A girl's fatal fall highlights the importance of proper supervision and medical care.

Athletics and recreation administrators have a legal duty to not only provide people using their facilities proper supervision during an activity, but also proper emergency medical care in the case of an injury. As is demonstrated in Spotlite Skating Rink Inc. v. Barnes [2008 Miss. LEXIS 322], what constitutes proper supervision and medical care will often hinge on which testimony a jury finds more credible. On Dec. 25, 2000, 10-year-old Bianca Barnes and some friends took a bus to the Spotlite Skating Rink in Greenwood, Miss. Accounts of what happened after she arrived there vary. According to Barnes' friends, Barnes was on the roller skating surface, without skates, and fell, hitting her head. After finding her on the floor crying and holding her head, they helped her to a nearby table, where she stayed with her head down for the rest of the evening. At no time, they claimed, were they asked by any Spotlite employees how to get in touch with Barnes' mother, and no one from Spotlite helped them get home. A Spotlite employee, however, claimed Barnes was not only wearing skates, but that he helped her onto the floor because he was told that she did not know how to skate. According to the employee's testimony, after seeing Barnes fall, he immediately helped the crying girl off the floor and, although he noticed no visible bumps or bleeding, got a bag of ice for her head. The employee also testified that he received Barnes' home number from one of her friends, and tried to call the girl's mother several times. In addition, he testified that a short time after the fall, he saw Barnes walking around and no longer crying, and he escorted Barnes home on the bus. What happened next, however, is unfortunately very clear. When Barnes' mother went to retrieve her from a neighbor's house the next day, she found Bianca unconscious. She was immediately taken to a local hospital, where she died the next day. The cause of death was an undiagnosed colloid cyst, a rare congenital condition, which had blocked the flow of spinal fluid from her brain. As a result of Bianca's death, her mother sued the Spotlite Skating Rink on two theories. First, she claimed that Spotlite was negligent in supervising Bianca and could have prevented the fall. Second, she argued that Spotlite was negligent by failing to render aid to Bianca once she was injured. The jury in the case returned a general verdict in favor of the mother and assessed damages at $600,000. On appeal to the Supreme Court of Mississippi, Spotlite presented three arguments. First, it claimed that there was no evidence to support a finding that Spotlite breached its duty of supervision and care. Second, it claimed that there was no evidence that any alleged negligence on behalf of Spotlite caused Barnes' death. Third, it claimed that there was no evidence that Barnes' death was a foreseeable consequence of Spotlite's alleged negligence. For these reasons, Spotlite argued, the trial court's verdict should be reversed. In reviewing Spotlite's arguments, the court began by noting that to succeed in any negligence case, a plaintiff must prove that there is a duty owed by the defendant to the plaintiff, a breach of that duty, damages, and a causal connection between the breach and the damages. In determining what type of duty of supervision Spotlite owed Barnes, the court held that those engaged in the business of providing public recreation or amusement must exercise a reasonable degree of watchfulness to guard against injuries likely to happen. Using this standard, and viewing the evidence in a light most favorable to Barnes' estate, the court concluded that Spotlite breached its duty of supervision by allowing Barnes onto the skating rink without skates. In rejecting the testimony of Spotlite's employee, the court held that there was sufficient evidence for a jury to reasonably conclude that Barnes was not wearing skates and that no employee was present when she entered the rink. Even if it were determined that Spotlite breached its duty of supervision, Spotlite asserted that Barnes' preexisting medical condition was the sole cause of her death. There was no proof, Spotlite argued, of a causal connection between its alleged breach of duty and the damages. In support of this argument, Spotlite pointed to expert medical testimony that Barnes would have died even had she not fallen. Once again, in rejecting this argument, the court found that there was sufficient evidence of causation. In particular, the court pointed to two expert witnesses who testified that Barnes died as a result of the fall, which caused the cyst to become dislodged and block the flow of fluid from her brain. Next, Spotlite argued that it only had a duty to protect Barnes from foreseeable dangers. In particular, Spotlite argued that since it was impossible to foresee that Barnes' fall would cause an undiagnosed colloid cyst to block the flow of fluid from her brain, it could not be held liable for her death. The court, however, held that the fact that a type of injury rarely occurs is insufficient to protect against a finding of negligence. The test for negligence, the court held, was whether Spotlite could foresee that an injury could result from its actions. Therefore, the court maintained that the fall, which could result in a head injury, was a reasonably foreseeable consequence of a lack of supervision. In reviewing whether Spotlite was negligent for failing to provide proper emergency care and aid to Barnes, the court cited the Restatement (Second) of Torts. This states that an owner of land who holds it open to the public is under a duty to take reasonable action "to give [invitees] first aid after [the owner] knows or has reason to know that they are ill or injured, and to care for them until they can be cared for by others." Viewing all of the evidence, the court concluded that there was sufficient evidence to support a finding that Spotlite breached its duty of care. The court found that no one from Spotlite attempted to render care to Barnes after she had fallen, made any attempt to contact Barnes' mother, or escorted her home on the bus. The court also rejected Spotlite's argument that there was insufficient evidence that had Barnes received prompt medical attention, her life could have been saved. In support of this argument, Spotlite pointed to the testimony of one doctor who said an operation to remove the cyst was a "fairly hazardous operation with a fairly high morbidity and mortality rate." However, since another doctor testified that if the cyst had been detected it could have been surgically removed, the court concluded that there was sufficient evidence to support causation. The decision of the Supreme Court of Mississippi may strike athletics and recreation administrators as unreasonably harsh, especially if the testimony of Spotlite's employee is to be believed. But if you accept the court's finding of fact, the decision offers some valuable lessons. First, as the court noted, in determining whether an injury is foreseeable, the test is not whether a facility operator was able to foresee the particular type of injury suffered, but whether any injury could be foreseen. Second, while it is impossible to prevent all injuries, it is important that facility owners are aware of any injuries that occur at their facilities and that they provide appropriate medical treatment. How much may be difficult to determine - it will depend on the injury and the particular activity - but it is clear that facility owners have a duty to take reasonable action to provide first aid after a patron is injured, and to continue caring for him or her until care can be provided by others. While it is difficult to determine what the court would have deemed appropriate in the Spotlite case, it's likely that had Spotlite done everything its employee said he did after watching Barnes fall, the rink would have satisfied its duty of care and not been held liable.