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Pope v. Cumberland County Hospital System7/19/2005
for relief: (1) the standard of care; (2) breach of the standard of care; (3) proximate causation; and (4) damages." Felts v. Liberty Emergency Service, 97 N.C. App. 381, 383, 388 S.E.2d 619, 620 (1990) (internal quotation omitted). A directed verdict is rarely appropriate in a negligence case involving the application of a standard of care. See Leatherwood v. Ehlinger, 151 N.C. App. 15, 19, 564 S.E.2d 883, 886 (2002) (the issue of whether the defendant breached the standard of care is ordinarily a factual question for the jury; directed verdict in negligence cases is seldom appropriate), disc. review denied, 357 N.C. 164, 580 S.E.2d 368 (2003).
I.
Defendant contends that this Court should affirm the directed verdict on the basis that plaintiffs failed to establish proximate causation. In particular, defendant argues that the failure of the NNPs on the resuscitation team to immediately order and infuse blood into Emma Pope when she did not respond to resuscitation efforts was an intervening cause of her injuries.
As "causation is an inference of fact to be drawn from the circumstances," proximate cause is ordinarily a jury question. Taylor v. Interim Healthcare of Raleigh-Durham, Inc., 154 N.C. App. 349, 353, 574 S.E.2d 11, 14 (2002), disc. review denied, 356 N.C. 695, 579 S.E.2d 102 (2003); see also Leatherwood, 151 N.C. App. at24, 564 S.E.2d at 889. North Carolina defines intervening cause as "an independent force which entirely supercedes the original action and renders its effect in the chain of causation remote." Adams v. Mills, 312 N.C. 181, 194, 322 S.E.2d 164, 173 (1984). Thus, "in order for the conduct of the intervening agent to break the sequence of events . . . the intervening conduct must be of such nature and kind that the original wrongdoer had no reasonable ground to anticipate it." Id.
Plaintiffs argue that the evidence supports two theories of a breach of the standard of care by the labor and delivery nurses and that each breach was a proximate cause of Emma Pope's injuries. Plaintiffs introduced the deposition testimony of Dr. McAlister, and this testimony was read into the record. Dr. McAlister testified that Nurse McLaurin was present in the room throughout the fetal scalp electrode attempts which resulted in the bleeding and the call for an emergency C-section. Dr. McAlister further testified that she relied upon the labor and delivery nurses to advise the NNPs that there had been a bleeding episode. Plaintiffs also introduced Nurse McLaurin's deposition testimony, which revealed that she was present in the room during the resuscitation efforts of the NNPs and that she did not at any point inform them of the bleeding. Plaintiffs' expert witness Dr. Dillard testified that Nurse McLaurin breached the standard of care by failing to communicate the information to the resuscitation team. He statedthat blood could have been available within five minutes of being ordered and that, had the NNPs been aware of the nature of the bleeding, they would have ordered blood immediately. Dr. Dillard further testified that the failure to have blood available and to give it immediately after the birth was the proximate cause of Emma's brain damage.
Defendant argues that the following testimony by Dr. Dillard demonstrates that the conduct of the neonatal nurses was an intervening cause:
Q: Dr. Dillard, do you have an opinion to a reasonable degree of medical certainty, if the jury finds from the facts in its greater weight [that the NNPs were not given the information about the bleeding] . . . as to whether or not they breached the standard of care in the way they resuscitated this baby even if they were completely in the dark?
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