Facts: In labor with her first child, Kelly Beilke was admitted to St. Luke's Hospital on November 18, 1989. On her admittance, it was noted on her chart that she was allergic to latex, which is similar to rubber. It was also noted at this time that Kelly's blood pressure was "elevated." She was given an epidural for relief of pain.

Later in the evening, nurse Coryell decided that it would be best to catheterize Kelly because the epidural would have made it impossible for Kelly to feel the need to urinate. Although testimony at trial suggests that nurse Coryell was informed that Kelly was allergic to rubber and Coryell's own testimony makes it clear that this information was at least readily available, she used a rubber catheter. At trial, Kelly testified that although she could not feel the catheter, after the catheterization she began to feel a warm and itchy sensation and shortness of breath. Kelly was given Benadryl to alleviate her allergy symptoms. Subsequently, the baby's heart rate dropped and an emergency forceps procedure was used to deliver the baby.

Matthew was not breathing when he was born and had to be cared for in the intensive care nursery. He has been diagnosed with cerebral palsy. The Beilkes contended at the trial that nurse Coryell's use of the rubber catheter caused an allergic reaction which eventually resulted in Matthew's cerebral palsy. After listening to substantial expert testimony, some supporting this theory and some rejecting it, the jury decided that the use of the rubber catheter was negligence but found that this negligence was not a proximate cause of the damages of which the Beilkes complained.

Court Decision: In this case the Supreme Court of North Dakota affirmed the judgment of the lower court releasing the nurse and the hospital from any liability because the plaintiffs did not prove that a "defendant's" negligent conduct was a "proximate cause" of the injury alleged. The jury apparently believed the testimony presented by the defense that the use of rubber catheter, although a negligent conduct, was not a cause of the child's cerebral palsy. Here's how the court describes what constitutes proximate cause:

A proximate cause is a cause which, in natural and continuous sequence, produces the injury and without which the injury would not have occurred. It is a cause which had a substantial part in bringing about the injury either immediately or through happenings which follow one another. There may be more than one proximate cause of the injury. The fault of two or more persons may contribute to cause the injury, and in such case each person's fault is regarded as a proximate cause.

The negligence or other wrongful conduct of two or more persons may contribute concurrently as the proximate causes of an injury, and to be a proximate cause of an injury one's conduct need not be the last cause nor the sole cause of the injury. To warrant a finding that one's conduct is the proximate cause of an injury, it must appear that the injury was the natural and probable result of the conduct and that it ought to have been foreseen or reasonably anticipated by the defendant as a probable result of the conduct.

In the instant case, the jury was instructed that a proximate cause is "a cause which had a substantial part in bringing about the injury either immediately or through happenings which follow one another." This part of the instruction informs the jury that other events or causes that occur simultaneously with or that follow the defendants' negligence will not negate the defendants' liability.

Here the trial court gave a complete proximate cause instruction which included the statement that "there may be more than one proximate cause of the injury."

The jury apparently believed the defense's testimony that the use of the rubber catheter was not a cause of Matthew's cerebral palsy.

Proximate Cause: Nurse Uses Rubber Catheter on a Pregnant Patient Allergic to Rubber

We find no reversible error in the trial court's jury instructions. Therefore, we affirm the denial of the motion for a new trial.