Nurse’s Expert Testimony Established Standard of Care Despite Authority of Physical Therapy Department When Nurse Provided Assistance

A woman broke her leg while being helped out of bed by a nursing assistant at a nursing home. The woman named a number of defendants in her malpractice suit. Prior to trial the defendants filed a motion for summary judgment. The trial court entered a summary judgment in favor of all the defendants except the company that owned the nursing home. At trial, the plaintiff, her son, the director of nursing at the nursing home, the physician who treated the plaintiff’s leg after the accident, and a registered nurse acting as an expert regarding the applicable standard of care testified. At the conclusion of the plaintiff's case-in-chief, the trial court entered a judgment as a matter of law in favor of the company that owned the nursing home.


The woman appealed arguing that the trial court erred both by entering a summary judgment in favor of all the defendants except the nursing home and by entering a judgment as a matter of law in favor of the nursing home. The defendants argued that the expert was not a “similarly situated health care provider” as required by the Alabama medical malpractice statute because the level of assistance that must be given to the defendant’s residents when they are moved was determined by the physical-therapy department at the nursing home, not the nursing department.


The Supreme Court of Alabama reversed the lower court’s decision and remanded. The court held that to determine the applicable standard of care where the defendant is an entity which has acted through another individual health care provider, the focus should be on the individual practitioner whose specific action allegedly fell below the required standard of care. A certified nursing assistant (CNA) was providing nursing services to the plaintiff at the time she suffered her injury. The CNA was not acting as a physical therapist or providing physical-therapy services to the plaintiff. Therefore, the registered nurse testifying as the plaintiff’s witness was a similarly situated health care provider.


The court disagreed with the defendant nursing home’s argument that because the plaintiff’s treating physician never expressly stated that this fracture probably resulted from this fall the plaintiff failed to establish causation. The court concluded that the testimony of the plaintiff’s treating physician in combination with the testimony of the plaintiff and the lack of any suggestion that any other physical trauma could have caused the plaintiff’s injury was sufficient to show causation.


The court held the trial court erred in granting summary judgment with respect to the other defendants. The plaintiff provided sufficient evidence to establish that there exists a genuine issue of material fact as to whether the defendants operated as a single business enterprise as to which the defendant nursing home was an alter ego.


See: Hill v. Fairfield Nursing and Rehabilitation Center, LLC, 2012 WL 5077166 (Ala., October 19, 2012) (not designated for publication).