Case Title: Dulin v. Northeast Alabama Regional Med. Ctr.

Citation: 

Docket Number: 1110742

State: alabama

Court: Alabama Supreme Court

Date: 2012-08-17T00:00:00Z

Document:
REL: 08/16/2012
Notice: This opinion is subject to formal revision before publication in the advance
sheets of Southern Reporter.  Readers are requested to notify the Reporter of Decisions,
Alabama Appellate Courts, 300 Dexter Avenue, Montgomery, Alabama 36104-3741 ((334)
229-0649), of any typographical or other errors, in order that corrections may be made
before the opinion is printed in Southern Reporter.
SUPREME COURT OF ALABAMA
SPECIAL TERM, 2012
_________________________
1110742
_________________________
Ex parte Alanna Nail et al.
PETITION FOR WRIT OF MANDAMUS
(In re:  George Dulin and Vivian Dulin
v.
Northeast Alabama Regional Medical Center et al.)
(Calhoun Circuit Court, CV-07-900077)
WOODALL, Justice.
Alanna Nail, Paul Watson, and Gennie Farragher,  all
registered 
nurses 
(hereinafter 
sometimes 
referred 
to
collectively as "the nurses"), petition this Court for a writ
1110742
of mandamus directing the Calhoun Circuit Court to vacate its
order denying the summary-judgment motion they filed, which
raised a statute-of-limitations defense.  We deny the
petition.
I. Factual and Procedural Background
According to the complaint filed in this case, George
Dulin was admitted to the Northeast Alabama Regional Medical
Center ("the Center") in May 2005 for treatment of "crush
injuries to his chest."  There, "he underwent a tracheostomy
for long term airway management."  On the morning of June 3,
2005, Dulin's tracheostomy tube allegedly became dislodged
during a bath administered by the nursing staff, resulting in
the loss of oxygen for an undetermined period.  He allegedly
suffered brain damage as the result of oxygen deprivation.
One month later, Vivian Dulin, George's wife, obtained
and reviewed the hospital records.  Included in the records
was a "Cardiopulmonary Pulmonary Arrest Flow Sheet" 
("the 
flow
sheet") dated June 3, 2005.  It purported to identify, by
handwritten entries, eight members of a "Code Team" involved
in the incident.  Four of the members were designated by an
initial, followed by a last name, which was, in turn, followed
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by the designation "RN."  The other four members were
generally listed only by first name, followed by "RT"
(respiratory therapist).
The names on the flow sheet are obscure, at best; little
can be made out with any certainty.  One of the more legible
of the RNs' names is the fourth name from the top, which
appears to be "P. Watkins."  Another initial appears to be an
"A."
The hospital records also included a "Nurses' Notes
Extension" ("the chart"), which gave a moment-by-moment
chronicle of the series of events that occurred during the
tube displacement and reintubation.  Each entry on the chart
was followed by a signature closely resembling the first
handwritten entry on the flow sheet, which possibly began with
the letter "A."
On May 2, 2007, the Dulins commenced a medical-
malpractice action against the Center and 17 fictitiously
named defendants.  The complaint averred, in pertinent part:
"On or about June 3, 2005, when nurses and/or
other employees of the [Center] were changing  [Mr.
Dulin's] position during a bed bath, [Mr. Dulin's]
tracheostomy tube became dislodged and he had a code
arrest. ... [The Dulins] aver that the nurses and/or
other employees of the [Center] that were attending
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Mr. Dulin at the time his tracheostomy tube became
dislodged, were agents, servants, or employees of
the [Center], and were working within the line and
scope of their employment.
"10. [The Dulins] aver that said nurses and/or
other employees of [the Center] and fictitious
defendant[s] 1 through 17 negligently failed to
provide a proper level of assistance to Mr. Dulin
while in the process of bathing him and/or changing
his position.  The negligent failure to provide such
proper assistance proximately resulted in the
injuries and damages sustained by the [Dulins]. 
"11. [The Dulins] further aver that [the
Center], through its employees and/or agents and
fictitious defendants 1 through 17, negligently
failed 
to 
properly 
secure 
[Mr. 
Dulin's] 
tracheostomy tube prior to attempting to bathe him
or change his position, and as a proximate
consequence of this negligent failure, the [Dulins] 
were caused to sustain ... injuries and damages ....
"....
