Title: Wilson v. Manning

State: alabama

Issuer: Alabama Supreme Court

Document:

880 So. 2d 1101 (2003)
Sherrian Y. WILSON
v.
Rhoda MANNING.
1020432.

Supreme Court of Alabama.
October 24, 2003.
*1102 Bryan G. Duhé, Mobile, for appellant.
K. Paul Carbo, Jr., of Atchison, Crosby, Saad & Beebe, Mobile, for appellee.
HARWOOD, Justice.
Sherrian Y. Wilson sued Rhoda Manning, a registered nurse, asserting medical-malpractice claims, alleging that Manning's negligence resulted in further amputation of Wilson's leg.[1] Manning filed a motion for a summary judgment, with supporting evidentiary submissions, and Wilson filed a brief opposing the motion. The trial court granted the motion, and made the summary judgment final pursuant to Rule 54(b), Ala. R.Civ.P.[2]
Our review of a summary judgment is de novo.
Hobson v. American Cast Iron Pipe Co., 690 So. 2d 341, 344 (Ala.1997).
The record reveals that Wilson was arrested at her home on Wednesday, May 21, 1997, and was taken to the Mobile County Metro Jail for failing to appear at a hearing on a charge of negotiating a worthless instrument. Wilson was brought to the jail at 6:30 p.m., and a corrections officer noted on her "Jail Receiving Screening Form" that she had "bone cancer." At the time of her incarceration, Wilson was receiving intravenous antibiotic medication twice daily, through a Groshong shunt[3] in her chest, to treat what she termed a "bone disease" in her left leg, which had been amputated below the knee. When she was admitted to the jail, she had not had her second daily dosage of the antibiotic medication.
Manning, an employee of the Mobile County Sheriff's Department, was director of nursing at the jail and was responsible for supervising two medical secretaries, five registered nurses, and seven licensed practical nurses. She testified in her deposition, filed in support of her motion for a summary judgment, that the warden ran the jail and that his immediate supervisor was the chief, who answered to the chief deputy, who answered to the sheriff. On Thursday, May 22, Wilson signed a "consent for medical care"[4] form and filled out a "request for medical evaluation,"[5] on which she wrote "PAIN, leg stumpneed IV treatm[ent]. I have a shunt in my chest for bone disease."
That same day, in response to Wilson's request for a medical evaluation, Manning visited Wilson and filled out a "medical encounter record." Manning noted in the medical encounter record that Wilson informed her that she was a patient of Infirmary Home Health Agency, Inc., and she provided her doctor's name, Dr. Steven G. Alsip, and a telephone number for Infirmary Home Health. Manning telephoned Infirmary Home Health and spoke to Jackie Woolfolk, the nurse who administered Wilson's medications to her at Wilson's home. Manning recorded in the medical encounter record, and subsequently testified on deposition, that Woolfolk told her that Wilson was taking one gram of Cefotan, an antibiotic, intravenously twice daily, at 6:00 a.m. and 6:00 p.m., and was having the dressing changed on the Groshong shunt three times per week.[6] She also stated in her deposition: "The assessment from this lady, Jackie, was osteomyelitis,[[7]] amputee, *1104 car accident two years ago, long-standing, chronic." During her deposition, Manning further described her telephone conversation with Woolfolk:
In regard to her conversation with Infirmary Home Health, Manning also stated that she telephoned them "to make them aware that [Wilson was] there so they [could] continue the treatment or whatever they do...." Woolfolk testified somewhat differently, by deposition, concerning the content of that telephone conversation. She stated that she telephoned the jail "and left a message for the head nurse to call me back." Woolfolk stated that when she talked to Manning, "I introduced myself, told her that I was the one who had been primarily seeing Sherrian. I told her what medication she was getting ... how often she was getting it, and who her doctor was, and I also gave her the doctor's phone number." Woolfolk testified that there was no discussion during that conversation about Infirmary Home Health's delivering Wilson's medication and she stated that Manning did not request that Infirmary Home Health send the medicine.
