Kale v. Gupta
CourtCourt of Appeals of North Carolina
Date FiledNovember 4, 2026
Docket25-542
JudgeJudge Jeff Carpenter
StatusPublished
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Full Opinion
IN THE COURT OF APPEALS OF NORTH CAROLINA
No. COA25-542
Filed 4 November 2026
Randolph County, No. 19CVS000872-750
MAGAN NANCE KALE, Plaintiff,
v.
RAJESH GUPTA, MD, RANDOLPH
GASTROENTEROLOGY CENTER, PA,
and RANDOLPH HOSPITAL, INC.
d/b/a RANDOLPH HOSPITAL, Defendants.
Appeal by Plaintiff from orders entered 31 May 2023 and 6 March 2025 by
Judge Vance Bradford Long in Randolph County Superior Court. Heard in the Court
of Appeals 10 February 2026.
Brown, Moore & Associates, PLLC, by Matthew Berthold, and Tin Fulton
Walker & Owen, PLLC, by Lauren Newton, for Plaintiff-Appellant.
Hall Booth Smith, P.C., by Brenda S. McClearn and Katherine W. Dandy, for
Defendant-Appellee Randolph Hospital.
Walker Allen, LLP, by Norman F. Klick, Jr. and Jacob R. Stump, for
Defendants-Appellees Rajesh Gupta, M.D. and Randolph Gastroenterology
Center, P.A.
CARPENTER, Judge.
Magan Nance Kale (“Plaintiff”) appeals after a trial court entered a protective
order as to her discovery request in favor of Rajesh Gupta, M.D., Randolph
Gastroenterology Center, P.A., and Randolph Hospital, Inc. (collectively,
“Defendants”), and granted summary judgment in favor of Defendant Hospital. On
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appeal, Plaintiff argues that the trial court erred by: (1) granting the protective order;
and (2) granting Defendant Hospital’s summary judgment motion. Defendants filed
two motions to dismiss the appeal (“MDAs”). After careful review, we affirm in part,
reverse in part, and remand.
I. Factual & Procedural Background
This appeal concerns the direct and vicarious liability of medical centers after
a doctor allegedly sexually assaulted a patient. On 18 October 2021 and 12 November
2021, Plaintiff served motions to compel documents from Defendant Hospital related
to documents about Defendant Gupta, which were reviewed by its credentialing
committee. On 29 November 2021, Defendants Gupta and Center filed a motion for
a protective order, which the trial court granted in part and denied in part. On 23
February 2023, Defendant Hospital moved for summary judgment, which the trial
court also granted. In the light most favorable to Plaintiff, the evidence tended to
show the following.
Plaintiff is a nurse at Defendant Hospital, who occasionally worked with
Defendant Gupta. On 20 June 2016, Defendant Gupta performed a colonoscopy on
Plaintiff at Defendant Hospital. Defendant Hospital did not determine the
anesthesia required for Plaintiff’s colonoscopy, did not decide that Plaintiff needed a
colonoscopy, did not prohibit Defendant Gupta from working in his own practice at
Defendant Center, and did not pay Defendant Gupta a wage.
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While alone in the recovery room after the colonoscopy, Defendant Gupta
touched Plaintiff, who was waking up from anesthesia, with his fingers and mouth.
Plaintiff told a nurse about the incident, and the nurse informed Defendant Hospital.
The next day, Plaintiff met with Defendant Hospital and the Asheboro Police
Department. The police department did not file any charges against Defendant
Gupta. Later, Plaintiff began experiencing signs of Post-Traumatic Stress Disorder
and sought treatment.
On 18 April 2019, Plaintiff filed a complaint alleging medical malpractice and
other tort claims against Defendants. As to Defendant Gupta, Plaintiff asserted
claims of negligence, battery, negligent infliction of emotional distress (“NIED”), and
intentional infliction of emotional distress (“IIED”). Plaintiff also alleged that
Defendant Center was vicariously liable for negligence and battery and directly liable
for NIED, IIED, and negligent credentialing, supervision, and retention of Defendant
Gupta. Plaintiff further alleged that Defendant Hospital was vicariously liable for
negligence and battery and directly liable for negligence, NIED, IIED, and negligent
credentialing, supervision, and retention of Defendant Gupta. Plaintiff claimed
damages in excess of $25,000.
