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In Gullatte v. The Charlotte-Mecklenburg Hospital Authority, NC Supreme Court Establishes New Liability For Nurses

August 24, 2022   |   Mary Kathryn Kurth

Summary by Mary Kathryn Kurth

Gullatte v. The Charlotte-Mecklenburg Hospital Authority

Opinion filed: Aug. 19, 2022

Attorneys for the case: John Edwards and Mary Kathryn Kurth of Edwards Kirby, LLP; Kristen L. Beightol, Edwards Beightol, LLC 

Supreme Court of North Carolina No. 331PA20

On Aug. 19, the Supreme Court of North Carolina overturned Byrd v. Marion General Hospital, 202 N.C. 337 (1932). Byrd, a 90-year-old case, exempted nurses from exposure to liability for negligence when acting under the direction of a supervising physician. In 1932, when Byrd was decided, advanced practice nurses like CRNAs did not exist. The case presented before the court involved allegations of negligence by a CRNA in his planning and administration of anesthesia to a three-year-old child. Over the past nine decades, the practice of medicine has changed dramatically. Advanced practice nurses, like CRNAs, have increased autonomy and involvement in decisions about patient care. The Court now recognizes that with that increased autonomy and involvement comes liability.  

The facts of the Byrd case are notable and certainly illustrate its obsolescence. Mrs. Byrd was sent to the hospital to be treated for “convulsions” in a “sweat cabinet.” The doctor told the nurse to leave Mrs. Byrd in the sweat cabinet for 30 minutes, and the nurse complied. Mrs. Byrd suffered severe burns. The jury returned a verdict against the nurse, which the North Carolina Supreme Court reversed.  The Supreme Court held that the nurse could not be personally liable for following the doctor’s order unless “such order was so obviously negligent as to lead any reasonable person to anticipate substantial injury,” such as “order[ing] a nurse to stick fire to a patient.” 202 N.C. at 341-42. 

The trial court, applying Byrd, excluded evidence of the professional standard of care applicable to CRNAs in their planning and selection of anesthesia — since, per the holding in Byrd, a CRNA could have no liability for decisions related to the anesthesia plan. The Court of Appeals affirmed the trial court’s exclusion of evidence in a unanimous decision, and plaintiffs petitioned the Supreme Court for discretionary review. 

In the opinion, the Supreme Court acknowledged “the evolution of the medical profession’s recognition of the increased specialization and independence of nurses in the treatment of patients.” The Court held 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.” 

The modern healthcare system is increasingly reliant on nurses, particularly advanced practice nurses like CRNAs and nurse practitioners.  Patients deserve trust that advanced practice nurses will be held to professional standards and held accountable when they violate those standards. At last, North Carolina’s case law has been reconciled with modern medicine and recognizes the nursing profession’s significant role in healthcare—with that significant role naturally comes liability.

About the Author

Mary Kathryn Kurth

Attorney, Edwards Kirby Attorneys At Law

Mary Kathryn Kurth

Attorney, Edwards Kirby Attorneys At Law

Mary Kathryn is a North Carolina native with litigation experience in cases involving serious injuries and medical malpractice. Mary Kathryn has committed her legal career to fighting for those who have been injured by the negligence of others. She is a passionate advocate who cares deeply about her clients.

When not practicing law, Mary Kathryn is very involved in the community. She is an active member of the North Carolina Bar Association, North Carolina Advocates for Justice and the Wake County Bar Association. Mary Kathryn is also an active member of Edenton Street United Methodist Church, where she serves as the coordinator of her Missional Community’s service project, which provides a meal once a month at the New Bern House in downtown Raleigh.

Mary Kathryn serves on the North Carolina Bar Association 4ALL Statewide Service Day Committee, the North Carolina Bar Association Women in the Profession Committee, the Wake County Bar Association’s Public Service Committee, the Campbell Law School Alumni Association Board of Directors and the Meredith College Paralegal Program Advisory Committee. Mary Kathryn chairs the Service Committee for the Campbell Law School Alumni Association Board of Directors. Mary Kathryn also leads the service projects at Edwards Kirby.