Manning noted in the May 22 medical encounter record that the medical "plan" for Wilson was for Lt. Smith, who she said in her deposition was "in charge of the jail's functions" at that time, to check on Wilson's being released because of the cost of her medications. On Friday, May 23, Manning added to the May 22 medical encounter record a notation that she had also notified Lt. York of Wilson's situation, and that he was going to telephone the judge to inquire about the possibility of Wilson's release. Manning acknowledged that this "plan" was adopted because the charge Wilson had been arrested for was a minor charge, but Wilson had not made bond and the estimated cost of her medicine, Cefotan, was "two hundred and fifty dollars a day."
Also on that Friday, Joann Peavy, a nurse working at the jail, completed a "physical examination" sheet, a "health history" sheet, a "mental status assessment sheet," and a "medical encounter record" in regard to Wilson. The health history sheet noted that Manning had cancer and that she wore a prosthesis below her left knee. The medical encounter record, which Manning signed, documented Wilson's medical condition, provided her doctor's name, and stated "no distress noted." That same day, Brenda Cain, a registered nurse working at the jail, filled out another medical encounter record concerning Wilson, which Manning also signed; that medical *1105 encounter record contained the following notation:
(Emphasis original.)
On Wednesday, May 28, Wilson, who was still incarcerated, filled out another request for medical evaluation form; that form stated, "I have an infection of the bone that is VERY active at present. I have a shunt in my chest and I need antibiotics I.V. and pain medication." (Capitalization in original.) At 9:10 a.m., on May 28, Manning completed another medical encounter record concerning Wilson, which stated:
In regard to her conversation with Dr. S. Eichold, Manning testified:
Manning testified that Wilson was given a dose of antibiotics on May 28, at 6:00 p.m., and stated further:
Wilson's counsel questioned Manning concerning a possible breach of the standard of care, as follows:
Dr. Alsip sent Infirmary Home Health a letter, dated May 28, 1997, which stated, in relevant part:
Wilson was released from the jail on May 29. According to Wilson's brief opposing Manning's summary-judgment motion and her brief to this Court, she was "taken immediately to Mobile Infirmary hospital where the remainder of her leg was amputated."
Wilson argues that the trial court "erroneously applied this Court's decision in Ex parte Alabama Department of Transportation, 764 So. 2d 1263 (Ala.2000), and found that Rhoda Manning was entitled to discretionary[-function] immunity, and, therefore, granted the Defendant's motion for summary judgment." The trial court stated in its summary-judgment order, in relevant part:
Discretionary-function immunity is now referred to as State-agent immunity. Giambrone v. Douglas, 874 So. 2d 1046, 1048 n. 1 (Ala.2003) ("The immunity available to individuals sued for actions taken on behalf of the State is now referred to as `State-agent immunity.'"). As Wilson notes in her brief to this Court, Manning's immunity claim should have been reviewed under the standard set forth in Ex parte Cranman, 792 So. 2d 392 (Ala.2000).[9] Explaining the issue of State-agent immunity, this Court stated in Alabama Department of Corrections v. Thompson, 855 So. 2d 1016, 1020 (Ala.2003):
As noted, Manning, a registered nurse, worked for the Mobile County Sheriff's Department and, as director of nursing for the jail, supervised 14 employees. Wilson, in her brief, cites Ex parte Cranman, supra, for the proposition that "this Court found that in a medical malpractice setting state employees who deny proper care to patients entrusted to them fit within no category of conduct recognized by the restated rule ... as immune."
The only categories enumerated in Cranman that could possibly have any applicability to the facts of this case are (1), (2), or (3). Manning, in her brief to this Court, argues only the applicability of category (2). She states that "she was exercising her judgment in the administration of a department of the government."[10] Wilson argues that Manning, in her dealings with Wilson, was in violation of § 14-6-19, Ala.Code 1975, which provides:
(Emphasis supplied.)
