Stone v. Missouri Department of Health & Senior Services
350 S.W.3d 14
| Mo. | 2011Background
- Stone is a licensed practical nurse employed as a charge nurse at Maries Manor in Vienna, Missouri.
- On November 3, 2007, Stone allegedly restrained K.S., a dementia patient, to force medication into K.S.'s mouth.
- K.S. had a care plan directing staff to leave her alone and to calm her before attempting medication again.
- Maries Manor terminated Stone on November 8, 2007 after internal investigation; the department opened an abuse investigation via hotline.
- The department placed Stone on the Employment Disqualification List (EDL) for 18 months after a hearing.
- The circuit court reversed the department; on transfer, the Missouri Supreme Court addressed the evidentiary standard and due process issues.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether expert testimony is required to prove knowing abuse | Stone argues expert testimony is necessary due to K.S.'s dementia | MDHSS contends lay testimony suffices to establish abuse | Expert testimony not required; lay evidence suffices under Klein. |
| Whether there is substantial evidence Stone knowingly abused K.S. | Stone asserts evidence does not show abuse or knowing injury | Department presents lay witness testimony showing restraint and forced medication | Substantial and competent evidence supports knowing abuse. |
| Whether the notice violated due process by omitting 19 CSR 30-88.010(13) and (21) | Notice did not reference the cited regulations; due process was violated | Hearing relied on 198.006(1) and 198.070.13; notice adequate | No due process violation; notice sufficient and decision properly grounded. |
Key Cases Cited
- Klein v. Mo. Dep't of Health & Senior Servs., 226 S.W.3d 162 (Mo. banc 2007) (low threshold for physical injury; applies to emotional harm too)
- McDonagh v. State Bd. of Registration for Healing Arts, 123 S.W.3d 146 (Mo. banc 2003) (credibility and deference to ALJ; standard of review for agency factfinding)
- Roy v. Missouri Pacific Railroad Co., 43 S.W.3d 351 (Mo. App. 2001) (lay witness admissibility; witness testimony open to senses)
- State ex rel. Dean v. Cunningham, 182 S.W.3d 561 (Mo. banc 2006) (emotional distress damages in common experience)
- Oakes v. Mo. Dept. of Mental Health, 254 S.W.3d 153 (Mo. Ct. App. 2008) (context of standard of care—distinguishes defensive actions from abuse)