As to Plaintiff’s medical malpractice claims, she included a Rule 9(j)
certification as to anticipated Rule 702 issues. Plaintiff also clarified that not all of
her claims “allege medical malpractice by a healthcare provider . . . in failing to
comply with the applicable standard of care[.]” Rather, the complaint alleged claims
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that fall “outside the requirements of Rule 9(j) of the Rules of Civil Procedure[.]”
Defendants Gupta and Center answered jointly, denying the claims and pleading the
affirmative defenses of contributory negligence, assumption of risk, and failure to
mitigate damages. Defendant Hospital answered separately, denying the claims and
pleading affirmative defenses, including contributory negligence.
In her response to Rule 9(j) interrogatories from Defendants, Plaintiff disclosed
two proposed experts: a healthcare administration consultant who stated that “Dr.
Gupta and Randolph Hospital, along with its agent, employees and servants, did not
comply with the applicable standards of care[,]” and a medical doctor who opined that
“Dr. Gupta did not comply with the applicable standards of care.” The medical expert
was a gastroenterologist from Florida. In the year prior to Plaintiff’s complaint, the
medical expert spent eighty-five percent of his time in clinical practice and fifteen
percent of his time teaching. The healthcare administration consultant was not a
licensed healthcare provider. Nevertheless, he held a graduate degree in hospital
administration; had a decades-long career in hospital management and operations;
held multiple academic appointments to teach healthcare administration; held
various memberships, including with the American College of Healthcare Executives;
and published and presented on issues related to healthcare management, including
hospital negligence and sexual assault.
During depositions, defense counsel asked Plaintiff, “So you were aware that a
lot of the physicians, including Dr. Gupta, were actually not employees of the hospital
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at all.” Plaintiff responded, “Yes they were not actual employees.” Plaintiff further
indicated that, as a nurse at Defendant Hospital, she knew that consent forms
routinely stated that physicians are “independent” from the hospital.
Plaintiff also inquired about the medical review committee of Defendant
Hospital, Defendant Gupta’s credentialing, and Defendant Hospital’s chaperone
policy. An employee of Defendant Hospital stated that, when applying for hospital
privileges around 2023, Defendant Gupta completed an application, and the medical
staff office “validated his credentials, his experience, his education, references, got
everything together, presented it to credentials committee and those physicians
reviewed everything, and then they [made] the recommendation to the med exec
committee.” Additionally, Defendant Hospital re-evaluated Defendant Gupta every
two years upon his biannual re-application for hospital privileges, including
researching the National Practitioner Data Bank.
Further, Defendant Hospital’s expert, a medical doctor, stated that Defendant
Hospital did not have a chaperone policy requiring third parties to be present in
rooms with patients and physicians and that having a third party present for
sensitive exams “was a common practice” but not required. Defendant Hospital’s
administrative expert also testified that he recommended the presence of a chaperone
during sensitive exams. Defendant Hospital’s vice president of quality and
accreditation testified that the presence of a third party in a patient room during a
sensitive exam would likely reduce the chance of sexual misconduct. Plaintiff’s
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expert, a healthcare administration consultant, testified that hospitals have a duty
to care for their patients through a chaperone policy.
Plaintiff served Defendant Hospital with requests for production of documents
related to its medical review committee, including “incident reports concerning Dr.
Gupta’s treatment of patients, employment agreements, and complaints and direct
allegations from any person regarding Dr. Gupta, as well as Dr. Gupta’s personnel
file, credentialing file, and documents relating to Dr. Gupta’s training including tests,
reports, and grades.” When Defendants did not produce the medical review
committee documents, Plaintiff filed two motions to compel. Later, Defendants
Gupta and Center filed a motion for a protective order.
