FI RST DI VI SI ON

DOYLE, C. J.

, A NDREWS, P. J.

, and RA Y, J.

N O T IC E : M otions for r e c ons i de r a tion m us t be

ph y sic a l ly r e ce iv ed i n our c le r k ’s offic e w ithin te n

da y s of the da te of de c is ion to be de e m ed tim e ly file d.

http://w w w .ga a ppe a l s .us /r ule s

Jul y 14, 2016



# I n th e Co u r t o f

A p p eals o f

G eo r g ia

A1 6 A1 60 0

. GRAHAM et al

. v

. W ELLSTAR HEALTH SYSTEM

, INC. et al

.

A N D R E W S , Pres i d in g J u d g e.

Th i s ap p eal i s fro m t h e g ran t o f p art i al s u m m ary ju dg m en t in an act io n ari s i n g

o u t o f t h e d eat h o f J us t in Grah am d u e t o l iv er fai l u re f o l l o w i n g h is arres t fo r DUI.

Th e o p erat i v e fact s o f th e cas e are fu l l y s et fo rt h i n a p rev i o u s ap p eal an d w il l n o t b e

rei t erat ed here. See G r a h a m v. Co b b Co un t y

, 3 1 6 Ga. Ap p

. 73 8 (7 3 0 SE2 d 4 3 9 )

(2 0 1 2).

Su b s eq uen t t o t h at earl i er ap p eal

, Grah am ’ s fam i l y (h erei n aft er Grah am ) fi l ed

a t h i rd am en d m en t t o t h e c o m p l ai n t wi t h d rawi n g al l rem ai n in g cl ai m s an d i n s t ead

as s ert i n g t h e fo l lo wi n g cl ai m s : (1 ) s i m p le neg l i g en ce as t o Dr. Cl aren ce Hen d ri x as

ch i ef m ed i cal o ffi cer at t he Co b b Co u n t y Ad u l t Det en t i o n In fi rm ary

, an d as t o Dav idHo wel l as Ad m i n is t rat o r fo r W el l s t ar Heal t h Sy s tem s; (2 ) p ro fes si o n al n eg l i g en ce as

t o D r. Hen d ri x ; (3 ) s i m

p le n eg l i g en ce as t o W el ls t ar un d er t he d o ct ri n e o f res p o n d eat

s u p eri o r b as ed o n t he act s o f Dr. Hen d ri x an d Dav i d Ho wel l ; (4 ) Neg li g en ce p er s e

as t o W el l s t ar; (5 ) wro n g fu l d eat h as t o al l d efen d an t s ; an d (6 ) p ai n an d s u fferi n g as

t o al l d efen d an t s.

On Feb ru ary 1 6

, 20 1 5

, as cl ari fi ed o n reco n s id erat i o n o n F e b r u ary 2 3

, 2 0 1 5,

t h e t ri al co u r t g r an t ed s u m m ary ju dg m en t fo r t h e d efen dan t s o n th e n eg l i g en ce an d

wro ng fu l d eat h cl ai m s as s ert ed ag ai n s t W el l s t ar an d Ho w el l . Th i s ap p eal fo l l o wed

.

1

. Neg l i g en ce p er se. Grah am co n t en ds t h at b y co n t ract i n g wi t h t h e Co b b

Co u n t y Sh eri ff’ s Offi ce t o p ro v i d e m ed i cal care fo r jai l d et ai nees

, W el ls t ar o wed a

d u t y u nd er OCGA §§ 42 -5 -2 (a), 4 2 -4

- 4 ( a ) ( 2 ), an d 4 2 -4 -3 2 (d ) t o p ro v i d e n eed ed

m ed i cal care fo r d et ai n ees

, an d b reach ed th at d u ty i n i t s m is m an ag em en t o f Grah am ’ s

care. Ho wev er, as n o t ed b y t h e t ri al co u rt i n i ts o rd er o n Feb ru ary 23

, 2 0 15

, Grah am

n ev er pl ead ed an y ap p l i cat i o n an d v i o l at i o n o f OCGA § § 4 2

- 4

- 4 (a) (2 ) o r 4 2 -4 -3 2

(d ) ag ai ns t W el l s t ar i n t h e t hi rd am en d ed co m p l ai n t

. Th e am en d ed co m p l ai n t d id

as s ert a p er s e v io l at i o n of OCGA § 4 2 -5 -2 (a), bu t t o t h e ex t en t t h at s tat u t e ap p l i ed

t o W el l s t ar b y v i rt u e of i t s co n t ract wi th t h e Co b b Co un t y Sh eri ff’ s Offi ce, i t creat ed

an o b l i g at i o n t o p ro v i d e det ai n ees wi th acces s t o m ed i cal care, b u t d i d n o t ad d res s t h e

2i s su e o f p r o p e r m ed i cal care. Ep p s v. Gwi n n et t Co u n t

y

, 2 31 G a. A p p

. 66 4

, 6 7 0 (8 )

(4 9 9 SE2 d 6 5 7) (1 9 9 8 ). A s i t i s u n di s pu t ed G rah am was p ro v id ed acces s t o m ed i cal

c a r e

, t h e t ri al co u rt d i d no t err i n co n cl u d i n g OCGA § 4 2 -5 -2 (a) p ro v i d es n o b as i s

fo r a n eg l i g en ce p er s e cl ai m ag ai n s t W el l s t ar.

