Title: Cowan v. Hospice Support Care

State: virginia

Issuer: Virginia Supreme Court

Document:

Present:  Hassell, C.J., Lacy, Keenan, Koontz, Lemons, and Agee, 
JJ., and Carrico, S.J. 
 
INGRID H. COWAN 
 
v.  Record No. 032758   OPINION BY JUSTICE BARBARA MILANO KEENAN 
 
 
 
 
 
 
 
November 5, 2004 
HOSPICE SUPPORT CARE, INC. 
 
 
FROM THE CIRCUIT COURT OF THE CITY OF FREDERICKSBURG 
John W. Scott, Jr., Judge 
 
 
In this appeal, we consider whether a plaintiff's claims of 
gross negligence and willful and wanton negligence against a 
charity are barred by the doctrine of charitable immunity. 
 
For purposes of this appeal, the facts relevant to this 
issue of law and question of first impression are not in 
dispute.  On July 9, 2001, the plaintiff, Ingrid H. Cowan, 
placed her mother, Ruth D. Hazelwood (the decedent), in Harbor 
House, a residential facility that provides temporary care for 
very ill persons when their primary caregiver seeks respite.  
Harbor House is operated by the defendant, Hospice Support Care, 
Inc. (Hospice), “a non-profit, non-medical volunteer hospice 
support corporation.” 
 
The decedent was bedridden and required the assistance of 
two persons to move her from her bed to a bedside commode.  
During the decedent’s first night at Harbor House, a single 
volunteer lifted her from the bed.  When the decedent’s right 
leg became “caught” in the bed, the volunteer heard a loud 
 
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“popping-cracking” noise in the leg.  That evening, and for the 
remainder of the decedent’s week-long stay at Harbor House, the 
decedent received morphine for pain in her leg, but she was not 
provided any other medical treatment. 
Cowan returned to Harbor House on July 16, 2001.  After she 
and her mother left the facility, Cowan discovered that the 
decedent’s leg was swollen and that she appeared to be in pain.  
As a result, Cowan took the decedent to a nearby hospital 
emergency room.  The decedent was diagnosed as having a 
shattered right femur, which required amputation of her leg 
above the knee.  The decedent died four days later from 
complications resulting from the surgery. 
Cowan filed an amended motion for judgment in the circuit 
court against Hospice alleging wrongful death of the decedent 
based on claims of simple negligence, gross negligence, willful 
and wanton negligence, and negligent hiring and retention.  Upon 
consent of the parties, the circuit court dismissed the simple 
negligence count.  Hospice filed a plea in bar of charitable 
immunity to the counts of gross negligence and willful and 
wanton negligence, and a demurrer to the negligent hiring and 
retention count.  The circuit court sustained the plea in bar 
and demurrer and dismissed these remaining counts with 
 
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prejudice1.  Among other things, the circuit court concluded that 
the charitable immunity doctrine barred recovery for acts or 
omissions of gross negligence and willful and wanton negligence.  
Cowan appeals. 
On appeal, Cowan argues that this Court has not applied the 
charitable immunity doctrine to shield a charity from liability 
for acts of gross negligence or willful and wanton negligence.  
She asserts that because gross negligence and willful and wanton 
negligence are different in degree and kind from simple 
negligence, the charitable immunity doctrine should not be 
defined as including immunity for those more extreme acts.  
Cowan also contends that the charitable immunity doctrine should 
not be applied to acts of gross negligence or willful and wanton 
negligence because, in instances of such extreme conduct, the 
public’s interest in encouraging charitable activities is 
outweighed by the need to deter such acts of “reckless and 
harmful behavior.” 
In response, Hospice argues that charities should be immune 
from liability for all degrees of negligence because the absence 
of such immunity would discourage them from performing their 
beneficial activities.  Hospice asserts that this Court, in its 
prior decisions, has discussed charitable immunity from 
                     
1 Cowan did not assign error to the trial court's decision 
sustaining the demurrer to the negligent hiring and retention 
 
