Court Opinion

ID: 9951876
Source: CourtListenerOpinion
Date Created: 2024-03-19 14:18:05.19235+00
Date Added: 2024-06-11T14:43:17.047503
License: Public Domain

COURT OF APPEALS OF VIRGINIA

              Present: Chief Judge Decker, Judges Fulton and Ortiz
UNPUBLISHED

              Argued at Richmond, Virginia

              ROY BLACK
                                                                           MEMORANDUM OPINION* BY
              v.     Record No. 0445-23-2                                  JUDGE JUNIUS P. FULTON, III
                                                                                MARCH 19, 2024
              C. T. WOODY, JR., ET AL.

                                FROM THE CIRCUIT COURT OF THE CITY OF RICHMOND
                                           Joseph J. Ellis, Judge Designate

                              Gary R. Hershner for appellant.

                              John P. O’Herron (William W. Tunner; Rachel W. Adams;
                              ThompsonMcMullan, P.C., on brief), for appellee C.T. Woody, Jr.

                              Margaret F. Hardy (Christopher F. Quick; Brian P. Clarke; Sands
                              Anderson, P.C., on brief), for appellee NaphCare, Inc.

                     Roy Black filed a complaint in the Circuit Court of the City of Richmond alleging that

              defendants Sheriff C.T. Woody, Jr. (“Sheriff Woody”) and NaphCare Inc. (“NaphCare”) provided

              negligent medical care while Black was incarcerated, leading to the amputation of his left leg below

              the knee. Black appeals the final order of February 16, 2023, granting defendants’ motion to strike

              and dismissing the case with prejudice.

                                                     I. BACKGROUND

                     Beginning on March 7, 2016, until his transfer to Retreat Hospital on April 1, 2016, Roy

              Black was an inmate at the Richmond City Justice Center (“the jail”). On March 20, 2016, Black

                     *
                         This opinion is not designated for publication. See Code § 17.1-413(A).
began experiencing significant pain and coldness in his left leg due to a prior medical condition. 1

The lower part of Black’s left leg turned “black as coal” and his condition was so debilitating

that he could no longer walk normally, having to hop to get his food tray and medications. Black

stated that he reported his condition to several unnamed deputy sheriffs and nurses who appeared

on his tier at the jail, begging each of them for medical care and to be seen by a doctor. He also

requested that he be allowed to call his treating physician who was familiar with his condition

prior to his incarceration.

       On March 31, 2016, Black encountered Nurse Baskerville at the jail and approached her

about the condition of his leg. Nurse Baskerville told Black that he needed to submit a medical

request after Black complained that he was in severe pain and needed to see the doctor. Black

could not write the request himself and had his cellmate fill it out for him. The request read:

“The stint in my left leg is completely messed up I am in serious pain; I need to see the doctor

asap. Please help I am in a great amount of pain.”2 That evening, Black saw another nurse and

described his symptoms to her as well, requesting that he be sent to the hospital. This nurse gave

Black “two little pills” and did not send him to the hospital.

       On the morning of April 1, 2016, Black saw Sergeant Abraham Bul come onto the floor

and approached Sergeant Bul about the condition of his leg. Sergeant Bul recognized the

severity of Black’s condition. Black testified that Sergeant Bul immediately

               got on the mic, called down to medical. Medical sent up a
               wheelchair. I got in the wheelchair. He wheeled me down to
               medical, pushed me in. At that time the doctor [had me] sit up on
               the table and she looked at my foot and my leg, called

       1
        Black was diagnosed with peripheral vascular disease (“PVD”) in 2013. Black had
previously undergone several surgeries to treat the disease, including a left-leg bypass, a
thrombectomy to remove persistent clotting, and a toe amputation in December 2015 as a result
of gangrene likely caused by small-vessel disease.
       2
        Even though the request is dated 3-3-16, all parties agree that it was actually completed
and submitted on March 31, 2016.
                                             -2-
               transportation. Transportation and two deputies came over and
               carried me to Retreat Hospital.

After being transported to Retreat Hospital, Black underwent a series of unsuccessful procedures

and ultimately had to have his left leg amputated below the knee.

