IN THE COURT OF APPEALS OF NORTH CAROLINA
No. COA16-1015
Filed: 16 May 2017
Robeson County, No. 15 CVS 1945
MARJORIE C. LOCKLEAR, Plaintiff,
v.
MATTHEW S. CUMMINGS, M.D., SOUTHEASTERN REGIONAL MEDICAL
CENTER, DUKE UNIVERSITY HEALTH SYSTEM and DUKE UNIVERSITY
AFFILIATED PHYSICIANS, INC., Defendants.
Appeal by Plaintiff from orders entered 2 February 2016 and 4 February 2016
by Judge James Gregory Bell in Robeson County Superior Court. Heard in the Court
of Appeals 8 March 2017.
Law Offices of Walter L. Hart, IV, by Walter L. Hart, IV, for Plaintiff-Appellant.
Cranfill Sumner & Hartzog LLP, by Jaye E. Bingham-Hinch, David D. Ward,
and Katherine Hilkey-Boyatt, for Defendant-Appellees Matthew S. Cummings,
M.D., Duke University Health System, and Duke University Affiliated
Physicians, Inc.
Brotherton Ford Berry & Weaver, PLLC, by Robert A. Ford and Demetrius
Worley Berry, for Defendant-Appellee Southeastern Regional Medical Center.
HUNTER, JR., Robert N., Judge.
Marjorie C. Locklear (“Plaintiff”) appeals from an order dismissing her
complaint against Defendants Dr. Matthew Cummings, Duke University Health
System, and Duke University Affiliated Physicians (collectively “Duke Defendants”)
under Rule 9(j), as well as the denial of her motion to amend under Rule 15(a).
LOCKLEAR V. CUMMINGS
Opinion of the Court
Plaintiff also appeals from an order dismissing her complaint against Defendant
Southeastern Regional Medical Center (“Southeastern”) under Rules 9(j) and
12(b)(5), as well as the denial of her motion to amend under Rule 15(a). After review,
we reverse in part and affirm in part.
I. Factual and Procedural Background
On 30 July 2015, one day before the statute of limitations expired, Plaintiff
filed a complaint against Defendants, seeking monetary damages for medical
negligence. The complaint alleges the following narrative.
On 31 July 2012, Dr. Cummings performed cardiovascular surgery on Plaintiff.
During surgery, Dr. Cummings failed to monitor and control Plaintiff’s body and was
distracted. Additionally, he did not position himself in close proximity to Plaintiff’s
body. While Plaintiff “was opened up and had surgical tools in her[,]” Plaintiff fell off
of the surgical table. Plaintiff’s head and the front of her body hit the floor. As a
result of the fall, Plaintiff suffered a concussion, developed double vision, injured her
jaw, displayed bruises, and was “battered” down the left side of her body. Plaintiff
also had “repeated” nightmares about falling off the surgical table. Duke Defendants
and Defendant Southeastern acted negligently by retaining physicians, nurses, and
other healthcare providers who allowed Plaintiff’s accident to occur.
On 9 September 2015, private process server, Richard Layton, served Duke
Defendants by delivering Plaintiff’s civil cover sheet, summons, and complaint to
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Opinion of the Court
Margaret Hoover, a registered agent for Duke Defendants. On 19 September 2015,
Gary Smith, Jr. served Plaintiff’s summons and complaint on Dr. Cummings. Lastly,
on 24 September 2015, Smith served Plaintiff’s summons and complaint on
Southeastern by delivering the papers to C. Thomas Johnson, IV, Southeastern’s
Chief Financial Officer.1
On 10 November 2015, Dr. Cummings and Duke Defendants filed a joint
answer and motion to dismiss. Dr. Cummings and Duke Defendants denied the
allegations in Plaintiff’s complaint and asserted defenses under Rules 12(b)(6) and
9(j) of the North Carolina Rules of Civil Procedure.
On 23 November 2015, Southeastern filed an answer and denied Plaintiff’s
allegations. Southeastern moved to dismiss Plaintiff’s compliant under Rules
12(b)(4), 12(b)(5), 12(b)(6), and 9(j) of the North Carolina Rules of Civil Procedure.
On 29 December 2015, Johnson filed an affidavit. In the affidavit, Johnson swore he
was the Chief Financial Officer of Southeastern, but not the corporation’s registered
agent.
