Case Title: DENISE BRYANT V OAKPOINTE VILLA NURSING CENTRE INC

Citation: 

Docket Number: 121723

State: michigan

Court: Michigan Supreme Court

Date: 2004-07-30T00:00:00Z

Document:
_______________________________ 
 
 
 
 
 
 
 
 
 
Michigan Supreme Court 
Lansing, Michigan 
Chief Justice:  
Justices: 
Maura D. Corrigan  
Michael F. Cavanagh 
Elizabeth A. Weaver 
Marilyn Kelly 
Opinion 
Clifford W. Taylor 
Robert P. Young, Jr. 
Stephen J. Markman 
FILED JULY 30, 2004 
DENISE BRYANT, Personal Representative
of the Estate of Catherine Hunt, Deceased, 
Plaintiff-Appellee, 
v 
 
 
 
 
 
 
Nos. 121723, 121724 
OAKPOINTE VILLA NURSING CENTRE, 
Defendant-Appellant. 
BEFORE THE ENTIRE BENCH 
MARKMAN, J. 
In this case, plaintiff, Denise Bryant, personal 
representative 
of 
the 
estate 
of 
her 
deceased 
aunt, 
Catherine Hunt, alleges that defendant Oakpointe Villa 
Nursing Centre, Inc. (Oakpointe), is liable for the death 
of her aunt, who died from positional asphyxiation while in 
defendant’s care. Plaintiff has alleged that defendant was 
negligent in four distinct ways: (1) by failing to provide 
“an accident-free environment” for her aunt; (2) by failing 
to train its Certified Evaluated Nursing Assistants (CENAs) 
to 
recognize 
and 
counter 
the 
risk 
of 
positional 
asphyxiation posed by bed rails; (3) by failing to take 
adequate 
corrective 
measures 
after 
finding 
Ms. 
Hunt 
 
 
 
 
 
entangled 
in 
her 
bedding 
on 
the 
day 
before 
her 
asphyxiation; and (4) by failing to inspect plaintiff’s bed 
arrangements to ensure “that the risk of positional 
asphyxia did not exist for plaintiff’s decedent.” 
We are 
required in this appeal to determine whether each claim 
sounds in medical malpractice or ordinary negligence. 
Plaintiff’s “accident-free environment” claim is one 
of strict liability; because medical malpractice requires 
proof of negligence, this claim is not legally cognizable. 
Moreover, under the standards set forth in Dorris v Detroit 
Osteopathic Hosp Corp, 460 Mich 26; 594 NW2d 455 (1999), 
plaintiff’s failure-to-train and failure-to-inspect claims 
sound in medical malpractice. 
Plaintiff’s claim that 
defendant failed to take action after its employees found 
Ms. Hunt entangled in her bedding on the day before her 
asphyxiation, however, sounds in ordinary negligence. 
We reverse the judgment of the Court of Appeals and 
remand this case to the Wayne Circuit Court for proceedings 
on plaintiff’s claim of ordinary negligence and, given the 
equities in this case, on her two medical malpractice 
claims as well. 
I. BACKGROUND 
Plaintiff’s decedent, Catherine Hunt, was a resident 
2  
 
 
 
 
 
  
                                                 
 
 
 
 
 
of Oakpointe. She suffered from multi-infarct dementia1 and 
diabetes, had suffered several strokes, and required 
twenty-four-hour-a-day care for all her needs, including 
locomotion, 
dressing, 
eating, 
toileting, 
and 
bathing. 
Hunt’s condition impaired her judgment and reasoning 
ability and, in turn, caused cerebral atrophy. Hunt had no 
control over her locomotive skills and was prone to sliding 
about uncontrollably and, therefore, she was at risk for 
suffocation by “positional asphyxia.”2 
Because Hunt had no control over her locomotive 
skills, Dr. Donald Dreyfuss, defendant’s medical director, 
1 According to Tabers Cyclopedic Medical Dictionary
(2002), “dementia” constitutes 
progressive, 
irreversible 
decline 
in 
mental 
function, marked by memory impairment and, often,
deficits 
in 
reasoning, 
judgment, 
abstract 
thought, registration, comprehension, learning, 
task execution, and use of language. 
The 
cognitive impairments diminish a person’s social,
occupational, and intellectual abilities. 
“Multi-infarct dementia” constitutes 
[d]ementia 
resulting 
from 
multiple 
small 
strokes. . . .  The cognitive deficits of multi­
infarct dementia appear suddenly, in “step-wise”
fashion. 
The disease is . . . most common in 
patients with hypertension, diabetes mellitus, or
other 
risk 
factors 
for 
generalized
atherosclerosis. 
Brain imaging in patients with
this form of dementia shows multiple lacunar 
infarctions. [Id.] 
2 “Positional asphyxia refers to suffocation that 
results 
when 
someone’s 
position 
prevents 
them 
from 
breathing properly. 
See  (accessed July 27, 2004). 
3  
 
 
 
   
 
                                                 
 
 
authorized the use of various physical restraints. 
These 
included bed rails to keep Hunt from sliding out of the 
bed, as well as a restraining vest that kept her from 
moving her arms, thereby impeding her ability to slide. 
The authorized restraints also included wedges or bumper 
pads that were placed on the outer edge of the mattress to 
keep her from hurting herself by striking, or entangling 
hereself in, the rails. The use of restraints of this sort 
is regulated by the state of Michigan to prevent overuse 
and excessive patient confinement, and must be authorized 
by a physician.3 
Several persons cared for Hunt on a twenty-four-hour 
basis, including registered nurses, practical nurses, and 
nursing assistants (CENAs). 
On March 1, 1997, nursing 
assistants Monee Olds and Valerie Roundtree noticed that 
Hunt was lying in her bed very close to the bed rails and 
3 
MCL 
333.20201(2)(l) 
specifies, 
with 
regard 
to 
restraints generally, that “[a] patient or resident is
entitled to be free from mental and physical abuse and from
physical and chemical restraints, except those restraints
authorized in writing by the attending physician for a
specified and limited time . . . .” Regarding bed rails in
particular, MCL 333.21734(1) provides, in relevant part: 
A nursing home shall provide bed rails to a
resident only upon receipt of a signed consent 
form authorizing bed rail use and a written order
from the resident's attending physician that 
contains statements and determinations regarding
medical 
symptoms 
and 
that 
specifies 
the 
circumstances under which bed rails are to be 
used. 
4  
 
 
 
 
   
 
                                                 
was tangled in her restraining vest, gown, and bedsheets. 
They untangled her from her vest and gown and attempted to 
position bed wedges onto decedent’s bed to prevent her from 
slipping into a gap that existed between the mattress and 
bed rail. 
The nursing assistants testified that they 
informed their supervisor that the wedges were not sticking 
properly and kept falling off, and that better care should 
be taken in that regard for all patients or else the 
patients could hurt or even fatally injure themselves.4 
The next day, March 2, 1997, Hunt slipped between the 
rails of her bed and was in large part out of the bed with 
the lower half of her body on the floor but her head and 
neck under the bed side rail and her neck wedged in the gap 
between the rail and the mattress, thus preventing her from 
breathing. 
When Hunt was extricated, she was transported 
to a hospital. 
There was no recovery and, on March 4, 
1997, she was taken off life support and died. 
The cause 
of her death was listed as positional asphyxia. 
Plaintiff filed a suit alleging ordinary negligence 
against defendant in the Wayne Circuit Court in April 1998. 
In May 1998, defendant moved for summary disposition 
pursuant to MCR 2.116(C)(4) and (C)(8), on the basis that 
plaintiff’s claims sounded in medical malpractice rather 
4 Whether the CENAs actually made the report, as
plaintiff notes in its brief to this Court, is in dispute. 
5  
 
