• View enhanced case on Westlaw
  • KeyCite this case on Westlaw
  • http://laws.findlaw.com/4th/011640p.html
                        PUBLISHED
    

              UNITED STATES COURT OF APPEALS
    

                  FOR THE FOURTH CIRCUIT
    

    ------------------------------------------------*

    ALINE JOAN IODICE; JAMES IODICE;

    MARY J. IODICE,

    Plaintiffs-Appellants,

              v.                          No. 01-1640
    

    UNITED STATES OF AMERICA;

    DEPARTMENT OF VETERANS AFFAIRS,

    an agency of the United States of

    America,

    Defendants-Appellees.

    ------------------------------------------------*

    ------------------------------------------------*

    BARBARA HANSEN, Administratrix of

    the Estate of Julie Marie Hansen,

    Plaintiff-Appellant,

              v.                          No. 01-1651
    

    THE DEPARTMENT OF VETERANS

    AFFAIRS,

    Defendant-Appellee.

    ------------------------------------------------*

    ------------------------------------------------*

    R. KENNETH BABB, Ancillary Public

    Administrator of the ESTATE OF

    MAIA CORY WITZL,

              Plaintiff-Appellant,        No. 01-1654
    

    v.

    DEPARTMENT OF VETERANS AFFAIRS,

    Defendant-Appellee.

    ------------------------------------------------*

      Appeals from the United States District Court
    for the Middle District of North Carolina, at Durham.
           James A. Beaty, Jr., District Judge.
          (CA-99-778, CA-99-781-1, CA-99-779-1)
    

                Argued: February 27, 2002
    

                   Decided: May 2, 2002
    

    Before WILKINS, MICHAEL, and MOTZ, Circuit Judges.
    

    ____________________________________________________________

    Affirmed by published opinion. Judge Motz wrote the opinion, in

    which Judge Wilkins and Judge Michael joined.

    ____________________________________________________________

                         COUNSEL
    

    ARGUED: David D. Daggett, LEWIS & DAGGETT, Winston-

    Salem, North Carolina; Robert Mauldin Elliot, ELLIOT, PISHKO,

    GELBIN & MORGAN, P.A., Winston-Salem, North Carolina, for

    Appellants. Gill Paul Beck, Assistant United States Attorney, Greens-

    boro, North Carolina, for Appellees. ON BRIEF: Rodney A. Guthrie,

    BENNETT & GUTHRIE, P.L.L.C., Winston-Salem, North Carolina,

    for Appellants. Benjamin H. White, Jr., United States Attorney,

    Greensboro, North Carolina, for Appellees.

    ____________________________________________________________

                         OPINION
    

    DIANA GRIBBON MOTZ, Circuit Judge:

    On September 4, 1996, Richard Thomas Jones, when driving his

    car while severely impaired by alcohol and prescription drugs,

    crashed into a car carrying several college students. The accident seri-

    ously injured Aline Joan Iodice, and killed two other students, Julie

    Marie Hansen and Maia Cory Witzl. Iodice and the administrators of

    Hansen's and Witzl's estates (collectively "the students") brought

                            2
    

    these consolidated actions, pursuant to the Federal Tort Claims Act,

    28 U.S.C.A. §§ 2671-2680 (1994), against the United States.1 They

    allege that employees of the Department of Veterans Affairs (VA)

    committed numerous negligent acts - including negligently dispens-

    ing narcotics to Jones and failing to institute, enforce, and monitor

    adequate policies concerning the dispensation of narcotics - that

    proximately and foreseeably caused their injuries. We affirm the dis-

    trict court's dismissal of their complaints, albeit on somewhat differ-

    ent grounds than those on which the district court relied.

                            I.
    

    In reviewing a dismissal for failure to state a claim under Federal

    Rule of Civil Procedure 12(b)(6), we accept the facts as alleged by the

    plaintiffs and construe them in the light most favorable to the plain-

    tiffs, but consider legal issues de novo. See Flood v. New Hanover

    County, 125 F.3d 249, 251 (4th Cir. 1997). The factual account below

    is drawn from the three amended complaints.

