Harris v. Miller

438 S.E.2d 731, 335 N.C. 379, 1994 N.C. LEXIS 16
CourtSupreme Court of North Carolina
DecidedJanuary 28, 1994
Docket345A91
StatusPublished
Cited by34 cases

This text of 438 S.E.2d 731 (Harris v. Miller) is published on Counsel Stack Legal Research, covering Supreme Court of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harris v. Miller, 438 S.E.2d 731, 335 N.C. 379, 1994 N.C. LEXIS 16 (N.C. 1994).

Opinions

EXUM, Chief Justice.

Of primary importance in this case is the following question: under what circumstances should a surgeon in charge of an operation be held vicariously liable for the negligence of medical personnel who assist in performing the operation?

I

On 1 June 1981, Mrs. Etta Harris underwent back surgery under general anesthesia at Beaufort County Hospital. Defendant George Miller, M.D., an orthopedic surgeon, performed the surgery assisted by William Hawkes, a nurse anesthetist. As a result of inadequate oxygenation during the surgery, Mrs. Harris suffered brain damage and paralysis. Some six years later, she died from complications secondary to the brain damage.

[383]*383In 1983, Mrs. Harris and her husband filed suit for personal injury and loss of consortium against the hospital, Dr. Miller and Nurse Hawkes. They later settled their claims against the hospital and Nurse Hawkes, executing a covenant not to sue, but specifically reserved the right to pursue any claims against Dr. Miller. When Mrs. Harris died, the complaint was amended to allege wrongful death and the case proceeded against Dr. Miller on theories of direct and vicarious liability. Plaintiff claimed that Dr. Miller was negligent in causing a severe bleeding problem during the surgery, in failing to properly treat the bleeding problem and in failing to adequately supervise Nurse Hawkes. Plaintiff also claimed that Dr. Miller should be held liable for the negligence of Nurse Hawkes under the doctrine of respondeat superior. At the close of plaintiff’s evidence, the trial court granted Dr. Miller’s motion for a directed verdict on the vicarious liability claim, finding the evidence insufficient to establish a master-servant relationship between Dr. Miller and Nurse Hawkes. As an alternative basis for the directed verdict, the trial court held that the prior release of Nurse Hawkes served to exonerate Dr. Miller. The case was submitted to the jury on the sole issue of Dr. Miller’s negligence.

The jury found for Dr. Miller and plaintiff appealed. The Court of Appeals, Judge Phillips dissenting, affirmed the judgment below. 103 N.C. App. 312, 407 S.E.2d 556 (1991). Plaintiff appealed to this Court on the basis of the dissent, presenting the following issues: 1) whether the trial court erred in directing a verdict on the issue of Dr. Miller’s vicarious liability, and 2) whether the trial court erred in excluding certain testimony of plaintiff’s expert on nurse anesthesia care. We granted plaintiff’s petition for discretionary review of an additional issue, not addressed by the Court of Appeals: whether the trial court erred in ruling that the release of the servant, Nurse Hawkes, extinguished the vicarious liability of the master, Dr. Miller. Having concluded that the Court of Appeals erred in affirming the trial court’s rulings on the first two issues, and that the trial court erred in its ruling on the release issue, we now reverse the Court of Appeals and grant plaintiff a new trial.

II

Plaintiff’s evidence tended to show the following.

In early 1981, Mrs. Harris began experiencing severe back pain. She consulted Dr. Miller, an orthopedic surgeon, who diag[384]*384nosed a ruptured disc requiring surgery. Dr. Miller performed the surgery on June 1, 1981, at Beaufort County Hospital, where he had staff privileges. Anesthesia was administered by Nurse Hawkes, a certified registered nurse anesthetist employed by the hospital and assigned to the case by the hospital’s Chief Anesthetist. Because the hospital did not employ a staff anesthesiologist, Nurse Hawkes worked for the duration of the case, as stated in the hospital’s Anesthesia Manual, under the “responsibility and supervision” of Dr. Miller. No anesthesiologist was available for consultation within thirty miles.

The operation appears to have been doomed from the start by Nurse Hawkes’ negligent performance of the pre-operative anesthesia evaluation. Among other errors, Nurse Hawkes interpreted Mrs. Harris’ chest X-rays as “negative” when in fact she had an enlarged heart — evidence of past heart disease —and failed to perform an electrocardiogram despite her mild obesity and history of high blood pressure. As a result, Nurse Hawkes was unaware of Mrs. Harris’ heart problems, an unfortunate circumstance given that he would be using anesthetic agents — Demerol, Innovar and Ethrane — that can significantly lower blood pressure in patients with depressed cardiac function.