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liability for negligence without specifically limiting that 
immunity to claims of simple negligence.  Thus, Hospice 
contends, because gross negligence and willful and wanton 
negligence are simply different degrees of negligence, 
charitable immunity extends to shield charities from liability 
for those categories of negligent conduct as well. 
Hospice also asserts that Code § 8.01-226.4, which 
effectively subjects hospice volunteers to liability for acts of 
gross negligence and willful and wanton negligence, is evidence 
of the General Assembly’s intent to shield charities from 
similar liability by providing a remedy against the individuals 
who actually commit such acts.2  We disagree with Hospice’s 
arguments. 
Under the doctrine of limited immunity applied to charities 
in this Commonwealth, a charitable institution is immune from 
liability to its beneficiaries for negligence caused by acts or 
omissions of its servants and agents, provided that the charity 
has exercised due care in their selection and retention.  
Straley v. Urbanna Chamber of Commerce, 243 Va. 32, 35, 413 
                                                                  
claim. 
2 Hospice additionally argues that even if it can be sued 
for gross negligence or willful and wanton negligence, Cowan has 
failed to plead sufficient facts to state a claim for either.  
However, we do not consider this argument because the circuit 
court did not rule on the sufficiency of the facts pleaded in 
the amended motion for judgment.  Thus, the issue is not before 
us in this appeal. 
 
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S.E.2d 47, 49 (1992); Thrasher v. Winand, 239 Va. 338, 340, 389 
S.E.2d 699, 701 (1990).  While this immunity shields a charity 
from claims made by its beneficiaries, the immunity does not 
extend to protect the charity from claims made by persons who 
have no beneficial relationship to the charity but are merely 
invitees or strangers.  Straley, 243 Va. at 36-37, 413 S.E.2d at 
49; Thrasher, 239 Va. at 340-41, 389 S.E.2d at 701. 
We adopted this doctrine of limited charitable immunity 
based on public policy considerations.  Moore v. Warren, 250 Va. 
421, 424, 463 S.E.2d 459, 460 (1995); Hill v. Leigh Mem'l Hosp., 
204 Va. 501, 504-05, 132 S.E.2d 411, 414 (1963); Weston v. 
Hospital of St. Vincent, 131 Va. 587, 609-10, 107 S.E. 785, 792 
(1921).  These considerations rest on the premise that the 
services charities extend to their beneficiaries also benefit 
the public by alleviating a public burden.  See Hill, 204 Va. at 
507, 132 S.E.2d at 415.  When charities are required to expend 
funds to litigate negligence claims, the charities’ ability to 
perform services for their beneficiaries is restricted.  See 
Moore, 250 Va. at 423, 463 S.E.2d at 460; Hill, 204 Va. at 507, 
132 S.E.2d at 415; see also Egerton v. R.E. Lee Mem'l Church, 
395 F.2d 381, 382 (4th Cir. 1968). 
 
These public policy considerations provide the framework 
for resolving the issue before us.  In deciding this question, 
we focus on the nature of the conduct involved in the differing 
 
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degrees of negligence and the extent to which each type of 
conduct deviates from the role of charities and their 
contribution to the public welfare. 
 
As our decisions have recognized, there are three levels of 
negligence.  The first level, simple negligence, involves the 
failure to use the degree of care that an ordinarily prudent 
person would exercise under similar circumstances to avoid 
injury to another.  Gossett v. Jackson, 249 Va. 549, 554, 457 
S.E.2d 97, 100 (1995); Griffin v. Shively, 227 Va. 317, 321, 315 
S.E.2d 210, 212-13 (1984).  The second level, gross negligence, 
is a degree of negligence showing indifference to another and an 
utter disregard of prudence that amounts to a complete neglect 
of the safety of such other person.  This requires a degree of 
negligence that would shock fair-minded persons, although 
demonstrating something less than willful recklessness.  Koffman 
v. Garnett, 265 Va. 12, 15, 574 S.E.2d 258, 260 (2003); Griffin, 
227 Va. at 321, 315 S.E.2d at 213; Ferguson v. Ferguson, 212 Va. 
86, 92, 181 S.E.2d 648, 653 (1971). 
The third level of negligent conduct is willful and wanton 
negligence.  This conduct is defined as “acting consciously in 
disregard of another person’s rights or acting with reckless 
indifference to the consequences, with the defendant aware, from 
his knowledge of existing circumstances and conditions, that his 
conduct probably would cause injury to another.”  Etherton v. 
 
