Court Opinion

ID: 9753335
Source: CourtListenerOpinion
Date Created: 2023-08-28 19:08:22.826918+00
Date Added: 2024-06-11T07:27:34.023007
License: Public Domain

POLLOCK,
Justice, dissenting.
This appeal arises out of a medical-malpractice action brought by plaintiffs, Giuditta Tobia (hereinafter “plaintiff”) and her husband, Sam, now deceased. The jury found that defendants, Cooper Hospital University Medical Center (Cooper), Clifford Bernstein, and other members of the hospital staff, had not been negligent and that the negligence of plaintiff had been the sole cause of her injuries. The trial court denied plaintiffs’ motion for a directed verdict or for a new trial, and the Appellate Division affirmed the judgment on the verdict. The majority reverses the judgment of the Appellate Division and grants plaintiffs a second trial.
Rule 2:10 directs appellate courts that “[t]he trial court’s ruling on such a motion shall not be reversed unless it clearly appears that there was a miscarriage of justice under the law.” Without finding any such miscarriage, the majority nonetheless gives plaintiff a second chance to recover for her personal injuries. I respectfully dissent.
Understandably, the jury might have sympathetically viewed plaintiff, an older woman for whom English is her second language. Sympathy, however, does not justify an appellate court in depriving defendants of a jury verdict. Nor does sympathy warrant creating a new rule of law eliminating comparative negligence as a defense for health-care providers. Such a rule spreads *348to other patients the cost of injuries sustained by a patient’s own negligence.
I agree with the Appellate Division, which wrote:
We are also satisfied that the trial court did not err by instructing the jury as to plaintiffs contributory negligence with respect to the first incident, that is, with respect to the injury that plaintiff sustained when she attempted to get off the stretcher without assistance and fell. The record plainly establishes that the trial court properly submitted the issue of plaintiff’s contributory negligence to the jury. Moreover, the question of contributory or comparative negligence is usually one for the jury and will be resolved by motion for judgment only if it is not reasonably debatable. Mellon v. Pennsylvania-Reading Seashore Lines, 7 N.J. 415, 422 [81 A.2d 747] (1951); Bacak v. Hogya, 4 N.J. 417, 426-27 [73 A.2d 167] (1950). It must be remembered that a fact can be considered “reasonably debatable” even if it is established by uncontroverted evidence, if the evidence is susceptible of conflicting inferences. Corcoran v. Hartford Fire Ins. Co., 132 N.J.Super. 234, 243-44 [333 A.2d 293] (App.Div.1975). Here, conflicting inferences could reasonably have been drawn as to whether plaintiff exercised reasonable care and caution for her own safety at the time she attempted to get off the stretcher to go to the bathroom. The tidal court, therefore, properly submitted the issue of plaintiff’s negligence to the jury and properly instructed the jury on this issue.
Beyond this, any argument concerning the trial court’s instructing the jury with respect to plaintiff’s contributory negligence was rendered moot by the verdict. The jury’s verdict concerning plaintiffs contributory negligence ultimately had no significance in the outcome of the matter, since the jury found that none of the defendants were negligent
-I-
Plaintiff presented herself at Cooper with abdominal pain. She was placed on a gurney outside the x-ray room. All parties recognize that plaintiff fell off the gurney and broke her hip. The crux of this case is whether plaintiff or Bernstein, or both, were responsible for the fall. Bernstein, now a physician but then a fourth-year medical student on Cooper’s staff, and plaintiff presented sharply-conflicting versions of the accident. Plaintiff claimed that while lying on the gurney, she told Bernstein that she needed to go to the bathroom. According to her, he lowered the side rail on the gurney and then left. Thereafter, she tried to get off the gurney. The gurney moved, and she fell to the floor, injuring herself.
*349Bernstein, however, testified that after plaintiff told him she needed to go to the bathroom, she twice refused his offers of help. He lowered the side rail so that she could sit on the gurney. At her request, he then left.
The jury could have found for plaintiff, particularly because Cooper had adopted a safety procedure that provides:
Any patient not being attended, or directly supervised or observed, either by a nurse or a doctor, shall be secured by having safety side rails raised on stretcher. This procedure will be specially monitored when handling patients who have symptoms of alcohol, drug ingestion, are unconscious, confused or elderly.
