Court Opinion

ID: 9613142
Source: CourtListenerOpinion
Date Created: 2023-08-22 04:14:30.849465+00
Date Added: 2024-06-11T18:03:25.727331
License: Public Domain

Judge Orr
dissenting.
After a careful review of the record and applicable law, I must respectfully dissent from the majority on the submission of the issue on wilful or wanton conduct. While recognizing the severe emotional impact of the facts surrounding the case, my research concludes that there was insufficient evidence to warrant the submission of wilful and wanton conduct by defendant to the jury. Therefore, in my opinion, the damage awards that were predicated on the jury’s positive answer to the wilful or wanton conduct issue must fail.
Plaintiffs contend that acts of the defendant hospital constituted negligence in that (1) there was a policy or practice of requiring physicians to discharge patients from the hospital when their insurance benefits expired, and (2) defendant allowed this policy or practice to operate in a way that interfered with Dr. Barnhill’s medical judgment, thereby causing Dr. Barnhill to discharge Joseph Muse, III in a medically-inappropriate manner.
For purposes of this analysis, we can assume that there was such a policy and that there was some evidence from which a jury could find that this policy influenced or interfered with Dr. Barnhill’s medical judgment and his decision to discharge Joseph Muse, III. That being the case, plaintiff arguably has made out a case of negligence and the jury so determined. However, the crux of the case rests squarely on the issue of whether the evidence, taken in a light most favorable to the plaintiff, is sufficient to submit the further issue of wilful or wanton conduct to the jury.
*483Our Supreme Court in Akzona, Inc. v. Southern Railway Co., 314 N.C. 488, 495-96, 334 S.E.2d 759, 763 (1985), defined wilful and wanton conduct as follows:
An act is done wilfully when it is done purposely and deliberately in violation of law, or when it is done knowingly and of set purpose, or when the mere will has free play, without yielding to reason. ‘The true conceptions of wilful negligence involves a deliberate purpose not to discharge some duty necessary to the safety of the person or property of another, which duty the person owing it has assumed by contract, or which is imposed on the person by operation of law.’
An act is wanton when it is done of wicked purpose, or when done needlessly, manifesting a reckless indifference to the rights of others.
(Citations omitted.) Further,
While “[o]rdinary negligence has as its basis that a person charged with negligent conduct should have known the probable consequences of his act,” we have said “[w]anton and willful negligence rests on the assumption that he knew the probable consequences, but was recklessly, wantonly or intentionally indifferent to the results.”
Id. at 496, 334 S.E.2d at 763-64 (citation omitted).
Turning now to the facts of this case, there is, as previously noted, evidence that defendant hospital had a policy or practice of discharging patients when their insurance ran out. This practice was obviously done for a business purpose; however, the evidence reveals that the policy was subject to being overridden on occasion by request of the treating physician or other financial consideration. Although there also was some evidence that this policy may have affected Dr. Barnhill’s decision to discharge the plaintiffs’ son, such evidence, while perhaps supporting a negligence theory, does not go beyond that.
Dr. Barnhill testified that the policy did not influence his decision, and more importantly, that a range of treatment options including a state psychiatric hospital were available for the patient. No evidence was presented that could lead a jury to conclude that the policy in question involved a deliberate purpose not to discharge some duty necessary to the safety of the person in question. While it can be said *484that the policy to discharge was deliberate, there is no evidence that the hospital expected, anticipated or intended for the patient to be released in circumstances that put the person’s safety in jeopardy. In fact, Joseph Muse, III was discharged into the custody and care of another physician and a community based mental health facility as well as the care of his parents with specific instructions for his care.
The trial court instructed the jury that “. . . a hospital is under a duty not to have policies or practices which operate in a way that interferes with the ability of a physician to exercise his medical . . . judgment. A violation of this duty would be negligence.”
While the jury found that defendant was negligent, I find insufficient evidence to raise the defendant’s conduct to the level required to submit the issue of wilful and wanton conduct to the jury. A policy to terminate a patient’s hospitalization based upon insurance benefits ending in and of itself is not wilful or wanton conduct. To sustain plaintiff’s contention there must be, according to our law, a deliberate purpose not to discharge a duty necessary for a person’s safety. If the hospital had simply discharged the patient with no referral to another physician or medical facility, then a cognizable claim for wilful or wanton conduct would have been established. Such was not the case here, as I read the record, and although Dr. Barnhill’s care in discharging the patient may well have been negligent, there is nothing to suggest that the hospital’s policy or its implementation by Dr. Barnhill was done with reckless or deliberate disregard for the patient’s safety. Therefore, I conclude that the trial court erred in submitting the issue of wilful and wanton conduct to the jury and would accordingly vote to reverse.