In 1975, neurosurgeon Dr. Anthony Hucks-Folliss (defendant) was granted staff privileges to perform surgical procedures at Moore Regional Hospital (defendant). Every two years, Moore Regional renewed Hucks-Folliss’ privileges after a review process. However, Hucks-Folliss was not board certified by the American Board of Neurological Surgery because he had failed the required certification exam on three different occasions. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredits hospitals and issues standards for them to follow when credentialing physicians for hospital privileges. In 1992, the JCAHO considered board certification as an “excellent benchmark” to be considered when hospitals re-credentialed physicians. On his application to renew his surgical privileges in 1992, Hucks-Folliss stated that he was not board certified. Moore Regional was aware of this and did not consider the lack of certification an issue in the re-credentialing of active staff physicians. In August 1993, Hucks-Folliss performed neck surgery on Tommy Carter (plaintiff) that resulted in Carter sustaining serious and permanent injuries including quadraparesis (limited use of both arms and legs). Carter brought suit against Hucks-Folliss and Moore Regional Hospital, alleging that the hospital was negligent in granting the doctor staff privileges to perform surgery, failed to ascertain whether Hucks-Folliss was qualified to perform neurological surgery, and failed to enforce the credentialing requirements set by the JCAHO. The trial court granted Moore Regional Hospital’s motion for summary judgment. Carter appealed.