On 11 January 2016, the trial court held a hearing on all the Defendants’
pending motions. During argument, Plaintiff requested “leave of the Court to amend
[the] complaint so that there’s no controversy hereafter.” Plaintiff moved under Rule
1 In Smith’s affidavit, he listed Johnson as Southeastern’s registered agent.
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Opinion of the Court
60, not Rule 15(a), because “Rule 60 . . . allows a mere clerical order – error to be
corrected.” Then, Plaintiff requested leave “pursuant to Rules 15(a) and 60.”
On 2 February 2016, the trial court granted Dr. Cummings’s and Duke
Defendants’ motion to dismiss pursuant to Rule 9(j) and denied Plaintiff’s motion to
amend under Rule 15(a). On 4 February 2016, the trial court granted Southeastern’s
motion to dismiss pursuant to Rules 9(j) and 12(b)(5) and denied Plaintiff’s motion to
amend under Rule 15(a). Plaintiff filed timely notice of appeal.
II. Standard of Review
The standard of review of a Rule 12(b)(6) motion to dismiss is de novo. Leary
v. N.C. Forest Prods., Inc., 157 N.C. App. 396, 400, 580 S.E.2d 1, 4 (2003). Likewise,
a trial court’s order dismissing a complaint pursuant to Rule 9(j) is reviewed de novo
on appeal because it is a question of law. Barringer v. Wake Forest Univ. Baptist Med.
Ctr., 197 N.C. App. 238, 256, 677 S.E.2d 465, 477 (2009) (citation omitted).
We review the trial court’s dismissal under Rule 12(b)(5) de novo. New
Hanover Cty. Child Support Enforcement ex rel. Beatty v. Greenfield, 219 N.C. App.
531, 533, 723 S.E.2d 790, 792 (2012) (citation omitted).
III. Analysis
A. Motions to Dismiss under Rule 12(b)(6) and Rule 9(j)
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Opinion of the Court
Plaintiff argues the trial court erred in dismissing her complaint against all
the Defendants under Rule 12(b)(6) and Rule 9(j). Because Plaintiff’s claims sound
in ordinary negligence, not medical malpractice, we agree.
“In North Carolina, the distinction between a claim of medical malpractice and
ordinary negligence is significant for several reasons, including that medical
malpractice actions cannot be brought [without Rule 9(j) compliance].” Gause v. New
Hanover Reg’l Med. Ctr., ___ N.C. App. ___, ___, 795 S.E.2d 411, ___ (2016) (citing
N.C. Gen. Stat. § 1A-1, Rule 9(j) (2015)).
“Whether an action is treated as a medical malpractice action or as a common
law negligence action is determined by our statutes[.]” Smith v. Serro, 185 N.C. App.
524, 529, 648 S.E.2d 566, 569 (2007). N.C. Gen. Stat. § 90-21.11(2)(a) defines a
medical malpractice action as “[a] civil action for damages for personal injury or death
arising out of the furnishing or failure to furnish professional services in the
performance of . . . health care by a health care provider.” N.C. Gen. Stat. § 90-
21.11(2)(a). “The term ‘professional services’ is not defined by our statutes but has
been defined by the Court as ‘an act or service arising out of a vocation, calling,
occupation, or employment involving specialized knowledge, labor, or skill, and the
labor or skill involved is predominantly mental or intellectual, rather than physical
or manual.’” Gause, ___ N.C. App. at ___, 795 S.E.2d at ___ (quoting Sturgill v. Ashe
Mem’l Hosp., Inc., 186 N.C. App. 624, 628, 652 S.E.2d 302, 305 (2007)). “Our courts
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Opinion of the Court
have classified as medical malpractice those claims alleging injury resulting from
activity that required clinical judgment and intellectual skill.” Id. at ___, 795 S.E.2d
at ___ (citation omitted). “Our courts have classified as ordinary negligence those
claims alleging injury caused by acts and omissions in a medical setting that were
primarily manual or physical and which did not involve a medical assessment or
clinical judgment.” Id. at ___, 795 S.E.2d at ___ (citation omitted).
