Savino v. Charlotte-Mecklenburg Hosp. Auth.

• Decision Date: 25 September 2020
• Docket Number: No. 18PA19,18PA19
• Citation: 375 N.C. 288,847 S.E.2d 677
• Parties: The ESTATE OF Anthony Lawrence SAVINO v. The CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, a North Carolina Hospital Authority, d/b/a Carolinas Healthcare System and CMC-Northeast.
• Court: North Carolina Supreme Court

375 N.C. 288

847 S.E.2d 677

The ESTATE OF Anthony Lawrence SAVINO

v.The CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, a North Carolina Hospital Authority, d/b/a Carolinas Healthcare System and CMC-Northeast.

No. 18PA19

Supreme Court of North Carolina.

Filed September 25, 2020

Zaytoun Ballew & Taylor, PLLC, Raleigh, by Matthew D. Ballew, Robert E. Zaytoun and John R. Taylor ; and Brown Moore & Associates, PLLC, Charlotte, by R. Kent Brown, Jon R. Moore, Paige L. Pahlke, for plaintiff.

Bradley Arant Boult Cummings, LLP, Charlotte, by Robert R. Marcus, Brian Rowlson and Jonathan Schulz ; and Horack Talley Pharr & Lowndes, PA, by Kimberly Sullivan, Charlotte, for defendant.

Patterson Harkavy, LLP, by Burton Craige, Raleigh, Trisha S. Pande, and Narendra K. Ghosh, Chapel Hill, for North Carolina Advocates for Justice, amicus curiae.

HUDSON, Justice.

Pursuant to plaintiff's petition for discretionary review, we address whether the Court of Appeals erred by reversing the trial court's denial of defendant's motion for a directed verdict on pain and suffering damages. We also allowed review of plaintiff's additional issue per North Carolina Rule of Appellate Procedure 15(d): whether the Court of Appeals erred in holding that plaintiff failed to properly plead administrative negligence under N.C.G.S. § 90-21.11(2)(b). In addition, we allowed defendant's conditional petition for discretionary review of two issues: (1) whether defendant was entitled to a new trial because it was prejudiced by the intertwining of plaintiff's evidence and the trial court's instruction to the jury on medical negligence and administrative negligence; and (2) whether the trial court erred by granting plaintiff's motion for a directed verdict on contributory negligence.

We modify and affirm in part, and reverse in part, the decision of the Court of Appeals because we conclude that (1) the trial court did not err by denying defendant's motion for a directed verdict on pain and suffering damages; (2) plaintiff was not required to plead a claim for administrative negligence separate from medical negligence; (3) defendant is not entitled to a new trial; and (4) the trial court did not err by granting plaintiff's motion for a directed verdict on contributory negligence.

Factual and Procedural Background

Just after 1:30 p.m. on 30 April 2012, Cabarrus County EMS was dispatched to the residence of Anthony Lawrence Savino. When EMS arrived, Mr. Savino was complaining of chest pain that was radiating down both of his arms and causing tingling and numbness. EMS checked his blood pressure and other vital signs in his residence before taking him into the ambulance. In the ambulance, EMS personnel performed an electrocardiogram

which showed a normal sinus rhythm; this indicated that Mr. Savino was not currently having a heart attack. EMS gave him an I.V., four baby aspirin, and sublingual nitroglycerin, and notified CMC-Northeast that they were bringing him in as a chest pain patient.

On the way to the hospital, EMT Kimberly Allred prepared a document called an "EMS snapshot," which provides a quick summary of the care that EMS provided to a patient; the snapshot is usually left with the intake nurse at the hospital. In the snapshot, EMT Allred included Mr. Savino's demographics, vitals, and a description of the care provided to Mr. Savino en route to the hospital, including the medications he was given. Plaintiff alleges that this snapshot and the information it contained was never given nor communicated to his treating physician.

A few hours after arriving in the emergency room, Mr. Savino was discharged. Later that evening, his wife found him unresponsive in their home after he suffered a heart attack

. Mr. Savino could not be resuscitated by EMS and was pronounced dead on the scene.

On 23 April 2014, Mr. Savino's Estate (plaintiff) filed a Complaint for Medical Negligence (the 2014 Complaint) against The Charlotte-Mecklenburg Hospital Authority, Carolinas Healthcare System, CMC-Northeast, the attending emergency physician, and the attending physician's practice. Defendants responded by filing an answer to the complaint. Then, on 2 January 2016, plaintiff filed a motion for leave to amend the 2014 Complaint in light of documents produced by defendant and depositions taken after the production of the documents. Plaintiff asserted that the 2014 Complaint provided defendants with sufficient notice of its negligence allegations and that plaintiff was seeking to file an Amended Complaint "out of an abundance of caution." But on 12 January 2016, plaintiff withdrew the motion for leave to amend the complaint. On 19 January 2016, plaintiff filed a notice of voluntary dismissal of all claims against all parties, but without prejudice to re-file against defendants.

