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Williams v. Covenant Medical Center

October 04, 2000

MARILYN JEAN WILLIAMS AND HERMAN J. WILLIAMS, PLAINTIFFS-APPELLANTS,
v.
COVENANT MEDICAL CENTER, DEFENDANT-APPELLEE.



Appeal from Circuit Court of Champaign County No. 98L36 Honorable John R. DeLaMar, Judge Presiding.

The opinion of the court was delivered by: Presiding Justice Cook

In February 1998, plaintiffs, Marilyn Williams (Williams) and Herman Williams, filed a medical malpractice complaint against Covenant Medical Center (Covenant), alleging that Covenant was negligent in allowing Williams to leave her bed and fall while she was a patient at Covenant. In November 1999, the trial court granted Covenant's September 1999 motion for summary judgment. Plaintiffs appeal, arguing that the trial court erred (1) in granting summary judgment on a basis not sufficiently raised in Covenant's motion for summary judgment, (2) in denying their motion to strike Covenant's motion for summary judgment and prematurely granting Covenant's motion for summary judgment, and (3) in denying their oral motion for a continuance to obtain an affidavit from their expert. We reverse and remand.

I. BACKGROUND

In February 1996, Williams was admitted to Covenant with chronic obstructive pulmonary disease. During the evening of February 23 or the early morning hours of February 24, she apparently fell after leaving her bed to use the bathroom. She suffered a compression fracture of her L1 lumbar vertebra.

In February 1998, plaintiffs filed a complaint against Covenant, alleging that Covenant was negligent in allowing Williams to leave her bed and fall, causing her pain and suffering, medical expenses, and disability.

In January 1999, Covenant deposed Williams. She could not recall the fall or even remember being hospitalized, possibly because she was heavily medicated during her hospital stay. Covenant also took discovery depositions of Williams' husband and her three daughters. On February 26, 1999, plaintiffs wrote a letter to Covenant's attorney, requesting the depositions of five nurses, two nurse's aides, and Vicky Garretson, Covenant's risk-management coordinator. In March 1999, Covenant filed a motion for summary judgment based on Williams' inability to remember that she fell, to describe how she fell, or to identify any witnesses of her fall. Covenant did not attach any affidavits from experts regarding the standard of care, breach of the standard of care, or proximate causation. Plaintiffs then filed a motion to compel Covenant to produce eight potential occurrence witnesses for deposition, alleging that Covenant refused to produce its employees until after a hearing on its motion for summary judgment. In April 1999, Covenant allowed plaintiffs to depose Garretson and four of its nurses.

Plaintiffs moved to revise the discovery schedule on April 1, 1999, the initial deadline for plaintiffs to disclose expert witnesses. In May 1999, the trial court extended the deadline "until a date 30 days after the depositions of Covenant personnel requested by plaintiff[s] in a letter to defense attorney dated February 26, 1999[,] are taken," and it allowed plaintiffs until June 15, 1999, to respond to Covenant's motion for summary judgment. On June 14, 1999, plaintiffs moved to continue the deadline for their response to summary judgment because Covenant failed to produce three of the eight employees for deposition. The trial court again granted the motion and stated in a docket entry, "The parties should notify the court when discovery relating to the motion for summary judgment is completed and said motion is ready for consideration." A September 17, 1999, docket entry states, "Counsel have agreed to a briefing schedule which concludes [October 14, 1999]." Also on that day, Covenant filed a motion for summary judgment that was substantially identical to the one that Covenant filed in March 1999.

On October 8, 1999, plaintiffs filed a response to Covenant's summary judgment motion. They attached depositions of Jane Brais, Williams' daughter; Garretson; Leslie Windler, R.N.; Twyla Ingram, R.N.; and Dr. Maury Topolosky, Williams' treating physician. They also appended an excerpt from Covenant's policy and procedure manual regarding its "fall prevention program" as well as a consultation report dated February 26, 1999, prepared by Dr. Ruth Craddock.

Brais stated that Garretson admitted to her that Williams fell. Windler's "falls assessment" report first indicated a history of falls on February 24. Ingram was on duty the night that Williams fell, and she made the following late chart entries on February 28 based upon her observations from the early morning of February 24:

"[00:15 a.m.] [patient] denies questions [or] concerns. *** [02:35 a.m.] [patient] has sustained no injury. [4:00 a.m.] Tylenol #3 [orally] given for back pain. *** [approximately 5:00 a.m.] I was informed [that patient disconnected] foley [catheter]. Found foley [catheter at] bed side with [balloon] inflated. [Patient] was in [b]athroom sitting on stool. *** [Patient] escorted to bed ***. *** States she needed to go to the bathroom."

Ingram explained in her deposition that the check marks for "rails" on Williams' chart indicate that the upper two bed rails were up. Those two rails are almost always raised for all patients to remind them that they can call a nurse for assistance. According to Ingram, only patients who are disoriented, psychotic, or have multiple tubes and intravenous needles would need to have all four bed rails up to prevent them from getting out of bed.

Dr. Topolosky stated in his deposition that Williams informed him that she had fallen. On the morning of February 24, Williams fit six criteria on Covenant's "falls assessment" form that put her at a risk of falling: she was over 60 years old; had an unsteady gait; had multiple diagnoses; and had medications with sedative, hypotensive, and diuretic effects. According to the form, a patient whose condition fits at least three criteria should be considered for safety intervention under Covenant's "fall prevention program." According to that program, keeping all four bed rails raised is one of the recommended safety precautions.

Dr. Craddock's consultation report stated, in pertinent part:

"Two to three evenings ago, [Williams] was trying to get out of bed to use the bathroom and she fell out of bed, noting that her oxygen cord was wrapped around her leg and making it difficult for her to maneuver easily. She landed on her right side. She did not note immediate pain and called for the nurse. The nurse helped her up and did get her [onto] the commode, which she used. She was then put back in bed and noted progressive pain in the low back and right side of the lower back region as the night wore on."

In October 1999, Covenant filed a rebuttal to plaintiffs' response to its summary judgment motion. For the first time, Covenant explicitly asserted that plaintiffs had no expert testimony to establish the standard of care and breach of the standard of care. In November 1999, plaintiffs filed a motion to strike Covenant's September 1999 motion for summary judgment as untimely because it attempted to circumvent expert discovery.

At a hearing in November 1999, the trial court denied plaintiffs' motion to strike because it found that the September 1999 motion for summary judgment was timely. Then, plaintiffs orally moved for a continuance to obtain an affidavit of an expert to respond to Covenant's summary judgment motion. Plaintiffs also disclosed to the court that Dr. George Schoedinger was their retained expert and that Dr. Schoedinger had prepared the health professional's report that plaintiffs attached to their complaint. The trial court denied the motion for a continuance and proceeded to a hearing on Covenant's motion for summary judgment.

The trial court granted Covenant's motion for summary judgment because plaintiffs failed to demonstrate that the standard of care required Covenant's nurses to keep all four rails raised on Williams' bed. Thus, the court found that no genuine issue of material fact existed regarding whether any negligence ...


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