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BRAMLETTE v. CHARTER-MEDICAL-COLUMBIA6/18/1990
te history from the family; failing to order more intense supervision for the first seven to ten days after admission; failing to prohibit an outing off hospital grounds; failing to diagnose Bramlette as a high risk for suicide based on his anxiety attacks and his unrealistic improvement immediately upon admission to the hospital. Dr. Kugler testified that a psychiatric patient is most likely to commit suicide during the first few days after admission and that extreme vigilance is required during the initial seven to ten day period to allow the medication and therapy to begin to take effect.
Dr. Kugler also testified regarding the conduct of hospital employees Higdon and Stroud. He testified Nurse Higdon deviated from the standard of care for a psychiatric nurse in allowing Bramlette to leave the hospital grounds supervised by Kim Stroud. He further testified the hospital deviated from
Appellants contend they were entitled to a directed verdict because respondent failed to prove proximate cause. We disagree.
As in any negligence action, the plaintiff in a
Causation in fact is proved by establishing the injury would not have occurred "but for" the defendant's negligence. Hanselmann v. McCardle, supra; Hughes v. Children's Clinic, P.A., 269 S.C. 389, 237 S.E.2d 753 (1977). Legal cause is proved by establishing foreseeability. Young v. Tide Craft, Inc., 270 S.C. 453, 242 S.E.2d 671 (1978). Although foreseeability of some injury from an act or omission is a prerequisite to establishing proximate cause, Young v. Tide Craft, supra; Stone v. Bethea, 251 S.C. 157, 161 S.E.2d 171 (1968); Kennedy v. Carter, 249 S.C. 168, 153 S.E.2d 312 (1967); Accordini v. Security, supra, the plaintiff need not prove that the actor should have contemplated the particular event which occurred, Greenville Memorial Auditorium v. Martin, ___ S.C. ___, 391 S.E.2d 546 (1990); Young v. Tide Craft, supra. The defendant may be held liable for anything which appears to have been a natural and probable consequence of his negligence. Greenville Memorial Auditorium v. Martin, supra; Childers v. Gas Lines, Inc., 248 S.C. 316, 149 S.E.2d 761 (1966). A plaintiff therefore proves legal cause by establishing the injury in question occurred as a natural and probable consequence of the defendant's negligence.
Generally, expert testimony is required to establish proximate cause in a
Here, respondent produced evidence of causation in fact from which such a causal link could be determined with a layperson's knowledge. Dr. Kugler testified a suicidal patient must be intensively supervised for the first seven to ten day period following admission to allow treatment to become effective. Dr. Kugler did not expressly state an opinion that appellants' negligence caused Bramlette's death. From his testimony, however, it is reasonable to infer that but for appellants' failure to properly diagnose, treat, and supervise Bramlette during this initial period, Bramlette would have overcome his suicidal impulses and would not have killed himself.
Further, Dr. Kugler testified a depressed patient who has contemplated suicide and who exhibits a high level of energy, as Bramlette did, is a high risk for suicide. The evidence indicates Dr. Pillinger and hospital staff knew a suicidal patient should not be allowed off hospital grounds because of the increased opportunity for self-harm. Thus, respondent produced evidence it was foreseeable Bramlette would commit suicide as a natural and probable consequence of appellants' negligence in allowing him off hospital grounds. We conclude respondent presented sufficient evidence to submit the issue of proximate cause to the jury.
Appellant Dr. Pilling
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