 
 
 
 
 
 
than ordinary negligence. 
In August 1998, Judge Pamela 
Harwood 
ruled 
that 
plaintiff’s 
complaint 
sounded 
in 
ordinary negligence and allowed the case to proceed. 
In 
January 1999, Judge Harwood recused herself from the case 
and it was reassigned to Judge John Murphy. 
In 
June 
1999, 
plaintiff 
filed 
a 
first 
amended 
complaint still alleging ordinary negligence. It contained 
three counts. 
These were, first, ordinary negligence “by 
and 
through” 
defendant’s 
employees 
generally; 
second, 
negligent infliction of emotional distress; and third, 
gross 
negligence 
by 
defendant’s 
employees 
generally. 
Plaintiff’s “ordinary negligence” count—the claim at issue 
in this appeal—contained four distinct claims against 
defendant: 
(a) Negligently and recklessly failing to
assure that plaintiff’s decedent was provided
with an accident-free environment; 
(b) Negligently and recklessly failing to
train CENAs to assess the risk of positional
asphyxia by plaintiff’s decedent despite having
received specific warnings by the United States
Food and Drug Administration about the dangers of
death caused by positional asphyxia in bed rails; 
(c) Negligently and recklessly failing to
take steps to protect plaintiff’s decedent when
she was, in fact, discovered on March 1 entangled
between the bed rails and the mattress; 
(d) Negligently and recklessly failing to
inspect the beds, bed frames and mattresses to
assure that the risk of positional asphyxia did
not exist for plaintiff’s decedent. 
6  
 
 
  
 
 
 
                                                 
In October 1999, defendant again moved for summary 
disposition on the basis that plaintiff’s new claims of 
ordinary 
negligence, 
in 
fact, 
sounded 
in 
medical 
malpractice. 
Unlike Judge Harwood, Judge Murphy, in June 
2000, agreed with defendant and ruled that plaintiff’s 
“ordinary negligence” count sounded in medical malpractice.5 
In addition, he ruled that, although ordinary negligence 
claims could be brought against the nursing assistants 
individually, these claims had not properly been pleaded. 
The court therefore dismissed the complaint in its entirety 
without prejudice. 
Plaintiff appealed the dismissal to the Court of 
Appeals. 
Meanwhile, however, seeking to comply with Judge 
Murphy’s decision, plaintiff, in August 2000, filed a 
notice of intent to sue in medical malpractice pursuant to 
MCL 600.2912b and, in February 2001, refiled her case, 
filing 
a 
second 
amended 
complaint 
alleging 
medical 
malpractice. 
Defendant again brought a motion to dismiss 
pursuant to 2.116(C)(7), on the basis that the two-year 
medical malpractice period of limitations had expired. 
Judge Murphy, in June 2001, disagreed and held that the 
period of limitations was tolled when Judge Harwood issued 
5 
The 
trial 
court 
found 
that 
this 
case 
was 
indistinguishable from Starr v Providence Hosp, 109 Mich
App 762; 312 NW2d 152 (1981), and Waatti v Marquette Gen
Hosp, Inc, 122 Mich App 44; 329 NW2d 526 (1982). 
7  
 
 
 
   
 
 
                                                 
 
her August 1998 decision until that decision was reversed 
by himself in June 2000. 
Defendant appealed this decision 
to the Court of Appeals. 
The Court of Appeals consolidated plaintiff’s appeal 
from Judge Murphy’s June 2000 decision with defendant’s 
appeal from his June 2001 decision. 
The Court of Appeals 
held in plaintiff’s favor, finding that the case sounded in 
ordinary negligence.6  The Court recognized that, having so 
held, the issue regarding the tolling of the period of 
limitations was moot. 
However, the Court concluded, in 
dictum, that if plaintiff’s claim had sounded in medical 
malpractice, Scarsella v Pollak, 461 Mich 547; 607 NW2d 711 
(2000), 
would 
require 
its 
dismissal 
with 
prejudice. 
Defendant appealed the Court of Appeals decision that 
plaintiff’s case sounded in ordinary negligence, and we 
granted leave to appeal in this case and in Lawrence v 
Battle Creek Health Systems, 468 Mich 944 (2003), ordering 
that the two cases be argued and submitted together.7 
II. STANDARD OF REVIEW 
In determining whether the nature of a claim is 
ordinary negligence or medical malpractice, as well as 
whether such claim is barred because of the statute of 
6 Unpublished opinion per curiam, issued May 21, 2002
(Docket Nos. 228972, 234992). 
7 468 Mich 943 (2003). 
8  
 
 
 
limitations, a court does so under MCR 2.116(C)(7). 
We 
review such claims de novo. 
Fane v Detroit Library Comm, 
465 Mich 68, 74; 631 NW2d 678 (2001). In making a decision 
under MCR 2.116(C)(7), we consider all documentary evidence 
submitted by the parties, accepting as true the contents of 
the complaint unless affidavits or other appropriate 
documents specifically contradict it. 
Fane, supra; see 
also MCR 2.116(G)(5)-(6). 
III. MEDICAL MALPRACTICE VS. ORDINARY NEGLIGENCE 
The first issue in any purported medical malpractice 
case concerns whether it is being brought against someone 
who, or an entity that, is capable of malpractice. 
In 
addressing this issue, defendant argues that, because MCL 
600.5838a refers to “the medical malpractice of . . . an 
employee or agent of a licensed health facility or agency 
who is engaging in or otherwise assisting in medical care 
and 
treatment,” 
plaintiff’s 
claim 
sounds 
in 
medical 
malpractice 
for 
the 
simple 
reason 
that 
it 
alleges 
negligence committed by an employee of a licensed health 
care facility who was engaging in medical care and 
treatment. In response, we point out that MCL 600.5838a(1) 
is an accrual statute that indicates when a medical 
malpractice cause of action accrues. 
Additionally, as we 
noted in Adkins v Annapolis Hosp, 420 Mich 87, 94-95; 360 
NW2d 
150 
(1984), 
this 
statute 
likewise 
expands 
the 
9  
 
 
 
  
                                                 
 
 
 
 