Plaintiff filed another "Complaint for Medical Negligence," (the 2016 Complaint) naming only The Charlotte-Mecklenburg Hospital Authority, Carolinas Healthcare System, and CMC-Northeast (collectively, "defendant"), on 1 February 2016. Defendant filed its answer on 5 April 2016.

During a hearing on pre-trial motions, plaintiff and defendant disputed whether the case involved two theories of medical negligence or two separate claims of medical and administrative negligence. Plaintiff argued that the 2016 Complaint contained both allegations that defendant did not meet the standard of care in "the delivery and provision of medical care" and allegations that defendant "failed to comply with its corporate duty or administrative duty." Plaintiff argued that both of these theories were part of the same medical negligence claim under N.C.G.S. § 90-21.11(2) (2011). Defendant argued, however, that only the first theory of medical negligence was alleged in the 2016 Complaint and then proceeded to object throughout the trial that plaintiff had not pled a separate administrative negligence claim.

The case was tried to the jury from 24 October 2016 through 15 November 2016. Plaintiff's theory of negligence at trial rested on the "hand-off" between EMS and CMC-Northeast which resulted in neither the EMS snapshot, nor the information contained within it—including Mr. Savino's chief complaint of chest pain and the fact that he was treated with aspirin

and nitroglycerin—being given or communicated to his treating physician.

At the close of plaintiff's evidence, defendant moved for a directed verdict on two grounds: (1) the evidence was insufficient to support plaintiff's medical negligence claims; and (2) plaintiff failed to properly plead its claim that defendant was negligent in its monitoring and supervision.¹ The trial court denied the motion. Defendant renewed the motion for a directed verdict at the close of all evidence, and the trial court again denied it.

On 15 November 2016, the jury returned verdicts finding that decedent's death was caused by defendant's (1) negligence; and (2) negligent performance of administrative duties. The jury awarded plaintiff $6,130,000 in total damages: $680,000 in economic damages and $5,500,000 in non-economic damages. The trial court entered judgment in these amounts. Following the entry of judgment, the trial court entered another order determining that plaintiff was entitled to recover (1) $15,571.53 from defendant in costs; and (2) $417,847.15 in pre- and post-judgment interest.

On 16 December 2016, defendant filed a motion for either judgment notwithstanding the verdict (JNOV) or for a new trial. The trial court denied the motions in orders filed on 19 January 2017. Defendant appealed.

The Court of Appeals reversed in part and vacated in part the orders of the trial court; it also granted a new trial in part. Estate of Savino v. Charlotte-Mecklenburg Hosp. Auth. , 262 N.C. App. 526, 822 S.E.2d 565 (2018). First, the Court of Appeals held that the testimony of plaintiff's expert was insufficient to support the jury's award for pain and suffering. Id. at 557, 822 S.E.2d at 586. As a result—and because the jury's verdict did not allow the court to determine which portion of the non-economic damages consisted of the pain and suffering damages—the Court of Appeals remanded for a new trial on non-economic damages. Second, the Court of Appeals held that plaintiff did not sufficiently plead "administrative negligence." Id. at 534, 822 S.E.2d at 572. Specifically, it concluded that the allegations in the 2016 Complaint "were not sufficient to put defendant on notice of a claim of administrative negligence" and thus, "the trial court erred in allowing plaintiff to proceed on an administrative negligence theory in the medical malpractice action." Id. at 541, 822 S.E.2d at 576. However, the Court of Appeals held that the jury's verdict was not tainted by plaintiff being allowed to proceed on the administrative negligence theory, and thus that no new trial was required on this issue. Id. at 549–50, 822 S.E.2d at 581. Finally, the Court of Appeals held that the trial court did not err in granting a directed verdict to plaintiff on the issue of contributory negligence because Mr. Savino did not have "an affirmative duty to report that EMS gave him medication in the ambulance." Id. at 558–559, 822 S.E.2d at 586.

For the reasons discussed herein, we modify and affirm in part, and reverse in part, the decision of the Court of Appeals.

Analysis

On the issues presented by plaintiff, we conclude that (1) the Court of Appeals erred by reversing the trial court's denial of defendant's motion for a directed verdict on pain and suffering damages; and (2) plaintiff properly pled a medical negligence claim, but did not allege a separate claim for administrative negligence. On the issues presented by defendant, we conclude that (1) defendant is not entitled to a new trial; and (2) the trial court did not err by granting plaintiff's motion for a directed verdict on contributory negligence.

I. Standard of Review

The standard of review for a motion for directed verdict and a motion for judgment notwithstanding the verdict (JN...