       In September 2019, Black filed suit against Sheriff Woody and NaphCare, with whom

Sheriff Woody had contracted to provide medical services at the jail. Black claimed that he was

deprived of medical care while incarcerated at the jail based on his complaining of pain and

coldness in his left leg beginning on March 20, 2016, and continuing until his transfer to Retreat

Hospital on April 1, 2016. Black asserted two claims against the defendants. Count I alleged

breaches of Virginia’s common law and statutory duties, and Count II alleged violations of

Article I, §§ 9 and 11 of the Virginia Constitution. The defendants each timely filed answers and

demurred to Count II of the complaint, arguing that no private right of action exists for either

constitutional provision. Black filed an answer to the demurrers arguing that because both §§ 9

and 11 are contained in the Bill of Rights, they are self-executing. After hearing arguments on

August 6, 2020, the court sustained the demurrers and dismissed Count II with prejudice.

       Black designated two expert witnesses during discovery. JoAnn Whitehead (“Nurse

Whitehead”) was designated to opine on the nursing standard of care and Mark Levy, M.D.

(“Dr. Levy”) was designated to opine on the medical causation of Black’s injuries. In response

to defendants’ interrogatories requesting the identities and opinions of Black’s experts, Black

identified Nurse Whitehead and Dr. Levy as follows:

               The plaintiff will call Joann B. Whitehead, a Registered Nurse, to
               testify about the breaches of duty by the nurses and health care
               providers at the Richmond Justice Center in March, 2016. Ms.
               Whitehead will opine that all of the nurses and the health care
               providers at the Richmond Justice Center who observed the
               plaintiff breached the standards of care for the profession by failing
               to send the plaintiff to the hospital some two weeks prior to April,
               2016, where the plaintiff could have received treatment for his
               obvious vascular condition. Ms. Whitehead will opine that the
                                               -3-
              delay in getting the plaintiff treatment caused him unnecessary
              suffering. Ms. Whitehead will base her opinions on her own
              training, review of the plaintiff’s Complaint and a review of the
              Richmond Justice Center medical records.

              The plaintiff will also call Mark M. Levy, M.D., . . . as an expert
              witness to testify about the injuries sustained by the plaintiff due to
              the failure to send the plaintiff to the hospital sooner than he was.
              Dr. Levy will opine that plaintiff should have been sent to the
              hospital sooner than he was. Dr. Levy will opine that plaintiff
              should have been sent to the hospital some two weeks prior to
              April, 2016 where he could have received an extension bypass,
              otherwise known as a jump gra[ft]. That would have been the
              appropriate medical treatment at the time. The delay in getting
              treatment for the plaintiff as set forth in Dr. Levy’s certification
              which accompanies these answers, decreased the plaintiff’s
              chances of avoiding amputation of his leg. At the very least, the
              amputation could have been avoided for several months. Dr. Levy
              will base his opinions on the allegations contained in the plaintiff’s
              lawsuit, a review of the plaintiff’s medical records, pre and post
              incident and the Richmond Justice Center medical records.

Black also provided certifications for Nurse Whitehead and Dr. Levy which stated:

              I, Joann B. Whitehead, am a Registered Nurse. I supervise
              Licensed Practical Nurses and Certified Nursing Assistants and I
              am very familiar with their standards of care. I have reviewed the
              allegations contained in the lawsuit that has been filed in the
              Circuit Court of the City of Richmond, styled, Roy Black v. C. T.
              Woody, Jr. and Naphcare, Inc., Case No.: CL17001318-00. I have
              further reviewed Roy Black’s medical records for the treatment
              and care that he received while he was an inmate in the Richmond
              City Jail and following his release. Based on this information, I
              believe that I have a reasonable understanding of the facts in the
              case and in particular the medical treatment received or not
              received by Mr. Black as an inmate in the Richmond City Jail in
              March, 2016. I am of the opinion that all of the nurses at the jail
              and all medical personnel breached the standard of care for their
              profession by failing to send Mr. Black to the hospital some two
              weeks prior to April 1, 2016 where he could have received
              treatment for an obvious vascular condition; This would have been
              the appropriate medical treatment at that time; The delay in getting
              treatment for Mr. Black caused him unnecessary suffering.

