Case Title: JOHNSON v. HILLCREST HEALTH CENTER, INC.

Citation: 

Docket Number: 97076

State: oklahoma

Court: Oklahoma Supreme Court

Date: 2003-02-18T00:00:00Z

Document:
JOHNSON v. HILLCREST HEALTH CENTER, INC.  JOHNSON v. HILLCREST HEALTH CENTER, INC. 2003 OK 16 70 P.3d 811 Case Number: 97076 Decided: 02/18/2003 THE SUPREME COURT OF THE STATE OF OKLAHOMA GERALDINE JOHNSON, Administratrix of the Estate of HENRY JOHNSON, Deceased, Plaintiff/Appellant, HILLCREST HEALTH CENTER, INC., an Oklahoma corporation, Defendant/Appellee. CERTIORARI TO THE COURT OF CIVIL APPEALS, DIVISION III Honorable Karl Gray, Trial Judge ¶O On December 11, 1997, Henry Johnson (patient/Johnson) sought treatment for chest pains at the Hillcrest Health Center (Hillcrest/hospital) emergency room. Johnson was admitted to the hospital under the care of Dr. Jozef Dzurilla (Dzurilla/doctor). After the doctor concluded that Johnson was not suffering from a heart condition, Johnson was discharged from the hospital on December 12, 1997. The next day, Johnson returned, again complaining of chest pains. He was again admitted to the hospital and then discharged on December 15, 1997. On December 19, 1997, Johnson went to Southwest Medical Center and died there on December 21, 1997. Subsequently, Johnson's wife (wife), the administratrix of his estate, sued the doctor, the hospital's pathologist and Hillcrest, alleging negligence. After the wife settled her claim against the doctor and dismissed the hospital's pathologist, Hillcrest moved for summary judgment. It argued that the wife could not show a breach of the standard of care or causation. The trial court entered judgment in favor of the hospital. The wife appealed, and the Court of Civil Appeals affirmed. We hold that summary judgment is precluded because: 1) sufficient evidence exists to raise material issues of fact concerning whether the hospital breached the applicable standard of care and the degree to which the breach may have caused or contributed to the patient's death; and 2) the summary judgment materials do not support a determination, as a matter of law, that the doctor's second discharge of the patient was an intervening cause of the patient's death. CERTIORARI PREVIOUSLY GRANTED; COURT OF CIVIL APPEALS OPINION VACATED; TRIAL COURT REVERSED AND CAUSE REMANDED. Howard K. Berry, III, Oklahoma City, Oklahoma, for Plaintiff/Appellant, Michael J. Heron, Daniel L. Cox, Oklahoma City, Oklahoma, for Defendant/Appellee. KAUGER, J: ¶1 The issues presented on certiorari are: 1) whether sufficient evidence exists to raise material issues of fact concerning whether the hospital breached the applicable standard of care and whether its breach may have caused or contributed to the death of the patient; and 2) whether the doctor's decision to discharge the patient from the hospital a second time was an intervening cause of the patient's injuries as a matter of law. FACTS ¶2 This cause concerns a negligence suit brought by the appellant, Geraldine Johnson (wife), the administratrix of her husband, Henry Johnson's (husband/patient/Johnson) estate, against the appellee, Hillcrest Heath Center (Hillcrest/hospital) of Oklahoma City, Oklahoma. On December 11, 1997, Johnson sought treatment for chest pains at the Hillcrest emergency room at about 10:30 a.m. The emergency room physician, concerned that Johnson's chest pains could be a heart attack, admitted Johnson to the hospital at about 1:45 p.m. for further testing under the care of Dr. Jozef Dzurilla (Dzurilla/doctor). ¶3 In 1997, laboratory blood tests known as CPK and CKMB isoenzyme tests (lab tests) were used to rule out a possible heart attack. ¶4 According to the laboratory and the hospital, the raw data from the lab tests which indicated an abnormal range were posted to the hospital computer system by 11:26 a.m. on December 12, 1997. The test results, along with the pathologist's report (lab report) interpreting the results and suggesting that the patient had an "[e]arly acute myocardial injury," would ordinarily be placed in the patient's chart after the test results were posted to the computer system. However, Johnson's test results were apparently placed in the wrong chart on December 12, 1997. The raw data from the lab tests was available on computer terminals located throughout the hospital, including Johnson's floor, but the pathologist's report was not on the computer. Dr. Dzurilla, without checking the computer, concluded that Johnson was not suffering from a heart attack and Johnson was released at 11:40 a.m. on December 12, 1997. ¶5 The next day, Johnson was readmitted to the hospital again under the care of Dr. Dzurilla still complaining of chest pains. The doctor treated Johnson and discharged him on December 15, 1997. Dr. Dzurilla insists that the lab tests and the lab report were not in Johnson's chart during either of his stays at Hillcrest and that, had he seen the information, he would have confirmed the tests results and consulted with a cardiologist rather than discharge Johnson. ¶6 On December 19, 1997, Johnson was admitted to Southwest Medical Center where he was diagnosed and treated for a heart attack. Johnson later died at Southwest on December 21, 1997. On December 2, 1998, Johnson's wife filed a negligence action against the doctor. Subsequently, she amended her petition to include claims against the pathologist and the hospital. On June 22, 2000, the wife dismissed her claim against the pathologist. After settling with the doctor, she dismissed her claim against him on August 20, 2001. ¶7 On September 4, 2001, the hospital filed a motion for summary judgment, arguing that the wife could not show that it breached the applicable