In cases of a plaintiff falling, the deciding factor is whether the decisions
leading up to the fall required clinical judgment and intellectual skill. Where the
complaint alleges or discovery shows the fall occurred because medical personnel
failed to properly use restraints, the claim sounded in medical malpractice. Sturgill,
186 N.C. App. at 628-30; Alston v. Granville Health Sys., 221 N.C. 416, 421, 727
S.E.2d 877, 881 (2012) (“Alston II”). However, when a complaint alleged the plaintiff
fell of a gurney in an operating room while unconscious, this Court held the claim
sounded in ordinary negligence, not medical malpractice. Alston v. Granville Health
Sys., No. 09-1540, 2010 WL 3633738 (unpublished) (Sept. 21, 2010) (“Alston I”).2 The
2 In Alston I, this Court reversed the trial court’s dismissal of plaintiff’s complaint and held
Rule 9(j) certification was not required, because plaintiff’s claims sounded in ordinary negligence.
Following discovery and a motion for summary judgment, the trial court granted summary judgment
for defendants and dismissed the plaintiff’s action again. This Court upheld the subsequent dismissal,
as discovery showed “the decision to restrain a patient under anesthesia is one that requires use of
specialized skill and knowledge and, therefore, is considered a professional service.” Alston II, 221
N.C. App. at 421, 727 S.E.2d at 881.
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Opinion of the Court
question is whether the actions leading to the fall require specialized skill or clinical
judgment. Gause, ___ N.C. App. at ___, 795 S.E.2d at ___ (citations omitted).
In her complaint, Plaintiff states, inter alia:
23. That, at all times relevant to this action, Defendant
Cummings . . . held himself out to possess the special skills
and knowledge possessed by other physicians practicing in
the specialized field of internal medicine, cardiology, and
cardiovascular surgery.
24. That the medical care and treatment rendered to
Plaintiff by Defendant Cummings on July 31, 2012 has
been reviewed by a person who is reasonably expected to
qualify as an expert witness under Rule 702 of the North
Carolina Rules of Evidence, and who is willing to testify
that the medical care rendered to Plaintiff fell below the
applicable standard of care.
25. That the medical care and treatment of Defendant
Cummings has been reviewed by a person that Plaintiff
will seek to have qualified by an expert witness under Rule
702 of the North Carolina Rules of Evidence, and who is
willing to testify that the medical care rendered to Plaintiff
fell below the applicable standard of care.
...
27. That the times, places, and on the occasion herein in
question, Defendant Cummings was negligent, and his acts
and omissions of negligence include, but are not limited to:
a) In failing to use his best professional judgment
and skill while operating on the Plaintiff;
b) In failing to properly control Plaintiff’s body
during the surgery;
c) In failing to properly monitor Plaintiff’s body
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LOCKLEAR V. CUMMINGS
Opinion of the Court
during surgery;
d) In allowing himself to be distracted;
e) In not positioning himself in close proximity to
Plaintiff’s body;
f) In not properly supervising and directing the
proximity of nurses and other staff in relation to
Plaintiff;
g) In allowing Plaintiff to fall off the operating table;
h) In failing to use good judgment, reasonable skill,
and diligence in the treatment of Plaintiff; and
i) Defendant Cummings was otherwise careless and
negligent.
Plaintiff’s complaint sounds in ordinary negligence, not medical malpractice.
Although Plaintiff uses language which would seemingly trigger a medical
malpractice claim, we conclude the facts in Plaintiff’s complaint give rise to a claim
of ordinary negligence. Plaintiff’s factual allegation, namely “Plaintiff was allowed
to fall off the operating table while Plaintiff was opened up and had surgical tools in
her[,]” forecasts the type of injury resulting from actions not requiring specialized
skill or clinical judgment. Gause, ___ N.C. App. at ___, 795 S.E.2d at ___ (citations
omitted).
Dr. Cummings and Duke Defendants contend Plaintiff failed to argue her
action is not medical malpractice, and, thus, Plaintiff is barred from raising this issue
on appeal. Defendants further contend we cannot address this issue on appeal, as it
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LOCKLEAR V. CUMMINGS
Opinion of the Court
would constitute this Court improperly supplementing an appellant’s brief. However,
in our de novo review, we cannot review whether the trial court erred in dismissing
Plaintiff’s complaint under Rule 9(j) without addressing whether Rule 9(j)
certification is required.
Notwithstanding Defendants’ arguments, we hold this action sounds in
ordinary negligence. Therefore, Plaintiff was not required to comply with Rule 9(j).
Accordingly, the trial court erred in dismissing Plaintiff’s complaint under Rules
12(b)(6) and 9(j).3
The concurring and dissenting opinion asserts our majority supplements
Plaintiff’s arguments on appeal and improperly concludes Plaintiff’s claims sound in
ordinary negligence. In support of this contention, the concurring and dissenting
opinion cites to the legislative intent of Rule 9(j).
