Bryant v. Presbyterian Hosp. in City of NY
Bryant v. Presbyterian Hosp. in City of NY
Opinion of the Court
The plaintiff, by this action, seeks recovery for personal injuries allegedly suffered by him while a patient in the defendant hospital, which injuries he claims resulted from the negligent administration of a single hypodermic medication by an undergraduate nurse.
The case is here on appeal by permission of the Appellate Division where a judgment of Trial Term was unanimously affirmed which dismissed the complaint at the close of plaintiff’s evidence.
From the record before us it appears that following plaintiff’s admission to the defendant hospital on July 31,1949 — at which time he complained of pains in his side and back — the diagnosis of his physical disorder, based upon various tests and analyses, was a dormant thromboangiitis obliterans (Buerger’s disease). Then followed a series of treatments in the course of which hypodermic injections of penicillin were administered by nurses “ dressed all in white.” As a result of those treat
Giving the plaintiff the benefit of every favorable inference reasonably to be drawn from the evidence (Faber v. City of New York, 213 N. Y. 411, 414; Hanlon v. Macfadden Publications, 302 N. Y. 502, 506) we find in the record a complete lack of certain items of proof essential to his recovery herein. In reaching that conclusion we have examined plaintiff’s pleadings and the record of evidence to ascertain whether proof was made of facts which underlie his claim, and upon the establishment of which he has the burden.
By his amended complaint the plaintiff alleges that the personal injuries for which he seeks recovery resulted from a hypodermic injection of medication — which a bill of particulars asserts was penicillin — administered to him on or about September 7, 1949. However, upon the trial the plaintiff was permitted to amend his complaint and bill of particulars to allege that the hypodermic injection in suit was given on August 17,1949. The amended complaint also alleges that the injection
Thus, although there is no suggestion that any hospital record was withheld from plaintiff for use upon the trial, there is no evidence of the fact pleaded by the plaintiff that on August 17, 1949, M. D. Smith, an undergraduate nurse, administered to him the hypodermic injection of which he complains. Nor did he, by his own testimony or by other proof, identify the person who administered that medication, except to describe her as having worn black shoes and black stockings and a light blue striped uniform which differed from that worn by other nurses who had attended him. That meager description by the plaintiff of the nurse who was in attendance upon him did not, without more, prove that the nurse who administered the hypodermic injection on August 17, 1949, was an undergraduate nurse with only a brief period of training; nor did it prove that she lacked experience in the administration of medications hypodermically, or that her proficiency in that form of medical treatment had not been the subject of careful investigation and selection by the defendant’s staff officers. Nor was there proof as to how much training is necessary to administer medications hypodermically. Upon that phase of the case there was evidence, intro- . duced as part of plaintiff’s case, that undergraduate nurses in attendance at the three-year training course conducted at the defendant hospital were permitted to give hypodermic injections during their first year of training. There was no testimony, however, that such a procedure was not in accord with practice approved by informed medical authorities, or was not in accord with similar practice prevailing in other teaching hospitals.
It is manifest that medication given to a patient by hypodermic injection is a medical act, not administrative routine. In this jurisdiction the liability of a hospital for negligence in the performance of such an act is predicated upon a lack of
The decision in Howe v. Medical Arts Center Hosp. (261 App. Div. 1088, affd. 287 N. Y. 698) does not reinforce the position of the plaintiff in the case at bar. Bather does it, in our view, serve to point up a vital lack in the record now before us. In the Howe case (supra) substantial evidence came into the record as part of plaintiff’s proof — and became the chief issue at the trial and the point chiefly argued on appeal — that when the woman whose alleged negligence caused plaintiff’s injuries joined the nursing staff of the defendant hospital, appropriate investigation was not made and care was not exercised by responsible staff officers of the hospital to ascertain her qualifications for professional nursing. Evidence of that character — which became a decisive factor in the Howe case — is, as we have seen, completely lacking in the record we now review.
The judgment should be affirmed, without costs.
