There may be no other single hospital event that causes more debate among the courts than patients falling off of beds and gurneys. Rails up or rails down.
Sometimes it is the hospital asserting that the fall should be judged under the rules of professional negligence, not ordinary negligence. In other cases, a hospital has asserted the opposite. A common thread is a plaintiff’s lawsuit that is filed too late under one theory, but timely under the other. Other implications include whether expert testimony will be required and whether non-economic damages will be limited under California’s Medical Injury Compensation Reform Act (MICRA).
The California Supreme Court now will attempt to bring some clarity to the issue with its decision to review a recent entry to the debate, Flores v. Presbyterian Intercommunity Hospital.
Catherine Flores alleges that she injured her left knee and elbow when her hospital bed rail collapsed, sending her to the floor. Nearly two years later, she sued the hospital for general negligence and premises liability. The hospital fought the pleadings by asserting that Ms. Flores’ allegations involved professional activity and that the suit should be dismissed under MICRA’s one-year deadline to sue for medical negligence. “The alleged negligence was an integral part of the professional services being rendered to plaintiff,” the hospital reasoned concerning the collapsed rail.
The plaintiff countered that she was the victim of ordinary negligence. “No negligence was committed in assessing the condition of plaintiff and in failing to raise siderails,” her attorney argued. “That medical assessment had already been made and a medical decision to raise the siderails had been made. As such . . . there was no professional negligence.” It was only after the rendition of all professional services that the rail collapsed, the attorney argued.
The trial court judge agreed with the hospital and dismissed the plaintiff’s suit, but the Los Angeles-based Second District Court of Appeal disagreed. In a published decision, the court surveyed the myriad cases decided over the years by California courts – with many an appellate court criticizing the prior holding of another. One case from 1974, Gopaul v. Herrick Memorial Hospital, found a patient’s fall from a gurney while unstrapped was ordinary negligence because “the need to strap plaintiff to the gurney while she was ill and unattended would have been obvious to all. The situation required no professional ‘skill, prudence and diligence.’”
Another case, decided five years later, arrived at an opposite conclusion. In Murillo v. Good Samaritan Hospital, the Court of Appeal found that a patient with lower-back shingles who fell out of her bed and was injured could maintain an action for professional negligence. “The question whether it was negligent to leave the bedrails down during the night while plaintiff was asleep is a question involving the hospital’s duties to recognize the condition of patients under its care and to take appropriate measures for their safety,” the Murillo court said. “Thus, the question is squarely one of professional negligence. . . .”
The most recent case, Flores, is different, the Court of Appeal reasoned, because the prior cases involved injuries from alleged failures to properly secure or supervise patients. Here, the court pointed out, the claim stems from an alleged equipment failure – the collapsed rail – and thus will turn on whether the hospital used reasonable care in maintaining its premises and inspecting its equipment.
Patients, judges, hospitals, and attorneys should hope for definitive guidelines from the Supreme Court as it weighs the Flores case. The lower courts have tried long enough to find their own way on falling patients.
If you have questions about this article, please contact us. This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.