By an order filed 18 January 2022, the trial court denied Plaintiff’s motion to
compel in part, finding in relevant part that the credentialing committee was a
medical review committee and Defendant Gupta’s credentialing file was not
discoverable from Defendant Hospital. On 13 January 2023, the trial court granted
in part and denied in part Plaintiff’s second motion to compel, finding that associated
materials from the witness nurse were discoverable but the privilege log from
Defendant Hospital was not. Finally, on 31 May 2023, the trial court granted the
protective order in favor of Defendants Gupta and Center.
On 23 February 2023, Defendant Hospital moved for summary judgment. It
argued that Defendant Gupta was not an agent or employee of Defendant Hospital
and that it was not directly negligent. Plaintiff objected and moved to continue the
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hearing, contending that the motion was “drastically premature with ongoing and
pending discovery[.]”
After a new judge was assigned to the case, Defendant Hospital again moved
for summary judgment. It stated that, although it had filed a motion earlier,
“Plaintiff requested additional time for discovery, so the motion was never heard.”
On 6 March 2025, the trial court granted summary judgment as to Defendant
Hospital, dismissing Plaintiff’s claims against Defendant Hospital with prejudice. On
7 March 2025, Plaintiff timely appealed.
II. Jurisdiction
As an initial matter, we must determine whether we have jurisdiction to
review the appeal. Plaintiff argues the trial court’s rulings implicate a substantial
right absent immediate review because it wrongfully withholds material discovery
information and may lead to inconsistent verdicts.
“In most instances, a party has ‘no right of immediate appeal from
interlocutory orders and judgments.’ ” Bartels v. Franklin Operations, LLC, 288 N.C.
App. 193, 195, 885 S.E.2d 357, 359 (2023) (quoting Goldston v. Am. Motors Corp., 326
N.C. 723, 725, 392 S.E.2d 735, 736 (1990)). “An interlocutory order is one made
during the pendency of an action, which does not dispose of the case, but leaves it for
further action by the trial court in order to settle and determine the entire
controversy.” Veazey v. City of Durham, 231 N.C. 357, 362, 57 S.E.2d 377, 381 (1950).
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Interlocutory orders, however, are immediately appealable “when the
challenged order affects a substantial right.” Denney v. Wardson Constr., Inc., 264
N.C. App. 15, 17, 824 S.E.2d 436, 438 (2019). “A substantial right is a legal right
affecting or involving a matter of substance as distinguished from matters of form; a
right materially affecting those interests which a [party] is entitled to have preserved
and protected by law: a material right.” Pentecostal Pilgrims & Strangers Corp. v.
Connor, 202 N.C. App. 128, 132, 688 S.E.2d 81, 84 (2010) (internal quotation marks
and citation omitted).
A. Discovery of Credentialing File
Plaintiff argues that the protective order affects a substantial right because
the credentialing file contains highly material information. In an MDA filed 14
October 2025, Defendants Gupta and Center jointly moved to dismiss the appeal,
contending that the trial court’s grant of a protective order does not affect a
substantial right. Plaintiff, however, asserts that this Court should deny the MDA
and consider sanctions due to the failure of Defendants Gupta and Center to join
Defendant Hospital’s earlier MDA.
Interlocutory orders denying discovery can affect a substantial right “(1) ‘if the
information desired is highly material to a determination of the critical question to
be resolved in the case,’ and (2) if ‘the desired discovery would not have delayed trial
or have caused the opposing party any unreasonable annoyance, embarrassment,
oppression or undue burden or expense.’ ” James v. Bledsoe, 198 N.C. App. 339, 345,
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679 S.E.2d 494, 498 (2009) (quoting Dworsky v. Travelers Ins. Co., 49 N.C. App. 446,
447–48, 271 S.E.2d 522, 523 (1980)). A party, however, is “not entitled to a fishing
expedition” to locate the evidence it seeks, and the record must show cause as to “what
relevant and material information, if indeed there is any, is sought.” Dworsky, 49
N.C. App. at 448, 271 S.E.2d at 524.
