Roach v. State

157 A.3d 1042

Victoria ROACH

v.STATE of Rhode Island et al.

No. 2014–204–Appeal

PC 09–4465

Supreme Court of Rhode Island.

April 18, 2017

For Plaintiff: Brian R. Cunha, Esq.

For Defendants: Michael W. Field, Department of Attorney General, Matthew I. Shaw, Department of Attorney General, Adam J. Sholes, Department of Attorney General

Present: Suttell, C.J., Goldberg, Flaherty, Robinson, and Indeglia, JJ.

OPINION

Justice Indeglia, for the Court.

This civil matter comes before the Court on appeal from a Superior Court judgment in favor of the plaintiff, Ms. Victoria Roach (Roach or plaintiff). The plaintiff slipped and fell while she was working as a per diem contract nurse at the Rhode Island Veterans Home (Veterans Home or the Home) on November 10, 2008. She brought suit against the State of Rhode Island and Gary Alexander in his official capacity as Director of the Rhode Island Department of Human Services (collectively, the state).

The case was tried before a jury beginning on March 12, 2014. At the conclusion of plaintiff's case-in-chief, the state moved for judgment as a matter of law pursuant to Rule 50 of the Superior Court Rules of Civil Procedure, which the state renewed at the close of the evidence. On March 19, 2014, the jury awarded plaintiff $500,000. Under Rule 59(e) of the Superior Court Rules of Civil Procedure, the state then filed a motion for new trial, and a motion to amend judgment and for a remittitur. The trial justice granted a remittitur, lessening plaintiff's award to $382,000; however, the prejudgment interest award increased the judgment to $631,373.66.

The state asserts multiple arguments on appeal: (1) the public-duty doctrine shields the state from liability; (2) the statutory tort cap in G.L. 1956 § 9–31–2 limits damages to $100,000; (3) the prejudgment interest award was improper; (4) the trial justice erred in denying the state's motion for judgment as a matter of law; and (5) the trial justice erred in failing to instruct the jury on comparative negligence. For the reasons set forth below, we affirm the judgment of the Superior Court.

IFacts and Travel

ABackground

The Veterans Home serves as a nursing home for many of Rhode Island's veterans.¹ Statutorily organized and governed under Rhode Island's Department of Human Services, its population generally spans between ages seventy and eighty, with many residents having served in World War II and the Korean War. Dispersed in multiple units, the Home's residents range from totally independent to bedridden. Each unit includes two wings (sides A and B), with each side housing about thirty to forty patients.

Of particular relevance here is Unit N–7 (N–7). A "skilled unit," N–7 included residents requiring heightened care and palliative (end-of-life) residents.² As such, a charge nurse,³ a staff nurse,⁴ and several Certified Nursing Assistants⁵ (CNAs) staffed the unit during a typical shift. A supervisory RN oversaw the Home's nursing operation, including resident-care oversight and nurse supervision. Nurses worked during three shifts: 8 a.m. to 4 p.m.; 4 p.m. to 12 a.m.; and 12 a.m. to 8 a.m.

At the start of a 4 p.m. shift, CNAs went directly to their respective room assignments and checked whether residents needed washing or changing.⁶ This was important because residents could not visit the dining room if soiled and often had not been checked or cleaned for a few hours. However, the CNAs prioritized transporting residents to the dining room because they ate dinner early, around 4:30 p.m. Additionally, CNAs provided meals and fed the few residents who did not leave their rooms. Generally, three CNAs assisted residents to the dining room while one CNA fed residents in their rooms.

BThe Accident

On November 10, 2008, Roach reported to work for her Veterans Home assignment, arriving around 3:45 p.m. for the 4 p.m. to 12 a.m. shift. As a contract nurse⁷ unacquainted with the Home's operations, Roach briefly met with N–7's charge nurse, Ms. Cheryl Kelley. Until about 4:25 p.m., Kelley orientated Roach with N–7, showing her the treatment cart, medical cart, bathroom, and kitchen. Then, Roach familiarized herself with N–7's residents' medications, which she planned to administer until about 5 p.m. While administering medications, she traveled down N–7's "B" side hallway, beginning with Room B–1.

Roach eventually arrived at Room B–7—the room from which the crux of this case arises. At the time, Room B–7 housed two resident-patients.⁸ Resident 1, a double amputee, often remained in his wheelchair. He was capable of pushing himself around the Home and usually wheeled himself to the dining room at dinnertime. In addition to being non-ambulatory, Resident 1 was incontinent, so nurses would assist him in accessing the toilet via a lift, transporting him from his bed or wheelchair to the toilet, and back. Resident 2 had end-stage Parkinson's disease. He rarely left his room or his bed, and he required nurse assistance to move from his bed to his wheelchair. Due to his lack of mobility, CNAs assisted Resident 2 with dinner in his room.

