Chief Nursing Officer – State-Agent Immunity

Ex parte Lisa Mestas, [Ms. 1200362, May 27, 2022] __ So. 3d __ (Ala. 2022). The Court (Shaw, J.; Bolin, Wise, Bryan, Sellers, and Mitchell, JJ., concur; Parker, C.J., and Mendheim and Stewart, JJ., concur in the result) grants Lisa Mestas’s (“Mestas”) petition for writ of mandamus directing the Mobile Circuit Court to grant her motion for summary judgment dismissing her from a medical negligence wrongful death case arising from the death of Bridgette Ann Moore at USA Medical Center. The Court concludes that Mestas established a clear legal right to dismissal based on State-agent immunity. The Court determines that Mestas established as a matter of law that given her essential job functions as Chief Nursing Officer of University of South Alabama Health System, including USA Medical Center, she was entitled to immunity under category 1 of Cranman “(1) formulating plans, policies, or designs” for a State agency. Ms. *7.

The Plaintiff submitted unchallenged affidavit testimony of Kimberly Arnold, a similarly situated CNO for an Arkansas hospital, contradicting Mestas’s assertions that she performed only administrative duties. The Court notes Arnold’s testimony that “the actions of CNOs like Mestas ‘directly affect patient care and patient safety.’ She indicated that Mestas’s ‘essential job functions,’ … were ‘mandatory and nondiscretionary requirements of the CNO at any hospital,’ including USA Medical Center.” Ms. *12. Despite this unchallenged expert testimony, the Court holds

Mestas is a State agent, and her job functions in creating standards of care and practice, assuring compliance with those standards, evaluating and developing systems for quality improvement, and advocating for patient safety are all actions in formulating plans and policies and exercising judgment in the administration of an agency for which Ex parte Cranman provides immunity. The evidence shows that Mestas performs administrative functions governing how clinical staff, including nurses, provide care to patients, including any care that might have been informed by the Joint Commission publications. To the extent that Arnold’s testimony shows that Mestas had a duty to implement Joint Commission guidance and failed to do so in a way that contributed to Moore’s death, that is relevant only as to whether Mestas was negligent in performing her functions, not as to whether the performance of her functions is protected by State-agent immunity in the first place.[] Autrey’s answer and respondent’s brief do not establish that Mestas’s alleged acts or omissions in this case were not the type of conduct covered by State-agent immunity.

Ms. **15-16.

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