2

. Or d i na r

y n eg l i g en ce o r p r of

es s i o n al n eg l i

g e n ce. Th e t ri al co u rt fo u n d

Grah am ’ s o rd i n ary n eg l i g en ce cl ai m s act u al ly were cl ai m s fo r p r o fes s i o n al

n eg li g en ce an d g ran t ed s u m m ary ju d g m en t fo r t h e d efen dan t s o n t h e bas i s t h e ex p ert

affi d av i ts fi l ed i n t h e cas e were i n s u ffi ci en t t o su p po rt an y su ch cl ai m s

. Grah am

co n ten d s t h e t ri al co u r t e r r e d i n cl as s i fy i n g th e cl ai m s ag ai n s t W el l st ar an d Ho wel l

as p ro fes s i o n al n eg l i g en ce, b ut e ve n so, t h e ex p ert affi d av i t s s p eci fi cal l y in co rp o rat ed

i n t h e t h i rd am en d ed co m p l ai n t s u f fi ci en t l y s t at ed s p eci fi c ex am p l es o f d u t y an d

al l eg ed b reach t hat s u p p ort cl ai m s fo r p ro fes s i o n al n eg l i gen ce.

“ W h et her a co m

p lai n t al l eg es o rd in ary n eg l i g en ce o r p ro fes s i o n al m al p ract i ce

i s a q ues t i o n o f l aw fo r t he co u rt

, reg ard l es s o f h o w t h e p l ai nt i ff cat eg o ri zes i t .”

(Ci t at i o n an d p u n ct u at i o n o m i t ted .) Gr a d y Gen

. H o s p

. v. Ki n g

, 2 8 8 Ga. Ap p

. 1 0 1

, 1 0 2

(6 5 3 SE2 d 3 6 7) (2 0 0 7 ). A c c o r d

, B u r ke v. Pa ul

, 2 89 G a. A p p

. 8 2 6

, 82 8 (6 5 8 SE2 d

4 3 0 ) (2 0 0 8 ). Th e c o u r t m u s t l o o k at t h e s u bs t an ce o f t h e act i o n, an d if t h e al l eg ed

n eg li g en ce req u i red ex erci s i n g p ro fes si o n al sk i l l an d ju d g m en t t o co m p l y wi t h a

3s t an d ard o f co n d u ct

, t h e act i o n w i ll i n v o l v e p ro fes s io n al n eg l i g en ce. Pi ed mo n t Ho s p.

v. D. M., 3 3 5 Ga. A p p. 4 4 2

, 4 4 5 (7 7 9 SE2 d 3 6) (2 0 15 ); Bu r ke v. Pa ul

, s u pra at 8 2 8.

Th e g rav am en o f t h e co m p lai n t i n t h i s cas e was t h at t h e defen d an t s fai l ed to

reco g n ize t h e sev eri t y o f Grah am ’ s co n d it i on

, fai l ed t o m o n i t or h i s co n di t i o n

, an d

fai l ed t o t ak e ap pro pri at e m eas u res t o t ry t o fo res t al l t h e p ro g res s i v e l iv er fai l u re. In

s h o rt

, t h e co m

p l ai nt al l eg es t h e d efen d an t s

, t h ro u g h t hei r i n at t e n t i o n

, n eg l ect ed

Grah am t o t h e p o i n t o f i rrev ers i b l e l i v er fai l u re an d deat h

. We f i n d t h e t ri al co u rt

p ro p erl y d et erm in ed t h e co m p lai n t s t at ed cl ai m s fo r pro fes s i o n al n eg l i g en ce i n s t ead

o f o rd i n ar y n e g l i g en ce. Ho wev er, th e t ri al co u rt erred in co n cl u di n g th e ex p ert

affi d av i ts o n fi l e were i n s uffi ci en t t o s u p po rt t h o s e p ro fes si o n al n eg l i g en ce cl ai m s

.

Th e ex p ert affi d av i ts i n t h e reco rd were o ri g in al l y s ub m i t t ed i n s u p p o rt o f t h e

p ro fes s i on al n eg l i g en ce as s ert ed ag ai n s t D r

. H e n d r i x an d v ari o us m em b ers o f t h e

n u r s i n g s t aff, b u t t he affi dav i t s al s o co n t ai n m u l t ip l e av erm en t s p ert ai n i ng t o t h e

s t an d ard o f care ap p l icab l e t o W el l s t ar an d t h e ad m i n i s t r a t o r Ho wel l