Although the statute states that "the sheriff or jailer" is responsible for providing "necessary medicines and medical attention," those duties were delegated to and assumed by Manning, as director of nursing for the jail, and she therefore also had the responsibility of conforming to the dictates of the statute. Compare Ex parte Progress Rail Servs. Corp., 869 So. 2d 459, 469 (Ala.2003) ("Alabama ha[s] recognized the right of an employee to sue a co-employee for negligently failing to carry out his individually delegated or assumed duty to provide a safe workplace."). The facts of this case raise a genuine issue of material fact as to whether Manning provided Wilson the "necessary medicines and medical attention" required by § 14-6-19. Even if Manning was "exercising ... her judgment in the administration of a department or agency of government," Cranman, supra, she had no discretion to decline to provide necessary medicines and treatment in violation of that statute. Accordingly, the trial court erred in entering the summary judgment on the basis that *1110 Manning was entitled to State-agent immunity.
In its order, the trial court also stated that "Rhoda Manning is entitled to judgment based on ... the failure of [Wilson] to present substantial evidence [which raises] a genuine issue of material fact regarding the breach of the standard of care." This Court stated in Vaughan v. Oliver, 822 So. 2d 1163, 1168 (Ala.2001):
Wilson argues in her brief to this Court that Manning "admitted that she breached the standard of care" and that, even if she had not admitted that she breached the standard of care, Manning would still be held liable under Ex parte HealthSouth Corp., 851 So. 2d 33, 42 (Ala.2002), which states:
(Emphasis supplied.)
Manning testified that Wilson "was my patient and I was trying to get medical orders. I was trying to get the medication. I was trying to get continuity." She explained that "continuity" means "to continue care in any setting" and acknowledged that "with antibiotics" continuity of care was important. Manning states in her brief to this Court that "[t]here is no testimony, expert or otherwise, which has been presented showing Nurse Manning or any of the nurses under her direction should have administered medication to Ms. Wilson without a doctor's order."[11] As noted, the record reveals that Manning testified that "the integrity of delivering nursing care would have been breached" if there had been a doctor's order that the nursing staff at the jail had not complied with for seven days. She admitted that "we had the doctor on the phone" and that an oral order from him would have been effective, but that no such order was requested from him; rather, her defense was simply, "he didn't give an order." Dr. Alsip stated in his letter to Infirmary Home Health, "I personally spoke with the jail sometime after 5 o'clock the evening of May 23, and I know that they had your number and there was a clear understanding to continue her therapy if she were not to be released, which at that point seemed very unlikely." Also, Manning replied "[y]es" when she was asked if "obviously" *1111 there had been a breach in the standard of care administered to Wilson.
"[T]his Court recognized [in Tant v. Women's Clinic, 382 So. 2d 1120 (Ala. 1980),] that a plaintiff's burden of proving the standard of care in a medical-malpractice case can be met by expert testimony of the health-care provider or its employees." Tuck v. Health Care Auth. of Huntsville, 851 So. 2d 498, 505 (Ala.2002). Drawing all reasonable inferences in favor of the nonmovant, Wilson, as we must, and taking into account Manning's testimony, we conclude that there was substantial evidence from which a reasonable juror could infer that Manning accepted Wilson as her patient with full knowledge of Wilson's "necessary medicines" and with full appreciation of the importance of continuity of care in antibiotic treatment, yet failed to provide that care beginning with the dosage due at 6:00 p.m. on May 21, 1997, through the 6:00 a.m. dosage due on May 28, resulting in a total of 14 missed doses.
For all that appears in the record before us, Manning did nothing to seek continuity of antibiotic treatment for Wilson from May 23 until May 28, when Wilson submitted another request for medical evaluation. Manning's only explanations for this prolonged interruption of continuity of care were that the "plan"devised May 22 and motivated by monetary considerations was to attempt to secure Wilson's release from jail and that Manning had no doctor's order to administer the drug. Manning elected to forgo asking Dr. Alsip or Dr. Eichold for such an order, passively relying on the fact that no such order was volunteered.
Dr. Alsip, in his May 28 letter to Infirmary Home Health, stated that it was his "clear understanding" on May 23, after he "personally spoke with the jail," that Wilson's therapy would be continued in the jail if she were not released. (Emphasis supplied.) He stated further that, "if there was a problem" in that regard, he would have expected to have heard from either Infirmary Home Health or "from the jail." Although he explains in that letter that he was continuously available for further contact after the conversation, he found out only on May 28 that Wilson's "antibiotic therapy was discontinued in spite of our efforts."