Instead, the jury found that defendants had not been negligent, a finding that establishes that the jury believed Bernstein, not plaintiff. Although we may not be able to ascertain the specific basis for the jury’s rejection of plaintiffs testimony, the record supports the conclusion that the jury could have found her to be evasive. Confronted with an evasive witness, the jury also could have wondered why her attorney produced a court interpreter for someone who answered questions on direct examination in English without the aid of an interpreter, someone who had communicated freely in English with Bernstein when providing her medical history at the hospital. We need not prolong the speculation, for the record supports the jury’s rejection of plaintiffs testimony.
-II-
Without finding that the verdict was against the weight of the evidence or was otherwise infected, the majority nonetheless overrides it. The majority reaches this result by creating “a class of medical patients whose inability to care for themselves may require an extra measure of care by health-care professionals.” Ante at 338, 643 A.2d at 2. The majority’s new class of patients consists of people who are infirm because “of age, substance abuse, or mental derangement.” Ibid. Old age, however, is not the same as drug abuse or mental derangement. The record, moreover, is devoid of any proof that plaintiff suffered from any infirmity that affected her ability to exercise due care for her safety while on the gurney. Indeed, the uncontroverted evidence *350is that she was alert and independent. By equating plaintiffs age with incapacity or drug abuse, ibid., and by finding, contrary to the jury verdict, that plaintiff was incompetent, the majority holds that plaintiff had no duty of care for her own safety while in the hospital and that her conduct was irrelevant as a matter of law. According to the majority, hospitals have a duty to foresee that patients will be negligent and that the failure “to prevent such a patient from engaging in self-damaging conduct” precludes a hospital from asserting “contributory negligence as a defense to a claim arising from the patient’s self-inflicted injuries.” Ibid. Thus, the majority creates a novel rule, under which a hospital virtually insures patients for injuries caused by their own negligence. Under the majority’s holding, when patients are admitted to a hospital, they leave in the admissions office their duty of care for their own safety. I disagree.
Like the majority, I accept the proposition that part of a hospital’s duty of care includes the duty to protect patients from foreseeable self-inflicted injuries. Ante at 338, 341, 643 A.2d at 2, 4. See Cowan v. Doering, 111 N.J. 451, 465, 545 A.2d 159 (1988) (stating hospital breached duty to prevent patient from attempting suicide, given patient’s mental condition and history of self-inflicted injury); Kent v. County of Hudson, 102 N.J.Super. 208, 217, 245 A.2d 747 (App.Div.1968) (finding that hospital, which knew of patient’s chronic confusion and resultant tendency to burn himself accidentally with cigarettes, had duty to protect patient from self-inflicted burns), affd o.b., 53 N.J. 546, 251 A.2d 760 (1969); see also Keyworth v. Southern Baptist Hosps., Inc., 524 So.2d 56, 59 (La.Ct.App.) (holding hospital staff liable to patient who freed self from restraining jacket and fell to floor; staff knew she had previously fallen out of bed after getting out of jacket), writ denied, 525 So.2d 1058, and unit denied, 525 So.2d 1061 (1988). That proposition restates the familiar principle that the duty of care one owes to another is reasonableness under the circumstances. See Merenoff v. Merenoff, 76 N.J. 535, 559, 388 A.2d 951 (1978) (stating, “ordinary standard of care applied in the marital context should enable a trier of fact to differentiate qualitatively *351between the conduct of married and unmarried persons and to recognize that certain behavior as between a married couple is acceptable and reasonable, even though such conduct might well be considered unreasonable and result in liability if engaged in by unmarried persons”). I support the proposition, moreover, that hospitals should be sensitive to the possibility that elderly patients may require special attention. Hence, a jury could find a hospital negligent for leaving an elderly patient unattended on a gurney. In this case, however, the jury, fully aware of Cooper’s regulation, found that Bernstein and the other defendants had not been negligent.
Hence, I believe the majority goes too far in holding that “a patient in [plaintiffs] circumstance cannot be considered negligent at all.” Ante at 344, 643 A.2d at 5. In so holding, the majority creates for patients an exception to the basic principle requiring people to exercise due care for their own safety.
