in going to the bathroom was for her safety, and because she was under a sedative, she might hurt herself if she tried to get up by herself.

Between 1:10 a. m. and 5:15 a. m., the nurses on duty periodically looked in upon respondent and observed her sleeping. At the latter time, respondent was found on the floor by her bed, the straps of the Posey being still attached to the bed. The Posey was not defective. Respondent was then x-rayed and it was found that she had fractured her hip, and surgery was performed thereafter to correct it, and respondent was discharged from the hospital on November 2, 1973.

The incident report stated that respondent's "apparent condition before incident" was that she was "disoriented", and a Dr. Willoughby's comment thereon was that she was disoriented, sedated, and not normal and alert. Respondent remembered only that when she first fell, she "had the feeling (that she) was going just round and around and around" and she remembered a commotion in the room and a nurse's comments. She did not remember a restraint being placed upon her or that she was given specific instructions.

Obviously, considering the foregoing facts in the light most favorable to respondent in support of her case, she made a submissible case of negligence against appellant. Of importance in this regard is respondent's known debilitation from blood loss which made her pale, weak and dizzy. She required a sleeping medication. She had fallen to the floor from her bed once before the fall which caused her injury. It was for the jury to determine if respondent had been properly restrained by the "Posey" or whether she had been sufficiently supervised by attending nurses. The thrust of appellant's argument is that respondent was required to present expert evidence as to proper application of the "Posey" restraint, and as to proper nurse supervision, to demonstrate a departure from appellant's standard of care. In Steele v. Woods, 327 S.W.2d 187, 198(18) (Mo.1959), the court noted that it is usually necessary to prove by expert testimony from members of the medical profession that the skill or technique used did not conform to the standards of the profession, and said further, "But where the conduct in question does not involve skill or technique in an area where knowledge of such is a peculiar possession of the profession and does involve a matter which any layman (or court) could know, then such 'professional' testimony is not necessary. (Citing authority and cases in footnote 25)." Cases cited by appellant, Williams v. Chamberlain, 316 S.W.2d 505 (Mo.1958); Swope v. Printz, 468 S.W.2d 34 (Mo.1971); and James v. Sunshine Biscuits, Inc., 402 S.W.2d...

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9 cases
  • Taylor v. City of Beardstown
    • United States
    • United States Appellate Court of Illinois
    • March 31, 1986 action to recover injuries when an elderly patient fell from her hospital bed and broke her hip. In Howard v. Research Hospital & Medical Center, Inc., (Mo.Ct.App.1978), 563 S.W.2d 111, the patient in question was disorientated, dizzy, and sedated due to loss of blood and a sleeping medi......
  • Bennett v. Winthrop Community Hosp.
    • United States
    • Appeals Court of Massachusetts
    • March 14, 1986
    ...was required and was not furnished, or was half-furnished, or furnished in a slipshod manner. See Howard v. Research Hosp. & Medical Center, Inc., 563 S.W.2d 111, 112 (Mo.App.1978); Smith v. Gravois Rest Haven, Inc., 662 S.W.2d 880, 883 (Mo.App.1983); Gordon v. Harbor Hosp., Inc., 275 A.D. ......
  • Robbins v. Jewish Hosp. of St. Louis
    • United States
    • Missouri Court of Appeals
    • December 13, 1983 her needs, that is, such reasonable care and attention as her known condition required. In Howard v. Research Hospital and Medical Center, Inc., 563 S.W.2d 111 (Mo.App.1978), a nurse, without instructions from a physician, determined a patient needed assistance to go to the bathroom. She......
  • Goodenough v. Deaconess Hosp.
    • United States
    • Missouri Court of Appeals
    • May 18, 1982
    ...testimony is not necessary." Steele v. Woods, 327 S.W.2d 187, 199 (Mo.1959). See also Howard v. Research Hospital & Medical Center, Inc., 563 S.W.2d 111, 112-113 (Mo.App.1978). As has been suggested by the foregoing, we also disagree with the trial court's view that plaintiff did not make a......
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