. Dr. Ro b ert

Kau fm an n i d en t i fi ed a s t an d ard o f care req u iri n g s u perv i s i o n o f h eal t h care pers o n n el

an d p o l i ci es an d p ro ced u res t h at i n su re t i m el y rev i ew of a p at i en t ’ s care. Bas ed o n h i s

rev i ew o f Grah am ’ s treat m en t reco rd s

, Dr. Kau fm an n o p i n ed t h at was n ot d o n e, an d

s p eci fi cal l y fau l ted t h e Ad m i ni s t rat o r fo r th e fai l u re t o act i v el y m o n i to r t h e m ed i cal

4care b ei n g pro v i d ed i n t h e faci l i t y

. Ot h er s p eci fi c v i ol at i o n s o f an ap p l i cab l e s t an d ard

o f care i n cl u ded th e n urs i n g s t aff’ s fai lu re t o m on i t o r Grah am ’ s i n p ut an d o u t p u t ;

fai l u re t o m o n i t or ch an g es in Grah am ’ s ab d o m en fo r an y as ci t es b u i l du p ; fai l u re to

d o cu m en t ad m i ni st rat i o n o f IV fl u i d s; fai lu re t o co m m u ni cat e ab n o rm al l ab v al u es to

t h e p h y s i ci an ; an d fai l u re t o d o cu m en t s u ffi ci en t d at a fo r t w o Co de Bl u e rep o rt s

.

Dr. M ark Gri ffi s av erred t h e s am e s t an dard s of care an d fai l u res o f t h e n u rs i n g

s t aff an d t h e Ad m i n i s t rat or i t erat ed b y Dr. Kau fm an n

. D r

. Gr i ffi s em p h as i zed t h e

s t an d ard o f care o f co n s ci en t io us l y s u p erv is in g h eal th care p ro v i d ers

, m o n it o ri n g t h e

p at i en t ’ s care an d co n di ti o n , an d i n t erv en i ng wh en n eces s ary

, an d n o ted t h e b reach

o f t h at s tan d ard i n Grah am ’ s cas e.

Bas ed o n h i s rev i ew o f t h e reco rd s o f Grah am ’ s t reat m en t

, Pat ri ck W as h i n g t o n,

a reg i s t ered n urs e, l is t ed m u l t i p l e d e f

i ci en ci es o f t h e nu rs i n g s t aff: t he fai l u re to

p ro cu re Grah am ’ s t ran sfer t o th e h o s p i t al fo l l o w i n g t wo Co d e Bl u e i n ci d en t s ; fai l u re

t o rep o rt l ab res ul t s o r fo l l o w-u p l ab res u l t s w i t h t h e ph y s i ci an on a t im el y b as i s ;

fai l u re t o rep o rt t o t h e m an ag em en t el ev at ed lab re s u l t s a nd v i tal s i g n l ev el s t h at

i n d i cat ed th e n eed fo r i m m ed i at e i n t e r v en t i o n ; fai l u re t o rep o rt t h e co nt i n u ou s

el ev at i o n o f p u l se rat es ; fai l u re t o rep ort al ert l ev el s o f b i l iru b i n

, an d n o n-res o l v i n g

jau n d i ce fo r d ay s ; fai l u re to reco rd t he p at i en t ’ s i n p u t an d o u t p u t ; fai lu re t o req u es t

5t h e ph y s i ci an t i m el y t o at ten d t o Grah am as hi s co n d i t i o n w o r s e n ed ; an d fai l u re to

d o cu m en t ad eq u at el y

Grah am ’ s s t at u s fo r m

u l t i p l e d ay s

.

Th e se affi d av i t s s et fo rt h “ at l eas t o ne n eg li g en t act o r o m i s s i o n cl ai m ed to

ex i s t an d t h e fact ual bas is fo r each s u ch cl ai m ,” OCGA § 9 -1 1 -9 .1 (a) (3 ), an d t hu s

t h e t ri al co u rt s h o u l d n o t h av e g ran t ed s um m ary ju d g m en t fo r t h e d efen d an t s o n t h e

p ro fes s i on al n eg l i g en ce cl ai m s as s ert ed ag ai n st W el l s t ar an d t h e ad m i n i s t rat o r

Ho wel l

.

3

. W r o n g fu l d ea t h cl a i ms

. In t h e o rd er en tered o n Feb ru ary 2 3

, 2 01 5

, t h e t ri al

co u rt fo un d t h at as Grah am ’ s n eg l i g en ce cl ai m s ag ai n s t W el l s t ar an d Ho wel l fai l ed

,

s o

, t o o

, m u s t t h e wro n g fu l d eat h cl ai m s as s ert ed ag ai n s t t h o s e t wo d efen d an t s

. In l i g ht

o f o u r d eci s i o n th at t h e tri al co u rt erred i n g ran t i n g s u m m ary ju d g m en t fo r W el l s t ar

an d Ho wel l o n t h o s e neg l i g en ce cl a i m s, th e t ri al co urt l i k ewi s e erred i n s i m i larl y

d i s p o s i n g o f t h e wro ng fu l d eat h cl ai m s

.

J u d g m en t af fi r med i n p a r t a n d r ever s ed i n p ar t

. Do

yl e, C. J., an d Ra

y

, J

. ,

co n cu r

.

6