At the outset, as stated above, our majority does not improperly supplement
Plaintiff’s appeal because, in our de novo review, we must decide whether Rule 9(j)
certification is required before we can affirm a trial court’s dismissal of a complaint
for lack of Rule 9(j) compliance.
Next, we note a court’s “consideration of a motion brought under Rule 12(b)(6)
is limited to examining the legal sufficiency of the allegations contained within the
3 Because we reverse the trial court’s order on Rule 12(b)(6) and Rule 9(j) grounds, we need
not address whether the trial court erred in denying Plaintiff’s motion to amend her complaint under
Rule 15 of the North Carolina Rules of Civil Procedure.
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Opinion of the Court
four corners of the complaint.” Hillsboro Partners, LLC v. City of Fayetteville, 226
N.C. App. 30, 32-33, 738 S.E.2d 819, 822 (2013) (citation omitted). See also
Jackson/Hill Aviation, Inc. v. Town of Ocean Isle Beach, ___ N.C. App. ___, ___, 796
S.E.2d 120, ___ (2017) (citation omitted). Additionally, “[d]ismissal of an action under
Rule 12(b)(6) is appropriate when the complaint ‘fail[s] to state a claim upon which
relief can be granted.’” Arnesen v. Rivers Edge Golf Club & Plantation, Inc., 368 N.C.
440, ___, 781 S.E.2d 1, 7 (2015) (quoting N.C. Gen. Stat. § 1A-1, Rule 12(b)(6) (2013))
(second alteration in original). “When the complaint on its face reveals that no law
supports the claim [or] reveals an absence of facts sufficient to make a valid claim . . .
dismissal is proper.” Id. at ___, 781 S.E.2d at 8 (citation omitted) (emphasis added).
Accordingly, there is no need to delve into the legislative intent behind Rule 9(j).
Instead, we look at the four corners of Plaintiff’s complaint and acknowledge that
Plaintiff revealed facts sufficient to make a valid claim, a claim of ordinary
negligence, under our case law. See id. at ___, 781 S.E.2d at 8 (citation omitted).
B. Motion to Dismiss under Rule 12(b)(5)
Plaintiff next contends the trial court erred in dismissing her claims against
Southeastern under Rule 12(b)(5). We disagree.
Rule 4 of the North Carolina Rules of Civil Procedure governs service of process
in North Carolina. Rule 4 states, inter alia:
(a) Summons — Issuance; who may serve.–Upon the filing
of the complaint, summons shall be issued forthwith, and
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Opinion of the Court
in any event within five days. The complaint and summons
shall be delivered to some proper person for service. In this
State, such proper person shall be the sheriff of the county
where service is to be made or some other person duly
authorized by law to serve summons.
...
(h) Summons—When proper officer not available.—If at
any time there is not in a county a proper officer, capable
of executing process, to whom summons or other process
can be delivered for service, or if a proper officer refuses or
neglects to execute such process, or if such officer is a party
to or otherwise interested in the action or proceeding, the
clerk of the issuing court, upon the facts being verified
before him by written affidavit of the plaintiff or his agent
or attorney, shall appoint some suitable person who, after
he accepts such process for service, shall execute such
process in the same manner, with like effect, and subject to
the same liabilities, as if such person were a proper officer
regularly serving process in that county.
(h1) Summons—When process returned unexecuted. –If a
proper officer returns a summons or other process
unexecuted, the plaintiff or his agent or attorney may
cause service to be made by anyone who is not less than 21
years of age, who is not a party to the action, and who is
not related by blood or marriage to a party to the action or
to a person upon whom service is to be made. This
subsection shall not apply to executions pursuant to Article
28 of Chapter 1 or summary ejectment pursuant to Article
3 of Chapter 42 of the General Statutes.
N.C. Gen. Stat. § 1A-1, Rule 4 (2016).
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Opinion of the Court
Plaintiff argues service by a private process server is permissible under the
North Carolina Rules of Civil Procedure if the private process server files an affidavit
under N.C. Gen. Stat. § 1-75.10.4
Southeastern contends holding Plaintiff’s service was proper conflates Rule
4(a) with Rule 4(h) and Rule 4(h1). We agree.
Here, Plaintiff hired a private process server, Smith, to serve Southeastern.
On 24 September 2015, Smith served Johnson, the Chief Financial Officer of
Southeastern. On 14 October 2015, Smith signed an “Affidavit of Process Server”
asserting he was over the age of 18 years, not a party to the action, and “authorized
by law to perform said service.”