    For more than fifteen years before the 1996 accident at the core of

    this case, doctors at VA facilities in Asheville, North Carolina, and

    Salisbury, North Carolina, treated Jones (a veteran) for a number of

    painful physical problems (including amputation of a leg and sur-

    geries on his back) and administered necessary pain medications to

    him. Jones became dependent on both prescription drugs and alcohol.

    For example, according to his medical history, in the eighteen months

    before the accident, Jones took 30-40 Percocet pills a day.

    The VA included Jones in a "drug registry" of addicts that it main-

    tained at its Asheville facility. Jones developed a "history of request-

    ing and receiving early refills of his prescriptions," and his wife urged

    VA employees to treat her husband for drug addiction and to limit his

    prescriptions. Nonetheless, the VA continued to prescribe narcotics to

    Jones and permitted him to receive prescription refills through the

    mail.

    ____________________________________________________________

    1 Although each student also named the Department of Veterans Affairs

    as a defendant, the parties and the magistrate judge agree that the United

    States is the only proper defendant. Throughout this opinion we therefore

    treat the United States as the sole defendant.

                            3
    

    On three occasions, VA facilities admitted Jones as an inpatient for

    alcohol or alcohol and drug detoxification; the last admission began

    on August 3, 1996. During that admission, Jones was reported to be

    drunk and under the influence of narcotics, and to have left the cam-

    pus twice to drink. Throughout the admission, Jones demonstrated

    effects of alcohol and narcotics abuse including belligerent behavior,

    an unsteady gait, slurred speech, and a strong odor of alcohol. Later

    in August, Jones left the inpatient program without completing detox-

    ification.

    On August 30, 1996, after Jones had ceased to be an inpatient, a

    VA doctor prescribed narcotics for Jones in doses even greater than

    his usual heavy dose. On September 3, 1996, a VA employee, either

    a doctor or a staff member, permitted Jones to refill his prescription

    early. The next evening, driving under the influence of alcohol and

    narcotics, Jones caused the fatal accident. In sum, the students allege

    that "veteran Jones was being prescribed excessive narcotic drugs and

    other medications which, at the time of the collision, impaired his

    ability and judgment, and proximately caused said collision, and

    resulting injuries and damages" to them.2

    The students sued the United States, alleging that the accident was

    proximately and foreseeably caused by breaches of a number of duties

    that the VA purportedly owed to Jones and to the public. A magistrate

    judge recommended that the complaints be dismissed for failure to

    state a claim. Apparently concluding that all claims asserted in the

    complaints constituted claims of medical malpractice, the magistrate

    judge ruled that the complaints should be dismissed because North

    Carolina law does not "recognize a cause of action for medical mal-

    practice brought by [unrelated third party] victims of a patient who

    commits the type of crimes committed by Jones in these cases." The

    district court rejected the students' timely objections, accepted the

    ____________________________________________________________

    2 Jones was convicted of one count of driving while impaired, one

    count of assault with a deadly weapon, and three counts of assault with

    a deadly weapon inflicting serious injury. See State v. Jones, 538 S.E.2d

    917, 921 (N.C. 2000). On appeal, the Supreme Court of North Carolina

    vacated two additional convictions for the first-degree murder of Hansen

    and Witzl. Id. at 922.

                            4
    

    magistrate judge's recommendation, and dismissed all three cases.

    These appeals followed.

    In this federal tort claims action, arising out of events occurring in

    North Carolina, the law of that state controls. See FDIC v. Meyer, 510

    U.S. 471, 478 (1994). We must rule as the North Carolina courts

    would, treating decisions of the Supreme Court of North Carolina as

    binding, and "depart[ing] from an intermediate court's fully reasoned

    holding as to state law only if `convinced' that the state's highest

    court would not follow that holding." See Assicurazioni Generali,

    S.p.A. v. Neil, 160 F.3d 997, 1003 (4th Cir. 1998). The students con-

    tend that they have alleged not one, but two, kinds of claims against

    Jones's health care providers - medical malpractice claims and ordi-

    nary negligence claims - and that North Carolina law permits them

    to bring both kinds of claims. We consider their arguments with

    respect to each kind of claim in turn.

                           II.
    

    By statute, North Carolina 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 per-

    formance of medical, dental, or other health care by a health care pro-

    vider," including a doctor, a pharmacist, or a hospital. N.C. Gen. Stat.

