Richmond County Hospital Authority v. Haynes
| Decision Date | 04 February 1970 |
| Docket Number | No. 44637,No. 3,44637,3 |
| Parties | RICHMOND COUNTY HOSPITAL AUTHORITY v. Oakley HAYNES |
| Court | Georgia Court of Appeals |
Syllabus by the Court
1. Under the facts of this case in which a hospital was sued for negligence, a charge on res ipsa loquitur was authorized.
2. Evidence of the plaintiff's receipt of social security benefits is not admissible to show plaintiff's motive for not returning to work.
Plaintiff, Oakley Haynes, brought suit in the Superior Court of Richmond County against the Richmond County Hospital Authority, operating the University Hospital for personal injuries allegedly sustained by him while a patient in the University Hospital in December 1964. A jury verdict in the amount of $25,250 was returned for the plaintiff. At the conclusion of the evidence the defendant made a motion for a directed verdict, which was denied. The court ordered judgment on the verdict and thereafter defendant filed a motion for judgment notwithstanding the verdict and a motion for new trial, both of which were overruled and denied by the court. Defendant appeals.
In his complaint plaintiff alleged that defendant was negligent in using tight leather wrist straps without adequate padding when better methods of restraint were available; and in subsequently failing to check them often enough to prevent the development of severe injury from the abrasive situation created.
The following evidence was presented on the trial of the case: Plaintiff was admitted as a paying patient to defendant hospital in a diabetic coma on December 12, 1964 at approximately 7 a.m. He was put to bed with leather restraining straps around his wrists and these straps remained in place until approximately 7 p.m. of the following day. When the straps were removed, it was discovered that plaintiff's wrists were badly bruised and that blisters were forming. These later burst leaving deep lacerations or ulcerations which became infected. Plaintiff suffered ulnar and median nerve damage and secondary muscle damage to his wrists and hands for which he had to take frequent electric muscle stimulating treatments for nearly two years. Plaintiff testified that he was unable to return to work for thirty-one months following his injury, that he was in severe pain following this injury for a number of weeks and could not use his hands or fingers at all for several months thereafter. He testified that even now the muscles of his hands were not as strong as they had been before; that although he could use his hands, he still had scars and he still experienced unpleasant prickling sensations in his hands and wrists. Plaintiff's testimony was corroborated by his treating physicians.
The evidence showed that the injury to his wrists and hands caused plaintiff to lose approximately $8,556 in wages and to incur expenses in excess of $2,500.
All the medical witnesses, testified that in 1964 leather wrist restraints were standardly used on patients who were violent and thrashing about; that this was for the protection of the patient; that patients put in such restraints had to be closely watched; and that these restraints should be applied and maintained in accordance with the rules and regulations for restraints in force at the hospital.
These rules provide that it is essential to have a physician's order to apply restraints; that keys to leather restraints are always kept with the narcotics keys; that all areas where friction is likely to occur should be padded with cotton wadding; that restraints should be removed at four-hour intervals to exercise the part being restrained; and that when the patient is removed from restraints, the area should be washed with soap and water and alcohol and powder applied.
While Dr. Griffin, the patient's private physician during his period of hospitalization, did not order the restraining straps to be applied, he was aware they had been, and he did not order their removal.
There was testimony from a number of lay witnesses who saw the plaintiff wearing the wrist restraints that he was lying still the whole time they were with him. However, plaintiff's own physician, as well as the nurses, said that plaintiff was thrashing violently when he was admitted and that restraint was necessary for his own good. During this period plaintiff was receiving intravenous fluids. None of the lay witnesses who visited plaintiff saw any cotton wadding underneath the wrist restraints nor did his attending physician. The only mention of any material between the straps and plaintiff's wrists was a reference to a piece of gauze which apparently hung down from one of his wrists on the second day he was in the hospital.
These lay witnesses also testified that during all the periods they visited with plaintiff in the hospital, no hospital personnel checked the restraints in any way to their knowledge. Some of these witnesses testified that the restraints appeared to be too tight around plaintiff's wrists and that his flesh was 'sort of puckered up' or swollen around them. They also testified that the bruises or rawness was visible to them while the restraints were still on plaintiff's wrists and one of these witnesses testified that she could already see blisters forming in the area.
Dr. Daniel, a neurosurgeon, testified that such wounds as plaintiff suffered from the restraints probably started forming in four to six hours; that if hospital personnel had been checking for vital signs every four hours (and in the case of a comatose patient this check should have been made far more frequently) they should have become aware that the friction from the restraints was causing severe bruising of plaintiff's wrists long before the injury became so severe. Dr. Daniel testified that it probably took somewhere between twelve and twenty-four hours for the wounds to develop to such severity. One of the doctors testified that had the injury to plaintiff's wrists been picked up in the early stages, cotton wadding could have been inserted between the straps and plaintiff's wrists to reduce friction and mitigate the injury, if the wrist restraints were in fact still necessary for plaintiff's protection. There was testimony that during plaintiff's relapse into a comatose condition some time later during his stay in the hospital, no expects that the wounds to plaintiff's wrists resulted from the wrist restraints.
All medical experts testified that injuries such as the plaintiff received were very rare. Some had never seen any similar injuries from wrist restraints and none of the doctors had previously seen an injury this severe. There was no conflict among the experts that the wounds to plaintiff's wrists resulted from the wrist restraints.
There was no direct testimony either way that the straps in some way also caused the nerve damage. It seems to have been assumed even by defendant, one of whose points on cross examination of plaintiff's neurosurgeon was that possibly the pressure exerted by plaintiff against the straps, rather than the ulcerations, caused the nerve damage.
Finally, there was expert medical testimony that diabetic patients must be specially watched for skin problems, pressure sores, and constriction of blood vessels as they are particularly fragile and can develop serious problems in these areas.
Fulcher, Fulcher, Hagler, Harper & Reed, Gould B. Hagler, Augusta, for appellant.
Lanier, Powell, Cooper & Cooper, L. Valdi Cooper, L. E. Maioriello, Augusta, for appellee.
1. The defendant enumerates as error the charge of the court on the doctrine of res ipsa loquitur contending that...
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