Modern medicine is a constantly developing arena and has advanced significantly since the early 1930s. Whether it’s the treatment, the procedure, the dosage, or the medical provider rendering the care, medicine is routinely evolving. Yet, one component of the practice of medicine has remained a topic of conversation despite all the innovations: liability. Since 1932, North Carolina has limited the liability of nurses properly executing the orders of physicians based on the Byrd v. Marion General Hospital case. The decision in Byrd essentially created protection for nurses from legal liability under specific circumstances. This 90-year-old precedent was overturned on August 19, 2022, when the North Carolina Supreme Court ruled on Connette v. Charlotte-Mecklenburg Hospital Authority, thereby creating a liability for nurses.
Why the Change?
In the split 3-2 decision, Justice Michael Morgan explained the Court “deemed it to be opportune” to “recognize the shift in a nurse’s legal culpability having appropriately grown commensurate with their professional responsibility.” Justice Morgan further clarified by stating, “in light of the increased, influential roles which nurses occupy in medical diagnosis and treatment, we hold that even in circumstances where a registered nurse is discharging duties and responsibilities under the supervision of a physician, a nurse may be held liable for negligence and for medical malpractice in the event that the registered nurse is found to have breached the applicable professional standard of care.” At the core of their rationale, the Court is relying on the development of nurses’ training and responsibility for the removal of liability protection. Justice Morgan offers a summation by stating, “due to the evolution of the medical profession recognition of the increased specialization and independence of nurses in the treatment of patients over the course of the ensuing ninety years, we determine that it is timely and appropriate to overrule Byrd.”
Not All in Favor
As mentioned previously, this decision from the Supreme Court was split 3 to 2. Justice Tamara Barringer authored the dissenting opinion and highlighted the Court’s improper creation of “liability without causation.” Justice Barringer stated, “such a policy choice should be made by the legislature, not merely three Justices of this Court.” Questions of applicability and exemptions are addressed by Justice Barringer when she writes, “departing from Byrd by expanding nurse liability would require us to determine which nurses’ training and responsibilities are so advanced or specialized as to warrant liability and which nurses, if any, remain not liable under Byrd. Further, dramatically expanding liability requires the type of factor weighing and interest balancing that are quintessential policy determinations for the legislature to make, not the Courts.”
What does this mean for nurses?
The Supreme Court’s decision now establishes a duty of care for nurses. Any potential liability claims would still likely be bound by the specific set of enactments found in Article 1, Chapter 90 of the North Carolina General Statutes. As stated in the Connette ruling, “medical malpractice actions in North Carolina are negligence claims upon which the Legislature has seen fit to erect extra statutory requirements—both substantive and procedural—which a plaintiff must satisfy in order to sustain such allegations. Turner v. Duke Univ., 325 N.C. 152, 162, 381 S.E.2d 706 (1989) (explaining that medical malpractice actions require a plaintiff to offer competent evidence of “(1) the standard of care, (2) breach of the standard of care, (3) proximate causation, and (4) damages”); see N.C.G.S. § 1A-1, Rule 9(j) (2021).” This ruling emphasizes that increased responsibility within the practice of modern medicine comes with increased liability. If you work in the healthcare industry and would like more in-depth information or have specific questions, please contact our office.
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