"14. As 
a 
proximate consequence 
of 
the 
aforesaid
negligent conduct of the defendant Northeast Alabama
Regional 
Medical 
Center 
and 
fictitious 
party
defendants 1 through 17 ..., plaintiff George Dulin
was injured and damaged ...."
The fictitiously named defendants were defined, in
pertinent part, as
"numbers 2, 3, 4 and 5 being that entity or
individual or those entities or individuals which or
who attempted to turn or change [Mr. Dulin's]
position on or about June 3, 2005 as set forth in
the complaint; ... numbers 6, 7 and 8 whether
singular or plural, being that individual or
individuals 
who 
undertook 
to 
provide 
medical
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services and/or care and/or assistance to plaintiff
George Dulin on the occasion made the basis of this
lawsuit, being negligence, wantonness, breach of
contract 
or 
other 
actionable 
conduct 
which
contributed to cause [Mr. Dulin's] injuries; ...
numbers 9, 10 and 11 being that person or entity
which caused or contributed to cause the injuries
made the basis of this suit; [and] Defendant numbers
12, 13 and 14 being the nurses and/or other
employees of defendant Northeast Alabama Regional
Medical Center that were attending Mr. Dulin at the
time his tracheostomy tube became dislodged ...."
Accompanying the complaint was a set of interrogatories
requesting, among other things, "the names of all individuals
who were assisting or attending to [Mr. Dulin] at the time
[his] tracheostomy tube became dislodged."  On September 10,
2007, the Center answered the interrogatories, stating that
the individuals were Alanna Nail, Paul Watson, and Gennie
Farragher.
On October 26, 2007, the Dulins amended their complaint
to substitute, pursuant to Rule 9(h), Ala. R. Civ. P., Nail,
Watson, and Farragher for 
the fictitiously named defendants 6,
7, 8, 9, 10, and 11.  More specifically, the amended complaint
averred that Nail, Watson, and Farragher were the individuals
who had negligently 
or 
wantonly undertaken "to provide medical
services and/or care and/or assistance to plaintiff George
Dulin on the occasion made the basis of [the] lawsuit."
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1110742
Subsequently, Nail, Watson, and Farragher moved for a
summary judgment on the ground that the amended complaint,
which purported to substitute their names for certain
fictitiously named defendants, was filed more than two years
after the alleged incident on June 3, 2005, and did not relate
back to the filing of the original complaint, because, they
argued, the Dulins failed to exercise "due diligence" in
ascertaining the nurses' identities.  They contended that the
claims against them were, therefore, barred by the applicable
two-year statute of limitations.  See Ala. Code 1975, § 6-5-
482.
In support of their motion, the nurses presented the
deposition testimony of Vivian Dulin and excerpts from George
Dulin's hospital records relating to the incident made the
basis of these claims.  Mrs. Dulin stated that she received a
telephone call from the Center on the morning of the 
incident, informing her that there was a "problem" and that
she should come to the Center.  When she arrived at George's
hospital room, she found a nurse named "Alanna" working in the
room, who told her that they "had a mess" and that George's
tracheostomy tube had become dislodged.  Susan Green was the
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1110742
nurse in charge of the intensive-care unit at the Center. 
According to Mrs. Dulin, she and Green live near one another,
and have occasionally encountered one another in the
neighborhood since the incident.  
In their summary-judgment motion, the nurses argued that
"the Dulins ... were on notice of a list of nurses in the room
at the time of the [incident] (even if they could not read all
of the names or needed help identifying the full names)." 
(Emphasis added.)  The Dulins, however, contended that "the
documents specifically relating to the treatment at issue in
this case are illegible."  The trial court denied the nurses'
motion, and they filed this petition.
II. Discussion
"Rules 9(h) and 15(c), [Ala.] R. Civ. P., govern the
relation back principles regarding substitution of an
identified party for a fictitiously designated party 
after 
the
statutory period of limitations as to the claims against that
party has run."  Ex parte Klemawesch, 549 So. 2d 62, 63 (Ala.
1989).  
Rule 9(h) provides: 
"(h) Fictitious parties. When a party is
ignorant of the name of an opposing party and so
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1110742
alleges in the party's pleading, the opposing party
may be designated by any name, and when that party's
true name is discovered, the process and all
pleadings and proceedings in the action may be
amended by substituting the true name."