    § 90-21.11 (1999). Unquestionably, some of the students' claims, spe-

    cifically those attacking the quality of the medical care the VA pro-

    vided to Jones in terms that track the statutory medical malpractice

    standard, constitute claims for medical malpractice. See N.C. Gen.

    Stat. § 90-21.12 (1999). Thus, it is clear that the students have alleged

    medical malpractice claims against Jones's health care providers.

    However, it is equally clear that North Carolina does not allow such

    claims. Rather, the Supreme Court of North Carolina has unequivo-

    cally held that "the relationship of physician to patient must be estab-

    lished as a prerequisite to an actionable claim for medical

    malpractice." Easter v. Lexington Mem'l Hosp., 278 S.E.2d 253, 255

    (N.C. 1981) (citation omitted).

    Nevertheless, the students insist that North Carolina law permits

    them, Jones's victims, to bring medical malpractice claims against

    Jones's health care providers. They rely on Pangburn v. Saad, 326

                            5
    

    S.E.2d 365 (N.C. Ct. App. 1985), and Mozingo v. Pitt County Memo-

    rial Hospital, 400 S.E.2d 747 (N.C. Ct. App. 1991). Neither case

    assists them.

    Pangburn simply holds that third party victims of a wrongly

    released mental patient may sue the patient's health care providers for

    negligent release. Pangburn, 326 S.E.2d at 367. A claim for negligent

    release is not a claim for medical malpractice. In Mozingo, although

    the North Carolina Court of Appeals did permit a plaintiff to pursue

    a medical malpractice claim against a doctor with whom he had no

    personal doctor-patient relationship, the plaintiff himself was a patient

    allegedly afforded inadequate medical care, not the victim of a patient

    afforded inadequate medical care. See Mozingo, 400 S.E.2d at 751-

    53; see also Webb v. Nash Hosps., Inc., 516 S.E.2d 191, 194 (N.C.

    Ct. App. 1999) (considering, but finding no facts to support, a Moz-

    ingo claim in a suit by a patient).

    Thus, the students have not cited, and we have not found, a single

    North Carolina case permitting unrelated third party victims of a

    patient to sue the patient's health care providers for medical malprac-

    tice, or even suggesting that such claims are possible.3 Instead, North

    Carolina courts have emphasized the policy reasons counseling rejec-

    tion of such suits; "`doctors should owe their duty to their patient and

    not to anyone else' so as not to compromise this primary duty." Rus-

    sell v. Adams, 482 S.E.2d 30, 33 (N.C. Ct. App. 1997) (rejecting a

    third party claim of harm based on the care provided by a medical

    provider to a patient) (citations omitted); see also Childers v. Frye,

    158 S.E. 744, 746 (N.C. 1931) (holding that doctors do not have to

    accept patients); Nash v. Royster, 127 S.E. 356, 359 (N.C. 1925)

    (holding that doctors may limit the extent of their responsibility to

    patients by narrowing the scope of the doctor-patient relationship).

    For these reasons, the district court properly dismissed the stu-

    ____________________________________________________________

    3 Of course, North Carolina has recognized that family members of an

    injured patient can sue the patient's health care providers for malpractice

    causing loss of consortium, see, e.g., Webb, 516 S.E.2d at 194, or loss

    of a child's services during his or her minority. See, e.g., Mozingo, 400

    S.E.2d at 749.

                            6
    

    dents' claims to the extent that the claims sound in medical malprac-

    tice.

                           III.
    

    The students, however, maintain that contrary to the holding of the

    district court, not all of the claims alleged in their complaints sound

    in medical malpractice. They contend that North Carolina distin-

    guishes between medical malpractice and ordinary negligence in the

    provision of health care. Moreover, they assert that they have alleged

    both kinds of claims in their complaints, and that state law permits

    them to bring ordinary negligence claims against Jones's health care

    providers, even if it does not allow them to bring medical malpractice

    claims.

                            A.
    

    North Carolina does permit a proper plaintiff to bring ordinary neg-

    ligence claims, in addition to medical malpractice claims, against a

    health care provider. By statute, North Carolina defines a medical

    malpractice action as one that "aris[es] out of the furnishing or failure

    to furnish professional services" by health care providers. N.C. Gen.