Here, Defendant Gupta’s credentialing file was highly material and would not
be unduly burdensome to produce. See James, 198 N.C. App. at 343, 679 S.E.2d at
497. A critical issue in this case was whether Defendant Hospital negligently
credentialed Defendant Gupta. Thus, Defendant Gupta’s credentialing file, which
the medical review committee of Defendant Hospital considered in its decision, was
highly material. See id. at 343, 679 S.E.2d at 497. Further, Defendant Hospital could
obtain the credentialing file from its own credentialing committee without undue
burden, expense, or delay. See id. at 343, 679 S.E.2d at 497. Accordingly, the trial
court’s protective order denying Plaintiff access to Defendant Gupta’s credentialing
file affects a substantial right and is therefore immediately appealable. See James,
198 N.C. App. at 345, 679 S.E.2d at 498; Sessions v. Sloane, 248 N.C. App. 370, 380,
789 S.E.2d 844, 853 (2016). We, therefore, deny Defendants Gupta and Center’s
MDA.
B. Inconsistent Verdicts
Plaintiff argues that her appeal of the summary judgment order affects a
substantial right because it may lead to inconsistent verdicts. On 6 June 2025,
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Defendant Hospital filed an MDA asserting that the trial court’s grant of summary
judgment in favor of Defendant Hospital was not immediately appealable. Plaintiff,
however, contends that this Court should deny Defendant Hospital’s MDA for lack of
proper service and failure to include a good-faith statement.
A challenged order or judgment that creates “a risk of ‘inconsistent verdicts,’
meaning ‘a risk that different fact-finders would reach irreconcilable results when
examining the same factual issues a second time[,]’ ” may entitle a party to immediate
appellate review under a substantial right theory. Doe v. City of Charlotte, 273 N.C.
10, 21, 848 S.E.2d 1, 10 (2020) (quoting Denney, 264 N.C. App. at 19, 824 S.E.2d at
439). Yet, “a party’s preference for having all related claims determined during the
course of a single proceeding does not rise to the level of a substantial right.”
Hamilton v. Mortg. Info. Servs., Inc., 212 N.C. App. 73, 79, 711 S.E.2d 185, 190 (2011).
While a party has “ ‘the substantial right to avoid two separate trials of the
same issues . . . avoiding separate trials of different issues is not a substantial
right.’ ” Id. at 79, 711 S.E.2d at 190 (quoting J & B Slurry Seal Co. v. Mid-South
Aviation, Inc., 88 N.C. App. 1, 7, 362 S.E.2d 812, 816 (1987)). “Issues are the ‘same’
if the facts relevant to their resolution overlap in such a way as to create a risk that
separate litigation of those issues might result in inconsistent verdicts.” Id. at 79,
711 S.E.2d at 190 (citation omitted). This Court “evaluate[s] the specific proof
required to litigate each claim in order to determine whether inconsistent verdicts
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might result in the event that we refrained from considering [a party’s] appeal on the
merits at this time.” Id. at 81, 711 S.E.2d at 191.
In Coastal Plains Utilities, Incorporated v. New Hanover County, the plaintiff
alleged several torts, including negligence, against five defendants after construction
of a water system. 166 N.C. App. 333, 337–38, 601 S.E.2d 915, 919 (2004). The trial
court granted summary judgment as to three defendants, which the plaintiff
appealed. Id. at 338, 601 S.E.2d at 919. On appeal, we determined that “there [wa]s
a potential for inconsistent verdicts[.]” Id. at 340, 601 S.E.2d at 920. “Because [the
plaintiff] asserts claims based on direct liability as well as respondeat superior,
subsequent trials would not be limited to the issue whether a master-servant or
principal-agent relationship existed.” Id. at 339, 601 S.E.2d at 920. “For example, in
a trial against [one defendant], a jury could find that [the plaintiff’s] damages
resulted from [another defendant], while the jury in a second trial could find that the
damages arose out of an unrelated deterioration to the [plaintiff’s] system.” Id. at
340, 601 S.E.2d at 920. Accordingly, this Court concluded that the appeal implicated
a substantial right because of the possibility of inconsistent verdicts. Id. at 340, 601
S.E.2d at 920.