 
  
traditional common-law list of those who are subject to 
medical malpractice actions.8
 However, we caution that, 
although § 5838a expands the category of who may be subject 
to a medical malpractice action, it does not define what 
constitutes a medical malpractice action.9 
The fact that an 
8 In construing the former MCL 600.5838, in which, in
the context of an accrual statute, the Legislature listed a
wide array of specific health care professionals and 
entities who could potentially be subject to medical 
malpractice, we stated: 
While it is true that [the former] RJA §
5838 is an accrual provision, not a definitional
section, there can be no other meaning of this
language other than that [those health care 
occupations listed in the former § 5838] may be
guilty of malpractice. Otherwise, there would be
no reason to list those occupations in an accrual
section. 
A malpractice action cannot accrue 
against someone who, or something that, is 
incapable of malpractice. 
. . . [The former § 5838] evidenced a 
legislative intent to alter the common law and 
subject other health professionals [as opposed to
physicians 
and 
surgeons 
only] 
to 
potential
liability for malpractice. [Adkins, 420 Mich 94­
95.] 
The former § 5838 was amended by 1986 PA
178, as a result of which, the accrual provision
relevant 
to 
medical 
malpractice 
actions 
was 
reenacted under the current § 5838a. 
Instead of 
listing specific health care professionals and
entities subject to medical malpractice, the 
current § 5838a refers generally to a “licensed
health 
care 
professional, 
licensed 
health 
facility or agency, or an employee or agent of a
licensed 
health 
facility 
or 
agency 
who 
is 
engaging in or otherwise assisting in medical
care and treatment . . . .” 
9 Perhaps complicating an understanding of this body of
law is this Court’s unanimous peremptory order in 1998 in
Regalski v Cardiology Assoc, PC, 459 Mich 891 (1998). 
In 
10  
 
 
 
                                                 
 
 
 
employee of a licensed health care facility was engaging in 
medical care at the time the alleged negligence occurred 
means that the plaintiff’s claim may possibly sound in 
medical malpractice; it does not mean that the plaintiff’s 
claim certainly sounds in medical malpractice. 
The second issue concerns whether the alleged claim 
sounds in medical malpractice. A medical malpractice claim 
is distinguished by two defining characteristics. 
First, 
medical malpractice can occur only “‘within the course of a 
Regalski, we were presented with a case in which the Court 
of Appeals had held that the plaintiff’s claim that the
defendant’s medical technician was negligent in assisting
the patient’s movement out of a wheelchair and onto the
examining table was a matter of ordinary negligence. 
We 
reversed 
and 
concluded 
that 
this 
was 
not 
ordinary
negligence but medical malpractice. 
While the facts of that case were only briefly stated,
we interpret this Court’s Regalski holding to mean that the
facts in that case led to the conclusion that the 
particular assistance rendered to that patient involved a
professional 
relationship 
and 
implicated 
a 
medical 
judgment. 
Even in the wake of Regalski, then, injuries incurred
while a patient is being transferred from a wheelchair to
an examining table (to take one example) may or may not
implicate professional judgment. 
The court must examine 
the particular factual setting of the plaintiff’s claim in
order to determine whether the circumstances—for example,
the 
medical 
condition 
of 
the 
plaintiff 
or 
the 
sophistication required to safely effect the move—implicate
medical judgment as explained in Dorris. 
In citing the medical malpractice accrual statute, MCL
600.5838a(1), in Regalski, we have caused some, including
defendant herein, to venture that we were holding that this
statute 
can 
also 
be 
understood 
as 
defining 
medical 
malpractice. 
This understanding is incorrect for the 
reasons that we have stated. 
11  
 
 
 
 
 
 
professional relationship.’” Dorris, supra at 45 (citation 
omitted). 
Second, 
claims 
of 
medical 
malpractice 
necessarily “raise questions involving medical judgment.” 
Id. at 46. 
Claims of ordinary negligence, by contrast, 
“raise issues that are within the common knowledge and 
experience of the [fact-finder].” 
Id. 
Therefore, a court 
must ask two fundamental questions in determining whether a 
claim sounds in ordinary negligence or medical malpractice: 
(1) whether the claim pertains to an action that occurred 
within the course of a professional relationship; and (2) 
whether the claim raises questions of medical judgment 
beyond the realm of common knowledge and experience. 
If 
both these questions are answered in the affirmative, the 
action is subject to the procedural and substantive 
requirements that govern medical malpractice actions. 
In considering whether there has been a professional 
relationship between the plaintiff and the defendant, 
Dorris is central to our analysis. 
In that case, this 
Court held: 
“‘The key to a medical malpractice claim is 
whether it is alleged that the negligence occurred within 
the course of a professional relationship.’” 
Id. at 45, 
quoting Bronson v Sisters of Mercy Health Corp, 175 Mich 
App 647, 652; 438 NW2d 276 (1989). 
A professional 
relationship sufficient to support a claim of medical 
malpractice exists in those cases in which a licensed 
12  
 
 
 
 
                                                 
 
 
health care professional, licensed health care facility, or 
the agents or employees of a licensed health care facility, 
were subject to a contractual duty that required that 
professional, that facility, or the agents or employees of 
that facility, to render professional health care services 
to the plaintiff. 
See Dyer v Trachtman, 470 Mich 45; 679 
NW2d 311 (2004);10 Delahunt v Finton, 244 Mich 226, 230; 221 
NW 168 (1928) (“Malpractice, in its ordinary sense, is the 
negligent performance by a physician or surgeon of the 
duties devolved and incumbent upon him on account of his 
contractual relations with his patient.”);11 see also Hill v 
Kokosky, 186 Mich App 300, 302-303; 463 NW2d 265 (1990); 
Oja v Kin, 229 Mich App 184, 187; 581 NW2d 739 (1998). 
After ascertaining that the professional relationship 
test is met, the next step is determining whether the claim 
raises questions of medical judgment requiring expert 
10 We held in Dyer that in an action for negligence in
performing an independent medical examination (IME), the
plaintiff’s claim sounded in medical malpractice rather
than ordinary negligence, but that a physician incurred
only a limited form of medical malpractice liability in
performing the IME. 
Id. 
This conclusion was based on the 
contractual relationship between the parties. 
11 When the Delahunt decision was rendered in 1928, 
only physicians and surgeons could be sued in medical
malpractice. See, for example, Kambas v St Joseph’s Mercy
Hosp of Detroit, 389 Mich 249; 205 NW2d 431 (1973).  As 
observed in n 8, the Legislature has since expanded the
common-law list of those who potentially may be subject to
medical malpractice liability. 
See MCL 600.5838a; Adkins,
420 Mich 94-95. 
13  
 
 
 
 
 