In North Carolina, private process service is not always “authorized under
law”. The proper person for service in North Carolina is the sheriff of the county
where service is to be attempted or some other person duly authorized by law to serve
summons. N.C. Gen. Stat. § 1A-1, Rule 4(a). Although Plaintiff’s process server filed
the statutorily required affidavit, a self-serving affidavit alone does not confer “duly
authorized by law” status on the affiant. Legal ability to serve process by private
process server is limited by statute in North Carolina to scenarios where the sheriff
is unable to fulfill the duties of a process server. N.C. Gen. Stat. § 1A-1, Rule 4(h),
4 In support of her argument, Plaintiff also cites Garrett v. Burris, No. COA14-1257, 2015 WL
4081832 (unpublished) (N.C. Ct. App. July 7, 2015). However, Garrett is an unpublished opinion and
is not binding authority.
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Opinion of the Court
(h1). For example, if the office of the sheriff is vacant, the county’s coroner may
execute service. N.C. Gen. Stat. § 162-5. Additionally, if service is unexecuted by the
sheriff under Rule 4(a), the clerk of the issuing court can appoint “some suitable
person” to execute service under Rule 4(h). Here, the record does not disclose the
sheriff was unable to deliver service so that the services of a process server would be
needed. This is commonly accepted statutory practice in North Carolina and
discussed in treatises dealing with civil procedure. See William A. Shuford, North
Carolina Civil Practice and Procedure § 4.2 (6th ed.); 1 G. Gray Wilson, North
Carolina Civil Procedure § 4-4, at 4-16 (2016). Accordingly, we affirm the trial court’s
order dismissing Plaintiff’s claims against Southeastern under Rule 12(b)(5) of the
North Carolina Rules of Civil Procedure.
IV. Conclusion
For the foregoing reasons, we reverse the trial court’s order dismissing
Plaintiff’s complaint against Dr. Cummings and Duke Defendants. We affirm the
trial court’s order dismissing Plaintiff’s complaint against Southeastern.
REVERSED IN PART; AFFIRMED IN PART.
Judge CALABRIA concurs.
Judge BERGER concurring in part and dissenting in part.
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No. COA16-1015 – Locklear v. Cummings, et al.
BERGER, Judge, concurring in part and dissenting in part.
Plaintiff failed to comply with Rule 4 of the North Carolina Rules of Civil
Procedure when she failed to serve her summons and complaint on Defendant
Southeastern Regional Medical Center (“Southeastern”) through a person authorized
by law. Therefore, I concur with the majority that the trial court did not err when it
granted Southeastern’s motion to dismiss pursuant to Rule 12(b)(5) for insufficiency
of service of process.
However, Plaintiff pleaded a claim of medical malpractice by a healthcare
provider in her complaint, not a claim of ordinary negligence as asserted by the
majority. Because this was a medical malpractice claim, Plaintiff did not comply with
pleading requirements when she failed to allege that “all medical records pertaining
to the alleged negligence . . . have been reviewed” as required by Rule 9(j). Because
the amendment of a complaint for medical malpractice to correct a deficient Rule 9(j)
certification is improper and does not relate back to the date of filing the complaint,
the trial court did not err in denying Plaintiff’s motion to amend which was filed after
the statute of limitations had expired. In dismissing Plaintiff’s complaint, the trial
court did not err, as stated in the majority’s opinion, and I must respectfully dissent.
On July 30, 2015, Plaintiff filed a complaint for damages and punitive damages
in Robeson County Superior Court alleging medical malpractice by Defendants in
that:
LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
(a) Defendant Cummings (“Dr. Cummings”), is a physician practicing in the
fields of internal medicine, cardiology, and cardiovascular surgery, and he
treated Plaintiff and had a responsibility to treat Plaintiff;
(b) Dr. Cummings “held himself out to possess the special skills and knowledge
possessed by other physicians practicing in the specialized field of internal
medicine, cardiology, and cardiovascular surgery[;] and held himself out to
possess the special skills and knowledge possessed by other physicians
practicing in the specialized field of internal medicine, cardiology, and
cardiovascular surgery in his locality or other similar localities with the
same training and experience.”
