Court Opinion

ID: 9615174
Source: CourtListenerOpinion
Date Created: 2023-08-22 04:32:13.424857+00
Date Added: 2024-06-11T18:03:42.149546
License: Public Domain

Utter, J.
(dissenting) — Under the doctrine of corporate negligence, a hospital owes a separate, nondelegable duty to a patient. Thus, it may be held liable for a patient's injury in spite of a lack of negligence on the part of the attending physician. In the present case, Providence owed a duty to supervise Dr. Freeman. In order to prevail in an action for corporate negligence against a hospital, a plaintiff must
prove by a preponderance of the evidence that the defendant . . . failed to exercise that degree of skill, care, and learning possessed at that time by other persons in the same profession, and that as a proximate result of such failure the plaintiff suffered damages ....
RCW 4.24.290. See also Alexander v. Gonser, 42 Wn. App. 234, 240-41, 711 P.2d 347 (1985), review denied, 105 *260Wn.2d 1017 (1986); Byerly v. Madsen, 41 Wn. App. 495, 503, 704 P.2d 1236, review denied, 104 Wn.2d 1021 (1985). In the present case, a preponderance of the evidence does not show a breach of duty by Providence which proximately caused plaintiff’s injury. Therefore, I dissent.
The jury exonerated Dr. Freeman, but found that Providence breached its duty of supervision, and that this breach proximately caused Douglas' injury. The trial court sustained the verdict. The Court of Appeals reversed, finding there was no evidence, no chain of circumstances, from which a jury could reasonably infer that Providence's negligence (lack of supervision) caused the injury.
Not one expert testified how Providence could have prevented the injury. The evidence does not establish that the absence of a dental assistant, a supervising dentist, or a licensed dentist caused Douglas' injury It is undisputed that all the expert witnesses agreed that it was Dr. Freeman who actually caused the injury Thus, there is no evidence that Providence's negligent conduct even contributed to the cause of Douglas' injury
Douglas v. Freeman, 57 Wn. App. 183, 191, 787 P.2d 76 (1990). The court therefore concluded that any evidence relied on by the jury was purely speculation and conjecture. I agree.
In order to support a separate claim for corporate negligence, the plaintiff must independently show negligence on the part of the hospital, e.g., through selection, supervision, or retention of the doctor. Pedroza v. Bryant, 101 Wn.2d 226, 677 P.2d 166 (1984). The only testimony which indicates Providence might have been negligent in its supervision is Dr. Freeman's own testimony that he would not perform an extraction without an assistant and plaintiffs testimony that an assistant was not present during the extraction. The majority believes this is sufficient evidence. I disagree.
Dr. Freeman's testimony is not sufficient evidence of the standard of care because he only testified as to his own usual practice, not that of the community. In medical
*261malpractice cases, the standard of care is based on proof of the customary and usual practices within the profession. Teig v. St. John's Hosp., 63 Wn.2d 369, 375, 387 P.2d 527 (1963).
As the majority points out, RCW 18.32.030 sets forth the applicable standard of care and requires Providence to supervise Dr. Freeman. Majority opinion, at 249. However, the statute does not indicate whether the duty to supervise includes the duty to provide an assistant. The majority states it need not decide this issue. It accepts Dr. Freeman's testimony that the presence of an assistant is essential to performing a wisdom tooth extraction. Majority opinion, at 250. As stated above, Dr. Freeman's testimony is not sufficient evidence regarding the standard of care. Furthermore, while he testified that he would not perform wisdom teeth extractions without an assistant, he never stated that the presence of an assistant would prevent lingual nerve damage. The record does not contain sufficient expert testimony to establish that the standard of care requires providing an assistant. Furthermore, RCW 7.70.040 provides:
The following shall be necessary elements of proof that injury resulted from the failure of the health care provider to follow the accepted standard of care:
(1) The health care provider failed to exercise that degree of care, skill, and learning expected of a reasonably prudent health care provider at that time in the profession ... in the state of Washington, acting in the same or similar circumstances;
(2) Such failure was a proximate cause of the injury complained of.
(Italics mine.) Providence is a "health care provider" falling within the purposes of the statute. See RCW 7.70-.020(3).
Two experts testified the clinic met the standard of care. Dr. Freeman himself testified that Dr. McMullan provided adequate supervision. Thus, there was no evidence presented at trial that Providence failed to comply with the applicable standard of care. There was *262insufficient testimony that a hospital's standard of care with regard to supervision requires providing an assistant. There was no testimony that the presence of an assistant was essential to preventing lingual nerve damage. There was conflicting testimony as to whether an assistant was present. Finally, all of the experts agreed that Dr. Freeman's negligence was the cause of Douglas' injury. Since the jury found Dr. Freeman was not negligent, it must have found an assistant was present, or that the absence of the assistant did not constitute negligence. There is not substantial evidence in the record to support a finding that Providence breached its duty to supervise Dr. Freeman.
The majority states it would be reasonable for the jury to infer that an assistant is required during wisdom teeth extractions, and that the absence of an assistant caused Dr. Freeman to perform the extractions in a manner which injured the plaintiff. Majority opinion, at 253-54. However, the fact the jury exonerated Dr. Freeman indicates that the absence of an assistant, if any, was not the cause of plaintiff's injury. The presence of an assistant has not been shown to be a requirement of the duty to supervise. The alleged failure to provide an assistant has not been established as a breach of duty on the part of Providence, and the plaintiff has failed to prove that Providence's negligence was the proximate cause of her injury.
Alexander v. Gonser, supra, involves an action against a hospital for corporate negligence. There, the plaintiff's only evidence of the hospital's negligence was an affidavit of a physician who testified that the hospital failed to adequately supervise plaintiff's attending physician. However, the court concluded the affidavit did not show proximate cause between the failure to supervise and plaintiff's injury. Two other experts testified the hospital complied with the accepted standard of care. The *263trial court granted summary judgment in favor of the hospital on the corporate negligence claim and the Court of Appeals affirmed. 42 Wn. App. at 241-42. Likewise, in the present case, two experts testified Providence complied with the accepted standard of care. The testimony upon which plaintiff now relies, her own and that of Dr. Freeman, is based upon mere speculation and conjecture.
No reasonable basis exists to support the verdict against Providence. In a case where medical testimony is required to establish the causal relationship, the evidence will be considered insufficient if it can be said that, considering all the medical testimony presented at trial, the jury must resort to speculation or conjecture in determining the causal relationship. McLaughlin v. Cooke, 112 Wn.2d 829, 774 P.2d 1171 (1989). The jury verdict in this case appears to be based on speculation and conjecture and is therefore not sustainable.
I would affirm the Court of Appeals.
Dolliver and Smith, JJ., concur with Utter, J.
Reconsideration denied October 22, 1991.