              I, Mark M. Levy, M.D., have reviewed the allegations contained in
              the lawsuit that has been filed in the Circuit Court for the City of
              Richmond, styled, Roy Black v. C.T. Woody, Jr. and Naphcare,
              Inc., Case No.: CL17001318-00. I have reviewed the medical
                                               -4-
                 records that relate to the treatment and care that was received and
                 not received by Roy Black in the Richmond City Jail including the
                 records in March, 2016. I have further reviewed Roy Black’s
                 medical records that occurred before he was incarcerated at the
                 Richmond City Jail in March, 2016 and his medical records for the
                 treatment that occurred while he was still an inmate at the
                 Richmond City Jail and following his release. Based on this
                 information, I believe I have a reasonable understanding of the
                 facts in the case and in particular the medical treatment received or
                 not received by Mr. Black as an inmate in the Richmond City Jail
                 in March, 2016. I am of the opinion and hereby certify that Mr.
                 Black should have been sent to the hospital some two weeks prior
                 to April 1, 2016 where he could have received an extension bypass
                 otherwise known as a jump graft; This would have been the
                 appropriate medical treatment at that time; The delay in getting
                 treatment for Mr. Black as set forth in this certification decreased
                 Mr. Black’s ability of avoiding amputation even without the delay
                 in treatment, in all likelihood Mr. Black could have delayed the
                 amputation of his leg.

       The defendants took the depositions of Nurse Whitehead and Dr. Levy in August 2021.

In September 2021, the defendants filed six motions in limine.3 NaphCare filed a “Motion to

Preclude any Evidence, Testimony, or Argument that NaphCare, or any of its Employees or

Agents, Breached the Standard of Care Prior to March 31, 2016” and a “Motion to Preclude

Argument that Plaintiff is Entitled to Compensation for any Alleged Damages that Arose Prior to

March 31, 2016.” Jointly, the defendants filed a “Motion to Exclude any Testimony, Evidence,

or Argument that Defendants or Their Agents Could Have Prevented Plaintiff’s Amputation or

Delayed it Beyond Four Months.” The trial court granted these motions in limine, precluding

Nurse Whitehead from testifying that NaphCare employees breached the standard of care prior to

March 31, 2016, and precluding Dr. Levy from testifying that an earlier intervention would have

delayed Black’s inevitable amputation by more than four months.

       Trial began on January 9, 2023, with Black testifying first, followed by a series of

employees of the Richmond City Sheriff’s Office who were questioned about the procedures for

       3
           Only three of these motions in limine are at issue on appeal.
                                                -5-
an inmate hospital transfer including how officers are to remain with inmates once they are

transferred to the hospital. The deposition testimony of Sheriff Woody was then read into the

record. Sheriff Woody testified that inmates may make medical complaints via a form in their

pod or by complaining to a staff member, that inmate transfers to the hospital “could be by way

of ambulance or the sheriff deputy in transportation,” and that a deputy is assigned to follow the

ambulance if an inmate is transported in one.

        Black then called Nurse Whitehead. On direct examination, Nurse Whitehead testified

that she had been a registered nurse since 2015. She stated that she was “aware” of the standards

for nurses’ evaluations of patients with a history of vascular disease, and she replied “[n]o” when

asked if the standards for nurses differ depending upon the setting such as if someone is in jail.

Nurse Whitehead was then asked if she had “an active clinical practice in nursing in 2015 and

2016” to which she responded, “[y]es.” Black then moved to qualify Nurse Whitehead as an

expert “in the field of nursing.”

        After Black sought to qualify Nurse Whitehead as an expert in the field of nursing,

NaphCare conducted a voir dire examination. On voir dire, Nurse Whitehead testified that she

had worked at Memorial Regional Medical Center in the progressive care unit (PCU) since

becoming a registered nurse in 2015 through 2019. Nurse Whitehead stated that as a nurse in the

PCU, she would never be in the position to determine whether a patient needed to go to the

hospital. Nurse Whitehead testified that she had never worked in a vascular surgery clinic,

doctor’s office, or jail.

        Following voir dire, NaphCare moved to exclude Nurse Whitehead’s proffered testimony

that its employees had breached the standard of care by failing to timely send Black to the

hospital on or after March 31, 2016. NaphCare asserted that Nurse Whitehead failed to satisfy

the requirements of Code § 8.01-581.20, noting that there were clear differences between

                                                -6-
correctional nursing and nursing in a PCU in an inpatient facility and that Nurse Whitehead did

not testify to any “familiarity with the procedures, the process, how inmates access care, how

that care is provided, what is necessary in terms of transferring patients or sending patients out.”