(c) On July 31, 2012, Dr. Cummings, with the assistance of nurses and staff of
Southeastern Regional Medical Center (“Southeastern”), performed
cardiovascular surgery on Plaintiff, and during the surgery, Plaintiff
suffered injuries when she “was allowed to fall off the operating room table
while Plaintiff was opened up and had surgical tools in her.”
(d) “[T]he medical care rendered to Plaintiff fell below the applicable standard
of care.”
(e) Defendants were negligent in failing to comply with the standard of care
set forth in Article 1B of the North Carolina General Statutes, entitled
“Medical Malpractice Actions”, Section 90-21.12, “Standard of health care”;
(f) Dr. Cummings failed to use his “best professional judgment and skill while
operating on the Plaintiff”; failed “to properly control Plaintiff’s body during
the surgery”; failed “to properly monitor Plaintiff’s body during surgery”;
was distracted; was not properly positioned during surgery; did not properly
supervise or direct nurses and staff regarding proper positioning; and failed
“to use good judgment, reasonable skill, and diligence in the treatment of
Plaintiff[.]”
(g) The remaining Defendants were directly and vicariously liable for negligent
employment and/or retention of health care professionals and their actions
in this matter.
(h) Plaintiff further alleged that the professional medical care and treatment
provided by Defendants was reviewed by an individual “reasonably
expected to qualify” and that “Plaintiff will seek to have qualified by an
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LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
expert witness . . . , and who is willing to testify that the medical care
rendered to Plaintiff fell below the applicable standard of care.”
Plaintiff’s complaint was a malpractice action, defined as either:
a. A civil action for damages for personal injury or death
arising out of the furnishing or failure to furnish
professional services in the performance of medical,
dental, or other health care by a health care provider.
b. A civil action against a hospital, a nursing home licensed
under Chapter 131E of the General Statutes, or an adult
care home licensed under Chapter 131D of the General
Statutes for damages for personal injury or death, when
the civil action (i) alleges a breach of administrative or
corporate duties to the patient, including, but not limited
to, allegations of negligent credentialing or negligent
monitoring and supervision and (ii) arises from the same
facts or circumstances as a claim under sub-subdivision
a. of this subdivision.
N.C. Gen. Stat. § 90-21.11(2)(a) and (b) (2015).
Plaintiff, throughout her complaint, asserted that Dr. Cummings,
Southeastern, Duke University Health System, and Duke University Affiliated
Physicians, Inc. had provided professional medical services to Plaintiff. She further
alleged that Dr. Cummings, while “acting in the course and scope of his employment,”
utilized his professional skill and judgment in operating on Plaintiff, and in doing so,
failed to position himself to properly control and monitor Plaintiff’s body. Plaintiff
further asserted that Dr. Cummings failed to properly supervise other health care
professionals during the operation.
3
LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
Plaintiff’s complaint alleges that each Defendant violated the standard of care
set forth in N.C. Gen. Stat. § 90-21.12. Subparagraph (a) of that statute reads as
follows:
Except as provided in subsection (b) of this section, in any
medical malpractice action as defined in G.S. 90-
21.11(2)(a), the defendant health care provider shall not be
liable for the payment of damages unless the trier of fact
finds by the greater weight of the evidence that the care of
such health care provider was not in accordance with the
standards of practice among members of the same health
care profession with similar training and experience
situated in the same or similar communities under the
same or similar circumstances at the time of the alleged act
giving rise to the cause of action; or in the case of a medical
malpractice action as defined in G.S. 90-21.11(2)(b), the
defendant health care provider shall not be liable for the
payment of damages unless the trier of fact finds by the
greater weight of the evidence that the action or inaction of
such health care provider was not in accordance with the
standards of practice among similar health care providers
situated in the same or similar communities under the
same or similar circumstances at the time of the alleged act
giving rise to the cause of action.
N.C. Gen. Stat. § 90-21.12(a) (emphasis added).
Plaintiff’s brief acknowledges that her complaint was one for medical
malpractice. In her Statement of the Case, Plaintiff states, “Marjorie Locklear
(“Plaintiff” or “Locklear”) commenced this medical malpractice action on 30 July
2015.” (emphasis added). Plaintiff’s brief also focuses on Rule 9(j) certification, which
is only applicable to medical malpractice claims.
4
LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
Plaintiff does not argue that this is an action for ordinary negligence as the
majority has found; thus, this argument should be deemed abandoned. “ ‘It is not the
duty of this Court to supplement an appellant's brief with legal authority or
arguments not contained therein. These arguments are deemed abandoned by virtue
of [Rule 28(b)(6) of the North Carolina Appellate Procedures].’ " Sanchez v.
