HARRISBURG – The Superior Court of Pennsylvania has upheld a Bradford County court’s ruling to grant summary judgment dismissal to a hospital faced with litigation after a patient fell from a bedside toilet and allegedly suffered serious injuries.
Superior Court Judge Correale F. Stevens issued a memorandum opinion to that effect on Aug. 7, in Marcia Wandell’s suit against Robert Packer Hospital.
The suit, initially filed in 2018, described that when Wandell was a patient at the hospital in April 2016, she was using a bedside commode when it broke, and, as a result, she fell to the ground, thus sustaining serious and permanent injuries.
Wandell claimed that Robert Packer employed Christine Mead, RN, who was the assigned nurse at the time of the incident, and that she was obligated to conform to the standard of care required of medical agents/employees of Robert Packer – but added that Nurse Mead deviated from this standard of care.
Wandell alleged injuries including a herniated cervical disc, rotator cuff tear to her right shoulder, right hip pain and aggravation of pre-existing cervical pain. Her case included counts of professional/corporate negligence and vicarious liability.
But the hospital filed counterclaims to Wandell’s suit, arguing that her April 2016 stay was for “kidney stones, as well as a possible renal cortical mass, and she had a ureteral stent placed during surgery on that date…at the time of her admission, [Wandell] had pre-existing disc problems due to a motor vehicle accident in 2000, [plus] inner ear problems and post-traumatic headaches from a motor vehicle accident in 2013.”
“Robert Packer alleged that, on April 22, 2016, prior to appellant’s surgery, the nursing staff assessed appellant and initially found her to be low risk on the fall protocol scale. She was walking independently and with no mobility limitations. However, after appellant reported taking two or more medications that increased the risk of falling, the nursing staff changed her assessment to a moderate risk fall protocol. After the surgery on April 22, 2016, appellant was assessed to be high risk on the fall protocol scale, and appropriate precautions in accordance with Robert Packer’s policies were put into place,” Stevens said.
“Robert Packer averred that, contrary to appellant’s assertion, an eyewitness reported that, while the bedside commode broke, appellant did not fall to the floor. Rather, she remained in the frame of the seat. Robert Packer averred appellant’s claims of falling from the bedside commode onto the ground, and sustaining injury therefrom, were fraudulent.”
The hospital asserted that Wandell’s claims “involve issues of corporate hospital and nursing care beyond the knowledge of a layperson, and, thus, she was required to produce a medical expert to establish the elements of duty, breach, causation, and damages.”
The trial court agreed and held that “appellant’s claims of professional corporate negligence and vicarious liability required expert testimony to establish the applicable standard of care and the deviation therefrom” – thus, granting the hospital’s summary judgment motion on Nov. 23, 2022.
Wandell appealed from the trial court’s ruling; however, the Superior Court quashed the appeal, because the trial court had not disposed of Robert Packer’s counterclaim for statutory insurance fraud.
Thereafter, on Oct. 16, 2023, the trial court approved a stipulation dismissing Robert Packer’s counterclaim, and on Nov. 6, 2023, Wandell filed a timely appeal from the final order. The trial court did not order Wandell to file a Pennsylvania Rule of Appellate Procedure 1925(b) statement, and, consequently, no such statement was filed. On Nov. 22, 2023, the trial court filed a brief Rule 1925(a) opinion.
“We find no abuse of discretion or error of law. Appellant suggests that Robert Packer’s corporate negligence, as well as vicarious liability for the nursing staff’s alleged negligence, may be presumed solely because the nurse left the room while she was using the bedside commode, which then broke. However, as indicated supra, as it relates to the claim of corporate negligence, Robert Packer’s omissions/actions must be ‘measured against what a reasonable hospital under similar circumstances should have done,” Stevens said.
“For example, what are the reasonable hospital standards regarding the inspection or maintenance of bedside commodes, the policies for nursing staff regarding assisting a patient such as appellant while she uses the bedside commode, and the policies regarding the use of bedside commodes vs. regular toilets for a patient such as appellant? Similar to the trial court, we conclude these issues relate to the accepted standard of care (i.e., what a reasonable hospital under similar circumstances should have done), as well as whether Robert Packer deviated from the standard of care. Moreover, similar to the trial court, we conclude these inquiries are not so obvious or within the knowledge of laypeople so as to obviate the need for expert testimony.”
Stevens held that “a qualified witness would be necessary to explain to a jury the impact of appellant’s medical condition on her ability to use the bedside commode without assistance, use the call button to signal the nurse when she was finished using the bedside commode, and react appropriately when the bedside commode broke.”
“Further, expert testimony would have been necessary to determine whether a patient in appellant’s condition should have been taken to the restroom instead of using the bedside commode. Simply put, specialized knowledge was needed to assess the risk of potential fall posed by the use of the bedside commode without supervision given appellant’s medical history and current health,” Stevens said.
“Thus, we conclude that, based on the cause of action of vicarious liability as pled in appellant’s complaint, as well as the discovery provided with regard to the cause of action, ‘the matter under investigation’ is not so simple, and the want of care is not so obvious as ‘to be within the range of the ordinary experience and comprehension of even non-professional persons.”
Stevens was joined in his opinion by fellow Superior Court judges Judith Ference Olson and Deborah A. Kunselman.
Superior Court of Pennsylvania case 1532 MDA 2023
Bradford County Court of Common Pleas case 2018-CV-0090
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at nick.malfitano@therecordinc.com