A recent malpractice case in North Carolina illustrates how plaintiffs may challenge the validity of a hospital’s standard of care for a particular situation.

In Johnson v. Wayne Memorial Hospital, Inc., the hospital in Goldsboro, NC, was sued by a patient who had been treated in the ED. The patient had a history of sickle cell anemia and presented with pain. A physician ordered a chest X-ray and other studies.

The emergency physician interpreted the chest X-ray as normal, discharging the patient soon after. Per hospital policy, a radiologist read the patient’s chest X-ray a few hours later. The radiologist documented a left lobe infiltrate, which he said was not “dangerous, ominous, or concerning.”

Hospital policy did not require the radiologist to immediately report the finding or the discrepancy with the emergency physician’s conclusion, so the conflict was only noted by an ED clinician 14 hours after the patient was discharged.

The patient had returned because of continuing pain and was already admitted with a diagnosis of acute chest syndrome, a complication of sickle cell anemia that can be fatal in some situations.

The patient died the next day and the family sued, alleging that hospital policy should have required the radiologist to report the X-ray reading discrepancy in a timelier manner. Evidence provided during the trial indicated that it was common for that report to take up to 24 hours at Wayne Memorial, but such a long time frame did not violate hospital policy as long as the radiologist did not judge a need for faster notification.

To prove the allegation that the hospital policy did not meet the standard of care, the plaintiff had to show that it “was not in accordance with the standards of practice among members of the same healthcare profession with similar training and experience situated in the same or similar communities under the same or similar circumstances at the time of the alleged act giving rise to the cause of action,” the court indicated.

The plaintiff’s expert witness testified that he had not researched similar policies at other hospitals and how the Wayne Memorial policy was similar or different. The trial court dismissed the case.

The Court of Appeals of North Carolina upheld the dismissal, saying the plaintiff failed to offer any evidence of “either (1) the standard of care to which a hospital in the same or similar community should adhere in its process for the review of X-rays, or (2) the hospital’s breach of the standard of care.”

The appeals court decision is available online at: http://bit.ly/2qM8LnY.