Darling v. Charleston Community Memorial Hospital

211 N.E.2d 253 (1965)

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Nature of the Case

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Facts

P, who was 18 years old, broke his leg while playing in a college football game. P was taken to the emergency room at D where Dr. Alexander was on emergency call that day. Dr. Alexander, with the assistance of hospital personnel, applied traction and placed the leg in a plaster cast. A heat cradle was applied to dry the cast. Not long after the application P was in great pain and his toes, which protruded from the cast, became swollen and dark in color. They eventually became cold and insensitive. On the evening of November 6, Dr. Alexander 'notched' the cast around the toes, and on the afternoon of the next day, he cut the cast approximately three inches up from the foot. On November 8 he split the sides of the cast with a Stryker saw and P's leg was cut on both sides. Blood and other seepage were observed and there was a stench in the room. P remained until November 19, when he was transferred to Barnes Hospital in St. Louis and placed under the care of Dr. Reynolds. Dr. Reynolds found that the fractured leg contained a considerable amount of dead tissue resulting from interference with the circulation of blood in the limb caused by swelling or hemorrhaging of the leg against the constriction of the cast. P’s leg had to be amputated eight inches below the knee. P sued D for negligence. Dr. Alexander made a $40,000 settlement. At trial, evidence showed that the nurses failed to follow hospital procedures to monitor his toes for changes in color, temperature, and movement, to check circulation every 10 to 20 minutes, and to report any changes to medical staff. the proof showed that these things were done only a few times a day. P argued that it was the duty of D’s staff to see that the proper procedures were followed and that either the nurses were derelict in failing to report developments in the case to the hospital administrator, or the administrator was derelict in bringing them to the attention of the medical staff, or the staff was negligent in failing to take action. D is a licensed and accredited hospital, and P contended that the licensing regulations, accreditation standards, and its own bylaws define the hospital's duty and that an infraction of them imposes liability for the resulting injury. D defense was that only an individual properly educated and licensed, and not a corporation, may practice medicine. D claimed it was powerless under the law to forbid or command any act by a physician or surgeon in the practice of his profession. D also claimed it was not an insurer of the patient's recovery, but only owes the patient the duty to exercise such reasonable care as his known condition requires and that degree of care, skill, and diligence used by hospitals generally in that community. D claimed it cannot be liable for the torts of its nurse committed while the nurse was but executing the orders of the patient's physician unless such order is so obviously negligent as to lead any reasonable person to anticipate that substantial injury would result to the patient from the execution of such order. D’s only duty was to create the standards by which the professionals performed their duties and to use reasonable care in selecting medical doctors and nurses. P counter-argued that it was the duty of D’s staff to ensure that all policies and procedures were followed and because D was licensed, any infraction imposed liability on D. P got the verdict for $150,000 reduced by Alexander’s settlement to $110,000. The appeals court affirmed. D appealed.