Opinion
Wе granted review to consider whether plaintiffs have viable claims as bystanders for negligent infliction of emotional distress arising out of alleged medical malpractice directed to their close relative. We conclude they do not.
I. Facts and Procedural Background
This is an action for wrongful death and negligent infliction of emotional distress (NIED) based on medical malpractice. Plaintiffs are the adult daughters of decedent Nita Bird. Nita succumbed to cancer on January 15, 1996. Defendants are the physicians who treated Nita. The superior court granted summary judgment for defendants on both claims, but the Court of Appeal reversed. In granting review, we limited briefing and argument to the question “whether defendants’ motion for summary judgment was properly granted on plaintiffs’ claim for negligent infliction of emotional distress.”
The very general allegations of plaintiffs’ complaint do not identify the specific acts underlying their claim for NIED. However, the evidence and arguments submitted in connection with the motion for summary judgment reveal that plaintiffs base the claim оn the events of November 30, 1994.
On that date, plaintiff Janice Bird brought her mother Nita to the hospital to undergo an outpatient surgical procedure. The. goal of the procedure was to insert a Port-A-Cath—a venous catheter surgically implanted to facilitate the delivery of chemotherapeutic agents. Nita was undergoing chemotherapy because she had six weeks earlier been diagnosed with metastatic ovarian cancer involving many of her internal organs and lymph nodes. Nita wаs taken into the operating room about 1:45 or 2:00 p.m. Janice expected the procedure to take about 20 minutes. After an hour had elapsed, Janice asked
Soon thereafter, Janice saw Nita “being rushed down the hallway to the CC—I presume she was going to the CCU [critical care unit]. She was bright blue. The angle of the bed was like this (indicating). Her feet were way up in the air, her head was almost touching the ground, there was all these doctors and nurses around there and they’re running down the hallway, down to that end of the hospital . . . .” The medical personnel rushed Nita into a room and closed the door behind them. Janice, who was in the hallway, asked Dr. Dowds what was happening. Dr. Dowds went to check and returned with this news: “From what I can see,” Janice remembers him saying, “I think they nicked an artery or a vein, and it looks like all the blood went into her chest. They’re going to have to insert a drainage tube into her chest to drain out the fluid, and they’re pumping—they’re trying to pump as much fluids and blood into her to keep her alive until the vascular surgeon gets there.” Ten or 15 minutes later, Janice saw Dr. Dowds running down the hall with multiple units of blood.
At this point Dayle arrived. Janice told her briefly what was happening. Dr. Dowds then told Dayle what he had already told Janice, namely, that an artery or vein had been nicked and that major surgery would be necessary. Shortly thereafter, Janice and Dayle saw Nita being rushed down the hallway to surgery. In Dayle’s words, “All of a sudden I saw, I would say, approximately at least 10 doctors and nurses running down the hall with my mother and I remember her head was towards the floor, her feet were up in the air and she was blue.” Janice’s description is essentially identical, with the addition that she understood her mother’s angle as intended “to keep the blood moving to the heart.”
Those are the events on which plaintiffs base their claim for NEED. Soon thereafter, emergency surgery stopped Nita’s internal bleeding. But plaintiffs do not claim that this subsequent procedure caused them to suffer actionable
In pleading their NIED claim, plaintiffs allege they “were all present at the scene of the injury-producing events at issue herein at the time when they occurred” and that they “were all aware that Defendants, and each of them, were causing injury to their mother, Nita Bird.” Defendants moved for summary judgment on the ground that the undisputed evidence showed plaintiffs had not been present in the operating room at the time Nita’s artery was transected, had not observed the transection, and had learned about it from others only after it had occurred. Plaintiff Kim Moran, moreover, had been out of the state. In support of their motion, defendants cited Thing v. La Chusa (1989)
In their opposition to the motion for summary judgment, plaintiffs admitted they had not been present in the operating room when Nita’s artery was transected. Plaintiffs disagreed, however, with defendаnts’ definition of the relevant injury-producing event as limited to the transection of Nita’s artery. In plaintiffs’ view, the event also included defendants’ failure immediately to diagnose and treat the damaged artery. To raise a triable issue of fact on the issue, plaintiffs submitted the deposition testimony summarized above. Plaintiffs Janice Bird and Dayle Edgmon also submitted declarations stating, in identical words, that, at the time Dayle arrived at the hospital, “[b]oth of us knew that our mother was severely injured and that the injury was continuing,” and that, аt the time Nita was rolled through the hallway to surgery, both “were aware that our mother was bleeding to death as we watched.”
The superior court, as already noted, granted defendants’ motion for summary judgment. The Court of Appeal reversed. “To the extent that the injury-producing event includes the alleged negligent care and treatment of [Nita] outside the operating room,” the court reasoned, “it remains a triable issue of fact as to whether appellants meet the test under Thing.” We granted review.
II. Discussion
This case requires us to consider once again the circumstances under which bystanders to an event injuring a third party may sue the allegedly
Applying these requirements to the facts before us in Thing, supra,
Here, only the second Thing requirement is at issue. Defendants argue that plaintiffs, who admittedly did not perceive the transection of their mother’s artery, were not present at the scene of the injury-producing event at the time it occurred and were not then aware that it was causing injury to the victim.
