Hernández Rivera v. Government of the Capital
Hernández Rivera v. Government of the Capital
Opinion of the Court
delivered the opinion of the Court.
There is no dispute as to the facts in this action for damages. Arranged in chronological order they are as follows:
On April 25, 1951 Marta Iris Hernández Rivera, a three year old girl, entered the Hospital of the Capital, an institution of public charity. She was suffering from a disease which later proved to be meningitis. She was placed in the children’s ward under the care of Dr. José E. Sifontes, hospital physician. The ward consisted of two rooms, one with sixteen beds and another with nine. Helen Gutiérrez de Soto, a graduate nurse, was in charge of both rooms with the help of Dolores Dones, a nurse’s aide. The principal duties of the nurse’s aide were to clean and change the children’s clothes and to prepare their meals and feed them. When she was not busy with these matters she watched the smaller room.
Since her confinement Marta Iris underwent a treatment of Chloromycetin, luminal, and serum, the amount of these medicines being modified according to the patient’s condition. She was seriously ill the first few days, but since May 1 the immediate danger of death had passed, although she was not completely well. Her temperature had fluctuated daily and on May 3 it read 100°F at 8 o’clock a. m. and 99° at 4 p. m. The normal temperature is 98.6°F. The pulse rhythm and her breathing had also fluctuated, but on May 3 they were close to normal. She was injected luminal when
On the evening of May 3, Mrs. Soto was in charge of 23 patients, “children and babies,” fourteen of whom were in the room with Marta Iris and nine in the other room. Among them there were at least four seriously ill: one with encephalitis,
During the afternoon of May 3, Marta Iris was restless, crying and moaning. Her restlessness increased after 8 o’clock p. m. Shortly thereafter —there is no evidence of the exact time — since the child was screaming and restless, Mrs. Soto tied her hands and feet, in the shape of a cross, to the side rails of the crib. This, however, upset the patient further and the nurse untied her about two minutes later. Then the child “turned on her stomach and remained apparently quiet” but not asleep. “The children, when we tie them, are afraid to be tied, and remain apparently quiet
As soon as the child calmed down, the nurse raised the side rail of the crib, turned off the light in the room and stepped into the adjoining room.
About five minutes after she had left Marta Iris the nurse was called by Dr. Sifontes. She went with the doctor to the place where the child’s crib was located and found her dead, hanging by the string of her nightgown. The string-had caught in a small screw on one side of the crib when the child had apparently tried to climb down. The death was caused by “asphyxia or strangulation.”
Dr. Sifontes had been making one of his several night rounds to examine the patients. He used a flashlight to light the cribs because the desk light was not sufficient to “notice . . . the finer things that enter into a patient’s observation.” On that round and at 8:45 p. m. he found Marta Iris in the afore-described position. In his opinion the child had died five or ten minutes earlier because her temperature was normal and there was no rigidity in the body. After verifying the death, he notified the nurse immediately.
On several occasions the child’s mother and grandmother had volunteered to care for the patient at daytime or nighttime and they were turned down saying that “there were
The trial judge dismissed the complaint because in his judgment it was “a lamentable and unfortunate accident for which the defendant cannot be held liable.” He added that “in this case the evidence does not indicate any negligence on the part of the defendant.” The appellant adopts the opposite view.
We shall immediately dispose of several questions which do not require discussion. In the first place, it is known that by law and the decisions on the matter, the Government of the Capital is liable for the negligent acts of its employees and officers performed iii the discharge of their duties.
The facts as stated raise the sole question of whether the defendant Government of the Capital, acting through some of the employees and officers of the hospital, was negligent in failing to give the child Marta Iris Hernández Rivera the necessary vigilance, protection, and care. We are dealing briefly with an alleged negligence in the performance of acts classified by American case law as “administrative” or “ministerial” and which may be briefly defined as routine acts toward the “care, protection, and the customary hospitalization” of the patient. Fowler v. Norways Sanitarium, 42 N. E. 2d 415, 419 (Ind. 1942) ; Stuart Circle Hospital Corp. v. Curry, 3 S. E. 2d 153, 157-59 (Va. 1939) ; St. Lukes Hospital Ass'n v. Long, 240 P.2d 917, 921 (Col. 1952); Capasso v. Square Sanitarium, 155 N.Y.S. 2d 313, 316-17 (1956).
The standards governing such liability are simple and may be explained briefly.
Under the circumstances of this case, it is necessary to explain further one of the afore-stated factors. The
After applying the general and specific standards to the particular circumstances of the present case, it is our opinion that the Hospital of the Capital was decidedly negligent in its duty to protect and care for the patient Marta Iris Hernández Rivera and that the damage caused could have reasonably been foreseen and avoided.
