Szymborski v. Spring Mountain Treatment Ctr., 66398

Citation403 P.3d 1280
Decision Date26 October 2017
Docket NumberNo. 66398,66398
Parties Lee E. SZYMBORSKI, Appellant, v. SPRING MOUNTAIN TREATMENT CENTER; and Darryl Dubroca, in his official capacity, Respondents.
CourtSupreme Court of Nevada

Garman Turner Gordon LLP and Eric R. Olsen, Las Vegas, for Appellant.

Hall Prangle & Schoonveld, LLC, and Tyson J. Dobbs and Michael E. Prangle, Las Vegas, for Respondents.

BEFORE PICKERING, HARDESTY and PARRAGUIRRE, JJ.

OPINION

By the Court, PICKERING, J.:

This is an appeal from a district court order dismissing a complaint against a medical treatment center for failure to attach a medical expert affidavit pursuant to NRS 41A.071. The district court determined that the allegations in appellant's complaint regarding the discharge of his son from respondent's treatment center were for medical malpractice, and because appellant did not attach a medical expert affidavit, his complaint required dismissal under NRS 41A.071. Appellant contends that the district court erred in dismissing his complaint because his claims are based in ordinary negligence, not medical malpractice, and therefore, an affidavit was not required. We agree as to appellant's claims for negligence, social-worker malpractice, gross negligence, negligence per se, and negligent hiring, supervision, and training, and disagree as to his claim for professional negligence. We therefore affirm in part, reverse in part, and remand.

I.

We accept as true the following facts alleged in appellant's complaint: Appellant Lee Szymborski's (Szymborski) adult son, Sean Szymborski (Sean), was admitted to Spring Mountain Treatment Center (Spring Mountain) for care and treatment due to self- inflicted wounds

. When it came time to discharge Sean, licensed social workers undertook the discharge planning, but also delegated some tasks to a Masters of Arts (MA). Szymborski and Sean had a turbulent relationship, and Sean was discharged with diagnoses of psychosis and spice abuse. A social worker documented that Szymborski directed a case manager not to release Sean to Szymborski's home upon discharge and that the case manager would help Sean find alternative housing. Spring Mountain nurses also documented that Sean did not want to live with his father, noting that he grew agitated when talking about his father and expressed trepidation about returning to his father's home. Due to this ongoing conflict, Sean participated in treatment planning to find housing independent of Szymborski.

On the day of Sean's release, an MA met with Sean to confirm the address of the apartment where Sean planned to live upon discharge. The MA noted, and Sean's continuing patient care plan confirmed, that Sean was vague about the apartment's address and wanted to stop at his father's house first to retrieve his debit card before going to his own apartment. The MA and case manager never verified that Sean had arranged to live elsewhere, and informed Sean that they would only give him enough money to take a taxi to his father's home. Spring Mountain did not inform Szymborski that they were releasing Sean, nor did they inform him that they were sending Sean to his residence that day. After being dropped off, Sean vandalized Szymborski's home, causing $20,000 in property damage, then disappeared until his arrest three weeks later. Szymborski was not home when Sean arrived.

Szymborski then filed a complaint with the State of Nevada Department of Health and Human ServicesDivision of Public and Behavioral Health (Division) about Sean's discharge and Spring Mountain's disregard of the discharge planning obligations imposed on it by NAC 449.332. After investigation, the Division issued a report crediting Szymborski's claims and finding that Spring Mountain committed multiple violations of NAC 449.332.

In his complaint, Szymborski asserted four claims against Spring Mountain, its CEO, Daryl Dubroca, and various social workers and MAs (collectively, Spring Mountain): negligence (count I); professional negligence (count II); malpractice, gross negligence, negligence per se (count III); and negligent hiring, supervision, and training (count IV). Szymborski attached the Division's report to his complaint, but not an expert medical affidavit. Spring Mountain moved to dismiss the complaint because Szymborski failed to attach an expert medical affidavit pursuant to NRS 41A.071.1 The district court granted Spring Mountain's motion to dismiss, finding that the claims in the complaint were for medical malpractice and required an expert medical affidavit. Szymborski appeals.

II.

"This court rigorously reviews de novo a district court order granting an NRCP 12(b)(5) motion to dismiss, accepting all of the plaintiff's factual allegations as true and drawing every reasonable inference in the plaintiff's favor to determine whether the allegations are sufficient to state a claim for relief." DeBoer v. Sr. Bridges of Sparks Fam. Hosp., 128 Nev. 406, 409, 282 P.3d 727, 730 (2012). A complaint should only be dismissed for failure to state a claim if "it appears beyond a doubt that it could prove no set of facts, which, if true, would entitle it to relief." Id.at 410, 282 P.3d at 730 (internal quotation marks omitted). In contrast, NRS 41A.071 provides that "[i]f an action for medical malpractice ... is filed in the district court, the district court shall dismiss the action, without prejudice, if the action is filed without a[ ] [medical expert] affidavit."2

A.

Spring Mountain argues that because Szymborski's claims involve employees of a hospital rendering services, the claims must be for medical malpractice and NRS 41A.071's affidavit requirement applies. However, when a hospital performs nonmedical services, it can be liable under principles of ordinary negligence. See DeBoer, 128 Nev. at 411–12, 282 P.3d at 731–32 ("[A] healthcare-based corporation's status as a medical facility cannot shield it from other forms of tort liability when it acts outside of the scope of medicine."). "[U]nder general negligence standards, medical facilities have a duty to exercise reasonable care to avoid foreseeable harm when they furnish nonmedical services." Id.at 412, 282 P.3d at 732. For example, in DeB oer, the district court erred in classifying the patient's claim as one for medical malpractice as opposed to ordinary negligence because the claim "was not related to medical diagnosis, judgment, or treatment." Id.at 408, 282 P.3d at 731–32. Thus, the mere fact that Szymborski's claims are brought against Spring Mountain, a mental health treatment center rendering services, does not mean the claims sound in medical malpractice.

