Bluitt v. Wake Forest Univ. Baptist Med. Ctr.
814 S.E.2d 477
N.C. Ct. App.2018Background
- Plaintiff Angela Bluitt underwent a cardiac ablation on January 31, 2014 and awoke with acute lower‑back pain later diagnosed as a third‑degree burn; she had no prior back injury.
- Bluitt filed a medical‑negligence complaint three years later relying solely on res ipsa loquitur and did not include an expert review or certification under Rule 9(j)(1) or (2).
- Defendants moved to dismiss under Rule 9(j), attaching four affidavits from cardiac electrophysiologists stating (in essence) that back burns can be an inherent, non‑negligent risk of ablation and that expert testimony is required to evaluate causation/standard of care.
- Plaintiff opposed with photographs and lay affidavits; no expert affidavit supporting negligence was filed by plaintiff.
- The trial court granted defendants’ Rule 9(j) motion, concluding plaintiff’s res ipsa claim failed because lay jurors could not, without expert testimony, determine whether the injury would rarely occur absent negligence.
- Plaintiff appealed; the Court of Appeals affirmed, holding Rule 9(j) dismissal proper where expert proof is necessary to establish that an injury does not ordinarily occur absent negligence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether trial court’s consideration of defendants’ expert affidavits converted the Rule 12(b)(6) motion to summary judgment | Bluitt: Consideration of affidavits required conversion and the pleadings’ allegations should be taken as true | Defendants: Courts may consider facts relevant to Rule 9(j) (including affidavits) without converting the motion | Court: No conversion; when ruling on Rule 9(j) courts may consider extraneous facts pertinent to the Rule 9(j) inquiry without converting the 12(b)(6) motion |
| Whether Rule 9(j)(1)/(2) certification requirements can be used to obtain dismissal of a pleaded Rule 9(j)(3) (res ipsa) claim | Bluitt: Having pleaded res ipsa, she should not be held to the expert certification of (1) or (2) and her complaint’s allegations must be accepted | Defendants: Plaintiff’s res ipsa claim fails on its merits because expert proof is required to determine causation/standard of care | Court: Rule 9(j)(1)/(2) do not apply to genuine res ipsa claims, but Bluitt’s factual allegations did not establish res ipsa as a matter of law, so dismissal under Rule 9(j) was proper |
| Whether res ipsa loquitur applies to burns alleged from a cardiac ablation | Bluitt: The injury is unexplained and thus fits res ipsa loquitur | Defendants: Cardiac ablation is a complex procedure; burns to the back can be an inherent, unforeseeable risk and require expert proof | Court: Res ipsa inappropriate because determining whether such burns are atypical (i.e., would rarely occur absent negligence) requires expert testimony beyond lay knowledge; dismissal affirmed |
Key Cases Cited
- Grigg v. Lester, 102 N.C. App. 332 (1991) (sets out res ipsa loquitur elements and examples where doctrine applies in medical context)
- McGuire v. Riedle, 190 N.C. App. 785 (2008) (courts may consider facts relevant to Rule 9(j) when ruling on a Rule 9(j) dismissal)
- Anderson v. Assimos, 356 N.C. 415 (2002) (Rule 9(j) certification applies to standard‑of‑care proof, not genuine res ipsa claims)
- Robinson v. Duke Univ. Health Sys., Inc., 229 N.C. App. 215 (2013) (discusses limits on res ipsa in medical malpractice; when jury lacks lay basis to assess injury, res ipsa inappropriate)
- Schaffner v. Cumberland County Hosp. Sys., 77 N.C. App. 689 (1985) (explains that many medical risks are inherent and beyond lay juror competence)
- Bowlin v. Duke Univ., 108 N.C. App. 145 (1992) (notes res ipsa is rarely appropriate in usual medical malpractice cases)
- Hayes v. Peters, 184 N.C. App. 285 (2007) (affirming dismissal where expert testimony was necessary to determine whether injury would not ordinarily occur absent negligence)
- Howie v. Walsh, 168 N.C. App. 694 (2005) (holding expert proof required for lay jurors to assess whether injury resulted from negligence in dental procedure)