TIMBRELL v. SUBURBAN HOSPITAL, INC

Factual and Procedural Background

The plaintiffs, husband and wife, brought suit against Suburban Hospital, Inc. and a nurse, Mrs. McGovern, for injuries sustained by Mrs. Timbrell while she was a patient at the hospital following a Caesarian operation. During her care, hot compresses and hot water bottles were applied to her body while she was unconscious, resulting in serious third-degree burns that later required skin grafting. The jury returned a verdict in favor of the nurse but against the hospital. The hospital appealed from the judgment entered on that verdict.

Legal Issues Presented

Whether a verdict that exonerates an employee but holds the employer liable under the doctrine of respondeat superior can stand.

Whether the res ipsa loquitur doctrine was properly applied in this case.

Whether the exclusion of evidence regarding local hospital custom in engaging special nurses was prejudicial error.

Whether the court erred in admitting expert testimony suggesting an alternative diagnosis to burns.

Whether certain jury instructions improperly suggested that the hospital was an insurer regardless of negligence.

Whether refusal to give an instruction clarifying the burden of proof under res ipsa loquitur was erroneous.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
Bradley v. Rosenthal, 154 Cal. 420, 97 P. 875	Principle that a verdict in favor of an employee necessarily exonerates the employer under respondeat superior.	The court distinguished this principle by assuming the jury found McGovern was not negligent or not an employee, allowing the hospital to be liable independently.
Meyer v. McNutt Hospital, 173 Cal. 156, 159 P. 436	Use of res ipsa loquitur in hospital negligence cases involving multiple potential tortfeasors.	Supported the jury's implied finding that injury was caused by hospital employees other than McGovern, justifying application of res ipsa loquitur.
McBride v. Clara Barton Hospital, 75 Cal.App. 161, 241 P. 941	Similar to Meyer, supports application of res ipsa loquitur and issues regarding hospital liability for nurses.	Reinforced the court’s acceptance of the jury’s implied findings and the applicability of res ipsa loquitur doctrine.
Hesler v. California Hospital Co., 178 Cal. 764, 174 P. 654	Limits hospital liability for malpractice of employed physicians; addresses proper jury instructions regarding hospital's duty.	The court distinguished this case, holding that the instructions in the present case properly defined hospital liability and did not mislead the jury.

Precedent

Rule or Principle Cited For

Application by the Court

Bradley v. Rosenthal, 154 Cal. 420, 97 P. 875

Principle that a verdict in favor of an employee necessarily exonerates the employer under respondeat superior.

The court distinguished this principle by assuming the jury found McGovern was not negligent or not an employee, allowing the hospital to be liable independently.

Meyer v. McNutt Hospital, 173 Cal. 156, 159 P. 436

Use of res ipsa loquitur in hospital negligence cases involving multiple potential tortfeasors.

Supported the jury's implied finding that injury was caused by hospital employees other than McGovern, justifying application of res ipsa loquitur.

McBride v. Clara Barton Hospital, 75 Cal.App. 161, 241 P. 941

Similar to Meyer, supports application of res ipsa loquitur and issues regarding hospital liability for nurses.

Reinforced the court’s acceptance of the jury’s implied findings and the applicability of res ipsa loquitur doctrine.

Hesler v. California Hospital Co., 178 Cal. 764, 174 P. 654

Limits hospital liability for malpractice of employed physicians; addresses proper jury instructions regarding hospital's duty.

The court distinguished this case, holding that the instructions in the present case properly defined hospital liability and did not mislead the jury.

Court's Reasoning and Analysis

The court analyzed the jury's verdict, noting that although the hospital argued that a verdict in favor of the nurse necessarily exonerated the hospital under respondeat superior, the jury must have found either that McGovern was not negligent or that she was not the hospital’s employee. The hospital had denied the employment relationship, asserting McGovern was an independent nurse employed by the plaintiffs. The court accepted this as a valid jury inference.

The court further upheld the use of the res ipsa loquitur doctrine, reasoning that the injury likely occurred while the patient was under the care of regular hospital employees, not McGovern. This doctrine was applicable under the circumstances as supported by prior case law.

