983 N.W.2d 747
Mich.2022Background
- Samuel Corrado, a nursing-home resident with a feeding tube, vomited twice on June 2, 2014; he later aspirated and died from hypoxia due to aspiration.
- Shelby Nursing Center had a standing order for nausea: check for impaction, give Tigan (one dose) and "report immediately to physician if >1 episode within 24 hours."
- RN Radi Gerbi observed the first vomiting, deferred feeding, later found a second vomiting episode, administered Tigan, attempted to reach the physician (could not), notified his supervisor, then took his break; Corrado deteriorated and later died.
- Meyers (decedent’s personal representative) sought to amend the complaint to add an ordinary‑negligence claim based on Gerbi’s alleged failure to follow the standing order to contact the physician.
- Trial court allowed amendment; the Court of Appeals reversed, holding the proposed claim sounded in medical malpractice and that the standing order could not establish the standard of care or be admitted; the Michigan Supreme Court granted review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Nature of proposed claim: ordinary negligence vs. medical malpractice | Meyers: violation of a mandatory standing order is a non‑medical, ordinary‑negligence failure to follow a rule | Shelby: claim implicates medical judgment and thus sounds in malpractice | Claim sounds in medical malpractice because assessing breach requires medical judgment beyond common knowledge |
| Can a private provider's standing order establish the legal standard of care? | Meyers: the applicable standard is compliance with the standing order | Shelby: private internal rules cannot fix the standard of care | No — private entity rules do not establish the standard of care in malpractice (or negligence) actions |
| Are internal rules/regulations admissible as evidence of the standard of care? | Meyers: standing order is relevant and should be admitted | Shelby: if it cannot establish the standard, it is irrelevant and inadmissible | Internal rules may be admissible as evidence to help prove the standard of care, subject to relevancy and MRE 402/403, and only if jury instructed they do not themselves fix the standard |
| Effect on the proposed amendment and next steps | Meyers: amendment alleges breach of standing order and should proceed as ordinary negligence | Shelby: amendment fails because it relies solely on the standing order | The proposed amendment, insofar as it alleges liability solely from violating the standing order, fails; factual allegations about the order may still be used as admissible evidence for other claims |
Key Cases Cited
- Bryant v. Oakpointe Villa Nursing Ctr., Inc., 471 Mich 411 (definition of malpractice; medical‑judgment issues typically require expert evidence)
- McKernan v. Detroit Citizens’ Street‑R. Co., 138 Mich 519 (private entity rules do not fix legal standard of care)
- Cox v. Flint Bd. of Hosp. Managers, 467 Mich 1 (standard of care for nurses described)
- Jilek v. Stockson, 289 Mich App 291 (Court of Appeals discussion of admissibility of internal hospital rules)
- Gallagher v. Detroit‑Macomb Hosp. Ass’n, 171 Mich App 761 (internal rules may be evidentiary in some circumstances but do not establish standard)
- Darling v. Charleston Cmty. Mem. Hosp., 33 Ill 2d 326 (leading out‑of‑state authority on internal hospital rules not conclusive of standard of care)
- Quijano v. United States, 325 F.3d 564 (internal policies may be evidence of standard but do not alone determine it)