Court Opinion

ID: 9545165
Source: CourtListenerOpinion
Date Created: 2023-08-07 17:07:34.221798+00
Date Added: 2024-06-11T15:14:13.714511
License: Public Domain

Hunter, J.
This appeal results from the trial court’s dismissal of the plaintiff’s action for the insufficiency of the evidence to establish a prima facie case, at the close of the plaintiff’s case in a jury trial.
The plaintiff (appellant), Omer H. Osborn, an 84-year-old man, was a patient in Samaritan Hospital at Moses Lake, owned and operated by Public Hospital District No. 1 *202for Grant County, Washington, who was alleged, to have fallen from a bed in defendant’s (respondent’s) hospital and sustained injuries for which the plaintiff sought to recover. The plaintiff was admitted to the hospital about 12 noon on December 10, 1968. The injuries occurred about 5 o’clock the following morning. The plaintiff died on March 18, 1970, prior to the trial of the case, and the executor of his estate, Robert H. Osborn, was substituted as party plaintiff.
Omer H. Osborn alleged in his complaint that the injuries he sustained were proximately caused by the negligence of the defendant, in that the defendant hospital district, through its agents and employees, failed to raise the side rails on the hospital bed on which the plaintiff had been placed, and in that the defendant had “wrongfully and negligently failed to give the proper attention, care, observation and consideration to plaintiff’s medical needs, well being, and condition.”
Omer H. Osborn was admitted to the defendant’s hospital on December 10, 1968, for a bowel condition, acute bronchitis and pneumonia. The services of his attending physician, Dr. James W. Young, terminated shortly after the accident and he was succeeded by Dr. Robert H. Ruby who testified from the hospital notes as to the attention and medication the plaintiff received during the period from the time of his admission at 12 noon, December 10th, until the time of his accident at about 5 o’clock the following morning.
The records show he was placed on a regime whereby his every urination was subject to urinalysis, a blood test was ordered, a diet ordered and the periodic giving of a narcotic or drug called “demerol.” Demerol was prescribed for given intervals of every 3 to 4 hours. Dr. Ruby described it as a synthetic narcotic drug, a substitute for morphine, and was given for pain. Its effect on some persons was to cause drowsiness.
Dr. Ruby testified that the hospital notes stated demerol was administered to Mr. Osborn on December 10th at 2 p.m., 5 p.m., 8 p.m., and 11 p.m. Nurse Martin testified that *203on December 11th she had administered 50 milligrams of demerol at 2:45 a.m., and again at 5:30 a.m., after his fall.
The hospital notes showed no limitation on bathroom privileges which was understood by custom to mean a patient may get up and go to the bathroom without assistance. However, the hospital notes further show that Mr. Osborn voided in a receptacle from which it could be inferred was during the time the bed rails were up prior to 5 a.m. on December 11th.
Mrs. Bea Johnson, the director of nursing services for the hospital, testified that the defendant’s general hospital policy with elderly people was to put the bed rails up at night and, where a patient has bathroom privileges, to put bed rails down some time around 5 a.m. for morning care.
Mrs. Frances Martin, a registered nurse, testified that Mr. Osborn’s mental condition was fine and he was not confused or disoriented at 2:45 a.m. when given a dosage of demerol. She further testified giving an oral antibiotic at 4 a.m. on the morning of December 11th, at which time he was reasonably rational and alert. A Miss Wentland lowered the bed rails and placed the bed in a low position at approximately 5 a.m. for the customary morning care. Shortly thereafter the plaintiff was found on the floor of his room.
Nurse Martin testified that upon finding him seated on the floor she asked him what had happened and he replied he had gotten up to go to the bathroom and that he fell; that he did not say anything about having fallen or rolling out of bed. She testified she had on previous occasions administered minimal dosages of demerol and that he had no difficulty handling it. On cross-examination, she testified Mr. Osborn was not confused or disoriented when he had sustained his fall. However, upon getting him back to bed, Nurse Martin testified as follows:
A. I questioned him regarding if he was having any pain from the fall. Q. What did he tell you? A. And he said — he had first said, no, when I asked him if his leg or hip or arm was hurt — he first said, no, and then he would *204say, yes, and then, ho, and then, yes. And he couldn’t really decide whether he was having pain or not.
(Italics ours.)
X rays taken that morning showed he had a fractured left hip. This had not healed at the time of his death approximately 1 year and 4 months later.
The plaintiff contends the trial court erred in finding the plaintiff had failed to establish a prima facie case of negligence on the part of the hospital for the reason that it based this conclusion primarily on the erroneous ground that the duty of care for the patient’s safety was placed upon the attending physician rather than the hospital.