Collectively, all of this evidence provides the requisite "substantial evidence" sufficient to allow the fact-finder to infer from it that Manning breached the standard of care in her handling of Wilson's care by allowing her patient to be without 14 consecutive doses of "necessary medicines." We recognize that Manning produced countervailing evidence; our conclusion, however, is controlled by the proposition that all reasonable inferences must be drawn in favor of Wilson as the nonmovant. Quad Cities Nissan, Inc. v. Griffin, 638 So. 2d 830, 831 (Ala.1994). Thus, the trial court erred in entering the summary judgment on the basis that there was not substantial evidence to prove a breach of the standard of care.
Accordingly, we reverse the summary judgment and remand the cause for further proceedings consistent with this opinion.
REVERSED AND REMANDED.
HOUSTON, SEE, LYONS, WOODALL, and STUART, JJ., concur.
JOHNSTONE, J., concurs specially.
JOHNSTONE, Justice (concurring specially).
I concur. I add that undertaking and then neglecting the medical treatment of a patient does not constitute "exercising ... judgment in the administration of a department or agency of government" and *1112 therefore does not constitute conduct immunized by paragraph (2) of the restatement in Ex parte Cranman, 792 So. 2d 392, 405 (Ala.2000).
[1]  Wilson also named other individuals and entities as defendants in her amended complaint, but later voluntarily dismissed her claims against one entity and did not appeal the summary judgments for the other defendants.
[2]  The summary-judgment motion was filed by, and summary judgment was entered for, three defendants; Wilson appeals only as to Manning.
[3]  The record does not expressly describe the Groshong shunt; however, we infer that it is a type of surgically installed catheter used to administer intravenous medication.
[4]  The consent stated, "I hereby authorize the Medical Staff at the Mobile County Sheriff's Department to treat and care for me while I am incarcerated at the Mobile County Jail."
[5]  According to Manning, these forms are also called "sick call slips," and "[t]he inmates that are requesting medical care or to be seen on sick call make out the Request for Medical Evaluation." She stated in her deposition, "If I am in the office, I go ahead and go through the sick [call] slips. If I am not in the office, then the clinic director, Linda Singleton, sees the patient."
[6]  The written order Dr. Alsip gave to Infirmary Home Health on May 12, 1997, called for that agency to administer the antibiotic in dosages of "1 gm in 50cc D5W q [every] 12 hours via Groshong," and "[c]hange dressing 3 × wk."
[7]  Manning stated in her deposition that osteomyelitis is "a bacteria, a germ, that most often you see as the result of a gunshot wound or a dirty wound." Osteomyelitis is "an infectious usu. painful inflammatory disease of bone often of bacterial origin that may result in the death of bone tissue." Merriam-Webster's Collegiate Dictionary (11th ed.2003).
[8]  Manning testified that "Dr. Eichold at that time was director of medicine [at the jail].... And he was basically responsible. So, I called him, gave him a report."
[9]  Wilson stated in her brief, "The trial court was in error by failing to find that Ex parte Cranman ... controlled when, as in this case, [Manning], a state employee, is being sued in his or her individual capacity for medical malpractice."
[10]  Manning also cites Ex parte Purvis, 689 So. 2d 794 (Ala.1996), and Lancaster v. Monroe County, 116 F.3d 1419 (11th Cir.1997), in support of her immunity claim. However, those cases address sovereign immunity, not State-agent immunity. Manning never argued to the trial court, and therefore never gave Wilson an opportunity to respond to, the issue of sovereign immunity.
[11]  Manning also argues that "[m]ore importantly, there is no evidence that any alleged breach of the standard of care by Ms. Manning proximately caused [Wilson's] injuries." Manning never raised the issue of lack of proximate cause in the trial court, giving Wilson no cause to present opposing argument or supplemental evidence; therefore, we will not consider the issue.