 
 
 
testimony or, on the other hand, whether it alleges facts 
within 
the 
realm 
of 
a 
jury’s 
common 
knowledge 
and 
experience. 
If the reasonableness of the health care 
professionals’ action can be evaluated by lay jurors, on 
the basis of their common knowledge and experience, it is 
ordinary 
negligence. 
If, 
on 
the 
other 
hand, 
the 
reasonableness of the action can be evaluated by a jury 
only after having been presented the standards of care 
pertaining to the medical issue before the jury explained 
by experts, a medical malpractice claim is involved. As we 
stated in Dorris: 
The determination whether a claim will be 
held to the standards of proof and procedural
requirements of a medical malpractice claim as
opposed to an ordinary negligence claim depends
on whether the facts allegedly raise issues that
are within the common knowledge and experience of
the 
jury 
or, 
alternatively, 
raise 
questions
involving medical judgment. 
[Dorris, supra at 
46, citing Wilson v Stilwill, 411 Mich 587, 611;
309 NW2d 898 (1981).] 
Contributing to an understanding of what constitutes a 
“medical judgment” is Adkins v Annapolis Hosp, 116 Mich App 
558; 323 NW2d 482 (1982), in which the Court of Appeals 
held: 
[M]edical malpractice . . . has been defined
as the failure of a member of the medical 
profession, 
employed 
to 
treat 
a 
case 
professionally, to fulfill the duty to exercise
that 
degree 
of 
skill, 
care 
and 
diligence
exercised by members of the same profession,
practicing in the same or similar locality, in
light of the present state of medical science. 
14  
 
 
 
 
 
  
 
 
 
                                                 
 
[Citation omitted.] 
IV. ANALYSIS OF ALLEGATIONS 
We now turn to the complaint in the present case.12 
Plaintiff alleges that defendant is liable for: (1) 
negligently failing to assure that plaintiff’s decedent was 
provided with an accident-free environment; (2) negligently 
failing to inspect the bed, bed frame, and mattress to 
assure the plaintiff’s decedent was not at risk of 
suffocation; (3) negligently failing to properly train its 
CENAs 
regarding 
the 
risk 
to 
decedent 
of 
positional 
asphyxiation posed by the bed rails; and (4) negligently 
failing to take steps to protect decedent from further harm 
or injury after discovering her entangled between her bed 
rail and mattress on March 1. 
We address the application 
of Dorris to each of these claims below.13 
A. PROFESSIONAL RELATIONSHIP 
The first question in determining whether these claims 
sound in ordinary negligence or medical malpractice is 
whether there was a professional relationship between the 
12 Because the Court of Appeals majority in this case 
based its decision on plaintiff’s June 1999 first amended
complaint, we will use the claims in that complaint to
analyze this case. 
13 As stated, we address only Count I of plaintiff’s
first amended complaint. 
Counts II and III (negligent
infliction of emotional distress and gross negligence) may
be addressed by the parties on remand in light of our
decision regarding count I. 
15  
 
 
 
 
 
 
allegedly negligent party and the injured party. 
This 
analysis is fairly straightforward and, in this case, is 
identical 
for 
each 
of 
plaintiff’s 
claims. 
Because 
defendant, Oakpointe Villa Nursing Centre, Inc., a licensed 
health 
care 
facility, 
was 
under 
a 
contractual 
duty 
requiring both it and its employees to render professional 
health 
care 
services 
to 
plaintiff’s 
decedent, 
a 
professional relationship existed to support a claim for 
medical malpractice. 
B. 
MEDICAL JUDGMENT VS. LAY KNOWLEDGE 
The second question is whether the acts of negligence 
alleged “raise issues that are within the common knowledge 
and experience of the jury or, alternatively, raise 
questions involving medical judgment.” 
Dorris, supra at 
46. 
1. 
“ACCIDENT-FREE ENVIRONMENT” 
Plaintiff’s first claim is that defendant “fail[ed] to 
assure that plaintiff’s decedent was provided with an 
accident-free environment.” This is an assertion of strict 
liability that is not cognizable in either ordinary 
negligence or medical malpractice. 
With reference to 
ordinary negligence, the test is whether the defendant 
breached a duty that proximately caused an injury to the 
plaintiff. 
See, e.g., Haliw v Sterling Hts, 464 Mich 297, 
309-310; 627 NW2d 581 (2001). 
With reference to medical 
16  
 
 
 
 
malpractice law, the Legislature has directed in MCL 
600.2912a et seq., that negligence is the standard. 
Thus, 
strict 
liability 
is 
inapplicable 
to 
either 
ordinary 
negligence or medical malpractice. 
As a result, because 
this claim is unrecognized in this area of our law, this 
allegation states no claim at all. 
2. 
FAILURE TO TRAIN 
Next, we must determine whether plaintiff’s claim that 
defendant failed to train its staff “to assess the risk of 
potential asphyxia” is one that requires expert testimony 
on medical issues. 
In Dorris at 47, we stated that the 
plaintiff’s allegations “concerning staffing decisions and 
patient 
monitoring 
involve 
questions 
of 
professional 
medical 
management 
and 
are 
not 
issues 
of 
ordinary 
negligence that can be judged by the common knowledge and 
experience of a jury.” 
That is not to say, however, that 
all cases concerning failure to train health care employees 
in the proper monitoring of patients are claims that sound 
in medical malpractice. 
The pertinent question remains 
whether the alleged facts raise questions of medical 
judgment or questions that are within the common knowledge 
and experience of the jury. Id. at 46. 
In Dorris, the staff training and patient monitoring 
issue 
sounded 
in 
medical 
malpractice 
because 
“[t]he 
ordinary layman does not know the type of supervision or 
17  
 
 
 
                                                 
 
 
 
monitoring that is required for psychiatric patients in a 
psychiatric ward.” 
Id. at 47 (emphasis added). 
That is, 
knowing how to correctly monitor psychiatric patients 
requires a specialized knowledge of the complex diseases of 
the mind that may affect psychiatric patients and how those 
diseases may influence their behavior, and such knowledge 
is simply not within the realm of “common knowledge.” 
Similarly, in order to assess the risk of positional 
asphyxiation posed by bed railings, specialized knowledge 
is generally required, as was notably shown by the 
deposition testimony of plaintiff’s own expert, Dr. Steven 
Miles. 
Dr. Miles testified that hospitals may employ a 
number of different bed rails depending on the needs of a 
particular patient.14
 Accordingly, the assessment of 
whether a bed rail creates a risk of entrapment for a 
patient requires knowledge of that patient’s medical 
history 
and 
behavior.15
 
It 
is 
this 
particularized 
14 Deposition Testimony of Dr. Steven Miles (“Well,
first off, there’s no such thing as generic side rails.”). 
15 Dr. Miles testified: 
Q. Okay. 
When you indicated that [Hunt]
required 
assistance 
for 
activities 
of 
daily
living, are all persons who require assistance
for such activities at risk for entrapment? 
A. No. 
As I stated in my previous comment,
that the overall profile is one of being frail
and disabled and having poor judgment and a 
history of impulsive behavior and a history of 
18  
 
 
 
 
 
                                                 
knowledge, according to Dr. Miles, that should prompt a 
treating facility to use the bedding arrangement that best 
suits a patient’s “individualized treatment plan,” and to 
properly train its employees to recognize any risks 
inherent in that bedding arrangement and to adequately 
monitor patients to minimize those risks. 
In 
describing 
the 
appropriate 
arrangement 
for 
plaintiff’s decedent, Dr. Miles testified: 
This patient had a long history of slide and
fall-type injuries, and her entire environment
should 
have 
been 
adjusted 
as 
part 
of 
the 
individualized treatment plan for this. 
And furthermore, the facility had a general
obligation to all of its patients, including Ms.
Hunt, to provide beds that did no prevent—present
a space that was large enough for an entrapment
asphyxiation. 
And 
they 
should 
have 
been 
particularly aggressive in using that type of
equipment for Ms. Hunt. 
This testimony demonstrates that the ability to assess the 
risk of positional asphyxia and, thus, the training of 
employees to properly assess that risk, involves the 
exercise of professional judgment. The picture necessarily 
gets 
more 
complicated 
when 
one 
considers 
additional 
restraint mechanisms used in tandem with bed railing such 
as vests or pelvic restraints to promote the safety of 
patients. 
previous near entrapments. 
These are the people
who are at risk, not the presence of any one of
those. 
19  
 