Cobblestone Homeowners Ass’n of Clayton, Inc., ___ N.C. App. ___, ___, 791 S.E.2d
238, 245 (2016) (citation and brackets omitted).
The majority cites to the unpublished opinion Alston, wherein this Court held
the decedent’s injuries from falling off a gurney in an operating room sounded in
ordinary negligence and not medical malpractice. Alston v. Granville Health Sys.,
207 N.C. App. 264, 699 S.E.2d 478 (2010), aff’d, 221 N.C. App. 416, 727 S.E.2d 877
(2012) (unpublished). This Court held the “[p]laintiff’s sole cause of action [wa]s for
ordinary negligence under a theory of res ipsa loquitur,” and did not require
compliance with Rule 9(j). Id. Further, “[b]ecause [p]laintiff herein elected to proceed
solely on a res ipsa loquitur theory, [p]laintiff is bound by that theory.” Id.
The transfer of a patient from the operating table to a gurney before or after
surgery, as in Alston, is “primarily manual or physical and … d[oes] not involve a
medical assessment or clinical judgment.” Gause v. New Hanover Regional Medical
Center, ___ N.C. App. ___, ___, 795 S.E.2d 411, 415 (2016).
5
LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
Conversely, in the case sub judice, Plaintiff alleged her injuries occurred from
falling off of the operating table during the surgery. The positioning and controlling
of Plaintiff’s body while on the operating table, during active surgery, while Plaintiff’s
opened body contained surgical tools, required “clinical judgment and intellectual
skill.” Id. Thus, because Plaintiff’s factual allegations sound in medical malpractice,
and her complaint specifically alleges medical malpractice, Plaintiff is required to
comply with Rule 9(j).
Further, converting Plaintiff’s action into one for ordinary negligence would
allow her to circumvent the requirement of expert certification for her medical
malpractice complaint. The majority’s finding that this is an action for ordinary
negligence creates a loophole for Plaintiff after she improperly filed her medical
malpractice claim. Plaintiff’s witnesses for an ordinary negligence claim will still be
testifying as to the proper positioning and monitoring of a body during cardiovascular
surgery, and the witnesses who will be qualified to testify are the same doctors and
nurses who would testify to the proper procedures during a cardiovascular surgery
under a medical malpractice lawsuit. The majority’s conversion of Plaintiff’s medical
malpractice action into an ordinary negligence action defeats the legislative intent of
Rule 9(j).
Turning to Plaintiff’s arguments under Rule 9(j), they fail. In pertinent part,
Rule 9(j) states that:
6
LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
Any complaint alleging medical malpractice by a health
care provider pursuant to G.S. 90-21.11(2)a. in failing to
comply with the applicable standard of care under G.S. 90-
21.12 shall be dismissed unless:
(1) The pleading specifically asserts that the medical care
and all medical records pertaining to the alleged
negligence that are available to the plaintiff after
reasonable inquiry have been reviewed by a person who is
reasonably expected to qualify as an expert witness
under Rule 702 of the Rules of Evidence and who is
willing to testify that the medical care did not comply
with the applicable standard of care;
(2) The pleading specifically asserts that the medical care
and all medical records pertaining to the alleged
negligence that are available to the plaintiff after
reasonable inquiry have been reviewed by a person that
the complainant will seek to have qualified as an expert
witness by motion under Rule 702(e) of the Rules of
Evidence and who is willing to testify that the medical
care did not comply with the applicable standard of care,
and the motion is filed with the complaint; or
...
Upon motion by the complainant prior to the expiration of
the applicable statute of limitations, a resident judge of the
superior court . . . may allow a motion to extend the statute
of limitations for a period not to exceed 120 days to file a
complaint in a medical malpractice action in order to
comply with this Rule, upon a determination that good
cause exists for the granting of the motion and that the
ends of justice would be served by an extension.
N.C. Gen. Stat. § 1A-1, Rule 9(j) (2015).
Thus, dismissal of a medical malpractice action is required unless the pleading
requirements of Rule 9(j) are satisfied. Our Supreme Court held that:
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LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
Rule 9(j) clearly provides that "any complaint alleging
medical malpractice . . . shall be dismissed" if it does not
comply with the certification mandate . . . [W]e find the
inclusion of "shall be dismissed" in Rule 9(j) to be more than
simply "a choice of grammatical construction." While other
subsections of Rule 9 contain requirements for pleading
special matters, no other subsection contains the
mandatory language "shall be dismissed." This indicates
that medical malpractice complaints have a distinct
requirement of expert certification with which plaintiffs
must comply. Such complaints will receive strict
consideration by the trial judge. Failure to include the
certification necessarily leads to dismissal.