As this Court has explained:
"'This Court has stated on numerous
occasions that in order to invoke the
relation-back 
principles 
of 
Rule 
9(h), 
that
is, in order for the amended complaint with
the defendant's true name to relate back to
the original complaint with the fictitious
name, the plaintiff must establish (1) that
the plaintiff was ignorant of the identity
of the fictitiously named party, in the
sense of having no knowledge at the time
the complaint was filed that the party
subsequently named was in fact the party
intended to be sued, Columbia Engineering
International, Ltd. v. Espey, 429 So. 2d
955 (Ala. 1983); and (2) that the plaintiff
used 
due 
diligence 
to 
discover 
the
defendant's 
true 
identity 
before 
filing 
the
original 
complaint, 
Fulmer 
v. 
Clark
Equipment Co., 654 So. 2d 45 (Ala. 1995).'
"The purpose of Rule 9(h) is to toll the
applicable statute of limitations when the plaintiff
has diligently pursued the identity of, but has been
unable 
to 
identify, 
certain 
defendants. 
The
fictitious name serves as a placeholder for the
defendant, and Rule 15(c)[, Ala. R. Civ. P.,] allows
the claim against the substituted defendant to
relate back to the date of the original complaint. 
Toomey v. Foxboro Co., 528 So. 2d 302 (Ala. 1988)."
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1110742
Weber v. Freeman, 3 So. 3d 825, 831-32 (Ala. 2008)(quoting  Ex
parte Atkinson, 976 So. 2d 1001, 1003 (Ala. 2007) (emphasis
added)).
"The due-diligence standard, as stated in Davis v. Mims,
510 So. 2d 227, 229 (Ala. 1987), 'is whether the plaintiff
knew, or should have known or was on notice, that the
substituted defendants were in fact the parties described
fictitiously.'"  Ex parte Griffin, 4 So. 3d 430, 436 (Ala.
2008) (emphasis added).  "'Diligence' is a relative term, and
what is due diligence must be determined by the circumstances
of each case."  Brown & Flowers v. Central of Georgia Ry., 197
Ala. 71, 75, 72 So. 366, 367 (1916).
"'This Court's standard of review
applicable to a petition for a writ of
mandamus is well settled:
"'"'Mandamus 
is 
an
extraordinary remedy and requires
a showing that there is "(1) a
clear 
legal 
right 
in 
the
petitioner to the order sought;
(2) an imperative duty upon the
respondent 
to 
perform,
accompanied by a refusal to do
so; (3) the lack of another
adequate remedy; and (4) properly
invoked 
jurisdiction 
of 
the
court."'"'"
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1110742
Ex parte Bowman, 986 So. 2d 1152, 1156 (Ala. 2007).  Further,
although a petition for a writ of mandamus is the proper
vehicle by which to seek review of the trial court's denial of
a summary-judgment motion on a statute-of-limitations ground
in the context of fictitious-party practice, the writ will
issue "'only if undisputed evidence show[s] that the
plaintiffs had failed to act with due diligence in identifying
[the fictitiously named defendants] as the part[ies] intended
to be sued.'"  Ex parte Stover, 663 So. 2d 948, 952 (Ala.
1995) (quoting Ex parte FMC Corp., 599 So. 2d 592, 595 (Ala.
1992)  (emphasis added)).
The nurses contend that Rule 9(h), Ala. R. Civ. P., does
not aid the Dulins because, they insist, the Dulins were "on
notice of [the nurses'] identities by way of the medical
records in [the Dulins'] possession."  Petition, at 4.  They
concede, however, that the medical records contain only the
last names of the nurses and that two of those names were
misspelled.  
In that connection, Farragher's name was apparently
spelled without the "h."  More significantly, "Watson"
appeared as "Watkins," which, it should be noted, is an
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1110742
entirely different name than Watson.  Additionally, it is
clear to this Court that the name "Nail" cannot reasonably be
made out from the flow sheet or the chart -- except in the
hindsight resulting from the Center's response to the Dulins'
interrogatories.
Indeed, the nurses argue that, "even without those
records[,] which [the Dulins] now contend[] were not clear or
legible, [the Dulins] failed to meet [their] duty to exercise
due diligence to inquire and learn the identities of the
nurses prior to filing suit."  Petition, at 4 (emphasis
added).  Thus, the nurses' mainstay argument is that,
regardless of whether the hospital records placed the Dulins
"on notice" of anything, the Dulins were dilatory -- as a
matter of law -- in relying on formal discovery to gain the
identities of the attending nurses.  We disagree. 