    Stat. § 90-21.11 (emphasis added). State courts have held that when

    a negligence claim against a health care provider does not "arise out"

    of the "furnishing" of "professional services," it is not a medical mal-

    practice claim, but rather may be brought as an ordinary negligence

    claim. See, e.g., Estate of Waters v. Jarman, 547 S.E.2d 142, 145-46

    (N.C. Ct. App. 2001) (ruling that when a claim against a hospital "ar-

    [ises] out of clinical care provided by the hospital to the patient," the

    claim sounds in medical malpractice, but when it "arises out of policy,

    management, or administrative decisions," it sounds in ordinary negli-

    gence).

    When bringing an ordinary negligence claim against a health care

    provider, a plaintiff need not assert in his complaint that the medical

    care has been reviewed by an expert who will testify that it did not

    comply with the applicable standard of care, as is required in medical

    malpractice actions. Id. Rather, courts apply "the reasonably prudent

    person" standard of care in assessing the sufficiency of a claim for

    "negligence on the part of the hospital for administrative or manage-

                            7
    

    ment deficiencies." Id. Thus, in such ordinary negligence actions the

    "liability of the defendant [health care provider] to the plaintiff

    depends on whether the defendant owed a duty of care to the plaintiff,

    which duty was violated, proximately causing injury to the plaintiff."

    Blanton v. Moses H. Cone Mem'l Hosp. Inc., 354 S.E.2d 455, 457

    (N.C. 1987).

    Moreover, North Carolina courts have enumerated a number of

    areas in which a hospital's breach of its duty may give rise to a suit

    for ordinary negligence, rather than medical malpractice. These

    include "fail[ing] to promulgate adequate safety rules relating to the

    handling, storage, and administering of medication," Bost v. Riley,

    262 S.E.2d 391, 396 (N.C. Ct. App. 1980) (citation omitted),

    endorsed in relevant part in Blanton, 354 S.E.2d at 455; "violat[ing]

    a safety standard which the hospital had purported to follow," Blan-

    ton, 354 S.E.2d at 458; "failing to follow hospital policies," Waters,

    547 S.E.2d at 145; failing to "monitor on an ongoing basis the perfor-

    mance of physicians on its staff," Blanton, 354 S.E.2d at 458; see also

    Waters, 547 S.E.2d at 145; and failing to "monitor and oversee . . .

    treatment." Bost, 262 S.E.2d at 397. See also Blanton, 354 S.E.2d at

    458 (citing additional ordinary duties); Waters, 547 S.E.2d at 145

    (same); Taylor v. Vencor, Inc., 525 S.E.2d 201, 203 (N.C. Ct. App.

    2000) (same); Bost, 262 S.E.2d at 396-97 (same).

    Review of the students' amended complaints plainly reveals that

    they have alleged that VA employees owed them a duty of care in a

    number of these areas. For example, they allege that the VA owed

    them duties relating to the training, monitoring, and supervision of its

    staff, and had an "obligation to maintain appropriate policies and pro-

    cedures to provide proper treatment of its patients, including those

    addicted to drugs and alcohol." All three amended complaints also

    allege that in violation of its duty of care, the VA failed to promulgate

    adequate policies and procedures to regulate the dispensation of nar-

    cotics to drug-addicted patients, failed to follow existing policies and

    procedures to the same end, and failed to communicate with its staff

    on these issues.

    Therefore, despite the contrary contentions of the United States and

    the conclusions of the district court, the students clearly do not assert

                            8
    

    only medical malpractice claims. They also seek to hold the VA liable

    in ordinary negligence.

                            B.
    

    It is less clear whether North Carolina allows third parties who are

    victims of patients to pursue ordinary negligence claims against the

    patients' health care providers, and if so, whether the students have

    adequately pled such a claim.

    As with medical malpractice claims, the students have not cited,

    and we have not found, any case in which the North Carolina courts

    have permitted a third party victim of a patient to bring an ordinary

    negligence action against a hospital.4 Cf. Blanton, 354 S.E.2d 455

    (suit by a patient); Waters, 547 S.E.2d at 143 (suit by a patient's

    estate); Taylor, 525 S.E.2d at 202 (same); Bost, 262 S.E.2d at 391

    (same). Indeed, North Carolina courts have repeatedly discussed ordi-

    nary negligence claims against health care providers as involving a

    duty that "a hospital . . . owes to its patients." Blanton, 354 S.E.2d at

    458; see also, e.g., Muse v. Charter Hosp. of Winston-Salem, Inc., 452

    S.E.2d 589, 594 (N.C. Ct. App. 1995); Burns v. Forsyth County Hosp.