standard of care or that it caused or contributed to Johnson's death. On November 8, 2001, the trial court, without hearing arguments, entered an order granting summary judgment in favor of the hospital. Johnson appealed, and on July 25, 2002, the Court of Civil Appeals affirmed. We granted certiorari on October 21, 2002. I. ¶8 SUFFICIENT EVIDENCE EXISTS TO RAISE MATERIAL ISSUES OF FACT CONCERNING WHETHER THE HOSPITAL BREACHED THE APPLICABLE STANDARD OF CARE AND THE DEGREE TO WHICH THE BREACH MAY HAVE CAUSED OR CONTRIBUTED TO THE PATIENT'S DEATH. ¶9 The wife's negligence claim against the hospital primarily concerns its alleged failure to post the lab tests and the lab report to her husband's chart and/or call them to the doctor's attention before Johnson was discharged from Hillcrest on December 12, 1997, and December 15, 1997. She asserts that: 1) the trial court erred in granting summary judgment to the hospital because her evidence establishes an actionable negligence claim against the hospital; and 2) material fact questions exist which preclude summary judgment. ¶10 The hospital argues that the wife's expert testimony evidence fails to establish an actionable negligence claim because she cannot show: 1) a breach of the applicable standard of care in its handling of the lab test or lab report; and 2) a causal link between the alleged deficiencies in its handling of the report and the death of the patient. In support of its argument, the hospital points to the deposition of the wife's expert witness in which the expert testified that: 1) the hospital's posting of its lab tests to the computer was an acceptable method of conveying the results to the doctor; ¶11 The wife counters that her expert's testimony shows that the hospital breached the duty of care that it owed to Johnson and that its breach caused and/or contributed to his injures. In support of her argument she points to her expert's deposition, ¶12 To support an actionable claim for negligence, a plaintiff must establish the concurrent existence of: a duty on the part of the defendant to protect the plaintiff from injury; a failure of the defendant to perform that duty; and an injury to the plaintiff resulting from the failure of the defendant. ¶13 Hospitals have an implied obligation or duty to exercise ordinary care in the delivery of professional services to their patients. ¶14 Title ¶15 The obvious purpose of the charting requirement is to provide a record to assist the physician in properly treating the patient. Physicians depend on the reliability and trustworthiness of the chart. As far as a hospital is concerned, there is no more important record than the chart for indicating the diagnosis, the condition, and the treatment required for patients. ¶16 A motion for summary judgment should be sustained only when the pleadings, affidavits, depositions, admissions or other evidentiary materials establish that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law. ¶17 The evidentiary materials show that the hospital's policy was to include the lab tests and lab reports in a patient's chart as soon as possible. Undoubtedly, doctors would not order the lab tests, nor would pathologists interpret the results if the test and the report did not aid a doctor in diagnosing a heart attack. Nothing in the expert's testimony indicates that the information would not have helped the doctor to make the proper diagnosis. ¶18 The expert testimony, II. ¶19 THE SUMMARY JUDGMENT MATERIALS DO NOT SUPPORT A DETERMINATION, AS A MATTER OF LAW, THAT THE DOCTOR'S SECOND DISCHARGE OF THE PATIENT WAS AN INTERVENING CAUSE OF THE PATIENT'S DEATH. ¶20 The hospital asserts that, as a matter of law, the doctor's second discharge of the patient caused the patient's death and served as an independent and intervening cause, cutting off any liability on its part. The wife contends that: 1) the determinative issue regarding the hospital's liability is the reasonable foreseeability of the doctor's discharge and the patient's subsequent death and the extent it relates to the hospital's failure to provide the laboratory data which indicated a heart attack; and 2) because the question of reasonable foreseeability is for the jury to determine, summary judgment was improper. ¶21 The general rule is that a causal chain between a negligent act and an injury may be broken by an intervening event -- a supervening cause. ¶22 For an occurrence to rise to the magnitude of a supervening cause it must possess three attributes: 1) independence from the original negligent act; 2) adequacy of itself to bring about the complained-injury; and 3) it must not be reasonably foreseeable. ¶23 We have reviewed the hospital's statement of undisputed facts in its motion for summary judgment and its reply, as well as the evidentiary materials submitted. On the record presented, we have found nothing which would support a determination that the doctor's discharge of the patient, after his second hospitalization, was an intervening cause as a matter of law. When the evidence is presented at trial, a jury might determine that the acts of the doctor and the hospital may be viewed as concurrent acts for which both may be liable. CONCLUSION ¶24 A hospital's duty requires such care and protection to its patients as the patient's condition requires. ¶25 Hospitals are required to document orders, treatment, tests, and services rendered in a patient's chart. CERTIORARI PREVIOUSLY GRANTED; COURT OF CIVIL APPEALS OPINION VACATED; TRIAL COURT REVERSED AND CAUSE REMANDED. WATT, C.J., HODGES, LAVENDER, HARGRAVE, KAUGER, SUMMERS, BOUDREAU, JJ., concur. OPALA, V.C.J., concurs in part; dissents in part. WINCHESTER, J., dissents. FOOT