This is the case of a three-year old child, who although her condition had improved, was still suffering from meningitis, in a feverish and very restless condition, and for
What attention, protection, and care did the hospital provide for a patient under those conditions and conduct? It placed her in a ward with 22 other patients, all children, four of whom required special supervision. That ward was entrusted to a graduate nurse assisted by a nurse’s aide, but the latter, due to the nature of her duties, used to spend part of the time outside the two rooms which composed the ward and at the time of the accident was outside. The hospital also provided a doctor who made several rounds during the night. The patient occupied a crib with side rails but with no other protection to prevent her from getting out, and the nurse, knowing her condition of great restlessness and the “scare” of the previous night, did not provide that protection upon leaving her alone. At the time of the accident there was only one small desk light covered by a shade to light the fourteen patients who were in the room with Marta Iris. The nurse was outside the room, busy changing the serum of one of the very sick patients, in a position where she could observe the adjoining room through a glass, but not Marta Iris directly. As a matter of fact, she did not look at Marta Iris while performing the said task.
We are told, however, that this was an “unusual” accident ( as classified by the nurse and physician) and that the hospital could not foresee that it would occur as it did. We believe, in the first place, that it is not so unusual for a three-year old child and in a state of fever and great restlessness, to try to leave a bed with side rails (an act which under the circumstances of the case was indeed clearly foreseeable) and become entangled in her nightgown or in the string around her neck and hurt herself. However, even .assuming that it was accepted that the hospital could not
For the reasons stated we find that the Government of the Capital acted negligently and we hereby award damages to the plaintiff for the death of her daughter and the loss of her companionship and affection. After considering all the elements of the case we believe that the amount of $15,000 plus all the costs of the suit and $1,500 for attorney’s fees is reasonable.
The judgment appealed from is reversed and a new judgment will be entered pursuant to this opinion.
This patient “had to be watched” but her crib was close to the nurse’s desk.
In a corner of the room there was a desk for the nurse. It had a small lamp with a shade which mainly lit the desk but permitted a view of the whole room. That lamp remained lit when the nurse left the room.
Section 46 of Act No. 99 of May 15, 1931 (Sess. Laws, p. 626), 21 L.P.R.A. § 561; Serra v. Transportation Authority, 67 P.R.R. 574, 580-81 (1947); Rodríguez v. People, 75 P.R.R. 377, 387 (1953).
Serra v. Transportation Authority, supra at 587; Carrasquillo v. Am. Missionary Association, 61 P.R.R. 837, 847 (1943).
It has been said that an act is within the scope of the practice of medicine where it consists of one of three things: “First, in judging the nature, character, and symptoms of the disease; second, in determining the proper remedy for the disease; third, in giving or prescribing the application of the remedy to the disease.” Underwood v. Scott, 23 Pac. 942, 943 (Ka. 1890). See the cited case of Carrasquillo, where the hospital as well as the intern who attended the patient was ordered to pay compensation for damages to the patient.
See, in general, Harbison, The Standard of Care Owed by a Hospital to Its Patients, 2 Vand. L. Rev. 660 (1949); Danko and Matthews, Liability for Non Attendance of Patient, 26 N. Dame Law 314 (1961); Annotations in 22 A.L.R. 341 (1923), 39 A.L.R. 1431 (1925), 124 A.L.R. 186 (1940), 31 A.L.R. 2d 1118, 1128 (1953); Hayt, Hayt and Groeschel, Law of Hospital, Physician and Patient, 198-209 (1952); Rice v. California Lutheran Hospital, 163 P.2d 860, 862 (Cal. 1945); Lexington Hospital, Inc. v. White, 245 S. W. 2d 927, 929-30 (Ky. 1952).
In this case the parties did not present evidence of those practices. However, the attendant circumstances having been considered, that evidence is convenient but not indispensable. Stallman v. Robinson, 260 S. W. 2d 743, 749 (Mo. 1953); McDonald v. Foster Memorial Hospital, 338 P.2d. 607, 616-17 (Cal. 1959).
On the standard of foreseeability see in general, 2 Harper and James,, The Law of Torts 1134-1151 (1956).
Seavey, Negligence, Objective or Subjective?, 41 Harv. L. Rev. 1 (1927); Prosser, The Law of Torts 124-146 (1955).
Gaccioni v. State, 18 N.Y.S. 2d 161, 165 (1940); Burtman v. State, 67 N.Y.S. 2d 271, 273 (1947); United States v. Gray, 199 F.2d 239, 242, 243 (10 Cir. 1952); Stallman v. Robinson, supra at 747; Murray v. St. Mary’s Hospital, 113 N.Y.S. 2d 104, 105 (1952).
Tate v. McCall Hospital, 196 S. E. 906, 908 (Ga. 1938) ; Spivey v. St. Thomas Hospital, 211 S. W. 2d 450, 455 (Tenn. 1947).
Hogan v. Clarksburg Hospital Co., 59 S. E. 943, 945 (W. Va. 1907).
Thomas v. Seaside Memorial Hospital, 183 P.2d 288, 293 (Cal. 1947) ; Rice v. California Lutheran Hospital, supra at 863-64.
St. Lukes Hospital Ass’n v. Long, supra at 921; Capasso v. Square Sanitarium, supra at 316; Thomas v. Seaside Memorial Hospital, supra at 292-93; Prosser, op. eit at 127-128; Irizarry v. People, 75 P.R.R. 740, 745 (1954).
St. Lukes Hospital Ass’n v. Long, supra at 921.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.