SMITH, ETC. v. Silver Spring-Wheaton Nursing Home, Inc.

Marbury, J., delivered the opinion of the Court. Suit was instituted in the Circuit Court for Montgomery County by Mrs. Emilie Smith, as administratrix c.t.a. of the estate of her deceased mother, Mrs. Ada M. Epple, to recover for injuries sustained by Mrs. Epple, as the result of a fall which took place when the latter was a patient in a nursing home ¹⁸⁸ owned and operated by the defendant, Silver Spring-Wheaton Nursing Home, Inc. The plaintiff’s declaration alleged that the Nursing Home had negligently breached its contractual duty to provide for adequate supervision of its patient and that such inadequate supervision was the proximate cause of Mrs. Epple’s fall. In May 1965, a jury trial was held, Judge James H. Pugh presiding, and at the conclusion of the plaintiff’s case the trial judge granted the defendant’s motion for a directed verdict on the ground that the evidence was legally insufficient to support a finding of primary negligence. Judgment was entered for the defendant for costs.

On this appeal the plaintiff-appellant strenuously contends that she had presented enough evidence to go to the jury on the issue of primary negligence because, she asserts, in substance, that there was legally sufficient evidence to show: (1) that the defendant had employed as its agent Jane Lochte to work as a practical nurse on Mrs. Epple’s case, and that this nurse was of unsound mind at the time of the hiring, and (2) that Mrs. Lochte’s unsound or deranged mental condition caused her to take certain irrational and imprudent actions in caring for the patient which proximately caused her injuries. For the purposes of this appeal, we will assume without deciding or without setting forth the facts relevant thereto, that Jane Lochte was the agent of the defendant. The administratrix, Mrs. Emilie Smith, testified that one week prior to being placed in the defendant’s nursing home her mother had suddenly developed a respiratory infection and had become quite ill, while staying at her (Mrs. Smith’s) home. Their family doctor suggested that Mrs. Epple be given antibiotics and that she be placed in an oxygen tent.

This was done and toward the end of the week Mrs. Epple was taken out of the tent, and was able to walk, with aid, to the bathroom. Despite the improvement, the family decided to put Mrs. Epple in the defendant’s nursing home because the Christmas holiday season was approaching and they thought that she would need quieter surroundings than the Smith residence provided. Mrs. Epple entered the nursing home on December 18, 1961, and at approximately 6:30 on the morning of December 20, 1961, Mrs. Epple fell and broke her hip soon after having been ¹⁸⁹ escorted to the bathroom by Jane Lochte, a practical nurse, who had been on duty with Mrs. Epple for only one night previous to the accident. Jane Lochte was, at the time of the accident, fifty-two years of age, and had in her youth been a student nurse. 1 Her training lasted for a period of one year and eight months, but before completing the entire course, she decided to terminate her studies in order to marry.

In 1949 Mrs. Lochte became a patient in the Springfield State (mental) Hospital. Her first stay at the hospital lasted only two months but in June of 1953 she was readmitted. In January 1960 Mrs. Lochte was released from the hospital as “improved.” She was, subsequent to the date of the accident involved in this suit, readmitted to Springfield, where she remained a patient until the trial of the instant case. During all of the time Mrs. Lochte was at the hospital she was diagnosed as having a “schizophrenic reaction, paranoid type.” A medical doctor with three years residency in psychiatry testified as to the nature of this mental illness.

He stated: “By schizophrenia we mean a major illness, usually involving some degree of loss of reality testing. By paranoid we mean a person who is unduly suspicious, has false beliefs; usually of a persecutory nature, somebody is doing something to her, things of this sort.” At the trial the plaintiff elected to put on as her witness, the practical nurse, Jane Lochte. Mrs. Lochte testified that on December 18, 1961, she had received a phone call from one of the defendant’s agents and was advised that Mrs. Epple was in need of a night duty practical nurse. She accepted the case and reported for duty that very evening.