In this case, Plaintiff faces the possibility of inconsistent verdicts. See Doe, 273
N.C. at 21, 848 S.E.2d at 10. The factual issues underlying Plaintiff’s claims against
Defendants Gupta, Center, and Hospital substantially overlap. See Hamilton, 212
N.C. App. at 79, 711 S.E.2d at 190. Moreover, because Plaintiff’s complaint includes
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claims related to the direct and vicarious liability of Defendant Hospital, the jury in
a second trial could find the issue of liability differently. See Coastal Plains Utils.,
Inc., 166 N.C. App. at 340, 601 S.E.2d at 920. Thus, the summary judgment order
implicates a substantial right. See Denney, 264 N.C. App. at 17, 824 S.E.2d at 438.
We, therefore, deny Defendant Hospital’s MDA.
III. Issues
The issues on appeal are whether the trial court erred by: (1) entering a
protective order for Defendant Gupta’s credentialing file; and (2) granting Defendant
Hospital’s summary judgment motion.
IV. Analysis
A. Protective Order
Plaintiff first argues that the trial court erred in concluding that Defendant
Gupta’s credentialing file was privileged because Defendant Gupta, not the
credentialing committee of Defendant Hospital, created the file. We disagree.
“It is ‘well established that orders regarding discovery matters are within the
discretion of the trial court and will not be upset on appeal absent a showing of abuse
of that discretion.’ ” Windman v. Britthaven, Inc., 173 N.C. App. 630, 632, 619 S.E.2d
522, 524 (2005) (quoting Velez v. Dick Keffer Pontiac-GMC Truck, Inc., 144 N.C. App.
589, 595, 551 S.E.2d 873, 877 (2001)). Yet, “on appeal from a trial court’s discovery
order implicating the medical review privilege, this Court reviews de novo whether
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the requested documents are privileged under N.C. Gen. Stat. § 131E-95(b).”
Hammond v. Saini, 229 N.C. App. 359, 365, 748 S.E.2d 585, 589 (2013) (cleaned up).
Under North Carolina law, a medical review committee is “formed for the
purpose of evaluating the quality, cost of, or necessity for hospitalization or health
care, including medical staff credentialing” and is “created by the governing board or
medical staff of the hospital or system or operating under written procedures adopted
by the governing board of medical staff of the hospital or system.” N.C. Gen. Stat. §
131E-76(5)(c) (2025). Discovery of materials considered by a medical review
committee is limited:
The proceedings of a medical review committee, the records
and materials it produces and the materials it considers
shall be confidential . . . and shall not be subject to
discovery or introduction into evidence in any civil action
against a hospital . . . which results from matters which
are the subject of evaluation and review by the committee.
Id. § 131E-95(b) (2025) (emphasis added). “However, information, documents, or
records otherwise available are not immune from discovery or use in a civil action
merely because they were presented during proceedings of the committee.” Id.
In Shelton, the trial court quashed the plaintiffs’ subpoena to a credentialing
committee for direct complaints and allegations of misbehavior against two doctors,
disciplinary investigations, credential evaluations, incident reports, and the minutes
taken from meetings of the executive committee and board of trustees about the
doctors. Shelton v. Morehead Mem’l Hosp., 318 N.C. 76, 88, 347 S.E.2d 824, 832
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(1986). On one hand, this Court concluded that the trial court erred in “quashing the
subpoena” commanding the production of documents related to complaints, incident
reports, and meetings of the board of trustees. Id. at 88, 347 S.E.2d at 832. On the
other hand, we determined that the credential evaluations and executive committee
meeting minutes were not discoverable from the committee. Id. at 88, 347 S.E.2d at
832.