    Auth. Inc., 344 S.E.2d 839, 845-46 (N.C. Ct. App. 1986); Bost, 262

    S.E.2d at 396. However, although these cases do state that hospitals

    owe such duties to patients, no North Carolina case states (or sug-

    gests) that hospitals owe such duties only to patients.

    Moreover, in a major decision analyzing and specifically permit-

    ting suits against hospitals based on ordinary negligence, the Supreme

    Court of North Carolina repeatedly emphasized that this cause of

    action represents "no more than the application of common law prin-

    ciples of negligence." Blanton, 354 S.E.2d at 457; see also id. at 459.

    This emphasis by the Supreme Court of North Carolina seems to

    direct courts to apply general principles of negligence in determining

    ____________________________________________________________

    4 The Pangburn court considered principles of ordinary negligence in

    permitting a claim for negligent release of a mental patient, but held that

    in conjunction with statutory immunity, such a claim would only be cog-

    nizable for "`wilful, wanton or recklessly' negligent acts or . . . inten-

    tional acts." 326 S.E.2d at 338 (citation omitted).

                            9
    

    whether a plaintiff has alleged a claim of ordinary negligence against

    a health care provider.

    Generally, North Carolina does permit suits by third parties for

    negligence under certain defined circumstances. Most significantly

    for the present case, in Hart v. Ivey, 420 S.E.2d 174 (N.C. 1992), the

    Supreme Court of North Carolina considered "the liability of a social

    host who serves an alcoholic beverage to a person who then injures

    someone while operating an automobile while under the influence of

    an intoxicating beverage." Id. at 177. The Hart court held that the

    third party victim of a drunk driver could sue a social host who served

    alcohol to the driver, if the host "knew or should have known" that

    the person served "was under the influence of alcohol [and] . . . would

    shortly thereafter drive an automobile." Id. at 178.

    The decision of North Carolina's highest court in Hart is obviously

    instructive in the present case, also involving provision of an intoxi-

    cant to a driver.5 Although serving alcohol violates a state statute bar-

    ring the provision of alcohol to persons under age 21, the Hart court

    expressly refused to base its decision on the statute. Id. at 176-77.

    Instead, the court relied on the common law duty of "every person

    who enters upon an active course of conduct . . . to exercise ordinary

    care to protect others from harm," and emphasized that its decision

    did not "recogniz[e] a new claim" but "appl[ied] established negli-

    gence principles." Id. at 178 (internal quotation marks and citation

    omitted). This emphasis seems particularly significant here given the

    Supreme Court of North Carolina's similar directive in Blanton that

    claims against hospitals for negligence (other than medical malprac-

    tice) are to be based on and governed by general ordinary negligence

    principles. See 354 S.E.2d at 457; see also Pangburn, 326 S.E.2d at

    367 (relying on ordinary principles of negligence to allow suit by a

    third party for negligent release of a mental patient).

    ____________________________________________________________

    5 The United States does not suggest that the difference in the intoxi-

    cant assertedly provided - narcotics rather than alcohol - distinguishes

    this case from Hart. This seems unlikely given that North Carolina treats

    alcohol and narcotics identically in all relevant respects for purposes of

    motor vehicle offenses. See N.C. Gen. Stat. §§ 20-138.1(a), 20-138.3(a)

    (1999).

                            10
    

    To be sure, a hospital's legal position presents more complications

    than that of a social host. Having accepted Jones as a patient, the VA

    had an affirmative duty to him, see, e.g., Russell, 482 S.E.2d at 33,

    a duty potentially in tension with its duty to the public if the latter

    required the hospital to restrict Jones's access to pain killers. A social

    host, meanwhile, whatever advertisers may suggest, has no positive

    duty to serve alcohol to guests. But North Carolina courts have

    acknowledged similar concerns in other cases simply by limiting ordi-

    nary negligence claims in the health care setting, not by barring such

    claims entirely. For example, in Blanton, the court allowed a suit

    against a hospital based on negligent failure to provide assistance to

    a doctor unqualified for his task, but required that the plaintiff show

    that the hospital knew the doctor to be unqualified. 354 S.E.2d at 459.

