Title: Flint City Nursing Home, Inc. v. Depreast

State: alabama

Issuer: Alabama Supreme Court

Document:

406 So. 2d 356 (1981)
FLINT CITY NURSING HOME, INC.
v.
James Daniel DEPREAST, as Administrator of the Estate of William B. Depreast, Deceased.
79-652.

Supreme Court of Alabama.
September 25, 1981.
Rehearing Denied November 6, 1981.
*357 John S. Key of Eyster, Eyster, Key & Tub, Decatur, for appellant.
Dan F. Nelson and James D. Whitmire of Brewer, Lentz, Nelson & Whitmire, Decatur, for appellee.
MADDOX, Justice.
Plaintiff James Daniel Depreast, as administrator of the estate of William B. Depreast, deceased, filed suit against Flint City Nursing Home, Inc., and alleged that the deceased, William B. Depreast, while a patient at the nursing home, fell from a window and sustained injuries which caused his death. In his complaint, the administrator charged that the nursing home was negligent or wanton in causing or allowing the deceased to fall from the window.
In its answer, and subsequently at the pre-trial hearing, the nursing home stipulated that plaintiff's intestate died as a result of injuries sustained when he fell from a window, but the nursing home denied that it failed to exercise reasonable care for the deceased's safety. The trial was before a jury, which returned a verdict in favor of the plaintiff in the sum of $225,000.
The primary issues determinative of the appeal involve evidentiary questions, viz.:
(1) Did the trial court err in admitting evidence concerning the licensure status of the nursing home and its administrator at the time of and prior to the accident?
(2) Did the trial court err in admitting evidence that the Alabama State Department of Health had cited the nursing home for various deficiencies?
We first discuss the issue of whether the trial court erred in admitting evidence concerning the licensure status of the nursing home and its administrator at the time of and prior to the accident. While we have been unable to locate any Alabama decision which specifically addresses the question of the admissibility of evidence of the licensure status of a business or enterprise or its administrator when the question posed is whether that business or enterprise exercised reasonable care on the occasion of the accident, we determine that this Court's case of Lindsey v. Barton, 260 Ala. 419, 70 So. 2d 633 (1954), which involved the admissibility of evidence that a motorist did not possess a driver's license, presented a similar question and is persuasive. The central question tendered to the Court in Lindsey concerned the action of the trial court in refusing to admit evidence proffered by the defendants that while driving his car at the time of the accident, the plaintiff did not have a driver's license. The Court discussed the question of the admissibility of that evidence, as follows:
This Court reached a similar result in Giles v. Gardner, 287 Ala. 166, 169, 249 So. 2d 824 (1971):
Although Lindsey and Giles both involved a failure of the person involved to have a driver's license, we think both cases are especially instructive on the legal issue presented in this casethe admissibility of evidence of the failure of a business or person, such as a regulated nursing home and its administrator, to have a license, when the question of actionable negligence on a specific occasion is at issue. As we read Lindsey, and the later case of Giles, evidence that one who is required to have a license by law does not have one, would be admissible only if:
(1) The statute which requires the license was enacted for the benefit of the person who seeks to invoke its violation as distinguished from the public generally or a class to whom the statute necessarily applies, and
(2) There was a causal connection between the failure of the person or business required to be licensed and the injuries suffered.
The plaintiff contends that the evidence was admissible under the two-prong test set out in Lindsey. We have studied plaintiff's arguments very closely and we conclude that the two-prong requirement mentioned in Lindsey was not met in this case. The statutes which were enacted to regulate and require nursing homes and their administrators to be licensed, were enacted under the police power to provide for the public health, welfare and safety, and are designed to protect the public generally from incompetent, unethical, and unscientific practitioners in nursing home care. Cf. Dent v. West Virginia, 129 U.S. *360 114, 9 S. Ct. 231, 332 L. Ed. 623 (1889). As this Court held in Lindsey, with regard to the requirement that persons who operate a motor vehicle on the highways of the state must have a driver's license, we hold that the statutes which regulate nursing homes impose a duty for the public at large. Any individual person injured, therefore, would acquire no new rights by virtue of the enactment of the statutes. Lindsey, 260 Ala. at p. 422, 70 So. 2d 633. Furthermore, we find no showing of a causal connection between the licensure status of the nursing home and its administrator at the time of and prior to the accident and the injuries received by the plaintiff's intestate.
The next issue is whether the trial court erred in admitting evidence that the Alabama State Department of Health had cited the nursing home for various deficiencies.
Unquestionably, the nursing home had been cited on previous occasions for many deficiencies. The deficiencies were as follows:
1. A safe and sanitary environment for patients and personnel does not exist.
2. Special care for patients. Patients with personality problems are not housed in a manner so as to prevent them from disturbing or even hurting other patients.
3. Maintenance is poor on building.
4. Several windows have loose screens or no screens.
5. Missing window screens and paucity of room air conditioners virtually insures inability to maintain comfortable room temperature.
6. The call system for the patient beds does not operate.
7. The nursing home does not have sufficient housekeepers to keep the building clean.
8. Windows and window sills contain accumulation of dust and grit for more than a day's duration.
9. Unsanitary conditions and offensive odors encountered in any area or section of the facility are indisputable facts that there are insufficient personnel assigned to this department.
10. The nurses' notes do not consistently include pertinent observations relative to the care rendered, i.e., the patient's response and progress to rehabilitative nursing being provided. The notification of the physician and family at the time of significant changes of the patient [sic].
11. The governing body has not appointed an administrator who functions in a manner so as to plan, organize and direct the enforcement of rules and regulations to assure the health, care and safety of the patients and the protection of their personal rights.
12. This individual is not a licensed nursing home administrator, nor does he have administrative experience in a health care setting.