Certainly defendants are correct that plaintiffs cannot prevail on a claim for NIED based solely on the transection of Nita’s artery. The undisputed facts establish that no plaintiff was present in the operating room at the time that event occurred. Indeed, plaintiffs assert that even the defendant physicians, who were present and actively involved in Nita’s care, failed to diagnose the transection for some time. Plaintiffs first learned an accident had taken place when they heard that news from a physician and saw some of the injurious consequences. The earlier call for a thoracic surgeon over the hospital’s loudspeaker system may seem full of portent in retrospect, but it carried no clear information to a bystander in a waiting room about the progress of a particular surgical procedure, To be sure, Thing's requirement that the plaintiff be contemporaneously aware of the injury-producing event has not been interpreted as requiring visual perception of an impact on the victim. A plaintiff may recover based on an event perceived by other senses so long as the event is contemporaneously understood as causing injury to a close relative. (Wilks v. Horn (1992)
Conceding the point at least implicitly, plaintiffs seek to redefine the injury-producing event to include something of which they were contemporaneously aware. In their own words, “[w]hile Plaintiffs do not dispute that Janice Bird and Dayle Edgmon were nоt in the operating room at the time Nita Bird’s artery was transected, Plaintiffs do contend that Janice Bird and Dayle Edgmon were aware that Nita Bird’s artery and/or vein had been injured as a result of Defendants’ conduct, that Defendants failed to diagnose that injury and that Defendants failed to treat that injury while it was occurring.”
The problem with defining the injury-producing event as defendants’ failure to diagnose and treat the damaged artery is that plaintiffs could not meaningfully have perceived any such failure. Except in the most obvious cases, a misdiagnosis is beyond the awareness of lay bystanders. Here, what plaintiffs actually saw and heard was a call for a thoracic surgeon, a report of Nita suffering a possible stroke, Nita in distress being rushed by numerous medical personnel to another room, a report of Nita possibly having suffered a nicked artery or vein, a physician carrying units of blood and, finally, Nita still in distress being rushed to surgery. Even if plaintiffs believed, as they stated in their declarations, that their mother was bleeding to death, they hаd no reason to know that the care she was receiving to diagnose and correct the cause of the problem was inadequate. While they eventually became aware that one injury-producing event—the transected artery—had occurred, they had no basis for believing that another, subtler event was occurring in its wake.
In other NIED cases decided after Thing, supra,
The leading case on point is Golstein v. Superior Court (1990)
In a footnote, the court in Golstein, supra,
The courts in other cases decided after Thing, supra,
Plaintiffs in the case before us rely almost entirely on Ochoa v. Superior Court (1985)
Even before Thing, supra,
On this point, a single decision to the contrary can be found predating our decision in Thing, supra,
The court in Mobaldi, supra,
The Court of Appeal in the case before us rejected that reasoning. “We do not bеlieve,” the court wrote, “that the bystander theory of recovery requires the plaintiff to have more medical acumen than the defendant doctor so as to be able to ‘perceive’ and understand that a misdiagnosis is being made; rather, all that Thing requires is that the plaintiff be present at the scene of the victim’s treatment and be aware that the course of treatment is causing injury to the victim.” (Italics added.) The Court of Appeal did not explain how a bystander without medical acumen, except in the most extreme cаse (see ante, at pp. 917-918), could meaningfully be aware that a course of treatment is causing injury. In any event, a rule permitting bystanders to sue for NIED on account of unperceived medical errors hidden in a course of treatment cannot be reconciled with Thing’s requirement that the plaintiff be aware of the connection between the injury-producing event and the injury. The Court of Appeal’s rule would, moreover, impose nearly strict liability on health care providers for NIED to bystanders who observe emotionally stressful procedures that turn out in retrospect to have involved negligence. We may reject such a rule as inconsistent with Thing even without accepting defendants’ more radical suggestion that as a matter of policy we categorically bar bystanders’ NIED claims based on medical malpractice.
In summary, plaintiffs have not shown they were aware of the transection of Nita’s artery at the time it occurred. Nor have they shown they were contemporaneously aware of any error in the subsequent diagnosis and treatment of that injury in the moments they saw their mother rolled through
III. Disposition
The decision of the Court of Appeal is reversed in part and remanded fоr further proceedings consistent with this opinion.
George, C. J., Kennard, J., Baxter, J., Brown, J., Moreno, J., and Parrilli, J.,
Notes
The court in Dillon, supra,
In both Nazaroff v. Superior Court, supra,
On the other hand, someone who hears an accident but does not then know it is causing injury to a relative does not have a viable claim for NIED, even if the missing knowledge is acquired moments later. (E.g., Fife v. Astenius (1991)
The court also held the claim barred under the Good Samaritan statutes (Bus. & Prof. Code, §§ 2395, 2396). (Breazeal v. Henry Mayo Newhall Memorial Hospital, supra,
In Ochoa, supra,
Associate Justice of the Court of Appeal, First Appellate District, Division Three, assigned by the Chief Justice pursuant to article VI, section 6 of the California Constitution.