Thigpen v. Ngo, 355 N.C. 198, 202, 558 S.E.2d 162, 165 (2002) (emphasis in original)
(internal citations and brackets omitted). Here, Plaintiff provided proper certification
regarding medical care and treatment, but failed to comply with Rule 9(j) as there
was no allegation concerning review of medical records.
On January 11, 2016, Plaintiff in open court moved to amend the complaint
pursuant to Rule 15(a) to comply with Rule 9(j). The trial court correctly denied this
motion as it was made nearly six months after the statute of limitations had expired.
This Court previously held that “Rule 9(j) must be satisfied at the time of the
complaint's filing.” Alston v. Hueske, ___ N.C. App. ___, ___, 781 S.E.2d 305, 309
(2016). In Hueske, as here, the plaintiff sought to amend her complaint to comply
with the certification requirements of Rule 9(j). This Court noted that
[b]ecause the legislature has required strict compliance
with this rule, our courts have ruled that if a pleader fails
to properly plead his case in his complaint, it is subject to
dismissal without the opportunity for the plaintiff to
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LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
amend his complaint under Rule 15(a). To read Rule 15 in
this manner would defeat the objective of Rule 9(j)
which . . . seeks to avoid the filing of frivolous medical
malpractice claims.
Id., at ___, 781 S.E.2d at 310 (emphasis in original) (internal citations and quotation
marks omitted).
The title of Rule 9, ‘Pleading special matters,’ plainly
signals the statute’s tailoring to address distinct situations
set out in the statute. [R]elation back is not available
through Rule 15(c) of the North Carolina Rules of Civil
Procedure to comply with Rule 9(j) . . . . Rule 9(j) mandates
that any complaint which fails to comply with the
certification requirement, “shall be dismissed.” . . . [A] trial
judge can dismiss with prejudice where a complaint does
not contain the certification required by Rule 9(j) and the
statute of limitations has expired.
Bass v. Durham Cty. Hosp. Corp., 158 N.C. App. 217, 225, 580 S.E.2d 738, 743 (2003)
(Tyson, J., dissenting) (internal citations and quotation marks omitted) (emphasis in
original), rev'd for the reasons stated in the dissenting opinion, 358 N.C. 144, 592
S.E.2d 687 (2004). See also Thigpen v. Ngo, 355 N.C. 198, 205, 558 S.E.2d 162, 167
(2002) (“[W]e hold that once a party receives and exhausts the 120-day extension of
time in order to comply with Rule 9(j)’s expert certification requirement, the party
cannot amend a medical malpractice complaint to include expert certification.”);
Fintchre v. Duke University, ___ N.C. App. ___, ___, 773 S.E.2d 318, 325 (2015)
(“[W]here plaintiff failed to file a complaint including a valid Rule 9(j) certification
within the statute of limitations, granting plaintiff's motion to amend . . . would have
been futile . . . .”).
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LOCKLEAR V. CUMMINGS, ET AL.
BERGER, J., Concurring in part and dissenting in part
Such is the case here. Plaintiff alleged that her care and treatment occurred
July 31, 2012, and she filed her action July 30, 2015, one day before the statute of
limitations would expire. Plaintiff’s medical malpractice complaint failed to include
a required Rule 9(j) certification regarding review of medical records.
Plaintiff failed to seek amendment of her complaint until January 11, 2016,
nearly six months after the statute of limitations had expired, and 44 days beyond
“[t]he 120-day extension of the statute of limitations available to medical malpractice
plaintiffs by Rule 9(j) . . . for the purpose of complying with Rule 9(j).” Bass at 225,
580 S.E.2d at 743 (citing N.C. Gen. Stat. § 1A-1, Rule 9(j) (2001)). Allowing an
amendment would have been futile, so it cannot be said that the trial court abused
its discretion in denying that motion. Plaintiff failed to plead proper Rule 9(j)
certification in her complaint before the statute of limitations expiration. If any
complaint alleging medical malpractice shall be dismissed for failure to comply with
the certification mandate of Rule 9(j), it cannot be said that the trial court erred in
granting Defendants’ motion to dismiss.
10