13. The facility's administrator has not planned ongoing liaison among the governing body, medical and nursing staff, and other professional and supervisory staff of the facility.
14. The governing body has not enforced rules and regulations necessary for the health, care and safety of the patients.
15. The facility's policy relating to notification of physician, next-of-kin and other responsible persons in case of change in patient's status are [sic] not appropriately written to assure that proper notification is made.
16. The education program is not effective as evidenced by the lack of proper orientation of its employees for disaster preparedness, lack of fire drills, lack of orientation and training for dietary employees, unsanitary practices of dietary employees and poor maintenance and storage throughout the facility.
Plaintiff, contending that the evidence of these citations was admitted for the purpose *361 of showing that the defendant nursing home had notice of the dangerous condition of the premises, summarizes his argument for the admissibility of his evidence, as follows:
Plaintiff argues that "evidence of deficiencies found by the State Department of Health was admitted for the purpose of showing notice to the nursing home of dangerous conditions existing at the nursing home and inadequate policies and procedures relative to the care and well-being of its patients." Plaintiff argues that the trial court had discretion to decide whether or not to permit these deficiencies to be shown and that the evidence of the deficiencies was allowed for "the limited purpose of showing notice to the nursing home, and [the court] so instructed the jury during the trial." Plaintiff is correct. The court did instruct the jury that evidence of past deficiencies was admitted for the purpose of showing notice.[1]
*362 Plaintiff contends that in view of the instruction which limited the jury's consideration of the evidence no prejudicial error was shown. Because the court did instruct the jury as it did, this case presents a difficult question on the presence or absence of prejudice. Plaintiff is correct in contending that evidence of knowledge by an alleged tort-feasor of a defective condition is admissible to show that notice was brought home to him of the defective condition. The rule of law is that, in an action for injury, under certain circumstances, especially when knowledge of the defective condition may be an issue, evidence of notice to the alleged tort-feasor, prior to the accident and suit, of the alleged dangerous condition, is relevant to the issue of negligence. Alabama Great Southern Railway Company v. Choate, 184 Ala. 636, 64 So. 78 (1913). On the other hand, good or bad character of a party in a civil action which is offered as tending to show that party's conduct on a specified occasion, is generally excluded. C. Gamble, McElroy's Alabama Evidence, § 34.01, p. 60. Nevertheless, the alleged defect, the notice of which was brought home to the tort-feasor, must have been one which proximately caused or proximately contributed to the injury or death complained of.
Applying the above-stated rule to the facts of this case, we determine that deficiencies which are numbered 5, 7, 8 and 15, were inadmissible. With regard to the other deficiencies we express no opinion, especially since the cause must be reversed on another point. If the case is re-tried, the question of admissibility of these other deficiencies may not arise, and if the question does arise, the parties and the court may well handle the matter differently than the matter was handled in the first trial.
We have made a full and fair examination of the record in this case, and we have carefully researched Alabama law regarding the evidentiary questions posed on this appeal, and we are convinced that the trial court (1) erred in admitting evidence which related to the licensure status of the nursing home and administrator and, (2) under the facts of this case, erred in admitting evidence concerning deficiencies numbered 5, 7, 8 and 15, which deficiencies were noted by inspectors of the Health Department, even though the court gave a limiting instruction with regard to the effect of the evidence of those deficiencies.
Even though we reverse the case, we are compelled to point out that the record contains sufficient evidence from which the jury could have found that the defendant was negligent on the occasion complained of, without considering the evidence we hold should not have been admitted. We would be reluctant to reverse the judgment of the trial court and order a new trial in this case except for the fact that we are not convinced that the admissibility of the evidence which we have determined should have been excluded did not affect the measure of damages assessed by the jury; therefore, we conclude that the nursing home is entitled to a new trial. Because of the judgment we reach on the evidentiary issues, we do not discuss the nursing home's contention that the verdict was excessive, but we should not be understood as agreeing with the nursing home's contention that the verdict was excessive. We only hold that the admission of the prejudicial evidence could have affected the size of the verdict, and because of that fact, we cannot apply the harmless error rule. Rule 45, A.R.A.P.
*363 The judgment of the trial court is due to be reversed and the cause remanded.
REVERSED AND REMANDED.
TORBERT, C. J., and JONES, SHORES, EMBRY, BEATTY and ADAMS, JJ., concur.
FAULKNER and ALMON, JJ., not sitting.
[1]  "THE COURT: In conjunction with the objections that have been made and the offers of evidence concerning deficiencies. You have heard me limit several items, ladies and gentlemen, in the testimony in the face of objection, and I will give you this instruction as concerns these alleged notices from the Department of Public Health: You may consider deficiencies cited by the Department of Public Health to the end that such would logically tend to put the defendant or its agents on noticeif you are reasonably satisfied that they had such a tendency. You should not consider them as being true. That would be hearsay. You should not consider any deficiency that you are not reasonably satisfied from the evidence logically tended to notify the defendant that specific conditions existed which might proximately cause injury to a patient if not corrected.

"You have heard me say several times I will let it in on the purpose of notice. They are allowed for that purpose, and not for the purpose of the truth of what is in them.
"The statements made by someone would have a tendency to notify somebody of an existing condition if a jury was reasonably satisfied after it was over with and had all the evidence that the reasonable [sic] conditions existed, whether the truth of what the person said was so or not.
"It is not allowed for the purpose of bolstering up or supporting that position. It is allowed only for the purpose of notice.
"With that instruction, I will let you go ahead.