On July 5, 2018, Charles J. DePaolo, M.D. performed an anterior approach left total hip replacement on Tracy Beck at a Mission Hospital-owned facility. Mission Hospital provided its staff to work in the operating room with Dr. DePaolo. Two of Mission Hospital’s circulating nurses were responsible for operating the Hana table on which Mrs. Beck’s surgery was performed. The Hana table is a specially designed operating table often used in anterior approach hip replacements to allow nurses to manipulate the patient’s leg and apply traction to open up the hip joint and provide visibility and access to the surgeon. During her recovery from the surgery, Mrs. Beck experienced numbness and weakness in her leg, which was discovered to be the result of an injury to her femoral nerve.
The Becks filed a North Caroilina medical malpractice complaint on November 23, 2020 against Dr. DePaolo, DePaolo Orthopedics, and Mission Hospital for medical malpractice and loss of consortium. On January 3, 2023, the trial court granted Mission Hospital’s motion for summary judgment and dismissed all of the plaintiff’s claims against Mission Hospital with prejudice. The plaintiffs then appealed.
In its June 4, 2024 opinion, the Court of Appeals of North Carolina stated : “Here, the record shows [plaintiffs’ expert] Dr. Boyce believed the cause of Mrs. Beck’s injury was one of two things—retractor placement or traction. During surgery, the doctor initially places the retractors on the patient’s tissue to open it up, creating a “window” for the doctor to operate. The doctor then gives the retractors “to the assistants to hold,” and they are supposed to apply pressure, or traction, to the patient who is positioned on the Hana table in order to hold open the patient’s joint space. Generally, the assistants do not exercise independent judgment regarding how much traction to apply, although the doctor cannot “watch over everything.” Both improper retractor placement and improper traction may injure the femoral nerve. Thus, the pertinent question is whether Dr. DePaolo’s retractor placement or the OR assistants’ application of traction on the Hana table caused Mrs. Beck’s injury.”
“We hold that in light of Dr. Boyce’s testimony that retractor placement rather than traction more likely caused Mrs. Beck’s injury by a ratio of ten-to-one, the possibility that it was traction was mere speculation, conjecture, or possibility. It follows that because Plaintiffs did not establish causation pursuant to the standard articulated in Cousart, they also failed to meet the more likely than not standard under Parkes. Through Dr. Boyce’s testimony, Plaintiffs can demonstrate merely that Mission Hospital, vicariously through its nurses, possibly caused Mr. Beck’s injury. Therefore, Plaintiffs failed to satisfy the burden of demonstrating proximate cause at the summary judgment stage. Accordingly, we affirm the trial court’s order granting summary judgment in Mission Hospital’s favor.”
Source Beck v. DePaulo, M.D., No. COA23-764.
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