Title: McCullough v. Bethany Med. Center

State: kansas

Issuer: Kansas Supreme Court

Document:

235 Kan. 732 (1984)
683 P.2d 1258
MARY ANN McCULLOUGH, Appellant,
v.
BETHANY MEDICAL CENTER, JIMMY KELSO, and CHARLES T. STUBBLEFIELD, M.D., Appellees.
No. 56,203

Supreme Court of Kansas.
Opinion filed June 8, 1984.
Bryson R. Cloon, of Cloon & Bennett, of Overland Park, argued the cause, and Kim Daniel Richey, of the same firm, was with him on the brief for appellant.
Sally H. Harris, of Wallace, Saunders, Austin, Brown & Enochs, Chartered, of Overland Park, argued the cause, and David K. Knowles, of the same firm, was with her on the brief for appellees Bethany Medical Center and Jimmy Kelso.
W. Warren McCamish, of Williamson & Cubbison, of Kansas City, argued the cause and was on the brief for appellee Charles T. Stubblefield, M.D.
The opinion of the court was delivered by
McFARLAND, J.:
This is a medical malpractice action in which plaintiff Mary Ann McCullough appeals from summary judgments entered in favor of defendants Bethany Medical Center, Jimmy Kelso and Charles T. Stubblefield, M.D.
We shall first consider the propriety of the summary judgment entered in favor of Dr. Stubblefield. The general rules relative to summary judgment were summarized in Olson v. State Highway Commission, 235 Kan. 20, 679 P.2d 167 (1984) as follows:
At this point a statement of the relevant facts in the light most *733 favorable to the plaintiff is appropriate. Unfortunately, what should be a relatively simple task is rendered difficult by virtue of defendant Stubblefield's noncompliance with Supreme Court Rule 141 (232 Kan. cxlviii), which provides:
The failure of Stubblefield to comply with section (a) thereof rendered it impossible for plaintiff to comply with section (b) of the rule. Therefore the "facts" come to us for appellate review in a rather amorphous mass. More will be said later in this opinion relative to the legal effect of failure to comply with Supreme Court Rule 141. However, we will state the general background from which the cause of action arose and how plaintiff's claim against Stubblefield reached its present legal posture.
In 1980 plaintiff and her husband Bruce McCullough were expecting their first child. Plaintiff selected Dr. Stubblefield as her obstetrician as he was involved in the Bradley method of unmedicated childbirth. Plaintiff and her husband participated in Bradley method classes during the pregnancy. On August 23, 1980, plaintiff went into labor and entered the Bethany Medical Center during the early evening hours. The pregnancy had been *734 normal and uneventful. The following morning plaintiff was examined by Dr. Stubblefield who advised her she had not dilated sufficiently for a natural childbirth and a Caesarian section would be necessary. Plaintiff became emotionally upset upon learning of this. She stated she wanted to be awake during the procedure. Dr. Stubblefield did not discuss the risks of a Caesarian section or, specifically, the risk of spinal or epidural anesthesia for this type of operation.
As plaintiff was being wheeled to the operating room she met defendant Jimmy Kelso, a nurse anesthetist employed by defendant Bethany Medical Center. Dr. Stubblefield was not present. Mr. Kelso had been advised by someone, possibly a nurse, that he was to use an epidural anesthetic on plaintiff. Mr. Kelso asked plaintiff questions relative to her medical history and explained how the lumbar epidural anesthetic would be administered. He did not explain the risk of this type of anesthetic presents, either in general or in particular, to a full-term pregnant patient. Anesthetization was attempted several times by inserting a needle with a syringe containing Nesacaine-CE 3%. Ultimately the anesthetic was injected by utilizing the single shot method. Plaintiff immediately went into convulsions and stopped breathing. Her breathing was supported. Dr. Stubblefield arrived and the Caesarian section was performed resulting in the delivery of a living child.
