Wells v. Storey

• Decision Date: 24 November 1999
• Parties: Teresa Gail WELLS v. Dr. Robert STOREY et al.
• Court: Alabama Supreme Court

792 So.2d 1034

Teresa Gail WELLS v. Dr. Robert STOREY et al.

1970450.

Supreme Court of Alabama.

November 24, 1999.

James C. Alison, Huntsville; and J. Allen Brinkley of Brinkley & Chesnut, Huntsville, for appellant.

Robert L. Williams of Spain & Gillon, L.L.C., Birmingham, for appellees Health Care Authority of the City of Huntsville, Alabama d/b/a Huntsville Hospital, Dr. Robert Storey, and Dr. Timothy Corbin.

James E. Davis, Jr., and Jeffrey T. Kelly of Lanier Ford Shaver & Payne, P.C., Huntsville, for appellees Huntsville Hospital, Donna Freedman Groce, and Sharon Arnold.

Michael A. Florie and Joseph S. Miller of Starnes & Atchison, L.L.P., Birmingham, for appellee Dr. Jess Power.

Dorothy A. Powell and Mark W. Lee of Parsons, Lee & Juliano, P.C., Birmingham, for amici curiae Alabama Hospital Ass'n Trust and Alabama Hospital Ass'n.

BROWN, Justice.

Teresa Gail Wells, the plaintiff in a medical-malpractice action, appeals from a summary judgment entered in favor of Drs. Robert Storey and Timothy Corbin; Huntsville Hospital; and nurses Donna Freedman Groce and Sharon Arnold; and she also appeals from a partial summary judgment entered in favor of Dr. Jess Power. We affirm.

On September 19, 1994, Wells was admitted to Huntsville Hospital. Wells contends that she was admitted for the induction of labor, while the defendants here on appeal assert that Wells was in the early stages of labor. Wells's prenatal care had been managed by the Family Practice Department of the University of Alabama in Huntsville ("UAH"). Wells was admitted by Donna Groce, a nurse employed by Huntsville Hospital. Nurse Groce obtained Wells's signature on an "Authorization for Procedure" form. At approximately 6:00 a.m. on September 20, 1994, Dr. Corbin, a resident physician employed by the UAH family-practice program, determined that Wells was in active labor, and he sent her to the delivery room. Nurse Arnold, the labor and delivery nurse who initially assisted Dr. Corbin, telephoned Dr. Power, the hospital's on-duty anesthesiologist, and reported to him that Wells was requesting an epidural anesthetic for labor pain.¹ Dr. Power then administered the epidural anesthetic to Wells. After administering the epidural, Dr. Power rotated off call and left the hospital. He did not see Wells as a patient again.

Nurse Arnold and Dr. Corbin, with the help of Dr. Storey, an attending physician employed by the UAH family-practice program, delivered Wells's child, her third, a healthy baby boy. After doing a post-delivery checkup, which included an examination of the spinal region where the epidural anesthetic had been inserted, Dr. Corbin discharged Wells from the hospital on the afternoon of September 22, 1994.

Wells returned to the hospital in an ambulance on September 23, 1994. She complained of back pain and pain in her right leg with numbness and tingling, and she had a fever of 99.8 degrees. The emergency-room physician noted that she was three days postpartum, that an epidural had been administered, and that she had a history of lumbar-disc rupture. The emergency room diagnosis was "lumbar radiculapathy; s/p epidural block; and morbid obesity." Wells was discharged without treatment. The discharge instructions were bed rest, gentle heat, and weight loss.

On September 26, 1994, Wells again returned to the hospital by ambulance, complaining of severe back pain and paralysis. Dr. Joel Pickett, a neurologist, examined Wells. He found and drained an epidural abscess from the lumbar area of the spinal cord.² Wells suffered irrevocable nerve damage from the abscess, and the result was permanent paralysis from the waist down.

Thereafter, Wells filed a medical-malpractice action against the aforementioned hospital, physicians, and nurses. Wells alleged that her physicians had violated the medical standard of care each owed to her as a patient. She also alleged that, aside from the physicians' duty to obtain her informed consent to the epidural procedure, the hospital and the two nurses also had had a duty to obtain her informed consent and that those defendants had breached that duty.

Each defendant moved for a summary judgment. Following a hearing, the trial court entered three summary judgments: (1) for the hospital and the nurses, on the ground that they had had no independent duty to obtain informed consent from Wells before she underwent a medical procedure; (2) for Drs. Storey and Corbin on the grounds that they were immune from suit, on the basis that at the time of the actions made the basis of Wells's claims they were employees of the UAH Family Practice Residency Program and were engaging in discretionary functions; and (3) for Dr. Power on all claims other than the claim regarding his alleged failure to obtain informed consent. Each of the three summary judgments was certified as final, pursuant to Rule 54(b), Ala.R.Civ.P.