Dissenting Opinion
(dissenting). In this negligence action, plaintiff’s complaint was dismissed at the close of his case. He adduced evidence that he became a patient in defendant’s hospital on July 31,1949. After more than two weeks of treatment by physicians and nurses “ dressed all in white ”, and on August
The following day, on August 17th, while dressed and waiting on the hospital porch for his discharge, he was approached by a person described by him as a nurse who was wearing a 1 ‘ light blue kind of a striped uniform ”, black shoes and black stockings — not the white uniform worn by other nurses who had previously treated him. She directed him to return to his bed, where she gave him an injection in the lower part of the buttock. Hospital records indicate that such injection was given for the purpose of introducing penicillin, but the nurse’s notes failed to show any such injection on that day.
There was also evidence that this defendant permitted student nurses to give injections to patients. Competent medical testimony was produced to show that the injection in question was negligently performed, in that the needle was inserted into an improper part of plaintiff’s anatomy, causing damage to the sciatic nerve. A notation upon the continuation sheet at defendant ’s clinic indicates a conclusion by three examining physicians that plaintiff was suffering from “ underlying thromboangiitis obliterans of both legs ” and that “ the injection he received at Presbyterian may have done something to accelerate or precipitate the process in the right leg ”. Plaintiff’s left leg was subsequently amputated at another hospital in August of the following year.
From the foregoing evidence, the jury could have found that the injection was not administered by a regularly registered or trained nurse, but by a student in defendant’s nursing school. It is now the holding of the majority of this court that such a finding is insufficient in law to establish a prima facie cause of action as against defendant hospital. With this holding I am constrained to disagree.
The traditional immunity of the hospital from liability for the acts of physicians and nurses, in their capacity as such, is based upon the view that the hospital’s duty to the patient is limited to the furnishing of competent personnel to perform medical duties. It is only for negligence in the selection of such personnel that the hospital may be held liable (Bakal v. University Heights Sanitarium, 277 App. Div. 572, affd. 302 N. Y. 870; Hamburger v. Cornell Univ., 240 N. Y. 328; Schloendorff v. Society of New York Hosp., 211 N. Y. 125).
When a hospital chooses to furnish other than duly qualified nurses for the performance of strictly medical duties, it should, in fairness, be required at least to accept the burden of justifying such selection when harm results. It may be that here defendant could show that the student who actually administered the injection (a note of which was made in its hospital records but not in its nurse’s notes, as above noted), had been properly instructed in anatomy and related subjects in defendant’s nursing school, and that she had demonstrated adequate knowledge and sufficient ability as a nurse to be entrusted with such tasks. In the absence of at least such a showing by defendant the complaint should not have been dismissed, for the mere fact that she was an undergraduate is insufficient to presume her competence (see Howe v. Medical Arts Center Hosp., 261 App. Div. 1088, affd. 287 N. Y. 698). In that case a student nurse negligently burned a patient with hot water bags; although she was an undergraduate, she was actually graduated from a nonaccredited nursing school and had also had several years’ experience at recognized hospitals. “ From the fact that the nurse was an undergraduate,” among other things, the Appellate Division pointed out, “ the jury was entitled to conclude that the defendant had failed in its duty ” to provide competent nurses.
The conclusion here reached is not repugnant to our holding in Phillips v. Buffalo Gen. Hosp. (239 N. Y. 188), where it was said that it is the character of the act (i.e., application of hot water bottles), rather than the title of the actor, that determines the extent of the hospital’s duty. Insofar as that case retains its authority (cf. Howe v. Medical Arts Center Hosp., supra), it is distinguishable from the case at bar in that we
For the foregoing reasons, the judgment appealed from should be reversed and a new trial ordered, with costs to abide the event.
Loughran, Ch. J., Conway, Desmond, Dye and Fuld, JJ., concur with Lewis, J.; Froessel, J., dissents in opinion.
Judgment affirmed.
Reference
- Full Case Name
- John Bryant, Appellant, v. Presbyterian Hospital in the City of New York, Respondent
- Cited By
- 15 cases
- Status
- Published