Plaintiff suffers from adhesive arachnoiditis and is now confined to a wheelchair. This neurological condition results from scar tissue growing around the spinal cord. The condition can be caused by negligent insertion of the anesthetic into the spinal space rather than the proper epidural space of the spinal column. There is also some indication an excessive amount of the anesthetic may have been used. There is no allegation plaintiff suffered from this condition before the administration of the anesthetic.
Plaintiff brought this action on behalf of herself, her husband and her child for her personal injuries resulting from the negligent administration of anesthetic and the failure of all involved to advise her of the risks of such anesthetization in order that she could make an informed decision. The original defendants were Dr. Stubblefield, Mr. Kelso, Bethany Medical Center and Pennwalt Corporation, of Philadelphia, Pennsylvania, manufacturer *735 of the anesthetic. Plaintiff subsequently settled with Pennwalt, and this aspect of the case will be discussed in detail in the next issue.
The district court entered summary judgment in favor of Dr. Stubblefield after making the following findings of fact and conclusions of law:
Plaintiff challenges the Stubblefield summary judgment on two grounds. The first is that said defendant's failure to comply with Supreme Court Rule 141 precluded the court from entering summary judgment. The second ground is that there were material facts which were in dispute. We shall first consider the issue in relation to Rule 141.
Instead of complying with Rule 141(a) defendant filed a memorandum which discussed each claim of negligence but did not even attempt to set "forth concisely in separately numbered paragraphs the uncontroverted contentions of fact relied upon by said movant (with precise references to pages, lines and/or paragraphs of transcripts, depositions, interrogatories ....)." Plaintiff responded to the motion by noting the summary judgment could not be heard until Rule 141 had been complied with, citing the first sentence in the rule which provides:
*736 By virtue of defendant Stubblefield's failure to comply with Rule 141(a), plaintiff could not comply with Rule 141(b) relative to what facts were controverted and what were not and the evidentiary basis therefor. At the hearing Stubblefield's counsel stated the case was complex and he thought the way he prepared his memorandum was better, under the circumstances, than following the mandates of Rule 141. The district court agreed and found defendant had "substantially complied" with the rule. We do not agree. The bottom line is the summary judgment was granted with no way to determine then or now what facts are or are not controverted or on what evidence the parties rely. Rule 141 is not just fluff  it means what it says and serves a necessary purpose. Contrary to the opinion of Stubblefield's counsel, a moving party's compliance with Rule 141(a) is even more crucial in complex cases than in simple ones. In accordance with the express language of the rule, the district court could not even hear the motion until the moving party was in compliance with the requirements of the rule. On this basis alone, the summary judgment for Stubblefield must be reversed.
We, therefore, do not reach the second claim of error. However, some comments thereon are appropriate. One of the crucial issues in this case as it pertains to defendant Stubblefield, is the legal relationship between the physician and the nurse-anesthetist. Dr. Stubblefield contends he had no control over Mr. Kelso and hence has no legal liability for any alleged negligence of Mr. Kelso. This is not the first time the legal relationship between a physician and an anesthetist has been before this court.
Voss v. Bridwell, 188 Kan. 643, 364 P.2d 955 (1961), was an action against a general surgeon with staff privileges at the University of Kansas Medical Center; an anesthetist-resident; and the department head of anesthesiology for negligent administration of general anesthetic during surgery. The anesthetic had been administered by the anesthetist-resident and the plaintiff sought to connect the resident's negligence to the general surgeon and the department head on a respondeat superior theory. See generally 8 Am. Jur. Proof of Facts 2d, Surgeon's Failure to Exercise Supervision and Control Over Anesthetist, p. 579; Annot., Hospital's Liability for Injury or Death to Patient Resulting From Or Connected with Administration of Anesthetic, 31 A.L.R.3d 1114; Annot., Liability of One Physician or *737 Surgeon For Malpractice of Another, 85 A.L.R.2d 889, § 12[b]. The general surgeon, Dr. Bridwell, alleged as his duties did not encompass the administration of anesthetic he could not be held liable for any injury which occurred to Mr. Voss because of the negligence of the anesthetist-resident. 188 Kan. at 653. The trial court granted the anesthesia department head's demurrer to the plaintiff's petition but denied the surgeon's and resident's demurrers. In the ensuing appeal this court noted the duty of a physician to his patient was not affected by the fact the service rendered was gratuitous, or by the fact the physician had employed a third person so no contractual relation existed between the physician and the patient. 188 Kan. at 652. The Voss court then discussed the crucial distinction between right to control and right to supervise the actions of another health care provider. For the latter a surgeon would not be liable, for the former, a surgeon could be accountable.
