Mr. Howard Kramer General Counsel North Carolina Board of Nursing PO Box 2129 Raleigh, NC 27602-2129
Re: Advisory Opinion: Medical Staff Requirement for Births in Hospitals; 10 NCAC 3C .4302.
Dear Mr. Kramer:
On behalf of the North Carolina Board of Nursing, you have asked whether 10 NCAC 3C .4302 permits a physician’s assistant to attend a birth in a hospital in lieu of a physician.
The above-referenced rule is applicable to all “hospitals,” as defined in N.C. Gen. Stat. § 131E-76, which are licensed to operate within the State. 10 NCAC 3C .4302(a) states:
The medical staff shall require that each birth be attended by a physician or certified nurse midwife who has documented evidence of current competence and appropriate privileges. (emphasis added).
It is our opinion that the rule is clear and unambiguous. The North Carolina Supreme Court has stated that, “[w]hen the relevant language of a statute is plain and unambiguous, there is no occasion for construction. Such being the case a statute must be given effect according to its plain and obvious meaning.” Wake County and City of Raleigh v. Ingle, 273, N.C. 343, 345, 160 S.E.2d 62, 64 (1968). By analogy, 10 NCAC 3C .4302 (a), as adopted by the North Carolina Medical Care Commission, should be given effect according to its plain meaning. Accordingly, the rule requires that each birth must be attended by either a physician or a certified nurse midwife. There is no exception to the requirement of this rule by virtue of the principal-agent relationship between a physician and a physician’s assistant.
For the foregoing reasons, we must conclude that 10 NCAC 3C .4302(a) requires that either a physician or a certified nurse midwife must attend all births that occur in hospitals within the State.
Ann Reed Senior Deputy Attorney General
June S. Ferrell Assistant Attorney General
cc: Lynda D. McDaniel Stephen J. White