Roach proceeded to administer Resident 2's medication. He required one medication, which she administered in a 30–cubic-centimeter (cc) cup along with a 90–cc Dixie cup filled about halfway with water. After he took his pill, about 30 ccs of excess water remained in his cup. Roach tossed the medication cup in the trash near B–7's entrance and approached the bathroom to dump the excess water in the sink.

Walking towards the bathroom with the water cup in her right hand, Roach reached inside the room with her left hand and attempted to flick on the light switch.⁹ However, before reaching the sink, she slipped and fell on the bathroom floor. Wearing her Nurse Mate sneakers, Roach recalled hydroplaning on liquid and landing in a split position. Roach felt "excruciating" pain, and her knee cracked on the way down.

While on the floor, Roach felt liquid on both sides of her. It was enough liquid to dampen both the back and side of her pants. Based on its smell, Roach believed the liquid was cleaning solution or soapy water used to bathe residents. Unable to reach the call light above her on the wall, Roach yelled out multiple times for help, to no avail. With no one around to assist, she used her uninjured leg to push herself up and out of the bathroom. Relying on the medical cart for support, Roach then made her way down the hall to the nursing station.

At the nursing station, Roach notified Kelley of her fall. Kelley provided Roach with an ACE bandage wrap and ice pack. She also gave Roach an incident report, which Roach completed shortly thereafter. Kelley retained a mop and bucket and went to Room B–7 to clean up the spill. Kelley recalled needing only one mop swipe to clean the liquid. Although plaintiff remained in pain, which she described as a "ten" on a one-to-ten scale, she completed her shift.

CBathroom Access

While the jury heard no direct evidence regarding how the liquid reached the bathroom floor, the parties presented circumstantial evidence detailing the possible events leading to Roach's slip and fall. All staff members, including nurses, CNAs, and housekeeping, could access B–7 and its bathroom. Additionally, the Home allowed visitors, who could access the Home and B–7, including the bathroom.

In particular, Heritage Healthcare Company (Heritage or housekeeping) cleaned the Home's rooms and bathrooms daily, including on November 10.¹⁰ Housekeepers worked between 7 a.m. and 3 or 3:30 p.m. They cleaned bedside tables, floors, and bathrooms, including the sink, toilet, and floor. Ms. Thelma Garcia, the Heritage housekeeper who cleaned the Home on November 10, cleaned N–7's rooms between 9 a.m. and 11:30 a.m. She was also available after 11:30 through the end of her shift to respond to any calls to clean spills. The housekeeping manager, Ms. Maria Depina, inspected each room daily around 1:30 p.m. Depina testified that her staff used an orange cleaning solution to clean floors—a color that she claimed was visible both in the cleaning bottle and on the floor. Housekeeping kept cleaning products locked in a closet, which Depina testified only the housekeeping manager and assistant manager could access. Depina said that she could not recall whether housekeeping received a call to clean a spill after the November 10 morning cleaning.

Beyond housekeeping, nurses and CNAs also accessed unit bathrooms. Several nurses and CNAs testified that they accessed the bathroom during the resident-cleaning process. Generally, CNAs used one of two resident-cleaning methods: either Perineal (Peri) Spray and disposable wipes, or a bucket of soapy water and a washcloth.¹¹ For the latter method, CNAs washed residents either bedside or over the toilet. When finished, the CNAs disposed of excess soapy water in the toilet.

Regarding B–7, Kelley testified that CNAs washed Residents 1 and 2 either bedside or over the toilet. If over the toilet, Kelley said that the CNAs cleaned Resident 1 with Peri Spray, while if they cleaned him at his bedside, they probably used warm water and soap. Ms. Ursula Souza, the N–7 LPN on duty before Roach during the 8 a.m. to 4 p.m. shift, testified that CNAs always washed B–7 residents at their bedsides. She also noted that CNAs disposed of washing materials and water in bathrooms. Additionally, Ms. Patricia Brum, a CNA who worked in N–7 during Roach's shift, testified that she used the bathroom to wash out any used urinals. Nurses also accessed bathrooms to wash their hands.

Because housekeeping staff left around 3:30 p.m., the nurses cleaned up spills after this time. Employees, including CNAs, consistently testified that if a CNA or nurse noticed a spill, they were responsible for cleaning it up. LPN Souza and CNA Demello covered Room B–7 during the 8 a.m. to 4 p.m. shift on November 10. Specifically, Demello cared for Resident 1 and eight to ten other B–wing residents. Souza testified that she could not recall seeing liquid...