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Doe, 268 Va. 209, 213-14, 597 S.E.2d 87, 90 (2004)(quoting 
Griffin, 227 Va. at 321, 315 S.E.2d at 213); see also Alfonso v. 
Robinson, 257 Va. 540, 545, 514 S.E.2d 615, 618 (1999). 
As these definitions illustrate, there are fundamental 
distinctions separating acts or omissions of simple negligence 
from those of gross negligence and willful and wanton 
negligence.  When we consider these distinctions in the context 
of the charitable immunity doctrine, their differing 
applications to the doctrine become apparent. 
Acts or omissions of simple negligence may occur routinely 
in the performance of the activities of any charitable 
organization.  Employees or volunteers, in carrying out their 
duties, may fail to understand or to adequately follow 
instructions of a supervisor, may exercise poor judgment, or may 
have a lapse in attention to an assigned task.  While serious 
consequences may result from these deficiencies in performance, 
they ordinarily do not involve an extreme departure from the 
charity’s routine actions in conducting its activities. 
In contrast, gross negligence involves conduct that “shocks 
fair-minded people,” and willful and wanton negligence involves 
such recklessness that the actor is aware that his conduct 
probably would cause injury to another.  Etherton, 268 Va. at 
213-14, 597 S.E.2d at 90; Wilby v. Gostel, 265 Va. 437, 446, 578 
S.E.2d 796, 801 (2003); Griffin, 227 Va. at 321, 315 S.E.2d at 
 
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213.  Thus, unlike simple negligence, these two levels of 
negligence are characterized by conduct that represents an 
unusual and marked departure from the routine performance of a 
charity’s activities. 
As a practical matter, a charity’s performance of its 
mission may be thwarted by litigation directed at the charity’s 
failure to perform its activities in accordance with standards 
of ordinary care.  For this reason, our Commonwealth’s public 
policy in favor of promoting the activities of charitable 
organizations has been employed to shield charities from 
liability for their acts of simple negligence. 
 
This rationale, however, is inapplicable to conduct 
involving gross negligence and willful and wanton negligence.  
Unlike acts or omissions giving rise to claims of simple 
negligence, such conduct can never be characterized as an 
attempt, albeit ineffectual, to carry out the mission of the 
charity to serve its beneficiaries.  Therefore, we conclude that 
the public policy rationale that shields a charity from 
liability for acts of simple negligence does not extend to acts 
of gross negligence and willful and wanton negligence. 
 
This conclusion does not represent a departure from our 
often-stated preference for legislative rather than judicial 
action to “abolish or relax” the charitable immunity doctrine.  
See, e.g., Moore, 250 Va. at 424, 463 S.E.2d at 460; Roanoke 
 
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Hosp. Ass’n v. Hayes, 204 Va. 703, 709, 133 S.E.2d 559, 563 
(1963); Hill, 204 Va. at 504, 133 S.E.2d at 563.  Instead, our 
present holding, like several of our earlier decisions, serves 
to define the contours of the doctrine with regard to a subject 
we have not previously addressed.  See, e.g., Moore, 250 Va. at 
424, 463 S.E.2d at 460-61 (volunteer of charity is immune from 
liability to charity’s beneficiaries while engaged in 
performance of charity’s work); Straley, 243 Va. at 37, 413 
S.E.2d at 50-51 (community member only generally served by 
charity is not beneficiary); Weston, 131 Va. at 610, 105 S.E. at 
792 (one who pays for charity’s services can be beneficiary of 
charity). 
 
We also observe that our holding today is consistent with 
the General Assembly’s enactment of Code § 8.01-226.4.  That 
statute provides civil immunity for the acts or omissions of 
hospice volunteers who render care to terminally ill patients, 
provided that the volunteers act in good faith and in the 
absence of gross negligence or willful misconduct.  In enacting 
this section, the General Assembly has expressed a clear 
preference for excluding from the protection of charitable 
immunity acts or omissions of gross negligence and willful 
misconduct. 
 
For these reasons, we conclude that the circuit court erred 
in sustaining the defendant’s plea of charitable immunity to 
 
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Counts II and III of Cowan’s amended motion for judgment.  We 
will reverse the circuit court’s judgment and remand the case 
for further proceedings consistent with the principles expressed 
in this opinion. 
Reversed and remanded.