Court Opinion

ID: 9707931
Source: CourtListenerOpinion
Date Created: 2023-08-26 02:25:00.523663+00
Date Added: 2024-06-11T18:22:40.045364
License: Public Domain

MOORE, Chief Justice.
I dissent.
I. These additional facts must also be considered. After arrangements were made on Friday, October 23, 1964 for plaintiff’s admittance to the psychiatric ward of defendant hospital she visited relatives and at 4:00 p. m. went with her husband to the sixth floor of the hospital and was duly admitted as a patient.
Mr. Kastler was questioned by registered nurse Norma Davis just outside the locked door to the ward where he related a several year history of plaintiff’s fainting spells. The nurse’s testimony includes:
“Q. And what did he say, what did you say? A. I don’t recall what I specifically said, but it came out that she had fainting spells, that she seemed to realize something was going to happen, she always *104made it to a chair and was able to sit down, was never hurt.
“I specifically asked Mr. Kastler if she ever hurt herself and he said that she had never hurt herself. She was ambulatory when she came in. This is not a medical ward. Medical patients are transferred from the ward if they require extended bed care. There is bed care that is required as a result of psychiatric treatment and in particular shock treatment. Patients like this who are confined to bed would probably take a shower because they usually feel better and more relaxed after a shower. The showers are therapeutic. They are a help to us. I don’t take showers with the patients that make use of the psychiatric facilities or go into the shower room with them and actually hold them up. They are encouraged to take showers on their own. There is not a bath available. They could take a sponge bath. There was no history given me either by the patient or by the husband or by the doctor of any seizures or grand mal seizures of any sort. It is my obligation to try to keep things normal in the ward as nearly as possible and to have them mix in society.
“All of the longhand writing on page 34 of the hospital records is mine. I am reading from that page as follows, ‘white 25 year old female with brown hair and eyes. Admitted ambulatory toward South 6 accompanied by her husband. Entered ward cooperatively but was tearful. Gait normal. Speech vibrant and coherent. Sensorium seems intact. Insight and judgment seem adequate. Attention and retention good. Recent and remote memory adequate. Husband states patient has been depressed off and on for four years and saw Dr. Haines in 1959. She has had fainting spells for many years. The last three or four years she appears to have an aura and cries a lot after waking up. Recently the spells have changed in that she does not pass clear out. The last one was two or three weeks ago. Since then she has had almost a constant headache and the last two or three days it has been more severe and she has had difficulty sleeping and eating. She has been depressed and cries easily.’ ”
Dr. Cash’s secretary had advised Mrs. Davis the standing orders were to be followed. On admittance plaintiff was taken to her room where an aide took her temperature, pulse and respiration. She was then shown around and oriented to the ward used by a total of about 24 patients. The routine of the ward was explained to her including activities with other patients, meal time and that she was expected to take a shower each night at about 9:00 p. m. Soon after admittance plaintiff took a shower which was not repeated that evening. That evening she socialized with other patients including dancing with one of them.
The next day, Saturday, plaintiff socialized with other patients, watched TV, took her scheduled meals and a shower that evening.
When plaintiff arose Sunday morning, ■ the accident date, she felt dizzy and generally sick all over. With help of another patient plaintiff did her laundry and then wrote a letter to her husband. She testified she attempted to talk to the nurse at the nurses’ station but was ignored. That afternoon she played bingo but became sick and did not finish the game. A nurse gave her permission to lie down and advised plaintiff her illness was due perhaps to excitement.
Plaintiff that Sunday evening at the usual shower time went to the shower room and waited her turn. Plaintiff testified she understood a shower was required. In the shower she became sick, fell and was injured. She had made no complaint to the shower attendant who was a few feet from her. Later she stated she had never before had such a sudden black out seizure. Dr. Cash opined she had a grand mal epileptic seizure.
The trial court submitted these two pleaded specifications of negligence to the jury.
*105“a. In leaving plaintiff unattended and unobserved in plaintiff’s physical and mental condition and under the circumstances then existing.
“b. In requiring plaintiff to take a shower bath when defendant knew or in the exercise of reasonable care should have known, of the danger to the plaintiff under the conditions then existing.”
In instruction 9 the trial court told the jury:
“You are instructed that it was the duty of the Iowa Methodist Hospital to give Betty Colleen Kastler such reasonable care and attention as it knew, or in the exercising of reasonable care should have known, her condition required. This duty is measured by the degree of care, skill and diligence customarily exercised by hospitals.
“A failure of the Iowa Methodist Hospital to render such ordinary care and attention to Betty Colleen Kastler would be negligence.
“However, the Iowa Methodist Hospital was not an insurer of Betty Colleen Kas-tler’s safety, and it was not required to guard against or take measures to avert that which a reasonable person under the circumstances would not anticipate as likely to happen.” (Emphasis added).
This statement of the applicable rule is almost verbatim with the form of instruction used in Bradshaw v. Iowa Methodist Hospital, 251 Iowa 375, 390, 101 N.W.2d 167, 176; Shover v. Iowa Lutheran Hospital, 252 Iowa 706, 712, 107 N.W.2d 85, 88 and Dickinson v. Mailliard, Iowa, 175 N.W.2d 588, 595. See also Baker v. United States, 8 Cir., 343 F.2d 222, 225; 40 A.L.R.3d 515; 40 Am.Jur.2d, Hospitals and Asylums, section 26, which state the same general rule.
In each of the above cited Iowa cases plaintiff introduced evidence of the customary practice and care exercised by the hospital in the given circumstances and its failure to meet the stated standard of care.
The record before us discloses no such evidence and therefore the ruling of the trial court sustaining defendant’s motion for judgment notwithstanding the verdict should be affirmed. But the majority would abandon or ignore the well established rule and adopt a rule applying against the hospital a duty under the fictional ordinary prudent man-reasonable care under the circumstances concept. This under the facts here would permit and require the jury to speculate and engage in guess work.
Under the doctor’s standing orders it appears life in the psychiatric ward has a therapeutic design. Once admitted, patients are allowed no visitors for at least five weeks. Each is expected to be up and mingle with other patients during the daytime except a nap period from two to three p. m. Great stress is placed upon the scheduling of patients’ lives and activities.
To encourage mingling with other patients many activities are scheduled. In her short stay plaintiff was exposed to bingo, a bowling game, ping pong and dancing. Time was set aside for television and reading. Plaintiff testified a shower made her feel better.
Thus the procedure and routine of the psychiatric ward can be seen as a treatment or therapy process of resocialization. Easing of tensions is the objective. It differs vastly from the procedure and routine in the ordinary medical ward.
Without evidentiary help the majority would cast aside our established rule and permit the jury to speculate as to the hospital’s duty and any breach thereof. I cannot agree. What knowledge does a layman have of the proper care of a psychiatric ward patient ?
The majority opinion states: “We will not at this time attempt to formulate a precise distinction between the two kinds of activities (professional or administrative).” Where does that leave the bench and bar in future cases? I would not change the *106general rule as recognized and applied in Bradshaw, Shover and Dickinson.
II. If the majority opinion is to be adopted certainly the judgment should not be re-entered. At most plaintiff under this record would only be entitled to a new trial.
I would affirm.
LeGRAND, J., joins in this dissent.