Although "[t]he conducting of formal discovery does not
necessarily prove due diligence," Ex parte Tate & Lyle
Sucralose, Inc., 81 So. 3d 1217, 1221 (Ala. 2011), "it
commonly is vital to demonstrating due diligence because it
provides 
objective 
evidence 
of 
the 
plaintiff's 
case 
activity." 
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1110742
Ex parte Hensel Phelps Constr. Co., 7 So. 3d 999, 1004 (Ala.
2008).  
The nurses rely specifically on Ex parte Mobile Infirmary
Ass'n, 74 So. 3d 424 (Ala. 2011); Ex parte Ismail, 78 So. 3d
399 (Ala. 2011); and Ex parte Klemawesch, supra.  Those cases
are clearly distinguishable.
The issue in Ex parte Mobile Infirmary, for example,
involved the proper legal name of the entity doing business as
the Mobile Infirmary Medical Center. Mary H. Shaw was
undisputedly admitted to the Mobile Infirmary Medical Center
on January 29, 2008, 74 So. 3d at 426, and, during her
treatment there, she developed "pressure sores."  Id.  She was
transferred for treatment of the pressure sores to a facility
operated by Infirmary Health Hospital, Inc., d/b/a Infirmary
Long Term Acute Care Hospital, and then to a facility operated
by Infirmary Health Hospital, Inc., d/b/a Infirmary West,
where she died on March 23, 2008.  Id.  On April 7, 2008,
Shaw's medical records were mailed to her family.  Appearing 
throughout the records as the facility where treatment was
first provided were the words, "Mobile Infirmary Medical
Center."       
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On December 10, 2009, Ernest Shaw, as administrator of
the estate of Mary Shaw, filed a complaint, naming as a
defendant "Infirmary Health Systems, Inc., doing business as 
Mobile Infirmary West and as Infirmary West Long Term Acute
Care Center."  The complaint also listed fictitiously named 
defendant "A," described as that "person[], firm[], or
corporation[] or other legal entit[y] who negligently failed
to provide competent and timely medical care, treatment,
evaluation, diagnosis, supervision, facilities and equipment
in the treatment of Mary H. Shaw."  Although the body of the
complaint contained nine paragraphs of facts alleging acts or
omissions occurring at the place of Ms. Shaw's first
admission, it never mentioned Mobile Infirmary Medical Center
by name.  Instead, it referred to that entity as "the Mobile
Infirmary Emergency Room," and as "the hospital."
Accompanying 
the 
complaint 
were 
interrogatories. 
However,
none of the interrogatories sought information regarding the
"correct legal name" of the Mobile Infirmary Medical Center. 
74 So. 3d at 427.  On March 30, 2010, after the statutory
limitations period for a wrongful-death action had expired,
Shaw supplemented his interrogatories with a request for
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"information regarding the 'proper legal entity for the
hospital commonly known as the Mobile Infirmary Medical
Center.'"  Id.  Infirmary Health Systems, Inc., responded on
April 2, 2010, and on April 12, 2010, Shaw amended his
complaint to substitute Mobile Infirmary Association d/b/a
Mobile Infirmary Medical Center (hereinafter referred to as
"the Infirmary") for fictitiously named defendant "A."
The Infirmary petitioned this Court for a writ of
mandamus vacating the trial court's denial of its motion to
dismiss the claims against it as time-barred.  This Court
granted the petition on the ground that Shaw had not acted
with due diligence in discovering the identity 
of 
fictitiously
named defendant "A."  74 So. 3d at 429.
The cases are clearly distinguishable.  Despite the fact
that the complaint in Ex parte Mobile Infirmary had alleged a
basis for a cause of action against "the Mobile Infirmary
Emergency Room" 
or "the hospital," the plaintiff neither 
used,
nor formally inquired about, the legal name of that entity
until after the limitations period had expired.  In other
words, the Infirmary and its alleged role in the decedent's
demise were definitely known, notwithstanding some alleged
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1110742
ambiguity as to its formal designation.  By contrast, the
nurses' identities were unknown at the time the complaint was
filed.  Indeed, there is little comparison between the
notoriety and visibility of a large hospital and that of the
individual 
members 
of 
its 
nursing 
staff. 
Here, 
interrogatories were propounded before the expiration of the
limitations period; in Ex parte Mobile Infirmary, the
limitations 
period 
had 
expired 
before 
relevant 
interrogatories
were issued.
