Carolyn Byrom sued Douglas Hospital, Inc. (“Douglas Hospital”) for negligence, attorney fees, and punitive damages after she sustained injuries in a fall while exiting a wheelchair provided by the hospital. The trial court granted summary judgment to Douglas Hospital, finding that (1) Byrom had asserted professional negligence claims without the required expert affidavit and (2) Byrom had equal or superior knowledge of the risk she faced exiting the wheelchair. Byrom appeals, arguing that she raised ordinary negligence claims аgainst Douglas Hospital. For the following reasons, we find that the trial court erred, and we reverse and remand for proceedings consistent with this opinion.
On appeal from the grant or denial of a motion for summary judgment, we conduct a de novo review of the law and evidence, viewing the evidence in the light most favorable to the nonmovant, to determine whether a genuine issue of material fact exists and whether the moving party was entitled to judgment as a matter of law.
(Citation omitted.) Agnes Scott College v. Clark,
So viewed, the record shows that Byrom went to Douglas Hospital on April 16, 2013, for pre-operative testing for a procedure scheduled for the next day. Byrom walked slowly and used a cane to support her knees. After taking Byrom’s vitals, a nurse offered to obtain a wheelchair to transport Byrom to the exam room. While Byrom was seated in the wheelchair, she rested her feet on the foot pedals, which were down. A nurse pushed Byrom in the wheelchair, and when they arrived in the exam room Byrom exited the wheelchair indеpendently. When Byrom stood up and sat down for the testing, the foot pedals were not raised up.
As the nurse was pushing Byrom back to the waiting room, they encountered a doorway that was not wide enough to fit the wheelchair. The nurse asked Byrom if she thought shе could make it to the waiting room on her own, and Byrom told her that she believed she could. The nurse, however, did not come around to assist Byrom in getting out of the wheelchair. Instead, Byrom held her cane in one hand and used her other hand to push up from the arm of the wheelchair. Byrom knew as she stood up that the foot pedals were still down. As Byrom stepped, her right pant leg caught on the wheelchair’s foot pedal and she fell. As a result of this fall, Byrom broke her leg, required surgery, and subsequently stayed in a rеhabilitation facility for three months.
Byrom filed suit, alleging that Douglas Hospital was negligent in failing to safely transport her, in failing to maintain a procedure for safely transporting individuals in
During discovery, Douglas Hospital acknowledged that patients are at risk of injury when exiting a wheelchair if it is not done safely. The hospital also admitted that its employees should follow manufacturer’s instructions and guidelines with regard to the operation of wheelchairs, though Douglas Hospital did not have any specific written policies, procedures, or training programs in place with regard to the safe use of wheelchairs. The instruction on the wheelchair itself stated that the patient should exit the wheelchair by lifting the arm and exiting on the side of the wheelchair, and Douglas Hospital admittеd that its employees should have ensured that patients exited wheelchairs in this manner.
At the conclusion of discovery, Douglas Hospital moved for summary judgment on Byrom’s complaint on two grounds, which are at issue in this appeal.
1. Byrom argues that she raised ordinary negligence claims, as opposed to claims for professional negligence, and thеrefore she was not required by OCGA § 9-11-9.1 to file an expert affidavit with her complaint. We agree.
A plaintiff who asserts a claim for medical malpractice against a hospital is required to file an expert affidavit along with her complaint setting fоrth at least one negligent act or omission and the factual basis for the claim. OCGA § 9-11-9.1. The fact that a patient’s injury occurs in a hospital setting or calls into question the actions of a medical professional, however, does not in and of itself mеan her claim is for medical malpractice. Brown v. Tift County Hosp. Auth.,
The determination of whether a claim is one for medical negligence and therefore whether it requires expert support at filing is determined on the basis of whether the act or omission was made regarding a medical question. Medical questions have been defined as those concerning highly specialized expert knowledge with respect to which a layman can have no knowledge at all, and the court and jury must be dependent on expert evidence. In cases involving a pеrson’s fall while in the care of medical professionals, it can be difficult to distinguish professional negligence from ordinary negligence. This distinction is a question of law for the court.
(Citations, punctuation and footnotes omitted.) Kerr v. OB/GYN Assoc. of Savannah,
Where the professional’s alleged negligence requires the exercise of professional skill and judgment to comply with a standard of conduct within the professional’s area of expertise, the action states professional negligence. But where the allegations of negligence do not involve professional skill and judgment, the action states ordinary negligence.
Here, the record does not show that only a person with medical training could transport Byrom in the wheelchair or that transporting her involved the exercise of medical judgment. Seе Strickland v. Hosp. Auth. of Albany/Dougherty County,
Further, Byrom’s claims arise from her allegation that the Douglas Hospital nurse failed to follow the manufacturer’s instructions for exiting from thе wheelchair — instructions which Douglas Hospital admits should have been followed. Use of equipment that is inconsistent with the manufacturer’s instructions, without more, does not constitute a medical malpractice claim. Lamb v. Candler Gen. Hosp.,
2. Byrom also argues the trial court erred in finding that shе had equal or superior knowledge of the risk posed by the wheelchair’s foot pedals. For the reasons that follow, we conclude that the trial court erred in applying the equal or superior knowledge analysis to Byrom’s claims and, therefоre, erred in granting summary judgment to Douglas Hospital.
Just as not all claims against a hospital constitute medical malpractice, not all claims which arise from an injury sustained inside a building constitute premises liability, regardless of how the claim is argued by the pаrties. Georgia law distinguishes between negligence cases where a condition on the premises causes injury to someone and those where an employee’s active negligence causes injury to someone. Lipham v. Federated Dept. Stores,
Claims of active negligence require the same proof as other simple negligence claims:
(1) A legal duty to conform to a stаndard of conduct raised by the law for the protection of others against unreasonable risk of harm; (2) a breach of this standard; (3) a legally attributable causal connectionbetween the conduct and the resulting injury; and, (4) some loss or damage flоwing to the plaintiffl.]
(Citation omitted.) Phillips v. South West Mechanical Contractors,
Although Byrom cites to OCGA § 51-3-1, the statute setting out liability for property owners, the factual bases that she identifies for her claims do not sound in premises liability.
At the inexplicable urging of the parties, and even though Byrom’s claims were primarily pled as ones for active negligence, the trial court analyzed this case as if it involved a static defect in the condition of the hospitаl premises. In so doing, it found that Byrom’s prior successful exit from the wheelchair demonstrated that she had equal knowledge of the risk posed by the wheelchair’s foot pedals such that her recovery was barred. Because nothing about Byrom’s claim implicates a condition of the hospital premises, we find cases applying the framework of a premises liability analysis inapposite to the present case. See Lipham, supra,
Judgment reversed and case remanded.
Notes
Douglas Hospital also moved for summary judgment on the ground that it was entitled to a setoff against any recovery Byrom may obtain for sums not charged for her care or sums which the hosрital paid to third-party care providers. The trial court did not address this argument, and where the trial court has not ruled on an issue, we will not address it. CDP Event Svcs. v. Atcheson,
Further, we are bound by the substance, not nomenclature, of claims, and we should construe pleadings to bring about substantial justice. Cotton v. Fed. Land Bank of Columbia,
We note that in light of the trial court’s grant of summary judgment to Douglas Hospital, it did not address Byrom’s claims for attorney fees and punitive damages.