Here, Defendant Hospital’s credentialing committee was a medical review
committee. See N.C. Gen. Stat. § 131E-76(5)(c). Defendant Hospital created the
committee for medical staff credentialing, and the committee adopted written
procedures. See id. Accordingly, Defendant Hospital qualified for the medical review
committee privilege. See id. § 131E-95(b).
Like Shelton, Defendant Gupta’s credentialing file was not discoverable from
Defendant Hospital in this civil action against Defendant Hospital. See Shelton, 318
N.C. at 83–84, 347 S.E.2d at 829. While the credentialing committee did not create
Defendant Gupta’s credentialing file, the file was created for the committee’s
consideration, and it was considered by the committee for credentialing purposes,
which protected it from discovery. See N.C. Gen. Stat. § 131E-95(b). Indeed, when
Defendant Gupta completed an application for hospital privileges, the medical staff
office “validated his credentials, his experience, his education, references, got
everything together, presented it to credentials committee and those physicians
reviewed everything, and then they [made] the recommendation to the med exec
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committee.” The trial court, therefore, properly found that the credentialing file was
privileged and not discoverable from Defendant Hospital. See id.
B. Summary Judgment
Plaintiff next asserts that the trial court erred by granting Defendant
Hospital’s motion for summary judgment because genuine disputes of material fact
remain regarding Defendant Hospital’s negligence and Defendant Hospital’s
vicarious liability for intentional torts outside the scope of Rule 9(j).1 Defendant
Hospital, however, responds that Plaintiff did not proffer a reasonably qualified Rule
9(j) witness to testify about its standards of care. We address each in turn.
1. Standard of Review
We review a trial court’s order granting summary judgment de novo. N.C.
Farm Bureau Mut. Ins. Co. v. Simpson, 198 N.C. App. 190, 191, 678 S.E.2d 753, 754
(2009). “ ‘Under a de novo review, the court considers the matter anew and freely
substitutes its own judgment’ for that of the lower tribunal.” Craig v. New Hanover
Cnty. Bd. of Educ., 363 N.C. 334, 337, 678 S.E.2d 351, 354 (2009) (quoting In re Greens
of Pine Glen, Ltd. P’ship, 356 N.C. 642, 647, 576 S.E.2d 316, 319 (2003)).
Summary judgment is appropriate when “there is no genuine issue as to any
material fact and that any party is entitled to a judgment as a matter of law.” N.C.
Gen. Stat. § 1A-1, Rule 56(c) (2025). In a motion for summary judgment, the trial
1 We note Plaintiff’s claims of emotional distress against Defendant Hospital are abandoned.
See N.C. R. App. P. 28(b)(6) (2025).
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court “must view the presented evidence in a light most favorable to the nonmoving
party.” Dalton v. Camp, 353 N.C. 647, 651, 548 S.E.2d 704, 707 (2001). To raise a
“genuine issue of material fact,” the opposing party must forecast “substantial
evidence” that a “ ‘reasonable mind might accept as adequate to support a conclusion’
and means ‘more than a scintilla or a permissible inference.’ ” United Cmty. Bank
(Georgia) v. Wolfe, 369 N.C. 555, 558, 799 S.E.2d 269, 271 (2017) (quoting Ussery v.
Branch Banking & Tr., 368 N.C. 325, 335, 777 S.E.2d 272, 278–79 (2015)). Yet,
evidence raising only “speculation or conjecture is insufficient as a matter of law to
withstand summary judgment.” Curlee by & through Becerra v. Johnson, 270 N.C.
App. 657, 664, 842 S.E.2d 604, 609 (2020) (citing Estate of Tipton v. Delta Sigma Phi,
264 N.C. App. 313, 321–22, 826 S.E.2d 226, 233 (2019)).
2. Claims Subject to Rule 9(j)
Plaintiff contends her medical malpractice claims against Defendant Hospital
are not subject to Rule 9(j) because they are corporate or administrative negligence
claims. We disagree. In the alternative, Plaintiff argues her non-medical expert met
her burden under Rule 9(j) as to her corporate and administrative negligence claims.
We agree.