Ex parte Ismail and Ex parte Klemawesch are even less
apposite.  In Ismail, for example, it was undisputed that the
plaintiffs, one of whom was allegedly injured while a patient
at Highlands Medical Center, actually knew, based on medical
records in their possession before filing their complaint,
that Dr. Younus Ismail had been one of two treating
physicians.  78 So. 3d at 407.  Nevertheless, they did not
attempt to substitute Dr. Ismail for a fictitiously named
party until more than two years after the expiration of the
limitations period.  78 So. 3d at 403.  Thus, the issue in
that case was not one of identity, but, rather,  the extent of
involvement the physician, whose identity was known, had with
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1110742
the patient.  Essentially, in other words, the plaintiffs were
improperly, id. at 408, attempting to use Rule 9(h) to gain
"additional time beyond the statutorily prescribed period
within which to formulate causes of action."  Columbia Eng'g
Int'l, Ltd. v. Espey, 429 So. 2d 955, 959 (Ala. 1983).   The
1
issue in this case is, of course, one of true identity: who
were the persons engaged in the procedure during which George
Dulin was allegedly injured?
In Ex parte Klemawesch, the plaintiff "had been on notice
of an unidentified [physician's] signature below a progress
note contained within medical records," 549 So. 2d at 64, that
had been in her possession since before she filed her
complaint. However, she had never filed a 
single 
interrogatory
and, indeed, had waited 27 months after the complaint was
filed to initiate any discovery at all.  Id.  Thus, her
attempt 
to 
substitute 
Dr. 
Stephen 
Klemawesch 
for 
a
fictitiously named party some 40 months after the expiration
of the limitations period was disallowed.  In this case, the
See Harmon v. Blackwood, 623 So. 2d 726, 727 (Ala. 1993)
1
("Rule 9(h) does not ... excuse the plaintiff's ignorance of
a cause of action against the fictitiously named defendant; it
only excuses, under certain circumstances, the ignorance of
the name of the party against whom the plaintiff has a cause
of action." (emphasis added)).
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Dulins initiated formal discovery simultaneously with the
commencement of their action and substituted the 
nurses' 
names
less than five months after expiration of the limitations
period.  These cases do not aid the nurses.
As we noted before, the nurses insist that due diligence
required the Dulins to have pursued some avenue of inquiry,
aside from formal discovery.  Although they concede that
"[d]etective work was not required," the nurses' reply brief,
at 14, the nurses contend that the Dulins should have
attempted to elicit information from Susan Green, with whom
Mrs. Dulin allegedly had a "friendly relationship," or from
"hospital administration."  Id.  
We disagree.  "Due diligence means ordinary, rather than
extraordinary, diligence."  United States v. Walker, 546 F.
Supp. 805, 811 (D.C. Hawaii 1982) (emphasis added); see also
State v. Gonzales, 151 Ohio App. 3d 160, 171, 783 N.E.2d 903,
911-12 (2002).  Short of what would amount to "detective
work," 
the 
adversarial 
process 
renders 
the 
nurses' 
contentions
unrealistic.  See Oliver v. Woodward, 824 So. 2d 693, 699
(Ala. 2001) (amendment of the complaint after two and one-half
years to substitute the name of the emergency-room physician
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who read an X-ray critical to the plaintiff's treatment was
not untimely, where 
the identification of the 
physician's 
name
resulted only from extensive formal discovery).  
Under the circumstances of this case, including (1) the
Dulins' prompt acquisition of the medical records, (2) the
state of the names of the nurses in the room with George Dulin
in his medical records, and (3) the promptness of discovery
and of the substitution, we cannot say, as a matter of law,
that the Dulins failed to exercise due diligence in
substituting 
the 
nurses 
for 
the 
fictitiously 
named 
defendants. 
Otherwise stated, the nurses have not produced undisputed
evidence of the absence of due diligence on the Dulins' part. 
Consequently, they have failed to show that they are entitled
to the writ of mandamus they seek.
III. Conclusion
For the above-stated reasons, the nurses have not shown
a clear, legal right to a writ of mandamus directing the
Calhoun Circuit Court to vacate its order denying their
summary-judgment motion.  The petition is, therefore, denied.
PETITION DENIED.
Malone, C.J., and Bolin and Main, JJ., concur.
Murdock, J., concurs in the result.
18