The court in Voss also held the district court had erred in granting the department head's demurrer to the petition for it alleged sufficient facts to show the department head could be *738 responsible for the negligent acts of the anesthetist-resident. 188 Kan. at 657.
The result of Voss that a physician could be liable for the negligence of an anesthetist is consistent with the general view the obligation to provide anesthesia is not necessarily limited to one person. Two doctors, writing on obstetric anesthesia have commented succinctly:
While Voss involved an anesthetist-resident, as compared to the instant action of a nurse-anesthetist, we note though a surgeon is generally not liable for the negligence of an anesthesiologist, a surgeon usually is liable for the negligence of an anesthetist-resident or nurse-anesthetist under the doctrine of "captain of the ship" which still pertains in most states. 8 Am. Jur. Proof of Facts 2d, Anesthetist Supervision And Control § 1, p. 587.
Conceivably, a factual situation could exist where summary judgment would be proper on the issue of responsibility of the operating surgeon for the negligence of a nurse-anesthetist. However, such a situation would be a rare bird. Ordinarily, determination of the right of control is a matter for the trier of facts. See 8 Am. Jur. Proof of Facts 2d, Anesthetist Supervision and Control § 6, pp. 598, 600-01. Also see generally Voss v. Bridwell, 188 Kan. 643; 12 Am. Jur. Proof of Facts, Anesthesia § 1, p. 453.
The summary judgment entered in favor of Dr. Stubblefield is reversed and plaintiff's claim against the physician is remanded for further proceedings.
The second issue before us is whether the district court erred in entering summary judgment in favor of defendants Bethany Medical Center and Jimmy Kelso.
The Pennwalt Corporation of Philadelphia, Pennsylvania, was an original named defendant in the action predicated upon product liability and negligence in connection with the Pennwalt anesthetic, Nesacaine-CE 3% used by Mr. Kelso. Counsel *739 for Pennwalt and the plaintiff entered into settlement negotiations which culminated in a release being executed on June 29, 1983, and modified the following day. Defendants Bethany and Kelso filed a motion for summary judgment contending this release was a general release of all claims arising from the August 24, 1980, anesthetization of plaintiff. The district, court sustained the motion.
In ruling on the motion the district court held:
This was error. As this court said in Fieser v. St. Francis Hospital & School of Nursing, Inc., 212 Kan. 35, 510 P.2d 145 (1973):
The Fieser rule is consistent with Restatement (Second) of Torts § 885, Comment d, p. 335 (1979):
Further, there is no indication in the record whether or not the district court placed the burden of proof upon defendants Bethany and Kelso to establish they came within the release. As this court stated in Fieser v. St. Francis Hospital & School of Nursing, Inc., 212 Kan. 35:
Succinctly:
See also Shinkle v. Union City Body Co., 94 F.R.D. 631, 633 (D. Kan. 1982.)
In the absence of any evidence produced by either party on the question of intent, and when the document is silent upon the matter, the Kansas rule is that other parties are "presumed" not released. Shinkle v. Union City Body Co., 94 F.R.D. 631; Stueve v. American Honda Motors Co., Inc., 457 F. Supp. 740 (D.Kan. 1978).
In Geier v. Wikel, 4 Kan. App.2d 188, 603 P.2d 1028 (1979), the Kansas Court of Appeals stated:
In Kennedy v. City of Sawyer, 228 Kan. 439, 618 P.2d 788 (1980), we stated:
With the rules and discussions contained in the aforecited cases in mind, we turn to the specific release before us.