    Thus, it seems unlikely that a North Carolina court would hold that

    a potential conflict with the hospital's duty to treat Jones's pain elimi-

    nates, as a matter of law, its duty to "exercise ordinary care to protect

    others from harm." Hart, 420 S.E.2d at 178 (internal quotation marks

    and citation omitted).

    In the case at hand, however, we need not definitively determine

    whether the Supreme Court of North Carolina would permit a third

    party victim of a patient to bring a properly pled ordinary negligence

    action against the patient's medical care providers. This is so because,

    even if such a claim exists under North Carolina law, the students

    have not alleged the facts necessary to support such a claim.

    Hart (and its progeny) provide the only potential basis in North

    Carolina law for the students' claim that a third party victim can

    recover from a patient's medical provider for negligent provision of

    an intoxicant to the patient.6 However, neither Hart nor the cases that

    follow it contains a discussion of the policy animating the approach

    taken. In the absence of such a discussion, we have few clues as to

    how the North Carolina courts would deal with certain differences

    between the Hart line of cases and the students' claims here. For

    example, a social host may fairly assume that a guest will immedi-

    ately drink any alcohol provided, limiting the time frame of any fore-

    seeable harm to third parties, while the timing of consumption of

    ____________________________________________________________

    6 The medical context of the present case, of course, distinguishes it

    from those cited by the students that concern other professions.

                            11
    

    prescription drugs is less clear. On the other hand, the Supreme Court

    of North Carolina has not distinguished between social hosts who pro-

    vide alcohol and commercial providers of alcohol, and the latter

    might well argue that they too could not be sure of the timing of con-

    sumption. See, e.g., Estate of Mullis v. Monroe Oil Co., 505 S.E.2d

    131 (N.C. 1998). In considering what a North Carolina court would

    do in the present circumstance, we are guided by North Carolina's

    apparent wariness of health care claims by third parties, evidenced

    both by its flat ban on medical malpractice suits by third party vic-

    tims, and the total absence of ordinary negligence cases permitting

    recovery against a health care provider by a third party victim.7 Given

    that background, we can only conclude that North Carolina would

    require a tight nexus between the provision of narcotics and the harm

    to the victim, if it permitted third party plaintiffs to recover at all.

    In Hart and its progeny, facing a similar calculus, the Supreme

    Court of North Carolina required a plaintiff to prove that the defen-

    dant possessed knowledge of the risk attendant to his negligent con-

    duct. Indeed, North Carolina law subsequent to Hart makes it

    unmistakably clear that a claim based on negligent provision of alco-

    hol to a driver cannot succeed without a showing that at the time the

    defendant supplied alcohol to the driver, he knew or should have

    known that the driver was intoxicated. See Estate of Mullis, 505

    S.E.2d 131 (affirming summary judgment in favor of a commercial

    vendor); Camalier v. Jeffries, 460 S.E.2d 133 (N.C. 1995) (affirming

    summary judgment in favor of a social host). Accord Smith v. Winn

    Dixie Charlotte, Inc., 542 S.E.2d 288, 293 (N.C. Ct. App. 2001). Both

    Estate of Mullis, 505 S.E.2d at 136, and Camalier, 460 S.E.2d at 134-

    35, affirmed grants of summary judgment to defendants sued by third

    party victims because the victim had presented no evidence of such

    knowledge; in both cases the plaintiff alleged and offered evidence of

    an automobile accident, caused by a drunken driver, to whom the

    defendant had supplied alcohol knowing that he would shortly drive

    ____________________________________________________________

    7 Only Pangburn even arguably permitted such a claim. Beyond its lim-

    itation by operation of statutory immunity to cases involving more than

    "ordinary negligent acts," 326 S.E.2d at 337-38; see supra n.4, that case

    involved specific knowledge by the health-care provider of a threat to a

    specific victim. Id. at 347-48. Pangburn thus supports our holding as to

    Hart's application in the present context.