Across the country, courts have rejected the idea that a competent patient should not be held accountable for his or her behavior in a hospital. See Haney v. Mizell Memorial Hosp., 744 F.2d 1467, 1479 (11th Cir.1984) (finding that jury “reasonably concluded” car-accident victim’s behavior “was the cause of his disability” where victim was intoxicated and disobeyed hospital personnel orders not to move); Brazil v. United States, 484 F.Supp. 986, 990 (N.DAla.1979) (finding patient’s disobeying doctor’s orders by “trying to sit up, and turning from side to side” contributed to, and materially increased, back injury and resulting damage); Seay v. Urban Medical Hosp., Inc., 172 Ga.App. 344, 323 S.E.2d 190, 193 (1984) (finding patient’s sitting up and walking during hospital stay for neck injury “could have caused” subsequent injuries; “[therefore, a charge on her negligence was proper”); Corlett v. Caserta, 204 Ill.App.3d 403, 149 Ill.Dec. 793, 799, 562 N.E.2d 257, 263 (1990) (finding patient’s refusal, on religious grounds, to accept “reasonable life-saving medical procedure” reduced physician’s liability “to the extent that the patient’s death was proximately caused by the patient’s refusal of the reasonable *352life-saving treatment”); Berry v. Rapides Gen. Hosp. Inc., 527 So.2d 583, 585-86 (La.Ct.App.1988) (stating hospital had no duty to protect “alert and fully ambulatory” patient from falling when patient was walking with assistance of hospital staff); Rogers v. Baptist Gen. Convention, 651 P.2d 672, 674-75 (Okla.1982) (finding contributory negligence properly submitted to jury where mentally-ill patient left hospital and was struck by car on highway); Elbaor v. Smith, 845 S.W.2d 240, 245 (Tex.1992) (finding contributory negligence an issue for jury where patient refused to take antibiotics against doctor’s advice and infection arguably resulted from such refusal); see also Spirito v. Temple Corp., 466 N.E.2d 491, 493 (Ind.Ct.App.1984) (finding contributory negligence properly charged to jury where evidence showed patient at convalescent facility tried to transport herself without help in contravention of instructions).
Berry, supra, 527 So.2d 583, is instructive. In that case, the Court of Appeals of Louisiana rejected the concept of a hospital as insurer. The plaintiff was admitted to a hospital emergency room complaining of neck and shoulder pain. Id. at 584. She was injured when she fell getting off an emergency-room table with a nurse’s assistance. Ibid.
The trial court found the hospital liable and awarded plaintiff damages, but the Court of Appeals reversed. Ibid. It noted that under Louisiana law “[a] hospital is bound to exercise the requisite amount of care toward a patient that the particular patient’s condition may require.” Id. at 585 (quoting Hunt v. Bogalusa Community Medical Ctr., 303 So.2d 745, 747 (La.1974)). The Court of Appeals then examined the plaintiff’s condition, noting that
there was nothing about plaintiffs history or physical condition that would indicate that she was unable to walk a relatively short distance with the assistance of hospital personnel---- [The doctor’s] examination and interview of the patient revealed that plaintiff was alert and fully ambulatory and had no complaints of weakness.

Ibid.

*353Accordingly, it rejected the trial court’s holding that the hospital “was negligent because it had a duty to protect plaintiff from falling, considering her age [seventy-two] and condition.” Ibid.
Spirito, supra, 466 N.E.2d 491, also is pertinent. There, plaintiff was admitted to a convalescent home after suffering a stroke, which caused paralysis on her left side, leaving her in need of “assistance in sitting up and standing.” Id. at 492. On two occasions, she was left unattended on the toilet for short periods of time; both times she was told not to attempt to get back to her wheelchair without help. Ibid, Nonetheless, plaintiff twice tried to reach her wheelchair unassisted, and fell both times, the second time suffering a broken hip. Ibid,
The jury found for the convalescent home, which had relied on the defense of contributory negligence. Ibid. The Court of Appeals affirmed, noting only that “[t]he evidence was sufficient to support the giving of the instructions” on contributory negligence. Id, at 493.
Given the facts of this case, the majority’s holding extends beyond the reach of its rationale. In short, the majority has created a class in search of a member. By extending the rationale of its opinion to an older person of unquestioned competence, the majority suggests that all older people are incapable of caring for themselves. True, some such people cannot care for themselves. Many others, like plaintiff, remain independent. The record is devoid of proof that the condition that gave rise to plaintiffs hospitalization affected her judgment in any way. Thus, the majority’s stereotypical view of older people will not support its unprecedented rule.
To avoid its confusion of old age with incompetence, the majority states that “[a]ll we hold is that if a jury should find that Mrs. Tobia was not competent to care for herself, the jury should not consider a failure to care for herself as contributory negligence.” Ante at 346, 643 A.2d at 6. Not so. The jury has already found that she was competent to care for herself and that her contributory negligence was the sole cause of her injuries. Only by ignoring *354that finding can the majority support the remand for a second trial.
