In the early morning hours of September 11, 1981, Estelle B. Edwards was treated at the emergency room of the Effingham County Hospital. At that time there was no physician on duty in the emergency room, though a physician, Dr. Tan, was on call. Dr. Tan directed the treatment by telephone after receiving information from the nurses on duty in the emergency room. Mrs. Edwards was discharged from the emergency room and later that morning was taken to the office of Dr. Webb. At Dr. Webb’s office, Mrs. Edwards went into cardiac arrest and subsequently died from complications arising out of a myocardial infarction. At trial there was evidence that Mrs. Edwards had an 85% to 90% chance of surviving the myocardial infarction after having arrived at the hospital if she had been treated for her ailment. The plaintiffs in this action against the defendant Effingham County Hospital Authority are the executor and children of Mrs. Edwards. The complaint as amended, alleges negligence by the hospital nurses, including their failure to obtain an accurate medical history of Mrs. Edwards and to fully report all known and observable symptoms plus the content of such history to the physician on call. The case was tried before a jury which returned a verdict in favor of defendant. Plaintiffs appeal. Held:
1. The “locality rule” states that a hospital owes to its patients only the duty of exercising ordinary care to furnish equipment and facilities reasonably suited to the uses intended and such as are in general use in hospitals in the area. See
Emory Univ. v. Porter,
*174 By motion in limine, plaintiffs sought to preclude any reference which might inform the jury of the “locality rule” in relation to the appropriate standard of nursing care. The trial court denied plaintiff’s motion holding that the “locality rule” governs the case sub judice and subsequently charged the jury as to the “locality rule” standard of care and gave no charge as to the general standard of nursing care.
Plaintiffs enumerate as error the application of the “locality rule” rather than the general standard of nursing care. The crux of the plaintiffs’ case is their evidence that the nurses employed by defendant failed to record and relay to the physician information concerning the decedent’s complaints of stomach pain, that decedent had a heart condition, and that decedent had taken a nitroglycerin pill shortly before her arrival at the hospital. Plaintiffs’ evidence also shows a failure to adhere to the general standard of nursing care in that no vital signs of Mrs. Edwards were taken after the administration of drugs. Also, no history of medication taken by Mrs. Edwards was obtained, although she regularly took several drugs.
As the plaintiffs are questioning the professional judgment of defendant’s nurses, rather than the adequacy of services or facilities, the “locality rule” does not provide the appropriate standard of nursing care in the case sub judice.
Wade v. John D. Archbold Mem. Hosp.,
2. Plaintiffs enumerate as error the trial court’s directing a verdict against them as to punitive damages sought by the plaintiff-executor. See
Ford Motor Co. v. Stubblefield,
Plaintiffs cite
Medical Center Hosp. Auth. v. Andrews,
“It is not essential to a recovery for punitive damages that the person inflicting the damage was guilty of wilful and intentional misconduct. It is sufficient that the act be done under such circumstances as evinces an entire want of care and a conscious indifference to consequences.”
Battle v. Kilcrease,
3. Plaintiffs contend the trial court erred in refusing to allow testimony of witnesses as to statements made to them by the deceased about her physical condition immediately prior to her death. Defendant objected to such statements on the ground that they were hearsay. Plaintiffs argue that the testimony should have been admitted “on the following proposition announced in
Lathem v. Hartford Accident &c. Co.,
4. Plaintiffs enumerate as error the trial court striking (removing from consideration by the jury) portions of the death certificate of the deceased prior to allowing its introduction into evidence. The death certificate showed the immediate cause of death as shock and respiratory failure due to or as a consequence of ventricular fibrillation and cardiac arrest. The certificate shows the interval between the onset of these causes and death as 30 to 60 minutes. Plaintiffs contend the trial court erred in deleting (removing from consideration by the jury) a further cause of death, a myocardial infarction showing an interval between onset and death of several hours and a further significant condition contributing to death as angina pains 48 to 72 hours prior to the myocardial infarction. “[A] death certificate serves as prima facie evidence only of (1) the death itself and (2) the immediate agency of the death. Other conclusions, such as those regarding the events leading up to the death or whether the cause of death was intentional or accidental, are not admissible.”
King v. State,
5. Plaintiffs enumerate as error three charges given the jury which plaintiffs contend are appropriate only in relation to physicians and surgeons, but should not have been applied to the nursing profession. The first of these charges sets forth the presumption that medical care was performed in an ordinarily skillful manner and places the burden on the one receiving the services to show a want of due care, skill and diligence. See
Hill v. Hosp. Auth. of Clarke County,
The second charge at issue states: “I further charge you that a hospital does not guarantee the results of its care and proof alone that the outcome of the care is different from that expected or is followed by disastrous instead of beneficial results neither establishes nor supports an inference of want of proper care, skill or diligence on the part of the hospital nurses.” A substantially similar charge was held applicable to hospitals in
Hill v. Hosp. Auth. of Clarke County,
The remaining charge at issue states: “I further charge you that a mere difference in views between medical experts or as to medical care exercised is insufficient to support an action for malpractice where it is shown that the case preferred by each is an acceptable and customary method of providing care.” This charge does not involve a principle peculiar to physicians or even to the medical area, but a general concept of tort law. There is no error in applying this principle to the nursing profession. See 65 CJS, Negligence, § 16;
Stefan Jewelers v. Berry,
6. Plaintiffs enumerate as error the trial court’s failure to give three requested jury instructions. The first of these instructions involves responsibility for the action of a nurse while performing acts which constitute a part of the patient’s treatment as prescribed by the attending physician. As there is no issue presented by the evidence involving negligence in the administration of a prescribed treatment this instruction is not adjusted to the evidence and we find no
*178
error in the trial court’s refusal to so instruct the jury.
Browning v. Kahle,
The second requested charge states: “Control remains with the hospital when its nurse employees perform non-medical acts. Where no unusual features are involved which call for an exercise of medical skill or experience, a doctor may reasonably take for granted that the experienced nurse on the staff of a modern hospital will attend to their ordinary and customary duties without detailed instruction.” The third requested instruction at issue states: “A doctor has no responsibility to instruct or warn nurses with respect to performance of matters within the ordinary and customary duties of the nursing profession.” Defendant contends that these requests are not adjusted to the evidence and that the jury was adequately instructed on the hospital’s responsibilities for its nurse-employees. We cannot agree. In view of the evidence and arguments suggesting that Dr. Tan was responsible for any failure in care that caused the death of Mrs. Edwards, the nature and boundaries of the duties of nurse and physician, as well as when the nurses were under control of the hospital or physician were crucial to the jury’s decision. We cannot find the substantial equivalent of these requested instructions in the trial court’s charge to the jury. The requested instructions are accurate statements of the law and adjusted to the evidence, therefore, the trial court erred in failing to give plaintiffs requested instructions (Nos. 23 and 24).
Porter v. Patterson,
7. Plaintiffs contend the trial court erred in directing a verdict on the issue of interest from the date of death to the date of rendition of the verdict. As there is no evidence of compliance with the “Unliquidated Damages Interest Act” (OCGA § 51-12-14) (1982) we find no error.
Standard Oil Co. v. Reagan,
Judgment reversed.