Publisher's note: This post appears here courtesy of the Carolina Journal, and written by Mitch Kokai.
"Stay in your own lane."
It's an easy suggestion to make when we see someone else exceeding his authority or speaking outside his area of expertise.
It can be harder for many of us to heed our own advice. We share opinions and offer suggestions, even when we have incomplete information or no direct involvement in the issue at hand.
Staying in one's own lane can prove especially difficult for a government official. If he believes he can right a wrong or correct a mistake that affects thousands or even millions of people, the shackles of his position can appear overly burdensome.
Incentives can encourage officials to swerve out of their lanes. Those who give in to the pressure to "do something," even if it exceeds their authority, are as likely as not to win public accolades for their actions. In contrast, those who refuse to overstep the boundaries of their jobs seldom win recognition. Sometimes they face criticism for ignoring the public's pleas.
Since those who accept the limitations of their government posts rarely win praise, it's nice to have the chance to offer some in this column. It highlights a June 16 opinion from the N.C. Court of Appeals.
Judge Richard Dietz reminded readers that the state's second-highest court is not in the business of rewriting state law. Nor can or should the Appeals Court reject precedents from the state Supreme Court, the final authority on North Carolina's constitutional matters.
Dietz's unanimous opinion stems from a case titled Connette v. The Charlotte-Mecklenburg Hosp. Auth
. It's based on a 2010 incident of medical error involving a 3-year-old girl named Amaya Hopper. While undergoing heart treatment, Amaya suffered permanent brain damage, cerebral palsy, and "profound developmental delay." Experts blamed the process medical professionals used to administer anesthesia.
Amaya's family sued. After a jury failed to reach a verdict in a 2015 trial, the family settled its claims against the anesthesiologist. But the case continued against both the hospital and Gus VanSoestbergen, a certified registered nurse anesthetist. The family lost at the trial court level in 2018, then appealed the verdict.
Here's where Dietz demonstrated a commitment to stay within his own lane.
"Nearly a century ago, our Supreme Court rejected the notion that nurses can be liable for medical malpractice based on their diagnosis and treatment of patients,"
his opinion began. "The Court reasoned that nurses 'are not supposed to be experts in the technique of diagnosis or the mechanics of treatment.'"
Though the state Supreme Court's decision in Byrd v. Marion Gen. Hosp. dates back to 1932, it still holds sway over judges operating in North Carolina's court system.
"Medicine is quite different today than in the early 20th century, and so, too, is the knowledge and skill of nurses in their varying fields and specializations,"
Dietz wrote. "Plaintiffs ... argue that the nurse anesthetist in this case participated in the treatment plan for Hopper's young daughter to such a degree, and with such an exercise of expertise and discretion, that the nurse effectively was treating the patient and thus should be subject to legal claims for medical malpractice."
Regardless of changes in medicine over the past 88 years, or the degree of VanSoestbergen's involvement in Amaya Hopper's treatment, state law remained clear to Dietz.
"We must reject this argument,"
he wrote. "Had Byrd left room for evolving standards as the field of medicine changed, this may be a different case. But the Byrd court's holding is categorical, and it is controlling here."
In other words, appellate judges face a clear conclusion. Working for North Carolina's second-highest court, they cannot ignore decisions handed down from the state's highest tribunal.
Dietz spelled out the potential danger of the Appeals Court straying from its lane. "If this Court were free to reject Supreme Court precedent that we felt did not age well, it would destabilize our position as an intermediate appellate court,"
he wrote. "On issues where our Supreme Court already has spoken, we do not make law, we follow it."
Some might view Dietz's opinion as a cop-out. If the nurse anesthetist in this case played a significant role in contributing to the medical error, they might argue, he deserves to be held liable for his actions. Decades-old court rulings shouldn't stand in the way of justice today.
Yet Dietz's opinion does not shut the door on the case. Amaya Hopper's family could appeal to the N.C. Supreme Court. If a majority of that court believes the Byrd case no longer applies to current circumstances, it could vote to overturn the precedent. If the plaintiffs are to prevail, the Supreme Court remains the proper venue for victory.
Nor does Dietz's ruling block legislative action. If health care has changed to such a great degree over the past 88 years that nurses should face new medical malpractice liability, that's a topic worthy of discussion and debate in the N.C. General Assembly.
In the meantime, this observer credits an Appeals Court judge for recognizing the importance of staying in his own lane.
Mitch Kokai is senior political analyst for the John Locke Foundation.