In 2011, the General Assembly amended Section 90-21.11 to expand the
definition of medical malpractice to include corporate or administrative negligence
claims against hospitals. See Estate of Savino v. Charlotte-Mecklenburg Hosp.
Authority, 375 N.C. 288, 295–96, 847 S.E.2d 677, 683 (2020). Following the
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amendment, there now exist two types of medical malpractice. First, section 90-
21.11(2)(a) provides for 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.” N.C. Gen. Stat. § 90-
21.11(2)(a) (2025). Second, section 90-21.11(2)(b) provides for corporate or
administrative claims:
A civil action against a hospital . . . for damages for
personal injury or death, when the civil action . . . 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 . . . arises from the same facts or circumstances as a
claim under [Section 90-21.11(2)(a)] . . . .”
Id. § 90-21.11(2)(b).
For both types of medical malpractice claims under sections 90-21.11(2)(a), (b),
our General Assembly set forth the applicable standard of care:
[I]n any medical malpractice action as defined in [section]
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 [section] 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
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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.
Id. § 90-21.12.
Under Rule 9(j) of the North Carolina Rules of Civil Procedure, “[a]ny
complaint alleging medical malpractice by a health care provider [under section 90-
21.11(2)(a)] in failing to comply with the applicable standard of care . . . shall be
dismissed unless:”
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.
N.C. Gen. Stat. § 1A-1, Rule 9(j)(1) (2025). Notwithstanding the text of Rule 9(j), our
Supreme Court has concluded, “Since the 2011 amendment, claims of administrative
negligence against hospitals . . . that arise from the same facts and circumstances as
a claim for furnishing or failing to furnish professional health services have been
classified as medical malpractice suits . . . .” Estate of Savino, 375 N.C. at 296, 847
S.E.2d at 683. Therefore, even those medical malpractice claims under section 90-
21.11(2)(b) “are required to adhere to the much more detailed requirements
of . . . Rule 9(j) . . . .” Id. at 296–97, 847 S.E.2d at 683. In other words, for all medical
malpractice claims, “Rule 9(j) serves as a gatekeeper, enacted by the legislature, to
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prevent frivolous malpractice claims by requiring expert review before filing of the
action.” Moore v. Proper, 366 N.C. 25, 31, 726 S.E.2d 812, 817 (2012) (citation omitted
and emphasis in original).
Under Rule 702 of the Rules of Evidence, “[i]n a medical malpractice action as
defined in [section] 90-21.11, a person shall not give expert testimony on the
appropriate standard of health care . . . unless the person is a licensed health care
provider in this State or another state and meets the following criteria:”
During the year immediately preceding the date of the
occurrence that is the basis for the action, the expert
witness must have devoted a majority of his or her
professional time to . . . [t]he active clinical practice of the
same health profession in which the party against whom or
on whose behalf the testimony or offered . . .; or [t]he
instruction of students in an accredited health professional
school or accredited residency or clinical research program
in the same health profession . . . .
N.C. Gen. Stat. § 8C-1, Rule 702(b)(2) (2025). Nonetheless, Rule 702(h) further
provides:
Notwithstanding subsection (b) of this section, in a medical
malpractice action as defined in [section 90-21.11(2)(b)]
against a hospital, or other health care or medical facility,
a person shall not give expert testimony on the appropriate
standard of care as to administrative or other nonclinical
issues unless the person has substantial knowledge, by
virtue of his or her training and experience, about the
standard of care among hospitals, or health care or medical
facilities, of the same type as the hospital, or health care or
medical facility, whose actions or inactions are the subject
of the testimony situated in the same or similar
communities at the time of the alleged act giving rise to the
cause of action.
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Opinion of the Court
Id. § 8C-1, Rule 702(h).
Here, Plaintiff’s medical malpractice claims against Defendant Hospital, albeit
corporate or administrative, were subject to Rule 9(j). See Estate of Savino, 375 N.C.
at 296, 847 S.E.2d at 683. Nevertheless, Plaintiff reasonably expected her non-
medical expert to qualify under Rule 702(h) for both of her corporate or
administrative negligence claims, including negligent credentialing, supervision, and
retention, and the failure to have a hospital chaperone policy. See N.C. Gen. Stat. §§
1A-1, Rule 9(j)(1); 8C-1, Rule 702(h).