Regarding evidentiary rulings, the court found that excluding evidence of local hospital customs did not prejudice the hospital since the nurse was absolved of negligence. Similarly, questions about the authority of the attending physician to engage nurses were irrelevant to the appeal.

The court addressed the expert testimony suggesting an alternative diagnosis, concluding that the evidence overwhelmingly indicated burns and that the testimony was insufficient to render the instructions erroneous.

The court examined the jury instructions challenged by the hospital, finding that despite some language about the hospital’s duty to exercise due care, the instructions as a whole correctly stated the law, including the requirement to prove negligence by a preponderance of the evidence and that the hospital was only liable for its own agents' negligence.

Finally, the court found no reversible error in denying an instruction clarifying that res ipsa loquitur does not shift the burden of proof, especially given the overall instructions provided.

Holding and Implications

The court affirmed the judgment in favor of the plaintiffs against the hospital.

The direct effect of this decision is the upholding of liability against the hospital despite a verdict favoring the individual nurse, based on the jury’s implied findings regarding employment and negligence. No new precedent was established beyond the application of existing doctrines such as res ipsa loquitur and principles governing hospital liability for employee negligence.

WALTER G. TIMBRELL et al., Respondents, v. SUBURBAN HOSPITAL, INC. (aCorporation), et al., Appellants.

THE COURT.

The plaintiffs, husband and wife, sued the defendant hospital and the defendant McGovern, a nurse, for injuries received by Mrs. Timbrell while she was a patient in the hospital following a Caesarian operation. Hot compresses and hot water bottles were applied to the body of the patient at a time when she was unconscious. Excessively hot applications resulted in serious third degree burns and later required a skin grafting operation. The jury returned a verdict in favor of the nurse and against the hospital. From a judgment on the verdict the hospital appeals.

The appellant propounds the following as the first question involved: "A verdict is expressly in favor of an employee but is against the employer. Can it stand when the only possible liability is based on the doctrine of respondeat superior?" In other words, it is contended that the verdict in favor of Mrs. McGovern necessarily exonerated the hospital. Reliance is placed on the case of Bradley v. Rosenthal, 154 Cal. 420 [ 97 P. 875, 129 Am. St. Rep. 171], and other cases to like effect.

The complaint charged the defendants specially named, and the agents, servants and employees of the hospital, with negligence in the treatment of the plaintiff patient with the appliances and equipment of the hospital. It was also alleged that the defendant McGovern was an agent and employee of the hospital in the treatment of the patient. In its answer the hospital denied that such relationship existed between itself and its codefendant, and alleged that Mrs. McGovern was a graduate and registered special nurse employed by the plaintiffs and acting in their behalf in the exercise of an independent calling. In her answer Mrs. McGovern denied that in the care of her patient she was guilty of any negligent act. The parties presented their respective claims on the theories advanced by their pleadings.

[1] The defendant hospital corporation is operated for profit. The plaintiff wife was received as a pay patient early on the morning of October 3d. Her physician advised the hospital staff that her condition was such as to require special nurses. From a list of registered graduate nurses in its possession the hospital obtained the name of a Miss Lane and notified her that the case was at her disposal. She accepted and entered upon her duties as day nurse. Almost immediately thereafter the operation was performed and Miss Lane remained on duty until 7 o'clock P.M. of that day, except during two periods when she was relieved by nurses from the regular hospital staff. The first period was during the luncheon hour and the second about half-past 5 during the dinner hour. During that day hot water bottles were applied to the body of the patient. At 7 P.M. Mrs. McGovern came on duty. Her services were obtained in substantially the same way as Miss Lane's. On the doctor's orders Mrs. McGovern applied hot compresses to the kidney area of the patient's back, but applied no hot water bottle treatments. The attending physician testified that the burns inflicted upon the patient could not be caused by the hot compresses as applied, and that the burns could occur from excessively hot water bottles.

