Johnson v. Wayne Mem'l Hosp., Inc., 254 N.C. App. 295

Decedent Mario Johnson presented to Wayne Memorial Hospital ED on Feb 11, 2011 with sickle cell–related pain; an ED physician read a chest X‑ray as normal and discharged him; a radiologist’s over‑read later showed a subtle infiltrate.
The hospital’s ED discrepancy policy routed radiology over‑reads through a nurse supervisor for next‑day review unless the radiologist directly contacted ED for an urgent finding; typical non‑urgent over‑reads could be reviewed ~24 hours later.
The radiologist who over‑read Johnson’s film reviewed it the morning of Feb 11 and did not deem it immediately dangerous, so the discrepancy was not directly reported to ED; the nurse supervisor logged it ~14 hours later and the PA reviewed it the next morning—after Johnson had already returned and later died of acute chest syndrome.
Plaintiff sued multiple providers and the hospital; plaintiff alleged the hospital’s discrepancy‑review timeframe breached the standard of care for hospitals in similar communities and proximately caused death.
At close of evidence the trial court granted directed verdict for the hospital on the hospital‑policy claim; plaintiff appealed that directed verdict (claims against individual providers proceeded to trial and resulted in defense verdicts, not appealed).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether plaintiff presented competent evidence of the applicable hospital standard of care for timely communication of radiology over‑read discrepancies	Johnson maintained Dr. Quigley (EM expert) showed the policy’s 24–28 hour delay was outside the standard and that ED should be notified within ~4–5 hours	Hospital argued plaintiff failed to prove the statutory standard (comparative practice in same/similar communities) and expert testimony did not establish that standard	Court held plaintiff failed to present competent evidence of the standard; Dr. Quigley admitted he made no inquiry into other hospitals’ practices and his 4–5 hour estimate was a guess, so directed verdict affirmed
Whether plaintiff proved breach and causation based on hospital policy timing even if policy was followed	Plaintiff argued the timeframe itself was negligent and proximately led to delayed recognition/treatment	Hospital argued (inter alia) no proof of breach and that any intervening physician conduct broke causation (court did not need to reach intervening‑negligence issue)	Court held breach not proven because standard of care was not established, so causation inquiry unnecessary

Green v. Freeman, 367 N.C. 136 (discussion of directed verdict standard)
Maxwell v. Michael P. Doyle, Inc., 164 N.C. App. 319 (directed verdict review and inferences for non‑movant)
Scarborough v. Dillard’s, Inc., 363 N.C. 715 (limitations on trial court factual findings in directed‑verdict rulings)
Heller v. Somdahl, 206 N.C. App. 313 (more‑than‑a‑scintilla standard to deny directed verdict)
Clark v. Perry, 114 N.C. App. 297 (elements of medical malpractice claim)
Lowery v. Newton, 52 N.C. App. 234 (standard for malpractice proof)
Goins v. Puleo, 350 N.C. 277 (breach of applicable standard is essential element)
Crocker v. Roethling, 363 N.C. 140 (requirement that plaintiffs establish standard of care via expert testimony and § 90‑21.12)
Tripp v. Pate, 49 N.C. App. 329 (failure to prove comparative hospital practice supports directed verdict)