Come the day of the operation, Nurse Hawkes put Mrs. Harris to sleep at 7:45 a.m. After inserting an endotracheal tube, he turned the patient and started the maintenance anesthesia: sixty-six percent nitrous oxide, thirty-three percent oxygen and one percent ethrane. As expected, Mrs. Harris’ blood pressure dropped slightly. In most patients, the drop in blood pressure at induction is a normal reaction to the anesthetic agents and is no cause for concern; the blood pressure soon rights itself in response to the stimulation of surgery. However, when surgery began at 8:05 a.m., Mrs. Harris’ blood pressure did not return to normal. Instead, it continued to drop, while her pulse rate rose dramatically.

Thinking that his patient was feeling pain, too lightly anesthetized, Nurse Hawkes administered high dosages of Demerol and Innovar, and continued to give high levels of Ethrane. Her pulse rate did not decrease, however, and her blood pressure remained dangerously low. In actuality, Mrs. Harris was suffering from a lack of oxygen and too much anesthesia. Post-surgery X-rays revealed that the endotracheal tube had slipped into her right lung, leaving the left lung unventilated. Her heart was beating faster [385]*385to compensate for the lack of oxygen, her blood pressure unresponsive because of the anesthetics. Nurse Hawkes did not realize that the endotracheal tube had slipped because, contrary to standard procedure, he had not checked for bilateral breath sounds when he turned the patient after intubation.

Nurse Hawkes continued to give high levels of anesthesia from 8 to 9 a.m. During this time, Mrs. Harris’ blood pressure remained at 100 systolic, 70 diastolic, some thirty to fifty points lower than normal, and her pulse rate at 130. Nurse Hawkes did not inform Dr. Miller of the problem.

For Dr. Miller, the operation proceeded smoothly until 8:40 a.m., when he noticed an unusual amount of bleeding. Having just finished removing the extruded disk, Dr. Miller applied small packs to the bleeding and proceeded to clean the disk space. This done, he removed the packing only to find that the bleeding had continued unabated. By 9 a.m., Mrs. Harris had lost roughly 400 cc’s of blood, 300 cc’s more than a patient would normally lose over the entire operation. At this point, Dr. Miller instructed Nurse Hawkes to start giving the patient blood.

In derogation of this direct order, Nurse Hawkes did not start giving blood until roughly 9:40 a.m. In the meantime, Mrs. Harris suffered a precipitous drop in blood pressure due to the loss of blood volume. By 9:15 a.m., her blood pressure had dropped to 90 systolic, 60 diastolic; by 9:25 a.m., to 80 systolic, her diastolic now inaudible; by 9:40 a.m., to 70 systolic. Here her blood pressure would remain, a level incompatible with normal brain function, until 10:20 a.m., while her pulse rate rose to 140. Yet still, Nurse Hawkes did not inform Dr. Miller. Nor did he take appropriate remedial measures.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Connette v. Charlotte-Mecklenburg Hosp. Auth.
Supreme Court of North Carolina, 2022
Connette v. Charlotte-Mecklenburg Hospital Authority
Supreme Court of North Carolina, 2022
Estate of Belk by and Through Belk v. Boise Cascade Wood Prods., L. L.C.
824 S.E.2d 180 (Court of Appeals of North Carolina, 2019)
Whicker v. Compass Group USA, Inc.
784 S.E.2d 564 (Court of Appeals of North Carolina, 2016)
Patricia Franza v. Royal Caribbean Cruises, Ltd.
772 F.3d 1225 (Eleventh Circuit, 2014)
Taft v. Brinley's Grading Services, Inc.
738 S.E.2d 741 (Court of Appeals of North Carolina, 2013)
Eads v. Borman
277 P.3d 503 (Oregon Supreme Court, 2012)
Langwell v. Albemarle Family Practice, Pllc
692 S.E.2d 476 (Court of Appeals of North Carolina, 2010)
Willis v. Bender
596 F.3d 1244 (Tenth Circuit, 2010)
Convit v. Wilson
980 A.2d 1104 (District of Columbia Court of Appeals, 2009)
Shelton v. STEELCASE, INC.
677 S.E.2d 485 (Court of Appeals of North Carolina, 2009)
Collins v. United States
564 F.3d 833 (Seventh Circuit, 2009)
Lail Ex Rel. Lail v. Bowman Gray School
675 S.E.2d 370 (Court of Appeals of North Carolina, 2009)
Ochoa v. Vered
212 P.3d 963 (Colorado Court of Appeals, 2009)
Pettiford v. City of Greensboro
556 F. Supp. 2d 512 (M.D. North Carolina, 2008)
O'Mara Ex Rel. Reavis v. Wake Forest University Health Sciences
646 S.E.2d 400 (Court of Appeals of North Carolina, 2007)
Ware v. Timmons
954 So. 2d 545 (Supreme Court of Alabama, 2006)
Gaines v. COMANCHE COUNTY MEDICAL HOSPITAL & NURSEFINDERS, INC.
2006 OK 39 (Supreme Court of Oklahoma, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
438 S.E.2d 731, 335 N.C. 379, 1994 N.C. LEXIS 16, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harris-v-miller-nc-1994.