GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 746
Short Title: Limited Immunity/Nurses. (Public)
Sponsors: Representatives Carson Smith, White, and Lambeth (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Health, if favorable, Judiciary 2, if favorable, Rules, Calendar, and Operations of
the House
April 3, 2025
*H746 -v-1*
A BILL TO BE ENTITLED 1
AN ACT TO PROVIDE LIMITED IMMUNITY AGAIN ST MEDICAL MALPRACTICE FOR 2
REGISTERED NURSES ACTING UNDER THE SUPERVISION OF A HEALTH CARE 3
PROVIDER AS ARTICULA TED IN BYRD V. MARION GENERAL HOSPITAL, 202 4
N.C. 337 (1932). 5
Whereas, Byrd v. Marion General Hospital, 202 N.C. 337 (1932) established case law 6
in North Carolina, enduring for 90 years, that prevented a registered nurse from being liable when 7
acting under the orders of a physician; and 8
Whereas, that case law was overturned in Connette ex rel. Gullatte v. Charlotte 9
Mecklenburg Hospital Authority, 2022-NCSC-95; and 10
Whereas, both the majority of the court and the dissent in that decision pointed out 11
that the authority to prevent this liability is a function of the North Carolina General Assembly, 12
but the General Assembly has been silent; and 13
Whereas, this General Assembly establishes the prevention from this liability with 14
the enactment of this general law; Now, therefore, 15
The General Assembly of North Carolina enacts: 16
SECTION 1. Article 1B of Chapter 90 of the General Statutes is amended by adding 17
a new section to read: 18
"ยง 90-21.15B. Registered nurses; limited immunity. 19
(a) If a nurse acts at the direction of a supervising health care provider during the course 20
of health care treatment, then the following standards apply: 21
(1) The nurse does not owe a separate duty of care to the patient, independent of 22
the duty of care owed by the health care provider. 23
(2) The nurse is not engaged in a collaborative process with joint responsibility 24
as part of a health care team. 25
(3) The primary duty of a nurse is to diligently execute the orders of a physician. 26
(4) The collaboration of a registered nurse with other supervising health care 27
providers under G.S. 90-18.2 does not create an independent separate duty of 28
care to the patient, unless the registered nurse acts independently of or departs 29
from the supervision of a health care provider as required by 30
G.S. 90-171.20(7) and G.S. 90-18(c)(14). 31
(b) No recovery under a medical malpractice action shall be allowed against a nurse upon 32
the sole grounds that the nurse owed a separate duty of care to the patient if the nurse was acting 33
upon the direction of a health care provider. 34 General Assembly Of North Carolina Session 2025
Page 2 House Bill 746-First Edition
(c) Nothing in this section shall be construed to exempt nurses from any of the following: 1
(1) The duty to exhibit professional conduct which is not in accordance with the 2
standards of practice in accordance with G.S. 90-21.12. 3
(2) Acts or omissions that are so obviously negligent as to lead any reasonable 4
person to anticipate that substantial injury would result to the patient by the 5
execution of that act or omission. 6
(3) Acts or omissions constituting gross negligence, wanton conduct, or 7
intentional wrongdoing. 8
(d) This section shall not apply to nurses acting outside of the supervision of a health care 9
provider." 10
SECTION 2. This act is effective when it becomes law and applies to acts or 11
omissions occurring on or after that date. 12