Plaintiff is one of many older people who remain alert and independent into their eighties. Defendants presented Bernstein’s uncontradicted testimony that plaintiff “seemed very alert and capable,” that her hearing and eyesight were generally fine, and that she was “oriented as to person, place, and time.” According to Bernstein, plaintiffs family described her as an independent person. Consistent with that description, plaintiff told Bernstein that “she did not want help” in getting off the gurney.
An increasing number of people, like plaintiff, remain competent and productive after eighty. The actress Jessica Tandy won an Academy Award at age seventy-nine, and in 1991, at age eight-two, was nominated for another. At eighty-five, Justice Harry Blackmun is serving his final term on the Supreme Court of the United States. Justice William O. Brennan served on that Court until age eighty-four, and Justice Oliver Wendell Holmes, Jr. until he was eighty-nine. This Court has recalled several retired Superior Court judges over the age of eighty to continue to preside in judicial proceedings. Many lawyers, including retired judges and justices, continue to practice law into their eighties.
The list goes on. See Lydia Bronte, The Longevity Factor, 385-89 (1993). Age does not necessarily render people incompetent. Older people, like younger people, should be treated as individuals. I respectfully suggest that the majority should not reject the uncontradicted testimony and assume that an alert, capable, and independent woman is incompetent merely because she is eighty-five.
-III-
I am unpersuaded by the majority’s statements that its new rule does not “in any sense minimize patients’ responsibility to care for themselves,” ante at 343, 643 A.2d at 4, and that hospitals “can assert a patient’s self-neglect to limit damages.” Ibid. Roughly translated, the majority holds that a jury may consider a patient’s *355conduct on damages, but not on liability. Such a rule circumvents the Legislature’s attempt to limit liability through the comparative-negligence statute, N.J.S.A 2A:15-5.1 to -5.8. The statute allows a plaintiff to recover only if his or her “negligence was not greater than the negligence of the person against whom recovery is sought____” N.J.SA 2A:15-5.1. It further requires the trier of fact to make separate damages and liability calculations whenever liability is disputed. N.J.SA 2A:15-5.2. Specifically, the trier of fact shall determine “the full value of the injured party’s damages,” N.J.SA 2A:15.5.2a, and shall allocate 100% of the liability, N.J.SA 2A:15-5.2b. Under the majority approach, however, the jury must subtract from the amount of plaintiff’s damages an amount determined in accordance with plaintiff’s liability.
Contrary to the comparative negligence act, the majority opinion permits plaintiffs to recover when they are responsible for more than fifty percent of their injuries. For example, a patient who is responsible for seventy-five percent of his or her injuries, calculated to be $100,000, formerly could not recover under the act; now he or she will recover $25,000. Whatever merit inheres in such a result is for the Legislature to decide.
A further effect of the majority opinion is to eliminate bifurcated trials in health-care cases. Under the opinion, defendants may not present evidence of plaintiff’s conduct on the liability phase of the trial. Such evidence would be irrelevant because the patient “cannot be considered negligent at all.” Ante at 344, 643 A.2d at 5. Thus, the jury would allocate 100% of the liability among defendants. Unaddressed by the majority is how the jury will treat plaintiff’s negligence in the damages phase. At the damages hearing, if the jury determines that plaintiff is ninety-nine percent at fault, is plaintiff to recover only one percent of the damages awarded? Or may the jury assign some indeterminate value to a plaintiff’s negligence in assessing damages? If so, the majority’s opinion is an invitation to chaos.
If the jury had returned a verdict in favor of plaintiff, I expect that the Appellate Division would have affirmed the judgment on *356that verdict. If so, I would not have voted to review that judgment. Absent a miscarriage of justice, appellate courts should accept jury verdicts whether they favor plaintiffs or defendants. Here, the jury did not believe plaintiff. In assessing her credibility, the jury performed a function that courts entrust to juries daily. Traditional respect for the role of juries prevents me from rejecting the jury’s assessment of plaintiff’s credibility and from fashioning a rule of law to circumvent that assessment.
For affirmance—Justices CLIFFORD and POLLOCK—2.
For reversal and remandment—Chief Justice WILENTZ and Justices HANDLER, O’HERN, GARIBALDI and STEIN—5.