 
  
                                                 
 
 
Indeed, an article in the Journal of the American 
Geriatrics Society coauthored by plaintiff’s expert, Dr. 
Miles, stresses the need for “clinical and ergonomic 
changes” in the use of bed rails and decries the widespread 
use of bed railings “without . . . a clear sense of their 
role in a treatment plan and without regulatory attention 
to their design.”16  This article concludes with a call for 
nursing homes to limit the use of bedrails, but notes that 
research into the relative costs and benefits of using 
bedrails is “needed urgently.”17 
This much is clear: in order to determine whether 
defendant adequately trained its CENAs to recognize the 
risks posed by particular configurations of bed rails and 
other prescribed restraint systems, therefore, the fact­
finder will generally require expert testimony on what 
specialists in the use of these systems currently know 
about their risks and on how much of this knowledge 
defendant ought to have conveyed to its staff. 
Given the patent need in this case for expert 
testimony regarding plaintiff’s claim of failure to train, 
we conclude that this claim sounds in medical malpractice 
under Dorris. 
16 Kara Parker and Steven H. Miles, Deaths caused by
bedrails, 45 J Am Geriac Soc 797 (1997). 
17 Id., p 799. 
20  
 
 
 
 
 
                                                 
3. 
FAILURE TO INSPECT 
Next, plaintiff alleges that defendant is liable for 
“[n]egligently and recklessly failing to inspect the beds, 
bed frames and mattress to assure that the risk of 
positional 
asphyxia 
did 
not 
exist 
for 
plaintiff’s 
decedent.” 
It is clear from the record in this case that 
plaintiff’s 
“failure 
to 
inspect” 
claim 
is 
not 
that 
defendant and its agents actually failed to check Ms. 
Hunt’s bedding arrangements,18 but that defendant failed to 
recognize that her bedding arrangements posed a risk of 
asphyxiation. 
As shown above, and as demonstrated through the 
deposition testimony of plaintiff’s expert, the risk of 
asphyxiation posed by a bedding arrangement varies from 
patient to patient. The restraining mechanisms appropriate 
for a given patient depend upon that patient’s medical 
history. Thus, restraints such as bed railings are, in the 
terminology of plaintiff’s expert physician, part of a 
patient’s “individualized treatment plan.” 
The risk assessment at issue in this claim, in our 
judgment, is beyond the ken of common knowledge, because 
18 
Indeed, 
plaintiff 
repeatedly 
stresses 
that 
defendant’s agents saw the gap between the bed and the
railing and failed to recognize that this gap created a
risk of asphyxiation. 
See § IV(B)(4) later in this 
opinion. 
21  
 
 
 
such an assessment require understanding and consideration 
of the risks and benefits of using and maintaining a 
particular set of restraints in light of a patient’s 
medical history and treatment goals. In order to determine 
then whether defendant has been negligent in assessing the 
risk posed by Hunt’s bedding arrangement, the fact-finder 
must rely on expert testimony. 
This claim, like the claim 
described above, sounds in medical malpractice. 
4. FAILURE TO TAKE STEPS 
We turn, finally, to a claim fundamentally unlike 
those 
discussed 
previously. 
Plaintiff 
alleges 
that 
defendant “[n]egligently and recklessly fail[ed] to take 
steps to protect plaintiff’s decedent when she was, in 
fact, discovered on March 1 [1997] entangled between the 
bed rails and the mattress.” 
This claim refers to an incident on March 1, 1997—the 
day before Ms. Hunt was asphyxiated—when two of defendant’s 
CENAs found Ms. Hunt tangled in her bedding and dangerously 
close to asphyxiating herself in the bed rails. 
According 
to the CENAs, they moved Ms. Hunt away from the rail and 
informed their supervising nurses that Ms. Hunt was at risk 
of asphyxiation. 
Plaintiff now contends, therefore, that defendant had 
notice of the risk of asphyxiation through the knowledge of 
its agents and, despite this knowledge of the problem, 
22  
 
 
defendant did nothing to rectify it.
 It bears repeating 
that plaintiff’s allegation in this claim is not that 
defendant took inappropriate steps in dealing with the 
patient’s compulsive sliding problem or that defendant’s 
agents were negligent in creating the hazard in the first 
place. 
Instead, plaintiff claims that defendant knew of 
the hazard that led to her death and did nothing about it. 
This claim sounds in ordinary negligence. 
No expert 
testimony is necessary to determine whether defendant’s 
employees should have taken some sort of corrective action 
to prevent future harm after learning of the hazard. 
The 
fact-finder can rely on common knowledge and experience in 
determining whether defendant ought to have made an attempt 
to reduce a known risk of imminent harm to one of its 
charges. 
Suppose, for example, that two CENAs employed by 
defendant discovered that a resident had slid underwater 
while taking a bath. 
Realizing that the resident might 
drown, the CENAs lift him above the water. 
They recognize 
that the resident’s medical condition is such that he is 
likely to slide underwater again and, accordingly, they 
notify a supervising nurse of the problem. 
The nurse, 
then, does nothing at all to rectify the problem, and the 
resident drowns while taking a bath the next day. 
If a party alleges in a lawsuit that the nursing home 
23  
 
 
  
 
 
 
was negligent in allowing the decedent to take a bath under 
conditions known to be hazardous, the Dorris standard would 
dictate that the claim sounds in ordinary negligence. 
No 
expert testimony is necessary to show that the defendant 
acted negligently by failing to take any corrective action 
after learning of the problem. 
A fact-finder relying only 
on common knowledge and experience can readily determine 
whether the defendant’s response was sufficient. 
Similarly, no expert testimony is required here in 
order to determine whether defendant was negligent in 
failing to respond after its agents noticed that Ms. Hunt 
was at risk of asphyxiation. 
Professional judgment might 
be implicated if plaintiff alleged that defendant responded 
inadequately, but, given the substance of plaintiff’s 
allegation 
in 
this 
case, 
the 
fact-finder 
need 
only 
determine whether any corrective action to reduce the risk 
of reccurrence was taken after defendant’s agents noticed 
that Ms. Hunt was in peril. 
Thus, plaintiff has stated a 
claim 
of 
ordinary 
negligence 
under 
the 
standards 
articulated in Dorris. 
V. STATUTE OF LIMITATIONS 
Having decided that three of plaintiff’s claims sound 
in 
medical 
malpractice, 
we 
must 
determine 
whether 
plaintiff’s medical malpractice claims are now time-barred. 
See MCR 2.116(C)(7). 
24  
 
 
 
 
 
