Nursing Home Liable for Not Supervising Smoking Resident

A California court rules that a nursing home was largely responsible for the injuries of a resident who accidentally set himself on fire while smoking. Lawson v. Skyline Healthcare Center (Cal. Ct. App., 2 App. Dist., B142164, Oct. 3, 2001)

Leonard Lawson suffered from acquired immune deficiency syndrome (AIDS) and was a patient at Skyline Healthcare Center, a skilled nursing facility. Mr. Lawson's medications often made him fall asleep in his wheelchair. Because Mr. Lawson liked to smoke, Skyline instituted a plan of care that ensured he would smoke in a safe environment. Under the plan, Mr. Lawson had to obtain cigarettes from the nurses' station, had to smoke in a designated area (the patio), and would be supervised by a nurse or other staff member while smoking. Although Mr. Lawson complied with his part of the plan, Skyline staff members rarely supervised him during his trips to the patio to smoke.

On December 27, 1997, while smoking alone on the patio, Mr. Lawson lit the wrong end of a cigarette and started a fire that spread to his body, causing severe injuries. Mr. Lawson sued Skyline for negligence. A jury found that both parties were negligent, although not equally: Skyline was 70 percent to blame and Mr. Lawson 30 percent. The jury awarded Mr. Lawson $73,777 for medical expenses and $250,000 for pain and suffering. Skyline appealed, arguing that Mr. Lawson was solely to blame for his injuries because he was aware of the risks of smoking without supervision.

The California Court of Appeal agrees with the jury. The court concludes that Skyline failed in its duty to protect Mr. Lawson from the harm caused by unsupervised smoking. The court notes that California's regulations governing skilled nursing facilities allow smoking only in designated areas and only under the 'periodic observation of facility personnel or responsible adults.' The court rejects Skyline's defense that it was only honoring Mr. Lawson's desire to smoke alone, as it would honor any patient's right to refuse medical treatment. Remarking that this argument borders on the frivolous, the court stresses that Skyline had a mandatory duty to provide supervision, whether or not Mr. Lawson wanted it. (Mr. Lawson died while the case was being appealed.)

This opinion has not yet been published.