83 Va. Cir. 407
Charlottesville Cir. Ct.2011Background
- This medical malpractice action concerns alleged negligence by Dr. West and Nurse Dean related to the death of Trenton Curry Roush at UVA Children’s Hospital; the court analyzes sovereign immunity defenses.
- Trenton, a 4½-month-old with congenital cardiac abnormalities, was transferred to UVA for observation and monitoring after a cardioversion.
- Trenton’s treatment team included Dr. Lim (attending cardiologist), Dr. West (fellow), and Nurse Dean (nurse).
- On August 21, 2009, Trenton received Propranolol shortly after an Atenolol-related history was reported; he subsequently died.
- Dr. West was six weeks into a pediatric cardiology fellowship and supervised, with input from a senior fellow, during the initial history and exam.
- Nurse Dean, an experienced nurse, was on the floor under standard hospital protocols, observing orders and reporting abnormalities, but not directly supervised on that shift.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Nurse Dean is entitled to sovereign immunity. | Dean’s role involved direct patient care and oversight without paramount state interest. | Dean’s duties fall within sovereign immunity due to hospital involvement and state control. | Nurse Dean’s sovereign immunity denied. |
| Whether Dr. West is entitled to sovereign immunity for taking Trenton’s medical history. | West, though a fellow, performed acts without proper supervision and should not be immune. | West functioned as a cardiology fellow under supervision, engaging in training with the state’s paramount interest. | Dr. West’s sovereign immunity granted. |
Key Cases Cited
- James v. Jane, 221 Va. 43, 282 S.E.2d 864 (1980) (four-factor test for immunity in simple negligence)
- Messina v. Burden, 228 Va. 301, 321 S.E.2d 657 (1984) (expands James factors for immunity analysis)
- McCloskey v. Kane, 268 Va. 685, 604 S.E.2d 59 (2004) (reaffirms four-factor approach)
- Lohr v. Larsen, 246 Va. 81, 431 S.E.2d 642 (1993) (high state control favors immunity; paramour state interests)
- Gargiulo v. Ohar, 239 Va. 209, 387 S.E.2d 787 (1990) (paramount state interest in training specialists; immunity for fellows in training)
- Lee v. Bourgeois, 252 Va. 328, 477 S.E.2d 495 (1996) (attending physician requirement; immunity limited when functioning as attending)