 
The period of limitations for a medical malpractice 
action 
is 
ordinarily 
two 
years. 
MCL 
600.5805(6). 
According to MCL 600.5852, plaintiff had two years from the 
date she was issued letters of authority as personal 
representative 
of 
Hunt’s 
estate 
to 
file 
a 
medical 
malpractice complaint. 
Because the letters of authority 
were issued to plaintiff on January 20, 1998, the medical 
malpractice action had to be filed by January 20, 2000. 
Thus, under ordinary circumstances, plaintiff’s February 7, 
2001, medical malpractice complaint (her third complaint in 
total) would be time-barred. 
The equities of this case, however, compel a different 
result. 
The distinction between actions sounding in 
medical 
malpractice 
and 
those 
sounding 
in 
ordinary 
negligence is one that has troubled the bench and bar in 
Michigan, even in the wake of our opinion in Dorris. 
Plaintiff’s failure to comply with the applicable statute 
of 
limitations 
is 
the 
product 
of 
an 
understandable 
confusion about the legal nature of her claim, rather than 
a negligent failure to preserve her rights. 
Accordingly, 
for this case and others now pending 
that involve similar 
procedural circumstances, we conclude that plaintiff’s 
medical malpractice claims may proceed to trial along with 
plaintiff's ordinary negligence claim. 
MCR 7.316(A)(7). 
However, in future cases of this nature, in which the line 
25  
 
 
 
 
 
 
                                                 
 
between ordinary negligence and medical malpractice is not 
easily distinguishable, plaintiffs are advised as a matter 
of prudence to file their claims alternatively in medical 
malpractice and ordinary negligence within the applicable 
period of limitations.19 
VI. CONCLUSION 
Plaintiff has stated two claims that require expert 
testimony and therefore sound in medical malpractice. 
Although these claims were filed after the applicable 
period of limitations had run and would ordinarily be time­
barred, the procedural features of this case dictate that 
plaintiff should be permitted to proceed with her medical 
malpractice claims. 
The claim that defendant negligently 
failed to respond after learning that Ms. Hunt’s bedding 
arrangements created a risk of asphyxiation sounds in 
ordinary negligence. 
Finally, plaintiff’s claim regarding 
an “accident-free environment” sounds in strict liability 
and is not cognizable. 
Accordingly, we reverse the 
judgment of the Court of Appeals and remand this case to 
the circuit court for further proceedings consistent with 
19 If the trial court thereafter rules that the claim 
sounds in ordinary negligence and not medical malpractice,
and may thus proceed in ordinary negligence, and this
ruling is subsequently reversed on appeal, the plaintiff 
will nonetheless have preserved the right to proceed with
the medical malpractice cause of action by having filed in
medical malpractice within the period of limitations. 
26  
 
 
this opinion. 
Stephen J. Markman
Maura D. Corrigan
Elizabeth A. Weaver 
Clifford W. Taylor
Robert P. Young, Jr. 
27  
 
 
 
 
 
 
 
 
 
 
 
 
 
_______________________________ 
 
 
 
 
S T A T E O F M I C H I G A N  
SUPREME COURT  
DENISE BRYANT, personal
representative of the estate
of Catherine Hunt, deceased, 
Plaintiff-Appellee, 
v 
Nos. 121723-121724 
OAKPOINTE VILLA NURSING CENTRE,
INC., 
Defendant-Appellant. 
KELLY, J. (dissenting). 
The question in this case is whether plaintiff's 
claims sound in medical malpractice or ordinary negligence. 
I disagree with the majority’s reading of plaintiff’s 
complaint and believe that all of plaintiff’s claims sound 
in 
ordinary 
negligence. 
I 
also 
disagree 
with 
the 
majority’s analysis of the statute of limitations issue. 
BACKGROUND 
Plaintiff's decedent was a resident of defendant’s 
nursing care facility. 
Among her needs were safety 
restraints on her bed to prevent her from falling out and 
injuring herself. 
In early 1997, defendant’s nurses’ 
assistants noted that she had developed a propensity to 
move around in bed. 
Because of her petite stature and the 
configuration of the bed, she was in danger of slipping 
 
 
 
 
 
 
 
 
  
                                                 
 
under the bedrails and catching her neck. 
This could lead 
to strangulation and death. 
Shortly after, the assistants’ fears were realized. 
First, they discovered plaintiff’s decedent “tangled up in 
the 
rails,” 
her 
clothes, 
and 
the 
bedding. 
They 
successfully extricated her, but feared that she was in 
grave danger of being hanged. 
Yet, no change was made in 
the restraint configuration. 
The next day, she was 
discovered caught by her neck under the rails. 
This time, 
she did not recover. 
She died two days later after being 
removed from life support. 
Plaintiff 
brought 
suit 
against 
the 
facility. 
Following 
pretrial 
motions 
for 
summary 
disposition, 
plaintiff was allowed to file a first amended complaint in 
June 1999. 
She alleged three counts of negligence: 
ordinary negligence, negligent infliction of emotional 
distress, and gross negligence.1 
Ante at 6. Central to the 
resolution of this case is plaintiff’s count for ordinary 
negligence. 
The ordinary negligence count consisted of four 
distinct claims. 
The first was that defendant, by 
1 
Plaintiff 
alleged 
that 
defendant 
negligently
inflicted emotional distress on her by attempting to 
conceal the true circumstances of her decedent's death. 
The third count alleged that the nurses’ assistants were
grossly negligent for failing to inform their supervisors
that they had found decedent entangled in her bedding the
day before her death. 
2  
 
 
 
providing medical care and housing to plaintiff’s decedent, 
owed her decedent a duty to provide an accident-free 
environment. 
Defendant had a duty, plaintiff asserted, to 
assure that plaintiff’s decedent was not subjected to an 
unreasonable risk of injury. 
Second, plaintiff asserted that defendant breached its 
duty to train its staff to recognize the danger posed by 
bedrails. 
According to plaintiff’s complaint, defendant 
had received specific information about this danger from 
the United States Food and Drug Administration (FDA). 
The 
allegation is that defendant failed to take precautions or 
share this information with its staff. 
Third, plaintiff asserted that defendant discovered 
plaintiff’s decedent caught between the rails and mattress. 
Plaintiff complains that defendant failed to prevent a 
recurrence 
by 
not 
remedying 
the 
rails-mattress 
configuration. 
Fourth, plaintiff asserted that defendant had failed 
to inspect the bed’s configuration to ensure that a danger 
of strangulation was not present. 
Defendant moved for summary disposition under MCR 
2.116(C)(7), and the circuit court granted the motion. 
It 
determined that plaintiff’s ordinary negligence claims were 
really allegations of medical malpractice. 
Plaintiff appealed to the Court of Appeals. 
She also 
3  
 
 
 
 
 