NaphCare then argued that as Nurse Whitehead’s sole designated opinion was that NaphCare’s

employees breached the standard of care by failing to timely send Black to the hospital —a

procedure she had no familiarity with based on her background in exclusively inpatient care—

her entire testimony should be excluded. The trial court granted NaphCare’s motion to exclude

Nurse Whitehead’s testimony.

       Black’s counsel proceeded “for the purposes of expediency” to proffer Dr. Levy’s

proposed testimony rather than call him to testify based on the theory or understanding that the

defendants would file a motion to strike the evidence because the standard of care expert’s

testimony had been excluded. Following the proffer, defendants each made a motion to strike

Black’s evidence. In Sheriff Woody’s motion to strike, counsel argued that there had been no

testimony by any witness that any of the Sheriff’s deputies did anything wrong or breached any

duty owed to Black, and therefore, there was no factual or legal basis to support any claim

against Sheriff Woody. Black did not contest either motion. When invited by the trial court to

respond to the motions, Black’s counsel admitted that, without the evidence suggested in his

proffer, he could not meet his burden of proof. The trial court granted the motions to strike and

dismissed the case with prejudice. This appeal follows.

                                          II. ANALYSIS

       Black assigns error to the dismissal of his case, asserting that: (1) the trial court erred in

excluding the expert testimony of Nurse Whitehead; (2) the trial court erred in sustaining the

demurrers to Count II of Black’s complaint; (3) the trial court erred in sustaining the motions in

limine by limiting the testimony of Nurse Whitehead to breaches of the standard of care only

                                                -7-
occurring on March 31, 2016; (4) the trial court erred in sustaining the motions in limine by

limiting Black’s claim to only four months loss of his leg; and (5) the trial court erred by

sustaining the motions to strike Black’s evidence.

             A. The trial court’s exclusion of Nurse Whitehead’s expert testimony 4

       “Whether a witness demonstrates expert knowledge of the appropriate standards of the

defendant’s specialty is a question largely within the sound discretion of the trial court.” Sami v.

Varn, 260 Va. 280, 284 (2000) (citing Lawson v. Elkins, 252 Va. 352, 354 (1996)). “Where the

admissibility of expert testimony is challenged on appeal, the standard of review is whether the

trial court abused its discretion.” Currie v. Commonwealth, 30 Va. App. 58, 64 (1999). “In

evaluating whether a trial court abused its discretion, . . . ‘we do not substitute our judgment for

that of the trial court. Rather, we consider only whether the record fairly supports the trial

court’s action.’” Grattan v. Commonwealth, 278 Va. 602, 620 (2009) (quoting Beck v.

Commonwealth, 253 Va. 373, 385 (1997)). Further, “[a circuit] court by definition abuses its

discretion when it makes an error of law. . . . The abuse-of-discretion standard includes review

to determine that the discretion was not guided by erroneous legal conclusions.” Porter v.

Commonwealth, 276 Va. 203, 260 (2008) (alterations in original) (quoting Koon v. United States,

518 U.S. 81, 100 (1996)).

       Black makes one argument on appeal pertaining to the trial court’s decision to exclude

Nurse Whitehead’s expert testimony: that the nursing standards of care do not differ based on

facilities. He contends that the nurses of NaphCare did not have a lower standard of care for

their profession simply because they worked in a correctional facility and, moreover, that the

evidence presented at trial showed that it was a simple matter to transport an inmate from the jail

       4
         Based on the finding that the trial court did not err in excluding Nurse Whitehead’s
testimony, we do not address Black’s third and fourth assignments of error relating to the trial
court’s granting of defendants’ motions in limine.
                                               -8-
to the hospital. While we generally might agree with Black’s assertion that the standard of care

does not differ based on whether a nurse works in a correctional facility or not, Nurse

Whitehead’s expert designation was that she would opine that a breach occurred when nurses at

the jail failed to send Black to the hospital. Although Nurse Whitehead testified that she was

aware of the standard of care for nurses evaluating patients with a history of vascular disease and

that the standard of care remained the same, regardless of the setting, the pre-trial designation

provided by Black was materially different from the foregoing. Her sole designation specifically

stated that the standard of care was breached by the failure to timely send Black to the hospital

rather than failing to assess Black’s PVD and recommend further treatment. Despite Nurse

Whitehead’s apparent qualification to opine on the assessment of PVD, Black’s designation of

Nurse Whitehead’s expert testimony did not include assessing Black’s PVD.