                            12
    

    a car. However, because the plaintiff failed to offer evidence that the

    defendant knew or should have known the driver was impaired at the

    time the alcohol was supplied to him, North Carolina's highest court

    held that the plaintiffs' claims failed, making it evident that such

    knowledge is a necessary element of such a claim. Estate of Mullis,

    505 S.E.2d at 138; Camalier, 460 S.E.2d at 139. If it permitted liabil-

    ity at all in the case at hand, we believe North Carolina would require

    similar knowledge.

    In sum, given the post-Hart decisions, we are not sure whether the

    North Carolina courts would allow a suit by a third party against a

    hospital for negligently providing narcotics to a driver. If so, we

    believe that North Carolina courts would, at a minimum, require a

    third party plaintiff to allege that the hospital "knew or should have

    known," when dispensing the drugs, that the patient was "under the

    influence of alcohol" or narcotics and "would shortly thereafter drive

    an automobile." Hart, 420 S.E.2d at 178. The students never make

    equivalent allegations.

    They do allege that when VA officials treated Jones "during

    August-September, 1996" they "w[ere] aware, or should have been

    aware" of his history of drug and alcohol addiction and yet "continued

    to prescribe large doses of narcotics"; that "prior to and on September

    4, 1996 . . . Jones was being prescribed drugs . . . which . . . impaired

    his ability . . . and proximately caused . . . [the] collision"; that "[a]s

    a proximate result of [the] VA's negligence [including a failure to

    supervise, manage, and administer proper dispensation of narcotics]

    . . . Jones operated his vehicle on September 4, 1996 while impaired

    from drugs or the combination of drugs and alcohol; and, as a result

    of his impairment, caused the collision"; and finally that "[i]t was rea-

    sonably foreseeable that" the VA's negligent acts "could or would

    result in injury or death to one or more third persons." However, the

    students never allege that when VA employees furnished Jones with

    narcotics, the employees knew or should have known that Jones was

    at that time "under the influence of alcohol" or narcotics and "would

    shortly thereafter drive an automobile." Hart, 420 S.E.2d at 178.

    Without such allegations, their ordinary negligence claims must fail.

    We recognize that, unlike Camalier and Estate of Mullis, which

    involved summary judgments, in this case the district court dismissed

                            13
    

    the complaints for failure to state a claim. This difference in proce-

    dural posture would be significant if the students had alleged facts

    sufficient to state the substantive elements of their claim. In this case,

    they did not. Because the students have not alleged that when VA

    employees provided narcotics to Jones, they knew or should have

    known that Jones at that time was intoxicated and would shortly be

    driving, they have failed to allege the elements necessary to state an

    ordinary negligence claim under Hart against the VA, even if North

    Carolina would permit such a claim.8 Dismissal of a complaint for

    failure to state facts supporting each of the elements of a claim is, of

    course, proper. See, e.g., Winters v. Lee, 446 S.E.2d 123, 126 (N.C.

    Ct. App. 1994) (affirming dismissal of complaint attempting to assert

    Hart claim because it failed "to allege facts sufficient to satisfy [one

    of] the substantive elements of common law negligence" (internal

    quotation marks and citation omitted)).

    Thus, we do not affirm here because the students failed to forecast

    evidence sufficient to prove an element of an ordinary negligence

    claim, as the courts did in Camalier and Estate of Mullis, but because

    the students have failed to allege facts sufficient to state elements of

    such a claim. Even in these days of notice pleadings, see Swierkiewicz

    v. Sorema, N.A., ___ U.S. ___, 122 S. Ct. 992 (2002), a complaint

    asserting a negligence claim must disclose "that each of the elements

    is present in order to be sufficient." 5 Charles Alan Wright & Arthur

    R. Miller, Federal Practice and Procedure § 1249 (2d ed. 1990 &

    Supp. 2001) (citing cases to the effect that the elements of negligence

    "are as essential under modern pleading as they ever were").

                           IV.
    

    For the foregoing reasons, the judgments of the district court are

                                            AFFIRMED.
    

    ____________________________________________________________

    8 Nor is dismissal without prejudice appropriate since there is no reason

    to believe that the students could have alleged as much. The fatal acci-

    dent did not occur until 10:30 p.m. on September 4, and none of the stu-

    dents suggest that Jones saw anyone at the VA on that date.

                            14
    

    FindLaw Career Center

      Search for Law Jobs:

        Post a Job  |  View More Jobs
    Ads by FindLaw