The first night was apparently uneventful, but Mrs. Lochte recalled that her patient was restrained in bed (by means of her ankles having been tied to the bed) and that she had given her a bedpan which was used by her about three times during the course of the night. As to the second night (December 19-20, 1961) Mrs. Lochte stated that “I might be wrong—I didn’t report until about eleven o’clock, until it was time for me to sit my eight hours,” and ¹⁹⁰ that when she reported Mrs. Emilie Smith was there. According to Mrs. Lochte, Mrs. Smith specifically asked her to get Mrs. Epple out of bed at 6:30 the next morning and take her to the bathroom. Mrs. Lochte recalled that when she arrived on duty for the second night the restraints were already on Mrs. Epple, but that the patient was still very restless and kept trying to get out of bed.

She also testified that “before she left Mrs. Smith, I believe, raised the sides of the bed.” Another practical nurse, Nan Merritt, who was a regular employee of the corporate defendant, had a slightly different version of when the restraints were put on Mrs. Epple. She testified that at about 1:00 a.m. in the morning of December 20, 1961, while walking by Mrs. Epple’s room, she noticed that Mrs. Epple was getting restless and at either Mrs. Lochte’s or her suggestion (she could not recall which) restraints were then put on the patient. In regard to the happening of the accident, Mrs. Lochte stated that at about 6:30 on the morning of December 20, 1961, she took the restraints off Mrs. Epple, put her arm around the patient’s waist and the patient draped her arm around Mrs. Lochte’s shoulder, and in this manner she walked Mrs. Epple to the commode. After the patient had urinated, Mrs. Lochte testified that “I * * * took her back and sat her in the chair,” 2 and then “I forgot I had [not] flushed the commode so I stood like this, put my hand back on her, on her arms laying on the arms of the chair, and put my hand like this trying to flush the toilet.

Then I released—I couldn’t do it and I let go and just flushed the toilet and turned right back around and she stood up just an instant like that (snaps fingers) * * *” and then “just sat down * * * real hard * * * on the floor.” Mrs. Emilie Smith, who testified before Mrs. Lochte took the stand, stated that she met Mrs. Lochte as she was coming off duty the first night (morning of December 19) and she chatted briefly with her at that time. She testified that on the afternoon of the 19th she again went to the hospital to take her mother some toilet articles and at that time her mother was ¹⁹¹ quite cheerful and was sitting up in a hospital room chair. She stated that she had herself taken her mother to the bathroom on that afternoon. In her testimony Mrs. Smith neither affirmed nor denied that she had given instructions to Mrs. Lochte to take her mother to the bathroom at 6:30 a.m. on the morning of December 20, 1961.

Her husband John Smith, Jr., however, did testify that at 11:00 p.m. on December 19, 1961, the time which Mrs. Lochte stated that she had had the conversation with Mrs. Smith, the latter was in bed, and that he and his wife had spent the entire evening, after 7:00 p.m., at home. Mrs. Epple’s doctor, Dr. Ashby Wade Smith (no relation to the plaintiff-appellant) testified that he had given no orders in regard to Mrs. Epple’s use of the lavatory, that he had not ordered restraints put on the patient while she was in bed and that he had not restricted Mrs. Epple from sitting up in a chair or in any other manner restricted her from being ambulatory. On this appeal the appellant asserts that Mrs. Lochte’s paranoid schizophrenic mental condition led her to take imprudent and irrational actions which were the proximate cause of Mrs. Epple’s fall. This contention is devoid of merit because the evidence is insufficient to relate Mrs. Lochte’s mental aberrations to the actions taken by her in regard to this patient.

In an attempt to associate Mrs. Lochte’s mental condition with the events which transpired on the morning of December 20, 1961, the appellant asserts that Mrs. Lochte’s testimony reveals that she had an insane delusion that Mrs. Smith had instructed her to get the elderly patient up at 6:30 in the morning and take her to the bathroom. According