The question stated by the hospital assumes that the jury found that Mrs. McGovern was an employee of the hospital, also that as such employee she was guilty of the negligence that caused the injury. But in aid of the verdict the assumptions must be to the contrary. At least it must be assumed that the jury found that Mrs. McGovern was not the nurse who applied the instrumentalities that caused the injury. In addition the jury could have found from the evidence that Mrs. McGovern was not an employee of the hospital but was either an independent agent or was the employee of the plaintiffs; and for the purposes of this appeal it may be assumed that the jury found in accordance with the defense of the hospital interposed on that theory.

It must then be assumed that the jury concluded that the injury occurred at the instance of the regular employees of the hospital who had charge of the patient when Miss Lane was not present. This implied finding of the jury would be justified and supported under the authority of Meyer v. McNutt Hospital, 173 Cal. 156 [ 159 P. 436], and McBride v. Clara Barton Hospital, 75 Cal.App. 161 [ 241 P. 941]. [2] In this connection the defendant hospital charges error in the submission to the jury of a res ipsa loquitur instruction. On the theory of the case as tried by the plaintiff the doctrine is applicable. On the theory now advanced by the hospital the doctrine was likewise applicable. Under these circumstances the operation of the rule as approved in Meyer v. McNutt Hospital, supra, is justified. Its application therefore furnishes sufficient in the record for the finding of the jury in favor of the plaintiffs.

[3] Since the jury in any event absolved the nurse McGovern from negligence the ruling of the court in sustaining an objection to the hospital's offer to prove the local custom of hospitals in the engagement of special nurses, even if erroneous (but see McBride v. Clara Barton Hospital, supra), could have resulted in no prejudice to the hospital.

For the same reason all questions of actual or ostensible authority of the attending physician to engage special nurses, and of ratification by the plaintiff husband of such engagements, are not pertinent to any question raised on this appeal. [4] In its instructions the court assumed that the injuries were burns. An expert witness who had never seen the patient was permitted to testify that the condition of the patient as described to him might have been a "herpes condition". The evidence as a whole overwhelmingly shows that the injuries were burns, and the evidence referred to as indicating some other condition was insufficient upon which to declare the instruction erroneous.

[5] The defendant hospital complains of certain instructions which it is claimed advised the jury that the hospital was an insurer regardless of negligence. Particular attention is called to an instruction that it was the duty of the hospital and its servants, agents and employees to exercise "due and proper care" in the preparation and use of hot instrumentalities to the body of the patient so as not to cause her injury. It is insisted that this instruction enabled the jury to conclude that the conduct of the hospital must approximate perfection and was therefore erroneous under the authority of Hesler v. California Hospital Co., 178 Cal. 764 [ 174 P. 654], wherein it was sought to hold the hospital for damages because of the alleged malpractice of one of the physicians employed by the hospital. The standard of conduct required of a physician was obviously not correctly stated to the jury in that case and the ruling therein does not justify a reversal in this case. Here the court, repeatedly and correctly in its lengthy instructions, advised the jury that the plaintiffs must prove their case by a preponderance of the evidence; that the defendant hospital was not responsible for the negligence, if any, of third parties, and was responsible only in the event that some one or more of its agents, servants or employees was or were guilty of negligence proximately causing the injury to the plaintiff wife; and negligence was fully defined. Considered in the light of the court's entire charge it cannot be said that the jury was misled or confused by any of the instructions complained of.

[6] The effect of the instructions given also answers the contention of the hospital that the court erred in refusing an instruction to the effect that the doctrine of res ipsa loquitur does not operate to shift the burden of proof. The jury was nowhere told that it did shift that burden. Assuming that the instruction might well have been given, it is difficult to conclude how its refusal would have affected the result.

Other points need not be discussed.

The judgment is affirmed.

Rehearing denied.

Factual and Procedural Background

Legal Issues Presented

Arguments of the Parties

Table of Precedents Cited

Court's Reasoning and Analysis

Holding and Implications

WALTER G. TIMBRELL et al., Respondents, v. SUBURBAN HOSPITAL, INC. (aCorporation), et al., Appellants.

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