B.

Instead, we must determine whether Szymborski's claims involve medical diagnosis, judgment, or treatment or are based on Spring Mountain's performance of nonmedical services.3 See id. ; see also Gold v. Greenwich Hosp. Ass'n, 262 Conn. 248, 811 A.2d 1266, 1270 (2002) (determining that the plaintiff's complaint was for medical malpractice because the "alleged negligence [was] substantially related to medical diagnosis and involved the exercise of medical judgment"); Gunter v. Lab. Corp. of Am., 121 S.W.3d 636, 640 (Tenn. 2003) ("When a plaintiff's claim is for injuries resulting from negligent medical treatment, the claim sounds in medical malpractice. When a plaintiff's claim is for injuries resulting from negligent acts that did not affect the medical treatment of a patient, the claim sounds in ordinary negligence.") (citation omitted).

Allegations of breach of duty involving medical judgment, diagnosis, or treatment indicate that a claim is for medical malpractice. See Papa v. Brunswick Gen. Hosp., 132 A.D.2d 601, 517 N.Y.S.2d 762, 763 (1987) ( "When the duty owing to the plaintiff by the defendant arises from the physician-patient relationship or is substantially related to medical treatment, the breach thereof gives rise to an action sounding in medical malpractice as opposed to simple negligence."); Estate of French v. Stratford House, 333 S.W.3d 546, 555 (Tenn. 2011) ("If the alleged breach of duty of care set forth in the complaint is one that was based upon medical art or science, training, or expertise, then it is a claim for medical malpractice."), superseded by statute Tenn. Code. Ann. 29–26–101 et seq. (2011), as recognized in Ellithorpe v. Weismark, 479 S.W.3d 818, 824–26 (Tenn. 2015). By extension, if the jury can only evaluate the plaintiff's claims after presentation of the standards of care by a medical expert, then it is a medical malpractice claim. See Bryant v. Oakpointe Villa Nursing Centre, 471 Mich. 411, 684 N.W.2d 864, 872 (2004) ; Humboldt Gen. Hosp. v. Sixth Judicial Dist. Court, 132 Nev. ––––, 376 P.3d 167, 172 (2016) (reasoning that a medical expert affidavit was required where the scope of a patient's informed consent was at issue, because medical expert testimony would be necessary to determine the reasonableness of the health care provider's actions).

If, on the other hand, the reasonableness of the health care provider's actions can be evaluated by jurors on the basis of their common knowledge and experience, then the claim is likely based in ordinary negligence. See Bryant, 684 N.W.2d at 872.

C.

The distinction between medical malpractice and negligence may be subtle in some cases, and parties may incorrectly invoke language that designates a claim as either medical malpractice or ordinary negligence, when the opposite is in fact true. See Weiner v. Lenox Hill Hosp., 88 N.Y.2d 784, 650 N.Y.S.2d 629, 673 N.E.2d 914, 916 (1996) ("[M]edical malpractice is but a species of negligence and no rigid analytical line separates the two.") (internal quotation marks omitted). Given the subtle distinction, a single set of circumstances may sound in both ordinary negligence and medical malpractice, and an inartful complaint will likely use terms that invoke both causes of action, particularly where, as here, the plaintiff is proceeding pro se in district court. See Mayo v. United States, 785...

To continue reading

Request your trial
36 cases
  • Trowell v. Providence Hosp. & Med. Ctrs., Inc.
    • United States
    • Supreme Court of Michigan
    • December 6, 2017
    ..., 499 Mich. at 303, 884 N.W.2d 537.37 Maiden , 461 Mich. at 135, 597 N.W.2d 817.38 Szymborski v. Spring Mountain Treatment Ctr. , 403 P.3d 1280, 1285 (Nev. 2017).39 As we noted in Bryant , 471 Mich. at 432-433, 684 N.W.2d 864, "[when] the line between ordinary negligence and medical malprac......
  • U.S. Bank, N.A. v. Thunder Props., Inc.
    • United States
    • Supreme Court of Nevada
    • February 3, 2022
    ...P.2d 359, 361 (1972) (alteration and quotation marks omitted); see also Szymborski v. Spring Mountain Treatment Ctr., 133 Nev. 638, 643, 403 P.3d 1280, 1285 (2017) (recognizing that "the gravamen of the claims rather than the gravamen of the complaint determines statute of limitations issue......
  • S. Nev. Adult Mental Health Servs. v. Brown
    • United States
    • Supreme Court of Nevada
    • November 17, 2021
    ...before he provided the required affidavit. But it held, consistent with Szyniborski v. Spring Mountain Treatment Center , 133 Nov. 638, 403 P.3d 1280 (2017), that the FAC was not founded exclusively on allegations of medical malpractice but on ordinary negligence as well and that, since cla......
  • Fitzpatrick v. Las Vegas Metro. Police Dep't
    • United States
    • United States District Courts. 9th Circuit. United States District Courts. 9th Circuit. District of Nevada
    • February 3, 2020
    ...Id.; Washoe Med. Ctr. v. Second Judicial Dist. Court, 148 P.3d 790, 794 (Nev. 2006). 85. Szymborski v. Spring Mountain Treatment Ctr., 403 P.3d 1280, 1288 (Nev. 2017); DeBoer v. Sr. Bridges of Sparks Fam. Hosp., 282 P.3d 727, 731-32 (Nev. 2012). 86. Szymborski, 403 P.3d at 1284. 87. Id. at ......
  • Request a trial to view additional results

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT