People ex rel. Sherman v. Cryns

Decision Date21 February 2003
Docket NumberNo. 93412.,93412.
Citation271 Ill.Dec. 881,203 Ill.2d 264,786 N.E.2d 139
PartiesThe PEOPLE of the State of Illinois ex rel. Leonard A. SHERMAN, Director of Professional Regulation, Appellee, v. Yvonne CRYNS, Appellant.
CourtIllinois Supreme Court

James T. Harrison, Woodstock, for appellant.

James E. Ryan, Attorney General, Springfield (Joel D. Bertocchi, Solicitor General, and Diane M. Potts, Assistant Attorney General, Chicago, of counsel), for appellee.

Chief Justice McMORROW delivered the opinion of the court:

At issue in this case is the narrow question of whether plaintiff, the People of the State of Illinois ex rel. Leonard Sherman, Director of the Illinois Department of Professional Regulation (Department), established a prima facie case that defendant, Yvonne Cryns, a lay midwife, violated provisions of the Nursing and Advanced Practice Nursing Act (Act) (225 ILCS 65/20-75(a) (West 2000)) when she participated in the August 19, 2000, birth of Spencer Verzi. Plaintiff filed a petition for a preliminary injunction against defendant, pursuant to section 20-75(a) of the Act (225 ILCS 65/20-75(a) (West 2000)), arguing that injunctive relief was warranted because defendant's actions during the Verzi birth constituted the practice of professional nursing and advanced practice nursing without a license. During a hearing on plaintiff's petition, the circuit court of McHenry County granted defendant's motion for directed finding at the close of plaintiff's case in chief. The circuit court found that plaintiff had presented no evidence showing that any acts engaged in by defendant at the Verzi home constituted acts of nursing or advanced practice nursing. The appellate court reversed, holding that plaintiff had presented prima facie evidence that during the birth of Spencer Verzi, defendant had practiced professional nursing and advanced practice nursing without a license in violation of the Act. The appellate court accordingly remanded this cause to the circuit court for further proceedings. 327 Ill.App.3d 753, 261 Ill. Dec. 655, 763 N.E.2d 904. For the reasons that follow, we affirm the judgment of the appellate court.

BACKGROUND

On January 18, 2000, Leonard Sherman, the Director of Professional Regulation (Director), issued a rule to show cause against defendant, who is a lay midwife. The rule to show cause alleged that, in practicing midwifery, defendant engaged in conduct that constituted the practice of professional nursing and advanced practice nursing, as defined within sections 5-10(l) and 15-5 of the Act (225 ILCS 65/5-10(l), 15-5 (West 2000)). The rule to show cause provided defendant with seven days in which to show why an order to cease and desist the unlicensed practice of nursing and midwifery should not be entered against her. Defendant responded by filing a special and limited appearance objecting to the Department's jurisdiction over her as a nonnurse midwife. Defendant also filed an affidavit in which she averred that she was not licensed as a nurse or engaged in a licensed profession.

On April 7, 2000, the Director issued a cease and desist order against defendant, commanding her to immediately cease and desist from engaging in conduct constituting the practice of nursing and midwifery, until she complied with the licensing requirements for a professional nurse and an advanced practice nurse contained within the Act. Specifically, the cease and desist order stated that defendant was not registered as a professional nurse pursuant to section 10-5 of the Act (225 ILCS 65/10-5(a), (b), (c) (West 2000)); that defendant did not hold a current, national certificate as a nurse midwife from the appropriate national certifying body (225 ILCS 65/15-10(a)(3) (West 2000)); that defendant had not complied with a post-basic advanced formal education program in the area of midwifery (225 ILCS 65/15-10(a)(5) (West 2000)); that defendant does not have a collaborative agreement with a physician as required of a certified nurse midwife under the Act (225 ILCS 65/15-15 (West 2000)); and that defendant has been practicing midwifery without the appropriate license and certificate.1 On October 3, 2000, plaintiff filed a verified complaint for injunctive relief against defendant. Pursuant to section 20-75(a) of the Act (225 ILCS 65/20-75(a) (West 2000)), the Director may, in the name of the People of the State of Illinois and through the Attorney General of Illinois, petition the circuit court for an order enjoining any violation of the Act or for an order enforcing compliance with the Act. The verified complaint alleged that the Department is statutorily authorized to enforce minimum standards of professional education and licensure for the practice of nursing and advanced practice nursing. According to the complaint, defendant, as a midwife, is improperly engaged in rendering prenatal, childbirth and postpartum care without a nursing license. The complaint further alleged that defendant violated provisions of the Act when she assisted with the birth of Spencer Verzi, at the Verzi home on August 19, 2000. According to the complaint, "[w]hile defendant was physically assisting with the delivery, the Verzi baby was born in a breech position. Defendant waited approximately more than 15 minutes before calling paramedics. Defendant made efforts to resuscitate the Verzi baby which were unsuccessful." The complaint further alleged that "[v]ideotape shot at the scene shows the entire incident and shows defendant physically assisting in the birth of baby Verzi, which amounted to the continued practice of nursing or Midwifery" without the requisite license. The complaint concluded by asserting that "[d]efendant's actions of continuing to practice nursing and Midwifery without the proper qualifications, licensing and supervision is creating an imminent danger of harm to the public."

On October 5, 2000, the circuit court entered a temporary restraining order against defendant's practice of nursing and midwifery, pending a hearing on plaintiff's complaint for preliminary injunction. The circuit court conducted a hearing on the preliminary injunction complaint on October 13, 2000. Plaintiff called Louis Verzi, the father of Spencer Verzi, to testify with respect to Spencer's birth. Verzi stated that he and his wife, Heather, hold "alternative ideas on health that are not shared with most doctors in hospitals." Accordingly, the Verzis decided that it was best that they have their child at home without the presence of a doctor or nurse. The Verzis desired to take a natural approach to childbirth and decided on a "water birth," wherein the mother gives birth while being partially submerged in a birthing pool. Verzi stated that the water-birth option was not available at any nearby hospitals, and that he and his wife hired defendant to work with them to accomplish a home water birth. According to Verzi, defendant never claimed to be a nurse, and he and his wife did not view defendant as a nurse. Rather, Verzi testified, the purpose of defendant being in their home during Spencer's birth was "to give us advice and to help us through the birth of our child, to help us in things that we didn't know." According to Verzi, defendant discussed with him and his wife the fact that if complications were to arise during the birth, medical assistance would not be immediately available.

According to Verzi, defendant had Heather fill out a "client form," in which Heather indicated that the Verzis believed in "natural health" and did not believe in prescriptions or over-the-counter medications. The responses on this form also indicated that the Verzis viewed Heather's mother as their "doctor," meaning that they relied on her for advice with respect to their health. According to Verzi, Heather had several prenatal visits with defendant, during which defendant monitored the baby's heartbeat using both a specially designed stethoscope known as a "fetoscope," and also a device known as a "Doppler," in which reflected sound waves are used to estimate the speed and direction of blood flow. Verzi stated that a few months before Spencer's birth, defendant had disclosed that a cease and desist order was issued against her by the Department. This information, however, did not deter the Verzis from continuing their relationship with defendant, as defendant was someone that they "had come to trust" and they "felt strongly" that defendant was the person to deliver their child.

Verzi testified that at mid-morning on August 19, 2000, his wife's water broke, and that defendant arrived at their home between 1 and 1:30 p.m. Several family members and friends had gathered at the Verzi house to witness the birth. At approximately 3:45 p.m., Heather began to deliver the baby when his left foot emerged from the birth canal. According to Verzi, during the delivery defendant used the fetoscope "four or five times" to listen to the baby's heartbeat, and also used the Doppler device. Verzi recalled that at one point during the birthing process, Heather asked defendant to physically pull the baby out, and that defendant refused Heather's request. Verzi stated that defendant instead told Heather to push the baby out, and that Heather's body would know the right thing to do. However, Verzi testified that Heather continued to have difficulty in delivering the baby and that "when matters became urgent" defendant did attempt to physically extract the baby. By 4:30 p.m., the baby was born. However, upon his birth Spencer was not breathing. Verzi stated that although defendant administered CPR to Spencer for approximately 10 minutes using an "Ambu bag," which is a device used to push air into a baby's lungs after birth, the baby was not responsive. Verzi testified that at that point defendant requested that 911 be called. According to Verzi, defendant was still at their home, attempting to resuscitate Spencer, when the ambulance and paramedics arrived.

Verzi further...

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