The trial court stated:
And it appears to the court that the actions of the nurse at the time, in the morning, that the bed rail was put down, when the A.M. morning activities started in the hospital, is right in accordance with the doctor’s orders. . . . But, the actions of the nurses and the people who run the hospital have been pretty well examined, and there has been no showing before the Court of any negligence on the part of the hospital, when you consider the matter in the light of the doctor’s orders.
Well, again I state that I am relying very strongly on Dr. Ruby’s testimony where he stated that the bed rails were put down, if bathroom privileges were allowed, about 5:00 a.m., and that generally the policy is to follow the doctor’s orders. “If the doctor did not otherwise order it, a patient has bathroom privileges.”
(Italics ours.)
The plaintiff cites RCW 70.41, containing the hospital licensing law of the State of Washington which, in the declaration of purpose, states that the primary purpose of this chapter is to promote safe and adequate care of individuals in hospitals “through the development, establishment and enforcement of minimum hospital standards for maintenance and operation.” To accomplish these purposes, RCW 70.41.010 provides:
(3) The establishment by the state board of health of *205standards, rules and regulations for the construction, maintenance and operation of hospitals;
(4) The enforcement by. the Washington state department of health of the standards, rules and regulations established by the board.
The Washington Administrative Code, WAC 248-18-200(7), of which this court can take judicial notice, provides as follows:
The hospital shall establish safety policies and procedures for the care of the patients who because of their age or condition are not responsible for their acts.
Clearly, as argued by the plaintiff, it appears that the hospital by statute has a duty of care for the safety of its patients, independent of the care that may be chargeable to a patient’s attending physician.
The reason for this is peculiarly illustrated by the facts of this case. The attending physician here having observed Omer H. Osborn at 12 noon on December 10th, did not have the advantage of observing his patient thereafter at 5 o’clock the following morning' after he had received at intervals five injections of 50 milligrams of demerol before the patient’s accident. Under these circumstances, it would appear unreasonable to say the hospital attendants who had the opportunity to observe the mental condition of this weak and ill 84-year-old man the following morning, could blindly follow the implied direction of the doctor (according to custom and practice) for the patient to have bathroom privileges, and be relieved of any responsibility for this patient’s physical safety in the administering of this care.
Assuming it could have, as a fact, been reasonably determined by the nurses administering morning care that the elderly plaintiff was confused and might be in need of assistance for his personal toilet needs, liability of the defendant for damages resulting from failure to furnish that assistance could not be avoided by relying upon the doctor’s observation of 12 noon the day before.
We hold there was a responsibility of the: hospital *206attendants to administer to the physical safety of this patient as their reasonable observation of Omer H. Osborn’s state of mind and physical condition at that time would reveal, independent of the implied direction from the attending physician as of the day before.
From this record the jury would be entitled to consider a probable inconsistency in Nurse Martin’s testimony by reason of her stated opinion that Mr. Osborn was not confused or disoriented, when she had knowledge of his indicated confusion as to his suffering pain at the time he had sustained a fracture of his left hip.
The jury, from this record, could have concluded that reasonable prudence for Mr. Osborn’s safety would have required the bed rails to have remained raised and assistance given Mr. Osborn in the exercise of his bathroom needs.
The defendant cites Adams v. State, 71 Wn.2d 414, 429 P.2d 109 (1967); Benjamin v. Havens, Inc., 60 Wn.2d 196, 373 P.2d 109 (1962); Roth v. Havens, Inc., 56 Wn.2d 393, 353 P.2d 159 (1960), which we have considered and find to be distinguishable on the facts.
The defendant argues we should not consider RCW 70.41 regarding safety standards of hospitals and rules adopted pursuant thereto since they were not brought to the attention of the trial court, and were raised for the first time on appeal. We disagree. The issue of the hospital’s duty for the safety of its patients was squarely before the trial court and the statutes of this state in regard thereto are therefore pertinent to our consideration.
Giving the testimony the most favorable inferences to the plaintiff, as we must in considering a motion for dismissal for the insufficiency of the evidence, Hayes v. Hulswit, 73 Wn.2d 796, 440 P.2d 849 (1968); Smith v. B & I Sales Co., 74 Wn.2d 151, 443 P.2d 819 (1968), we hold there was a jury question as to the issue of the defendant’s negligence in caring for the plaintiff, Omer H. Osborn, at the time of his accident, and that the trial court erred in dis*207missing the plaintiff’s action at the conclusion of the plaintiff’s case.
The trial court’s order is therefore reversed and the case is remanded for a new trial. Costs will abide the final determination of the cause.
Hamilton, C.J., Finley, Rosellini, Hale, and Stafford, JJ., concur.