       Under Rule 4:1(b)(4)(A)(i),

               [a] party may through interrogatories require any other party to
               identify each person whom the other party expects to call as an
               expert witness at trial, to state the subject matter on which the
               expert is expected to testify, and to state the substance of the facts
               and opinions to which the expert is expected to testify and a
               summary of the grounds for each opinion.

Applying Rule 4:1(b)(4)(A)(i), the Supreme Court of Virginia, in John Crane, Inc. v. Jones, 274

Va. 581 (2007) held that “a party is not relieved from its disclosure obligation under the Rule

simply because the other party has some familiarity with the expert witness or the opportunity to

depose the expert.” Crane, 274 Va. at 592. There, the disclosure at issue stated that the expert

would testify to the pathological diagnosis and testing he performed; the association between

asbestos and the alleged disease process involving the plaintiff; the contribution, if any, of

exposure to the defendant’s products and products of other companies in the causation of

plaintiff’s asbestos-related disease; and the burden of asbestos in plaintiff’s lungs and its

contribution, if any, in causing plaintiff’s asbestos-related disease. Id. at 591-92. However, the
                                                -9-
disclosure included nothing about the expert opining on asbestos in the ambient air. Id. at 592.

Crane argued that the expert’s opinions including those regarding asbestos in the ambient air

were “well known” to the Estate of the plaintiff because it questioned the expert about the

opinions during a deposition. Id.

       Here, the pretrial disclosure of Nurse Whitehead’s testimony was that she would “opine

that all of the nurses and the health care providers at the Richmond Justice Center who observed

the plaintiff breached the standards of care for the profession by failing to send the plaintiff to

the hospital.” (Emphasis added.) Her testimony at trial was therefore limited to opining on the

actual transfer of Black from the jail to the hospital, not the assessment of Black’s condition by

nurses at the jail and subsequent recommendation that he be transferred to a hospital for further

treatment. Further, just as the expert in Crane was not designated to opine on “asbestos in the

ambient air,” Nurse Whitehead was not designated to opine on the standard of care related to

assessing PVD. Simply because the defendants were able to depose Nurse Whitehead and were

aware of her opinions regarding the standard of care in making the necessary assessment in this

case, Black was not relieved of his disclosure obligation under Rule 4:1(b)(4)(A)(i).

       Because Black’s pre-trial designation regarding Nurse Whitehead’s testimony stated only

that she would opine on the failure to send Black to the hospital, the trial court did not abuse its

discretion in excluding her testimony based on its finding that she was not familiar with the

institutional policies associated with transferring an inmate to the hospital.

   B. The trial court’s sustaining of defendants’ demurrers to Count II of Black’s complaint

       “A demurrer tests the legal sufficiency of the facts alleged in a complaint assuming that

all facts alleged therein and all inferences fairly drawn from those facts are true.” Givago

Growth, LLC v. iTech AG, LLC, 300 Va. 260, 264 (2021). “This Court reviews a circuit court’s

decision to sustain a demurrer de novo.” Id.

                                               - 10 -
       Further, “as a general rule, the sovereign is immune not only from actions at law for

damages but also from suits in equity to restrain the government from acting or to compel it to

act.” Gray v. Sec’y of Transp., 276 Va. 93, 102 (2008). However, if the relevant provisions of

the Virginia Constitution are “self-executing,” then that is an express constitutional waiver of

sovereign immunity. Id. “A constitutional provision is self-executing when it expressly so

declares.” Id. at 103 (quoting Robb v. Shockoe Slip Found., 228 Va. 678, 681 (1985)); see, e.g.,

Va. Const. art. I, § 8. “[C]onstitutional provisions in bills of rights,” declarations of common

law, and “provisions which specifically prohibit particular conduct” are generally considered

self-executing, even with no express declaration. Gray, 276 Va. at 103 (quoting Robb, 228 Va.

at 681-82). This Court reviews de novo whether a provision of the Virginia Constitution is self-

executing. See id. at 101-07; see also Robb, 228 Va. at 681-83.

