Rep. Smith files bill in North Carolina House on nurse malpractice immunity

A new bill filed by State Rep. Carson Smith in the North Carolina House seeks to clarify liability and duty of care for nurses acting under healthcare provider supervision, according to the North Carolina State House.

The bill, filed as HB 746 on April 2 during the 2025 regular session, was formally listed with the short title: ‘Limited Immunity/Nurses.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill provides limited immunity from medical malpractice for registered nurses acting under the supervision of a healthcare provider. It states that when a nurse is acting on the orders of a supervising provider, the nurse does not owe a separate duty of care to the patient beyond the healthcare provider’s duty. Furthermore, a nurse’s collaboration with healthcare providers does not establish an independent duty of care, unless the nurse acts independently or outside the provider’s supervision. The bill does not exempt nurses from adhering to professional conduct standards or liability for gross negligence, wanton conduct, or intentional wrongdoing. The act applies to actions or omissions occurring after it becomes law.

Of the three sponsors of this bill, Donny Lambeth proposed the most bills (48) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Smith, a Republican, was elected to the North Carolina State House in 2019 to represent the state’s 16th House district, replacing previous state representative Bob Muller.