  
                                                 
took measures to preserve her claims as malpractice claims 
by filing an amended complaint and a notice of intent to 
sue pursuant to MCL 600.2912b. Defendant moved to dismiss, 
asserting that the suit was time-barred under the medical 
malpractice 
statutory 
period 
of 
limitations. 
MCL 
600.5805(6). 
When the circuit court held that the 
statutory period had been tolled, defendant went to the 
Court of Appeals. 
The Court of Appeals consolidated both parties' 
appeals. 
It concluded that plaintiff's claims sounded in 
ordinary negligence, adding that they would be barred by 
the 
limitations 
period 
if 
they 
sounded 
in 
medical 
malpractice. 
Unpublished opinion per curiam, issued May 
21, 2002 (Docket Nos. 228972, 234992). 
We granted 
defendant’s subsequent application for leave to appeal.2 
468 Mich 943 (2003). 
The majority determines that only one of plaintiff’s 
claims sounds in ordinary negligence, that another is not 
cognizable under Michigan law, and that the other two are 
medical malpractice claims. 
It bases its holding on two 
facts: 
One, defendant did not respond at all upon finding 
plaintiff’s 
decedent 
entangled 
in 
her 
bedding 
and, 
therefore, one of plaintiff’s claims is for ordinary 
2 We also ordered that the case be argued and submitted
with Lawrence v Battle Creek Health Systems, 468 Mich 944 
(2003). 
4  
 
 
 
 
                                                 
  
negligence. Two, the use of bedrails must be prescribed by 
a medical professional and, therefore, the remaining claims 
necessarily sound in medical malpractice. 
STANDARD OF REVIEW 
We review motions for summary disposition under MCR 
2.116(C)(7) de novo. 
We accept the allegations in the 
complaint and documentary evidence as true unless other 
documents specifically contradict them. 
Fane v Detroit 
Library Comm, 465 Mich 68, 74; 631 NW2d 678 (2001). 
MEDICAL MALPRACTICE VERSUS ORDINARY NEGLIGENCE 
In Adkins v Annapolis Hosp,3 we recognized that 
ordinary negligence could occur in the course of medical 
care. 
In this case, plaintiff is alleging that ordinary 
negligence 
occurred. 
She 
does 
not 
dispute 
that 
a 
professional medical relationship existed between defendant 
and her decedent. 
But she relies on the established fact 
that every medical professional remains under a duty to 
exercise reasonable care. 
Also, professional standards of 
medical care supplement but do not necessarily supplant the 
ordinary duty of care. 
Various differences exist between medical malpractice 
and negligence. When medical malpractice occurs, there has 
been a failure or omission that cannot be assessed by a 
3 420 Mich 87; 360 NW2d 150 (1984). 
See also Dyer v
Trachtman, 470 Mich 45, 54 n 5; 679 NW2d 311 (2004). 
5  
 
 
 
 
 
 
 
layperson; it involves a matter that requires the exercise 
of 
professional 
medical 
judgment. 
Without 
expert 
testimony, the ordinary juror cannot determine if a 
defendant medical professional has fulfilled its duty of 
professional care. Dorris v Detroit Osteopathic Hosp Corp, 
460 Mich 26, 47; 594 NW2d 455 (1999). 
By contrast, expert 
witnesses are not always required in ordinary negligence 
actions because the trier of fact can often rely on its own 
common knowledge and experience. In addition, medical 
malpractice actions involve the alleged breach of medical 
standards of care; negligence actions do not. 
THE NEGLIGENCE ALLEGED 
Here, 
plaintiff’s 
amended 
complaint 
alleged 
that 
defendant was negligent in four ways. Defendant is alleged 
to have breached its duties to 
(a) . . . assure that plaintiff’s decedent 
was provided with an accident-free environment;
(b) . . . train 
[nurses’ 
assistants] 
to 
assess 
the 
risk 
of 
positional 
asphyxia 
by
plaintiff’s 
decedent 
despite 
having 
received 
specific warnings . . . ;
(c) . . . take steps to protect plaintiff’s 
decedent when she was, in fact, discovered on
March 1 [1997] entangled between the bed rails 
and the mattress;
(d) . . . inspect the beds, bed frames and 
mattresses to assure that the risk of positional
asphyxia did not exist for plaintiff’s decedent.
With respect to the first claim, I disagree with the 
majority that plaintiff’s assertion of a duty to provide an 
accident-free environment is not cognizable under Michigan 
6  
 
 
 
 
 
 
law. 
Ante at 17-18. 
We have consistently held that the 
nature of the claim alleged is based on the underlying 
facts. It is independent of the words used to describe it. 
See Dorris at 43. 
Plaintiff's decedent was in defendant’s custodial 
care. 
As the Court of Appeals stated, defendant was 
obligated to take reasonable precautions to provide a 
reasonably safe environment. 
Unpublished opinion per 
curiam, issued May 21, 2002 (Docket Nos. 228972, 234992), 
citing Owens v Manor Health Care Corp, 159 Ill App 3d 684, 
688; 512 NE2d 820 (1987). 
A breach of this duty can 
support a claim for ordinary negligence. Plaintiff's first 
claim should be read to mean that defendant was obligated 
to provide an environment free of negligently caused 
accidents. 
Contrary to the majority’s reading of this claim, 
plaintiff has not asserted that defendant was the guarantor 
of the safety of plaintiff's decedent. 
The ordinary juror 
can assess whether defendant’s alleged actions or inactions 
constituted reasonable measures to fulfill its duty. 
The second claim is that defendant breached its duty 
to train its nurses’ assistants. I agree with the majority 
that assessing the medical needs of patients requires 
medical expertise. 
Similarly, assessing whether those 
needs were adequately addressed requires medical expertise. 
7  
 
 
 
  
                                                 
See part IV(B)(2) ante. 
However, a fair reading of this 
claim reveals that plaintiff is not challenging defendant’s 
assessment of her decedent’s medical needs. 
Moreover, 
plaintiff is not challenging whether bed rails and other 
restraints were appropriately prescribed. 
Instead, plaintiff asserts that defendant knew of the 
dangers posed by bed rails, yet, it took no steps to pass 
this information along to its employees. 
As the majority 
opines, 
[n]o expert testimony is necessary to determine
whether [defendant] should have taken some sort 
of corrective action to prevent future harm after
learning of the hazard. The fact-finder can rely
on common knowledge and experience in determining
whether defendant ought to have made an attempt
to reduce a known risk of imminent harm to one of 
its charges.[4] 
“Some sort of corrective action” may include, as plaintiff 
alleges, training employees or passing along specific 
information to them that it has learned from other 
employees or the FDA. 
Plaintiff asserts that defendant 
failed to act once it had knowledge of a hazard, not that 
it breached a medical standard of care. 
Hence, this claim 
sounds in ordinary negligence as well. 
Plaintiff’s 
third 
and 
fourth 
claims 
concern 
defendant’s actions with respect to her decedent becoming 
entangled in the bedding. Plaintiff alleged that defendant 
4 See ante at 24, discussing plaintiff’s claim for
defendant’s failure to respond after initially finding 
plaintiff's decedent entangled in her bedding. 
8  
 