I.

Wells contends that the trial court erred in entering the summary judgment in favor of Huntsville Hospital and nurses Groce and Arnold against her claim that they had breached the appropriate standard of care by failing to obtain her informed consent.

Our review of a summary judgment is de novo.

"In reviewing the disposition of a motion for summary judgment, `we utilize the same standard as the trial court in determining whether the evidence before [it] made out a genuine issue of material fact,' Bussey v. John Deere Co., 531 So.2d 860, 862 (Ala.1988), and whether the movant was `entitled to a judgment as a matter of law,' Wright v. Wright, 654 So.2d 542 (Ala.1995); Rule 56(c), Ala.R.Civ.P. When the movant makes a prima facie showing that there is no genuine issue of material fact, the burden shifts to the nonmovant to present substantial evidence creating such an issue. Bass v. SouthTrust Bank of Baldwin County, 538 So.2d 794, 797-98 (Ala.1989). Evidence is `substantial' if it is of `such weight and quality that fair-minded persons in the exercise of impartial judgment can reasonably infer the existence of the fact sought to be proved.' Wright, 654 So.2d at 543 (quoting West v. Founders Life Assurance Co. of Florida, 547 So.2d 870, 871 (Ala. 1989)). Our review is further subject to the caveat that this Court must review the record in a light most favorable to the nonmovant and must resolve all reasonable doubts against the movant. Wilma Corp. v. Fleming Foods of Alabama, Inc., 613 So.2d 359 (Ala.1993); Hanners v. Balfour Guthrie, Inc., 564 So.2d 412, 413 (Ala.1990)."

Hobson v. American Cast Iron Pipe Co., 690 So.2d 341, 344 (Ala.1997).

Wells's admitting nurse was Donna Groce. As part of the admission process, Groce obtained Wells's signature on a form entitled "Huntsville Hospital Authorization for Procedure." This form stated, in pertinent part:

"I, the undersigned hereby authorize Dr. ____________ and any designated assistants, to perform the following procedure(s) Vaginal Delivery Epidural Anesthesia and any such additional procedure(s) as are considered necessary on the basis of findings during the course of said procedure(s). I also consent to the administration of local anesthetics as necessary. This Authorization for Procedure and the possible alternative modes of treatment have been explained to me by my physician. The risks, dangers and possible complications of the procedure(s) have been carefully, fully and satisfactorily explained to me by my physician, and no guarantee or assurance has been made as to the results that may be obtained."

(Groce deposition, plaintiff's exhibit 1.)

During her deposition, Groce testified that the phrases "Vaginal Delivery" and "Epidural Anesthesia" were stamped onto the form before Wells signed it. Wells, however, disputed Groce's testimony, claiming that there was nothing stamped on the form when she signed it. Wells also testified that neither Nurse Groce nor Nurse Arnold, who assisted with the delivery, explained to Wells the risks associated with epidural anesthesia. Wells argues that this Court should create an independent duty that would require a hospital and its nurses to obtain informed consent from a patient for a medical procedure before a physician performs the procedure. We disagree.

Section 6-5-484, Ala.Code 1975, sets out the standard of care owed to a patient:

"(a) In performing professional services for a patient, a physician's, surgeon's, or dentists's duty to the patient shall be to exercise such reasonable care, diligence and skill as physicians, surgeons, and dentists in the same general neighborhood, and in the same general line of practice, ordinarily have and exercise in a like case. In the case of a hospital rendering services to a patient, the hospital must use that degree of care, skill, and diligence used by hospitals generally in the community.

"(b) Neither a physician, a surgeon, a dentist nor a hospital shall be considered an insurer of the successful issue of treatment or service."

In Fain v. Smith, 479 So.2d 1150, 1152 (Ala.1985), this Court recognized a duty on the part of a physician to inform his patient of all material risks associated with a medical procedure, noting that a physician may be held liable if he negligently performs that duty. This Court stated, "We think the legislature has adopted the traditional view that the doctor's duty to get the informed consent of the patient must be measured by a professional medical standard." Id.

Although the question whether nurses and hospitals have an independent duty to obtain the informed consent of a patient is a question of first impression in this state, approximately one-half of the states have addressed this issue. In those states, the courts have uniformly held that the duty to obtain a patient's informed consent rests solely with the patient's physician, rather than with a hospital or its nurses (unless, because of special circumstances, the physician is an agent for the hospital). Krane v. Saint Anthony Hosp. Systems, 738 P.2d 75, 77 (Colo.App.1987); ...