The release executed on June 29, 1983, was captioned "General Release of all Claims." The document indicated the agreement was only between the McCulloughs (including their son, B.J.) and "THE PENNWALT CORPORATION, Philadelphia Pennsylvania, including its Pharmaceutical Division, Rochester, New York, and its manufacturing agent, Taylor Pharmacal Co., Decatur, Illinois, hereinafter collectively referred to as `Pennwalt.'" Nowhere in the document was there any explicit mention of the remaining defendants. However, the document did state the McCulloughs:
The document contained the following indemnity clause:
On June 30, 1983, some concern arose on the part of the plaintiff's attorney relative to the language of the release. It was determined certain interlineations should be made to make the point precise that the only party being released was Pennwalt. Consequently, the title of the document was amended to read "General Release of All Claims as to Pennwalt Only" rather than the previous designation, "General Release of All Claims." On the second page of the release a clause which had read: "... in consideration for plaintiff's agreement to dismiss, with prejudice, the aforementioned pending lawsuit, and to enter into this General Release...." was amended to state:
The number four paragraph on June 29 had read: "Mary Ann McCullough hereby stipulates and agrees that she, as the named plaintiff, will stipulate to the dismissal with prejudice and shall dismiss the pending lawsuit, Case No. 81-C-4009 in the District Court for Wyandotte County, Kansas." On June 30, as amended, paragraph four declared: "Mary Ann McCullough hereby stipulates and agrees that she, as the named plaintiff will stipulate to the dismissal of Pennwalt only, with prejudice, from the pending lawsuit, Case No. 81-C-4009 in the District Court of Wyandotte County, Kansas." (Emphasized portions being insertions.) Another interlineation to plaintiff's release occurred in paragraph eleven. Previously, as pertinent here, the paragraph had read: "... with regard to the advisability of entering into this General Release of All Claims, and that they have been fully advised by said counsel regarding their rights in the execution of this General Release." As amended, paragraph eleven stated: "... with regard to the advisability of entering into this *743 General Release of All Claims as to Pennwalt only, and that they have been fully advised by said counsel regarding their rights in the execution of this General Release."
The June 30, 1983, release modifications were made prior to the filing, the same day, of a Stipulation for Dismissal with Prejudice of plaintiff's claim against Pennwalt. The remaining defendants did not sign the dismissal order as required by K.S.A. 60-241(a) but they do not contend this rendered the release ineffectual. Rather, they argue they are included in the release. This contention is predicated upon the claim that they were "distributing" or "dispensing" Nesacaine when the same was used on plaintiff and hence, they were included in the following release phrase:
The district court held the release, even with the interlineations, constituted a general release and entered summary judgment for defendants Bethany Medical Center and Kelso.
It is undisputed neither Bethany nor Kelso participated in the Pennwalt settlement negotiations. In fact, when invited to do so by Pennwalt, these other defendants declined. On June 23, 1983, Pennwalt's counsel wrote other defense counsel, stating:
No mention was made of any indemnification claim Pennwalt might assert against the other defendants. None has ever been asserted. It was agreed by plaintiff and Pennwalt the amount of settlement was confidential and must never be revealed. The amount has not been disclosed despite the other defendants' efforts to obtain this information. On June 24, 1983, counsel for defendants Bethany and Kelso wrote the district judge herein acknowledging he had been informed "a settlement has been reached between plaintiff and defendant Pennwalt" and seeking to delay Pennwalt's dismissal until after completion of discovery. *744 The stipulation of dismissal filed on June 30, 1983, provided:
Affidavits filed by plaintiff, her attorney, and the Pennwalt counsel are wholly consistent with plaintiff's position that only her claim against Pennwalt was intended to be included in the release.
We conclude, under the totality of the circumstances herein, defendants Bethany Medical Center and Kelso have, as a matter of law, failed to carry their burden of proof that they were included in the release filed herein and that the district court erred in entering summary judgment in favor of these defendants.
The judgments herein are reversed and the case is remanded for further proceedings.