Plaintiff’s non-medical expert was a healthcare administration consultant who
testified about corporate and administrative duties of hospitals and their staff under
section 90-21.11(2)(b). See id. § 8C-1, Rule 702(h). Further, Plaintiff’s non-medical
expert possessed substantial knowledge, by virtue of his training and experience of a
similarly situated hospital’s standard of care. See id. Specifically, Plaintiff’s non-
medical expert: held a graduate degree in hospital administration; had a decades-
long career in hospital management and operations; held multiple academic
appointments to teach healthcare administration; held various memberships,
including with the American College of Healthcare Executives; and published and
presented on issues related to healthcare management, including hospital negligence
and sexual assault. Moreover, Plaintiff’s non-medical expert had a lengthy career in
hospital consulting, which included operational consulting, strategic planning, risk
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Opinion of the Court
prevention, managed care strategies, and hospital-physician relationships.
Defendant Hospital briefly asserts that Plaintiff’s non-medical expert could not
testify to Defendant Hospital’s alleged negligence for its failure to have a chaperone
policy. Defendant Hospital relies on Deal v. Frye Reg’l Med. Cntr, Inc., 202 N.C. App.
584, 691 S.E.2d 132 (2010) (unpublished) for support. In Deal, this Court held that
the implementation of a fall prevention policy was a clinical matter rather than a
corporate or administrative one because the policy required nurses to assess patient
fall risk based on a series of medical factors, such as vision impairment,
disorientation, and neurological deficits. See id. at __, 691 S.E.2d at __.
Defendant Hospital’s assertion is unavailing. The chaperone policy at issue in
this case would simply require determination of whether a patient is sedated or
undergoing a sensitive exam, both of which could be determined by observing a
patient. Such a chaperone policy requires no clinical assessment or specialized
medical knowledge. See Lewis v. Setty, 130 N.C. App. 606, 608, 503 S.E.2d 673, 674
(1998) (concluding that a physician’s failure to properly lower a patient’s bed when
transferring the patient to a wheelchair required no clinical assessment or medical
knowledge); Norris v. Rowan Mem’l Hosp., Inc., 21 N.C. App. 623, 626, 205 S.E.2d
345, 347–48 (1974) (concluding that a nurse’s failure to follow a hospital’s mandatory
fall prevention policy, requiring the bed rails of sedated patients over the age of sixty
to be raised, required no clinical assessment). Thus, Plaintiff could reasonably expect
her non-medical expert qualify and testify that Defendant Hospital was negligent for
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Opinion of the Court
its failure to have a chaperone policy.
Accordingly, Plaintiff’s corporate and administrative negligence claims against
Defendant Hospital were subject to Rule 9(j). See Estate of Savino, 375 N.C. at 296,
847 S.E.2d at 683. Plaintiff’s non-medical expert met Rule 9(j) and Rule 702(h)
requirements. See N.C. Gen. Stat. §§ 1A-1, Rule 9(j)(1), 8C-1, Rule 702(h). Thus,
Plaintiff met her burden under Rule 9(j) to provide an expert witness as to her
corporate or administrative negligence claims. See id.
a. Plaintiff’s Direct Liability in Negligence Claims
Now, we turn specifically to Plaintiff’s direct corporate and administrative
negligence claims against Defendant Hospital. Plaintiff contends genuine issues of
material fact existed as to whether Defendant Hospital was directly liable for
negligent credentialing, supervision, and retention, and failing to follow the statutory
standard of care in section 90-21.12 by not having in place a hospital chaperone
policy. We agree in part.
i. Negligent Credentialing, Supervision, and
Retention
Negligent credentialing, supervision, and retention is a corporate or
administrative claim under section 90-21.11(2)(b). See N.C. Gen. Stat. § 90-
21.11(2)(b). “[I]n cert