 
 
failed to “take steps to protect plaintiff’s decedent when 
she was, in fact, discovered on March 1 [1997] entangled 
between the bed rails and the mattress” and to “inspect the 
beds, bed frames and mattresses to assure that the risk of 
positional 
asphyxia 
did 
not 
exist 
for 
plaintiff’s 
decedent.” 
Plaintiff asserts that the nurses’ assistants employed 
by defendant failed to notify their supervisors when 
plaintiff’s decedent was found caught in the bedrails on 
the first occasion. 
Alternatively, plaintiff asserts that 
a 
warning 
was 
given 
to 
the 
supervisors 
that 
they 
disregarded. 
Again, plaintiff states: 
they “[n]egligently and 
recklessly fail[ed] to inspect the beds, bed frames and 
mattresses to assure that the risk of positional asphyxia 
did not exist . . .” and “to take steps to protect 
plaintiff’s decedent . . . .” These allegations assert the 
breach of a duty of due care owed by defendant to 
plaintiff’s decedent that can be evaluated by ordinary 
jurors. 
Defendant’s nurses’ assistants were alerted to the 
danger when two of them first found plaintiff’s decedent 
trapped in the bedrails. 
One specifically testified that, 
although she did not comprehend the medical needs of 
plaintiff’s decedent, she recognized that the decedent was 
9  
 
 
 
 
 
 
 
   
                                                 
 
in 
serious 
physical 
danger. 
She 
expressed 
to 
her 
supervisor her fear that the elderly woman would be found 
dead if something were not done. 
Plaintiff has presented evidence that defendant’s 
nurses’ assistants did not require medical training to 
understand that this small, frail person could again slip 
under the bedrail and jam her neck, endangering her life. 
Medical training was not needed to instruct them that the 
bedrail-mattress configuration had to be changed. 
Laypersons can properly assess whether the manner in 
which bedrails and mattresses are configured creates an 
unreasonable risk of harm to a person like plaintiff's 
decedent. 
The claims do not involve the breach of a 
medical standard of care. 
They involve simple neglect to 
act or ordinary negligence, as the majority concedes. 
Unlike the majority, I do not place undue emphasis on 
the fact that the nurses’ assistants had previously 
discovered plaintiff's decedent in a dangerous position. 
Ante at 25. 
Any person caring for her could have 
recognized the danger that the bedding posed to a petite, 
frail, and elderly person who lacked normal control over 
her movements.5 
5 One nurses’ assistant testified that she recognized
the 
dangerous 
bedding 
arrangement 
that 
entangled
plaintiff's decedent on a previous occasion even though she
was not plaintiff’s decedent’s usual caregiver. 
This 
10  
 
 
 
                                                 
The danger here was similar to that experienced by an 
infant in a crib whose mattress is too small and whose 
rails allow the baby to slip through. 
Those caring for 
such a child would quickly recognize the danger, and an 
expert would not be required to point it out. 
Similarly, 
ordinary jurors can assess whether defendant's caregivers 
here should have recognized the danger and acted with due 
care. 
As stated earlier in this opinion, the nature of the 
claim is independent of the words used to describe it. 
Plaintiff used the proper term “positional asphyxia” to 
describe being hanged. 
However, use of the medical term 
does not transform plaintiff's negligence claim into one 
sounding in malpractice. 
Defendant’s 
supposition 
that 
ordinary 
people 
are 
incapable of recognizing an obvious danger of hanging is 
untenable, 
particularly 
here 
where 
untrained 
people 
actually did recognize the danger. 
The assessment of a 
hazard does not require professional training merely 
because a professional is capable of assessing it as well 
and can explain the exact mechanism of the danger. If that 
were true, a physical science expert would be required in 
this case as well as a medical one. 
That expert would be 
assistant had not had an opportunity to observe plaintiff's
decedent for a prolonged period. 
11  
 
 
 
needed to inform the jury how plaintiff’s decedent was in 
danger of strangulation because gravity would pull her down 
once she slipped beneath the bedrails. 
STATUTE OF LIMITATIONS 
Generally the period of limitations is tolled at the 
time the complaint is filed. 
MCL 600.5856(a). 
The period 
for an action premised on ordinary negligence is three 
years. 
MCL 600.5805(10); Stephens v Dixon, 449 Mich 531; 
536 NW2d 755 (1995). 
Plaintiff’s decedent died in March 
1997, and plaintiff brought her action in April 1998. This 
was well within the period of limitations applicable to 
ordinary negligence actions, as well as wrongful death 
actions premised on medical malpractice. MCL 600.5852; MCL 
600.5805(6). 
Still well within the applicable period of 
limitations, 
the 
trial 
court 
initially 
ruled 
that 
plaintiff’s claim sounded in ordinary negligence.  Thus, 
under MCL 600.5856(a), the period of limitations was 
tolled. 
I believe that plaintiff and other similarly situated 
litigants are entitled to rely on a trial court’s decision 
that their case sounds in ordinary negligence. 
The filing 
of plaintiff's ordinary negligence complaint tolled the 
period of limitations, at least until the new trial judge 
reversed that decision. 
“Plaintiff’s failure to comply with the applicable 
12  
 
 
 
 
 
                                                 
 
statute of limitations” was less the “product of [her] 
understandable confusion about the legal nature of her 
claim . . .”6 and more the product of plaintiff’s 
justifiable reliance on the trial court’s initial ruling. 
This 
Court 
need 
not 
resort 
to 
equity 
to 
save 
plaintiff’s so-called medical malpractice claims. 
MCL 
600.5856(a) and the initial trial court decision dictated 
that 
plaintiff’s 
filing 
of 
the 
ordinary 
negligence 
complaint tolled the running of the period of limitations. 
Finally, 
the 
majority’s 
“prudent” 
decision 
that 
obliges someone injured by a negligent medical practitioner 
to allege alternate theories of medical malpractice and 
ordinary negligence pertaining to a single injury is ill­
conceived. 
It needlessly complicates and impedes the 
injured person's efforts to recover through the courts from 
those responsible for his plight. 
The majority’s free and 
unsolicited advice sends the wrong message to the bench and 
bar, and places an undue burden on injured people. 
CONCLUSION 
In this case, plaintiff has alleged that defendant had 
notice of a risk of harm that was readily apparent to the 
layperson and could have been rectified by a layperson. 
She has also alleged that, after receiving notice of the 
danger, defendant negligently missed several opportunities 
6 Ante at 26. 
13  
 
 
to avert it. 
Medical expertise is not required to determine whether 
defendant’s nonresponses constituted a failure to take 
ordinary care. 
An expert could render an opinion on the 
issues in this case, but it is unnecessary because the case 
does not raise questions of medical judgment. 
It does not 
involve the breach of medical standards of care. 
Instead, 
the issues are within the common knowledge and experience 
of lay jurors. 
Hence, plaintiff should be enabled to 
proceed under a theory of ordinary negligence. 
Moreover, if any of plaintiff’s claims did sound in 
medical malpractice, more than the equities of this case 
require that plaintiff be allowed to proceed; plaintiff 
reasonably relied on the decisions of the lower courts that 
Michael F. Cavanagh 
all her claims sound in ordinary negligence. 
The decision of the Court of Appeals 
affirmed to the extent that it found that 
should 
all 
be 
of 
plaintiff's claims sound in negligence. 
Marilyn Kelly 
14