       Black makes one argument on appeal pertaining to the trial court’s decision to sustain the

defendants’ demurrers as to Count II of his complaint: that the law in Virginia is clear that

constitutional provisions in bills of rights and those merely declaratory of the common law are

usually self-executing and, therefore, a lawsuit may be filed to enforce a violation of those rights.

Count II of Black’s complaint states in relevant part that:

               The actions and omissions of the defendants and their employees
               therefore constitute cruel and unusual punishment and/or the denial
               of the due process of law, as prohibited by paragraphs 9 and 11 of
               Article I of the Constitution of Virginia.

       The Supreme Court of Virginia, in Robb, established that:

               A constitutional provision may be said to be self-executing if it
               supplies a sufficient rule by means of which the right given may be
               employed and protected, or the duty imposed may be enforced; and
               it is not self-executing when it merely indicates principles, without
               laying down rules by means of which those principles may be
               given the force of law.

                                               - 11 -
Robb, 228 Va. at 682 (quoting 1 T. Cooley, Constitutional Limitations 167-68 (8th ed. 1927)).

Further, the Court in Robb established a four-part test for determining when a constitutional

provision provides a private right of action. First, does the provision contain a declaration that it

is self-executing? Id. at 681. Second, is the provision contained in the Bill of Rights? Id. Next,

is the provision declarative of common law? Id. Finally, does it provide rules by which its

principles may be given the force of law? Id. at 682. As to Article I, § 9, there is no declaration

within § 9 that it is self-executing. While it is contained within the Bill of Rights and is

declarative of common law, there are no rules contained within § 9 by which the principle that

“cruel and unusual punishment [ought not be] inflicted” may be given the force of law.

Therefore, § 9 cannot be considered to be self-executing and, therefore, no private right of action

exists under § 9.

       Applying the test to the due process clause of Article I, § 11, nowhere in § 11 is there a

declaration that it is self-executing. Like § 9, § 11 is contained within the Bill of Rights and is

declarative of common law, but there are no rules by which the principle “[t]hat no person shall

be deprived of his life, liberty or property without due process of law,” are to be given the force

of law. Conversely, the property taking clause of Article I, § 11 does lay down rules by which

some of its principles may be given the force of law, stating in relevant part that “[j]ust

compensation shall be no less than the value of the property taken, lost profits and lost access,

and damages to the residue caused by the taking.” Therefore, the due process clause of § 11

cannot be considered to be self-executing and no private right of action exists under this clause.

       The trial court here did not err in holding that §§ 9 and 11 of Article I of the Virginia

Constitution are not self-executing and that no private right of action exists for Black’s claims

under them. For the above reasons, we affirm the ruling of the trial court sustaining the

defendants’ demurrers to Count II of Black’s complaint.

                                               - 12 -
           C. The trial court’s granting of defendants’ motions to strike Black’s evidence

       “We review a circuit court’s decision on a motion to strike in the light most favorable to

the non-moving party, and the non-moving party ‘must be given the benefit of all substantial

conflict in the evidence, and all fair inferences that may be drawn therefrom.’” Dill v. Kroger

Ltd. P’ship I, 300 Va. 99, 109 (2021) (quoting Egan v. Butler, 209 Va. 62, 73 (2015)).

       Based on our holding that the trial court did not err in excluding Nurse Whitehead’s

testimony as Black’s standard of care expert and his concession that he could produce no

evidence establishing a prima facie case against Sheriff Woody, we also find that the trial court

did not err in granting the defendants’ motions to strike Black’s evidence.5 For these reasons, we

affirm the finding of the trial court.

                                         III. CONCLUSION

       The trial court did not err in excluding Nurse Whitehead’s testimony on the standard of

care owed to Black, and subsequently in granting the defendants’ motions to strike Black’s

evidence. Further, the trial court did not err in sustaining the defendants’ demurrers to Count II

of Black’s complaint because Article I, §§ 9 and 11 are not self-executing, and therefore, no

private right of action exists for these claims.

                                                                                         Affirmed.

       5
         In medical negligence cases, the burden of proof rests on the plaintiff and to meet that
burden, Black was required to prove, through expert testimony, “the applicable standard of care,
a deviation from that standard, proximate causation, and damages.” Rogers v. Marrow, 243 Va.
162, 167 (1992) (citation omitted).
                                             - 13 -