PRESIDING JUSTICE McBRIDE delivered the opinion of thecourt: This appeal arises from the trial court's dismissal of countII of the first amended complaint (the complaint), which was filedby plaintiff-appellant, Eva Collins, special administrator of LauraCollins' Estate,⁽¹⁾ against defendant-appellee, Superior Air-GroundAmbulance Service, Inc., (Superior), under section 2-615 of theIllinois Code of Civil Procedure. 735 ILCS 5/2-615 (West 2000). Count I of the complaint alleged statutory nursing home violationsagainst defendant Alden Wentworth Rehabilitation and Health CareCenter, Inc. (Alden), as a result of injuries sustained byplaintiff's decedent while in Alden's care. Count II of thecomplaint alleged negligence under the doctrine of res ipsaloquitur against both defendants. Specifically, plaintiff allegedthat her mother's injuries occurred during the period of time whenshe was under Superior "and/or" Alden's control and that theseinjuries "would not have occurred if defendants had used areasonable standard of care while Collins was under defendant(s)[']control and management." Further, plaintiff alleged that as adirect and proximate result of defendants' negligence, Collinssuffered severe and permanent disabling injuries to her body, painand suffering, and mental anguish. The defendants moved to dismisscount II of the complaint on the ground that it failed to state acause of action for res ipsa loquitur. Superior also claimed thatplaintiff's claim against it was barred based on the immunityprovision set forth in the Emergency Medical Services (EMS) SystemsAct (EMS Act) (210 ILCS 50/3.150 (West 2000)). On September 17,2001, the trial court granted Superior and Alden's motion todismiss count II on the ground that the complaint failed to statea cause of action under the doctrine of res ipsa loquitur. In itsorder, the trial court found that because the defendants were incontrol of different instrumentalities at different times, res ipsaloquitur could not apply. The trial court never reached Superior'simmunity argument. The trial court's finding pursuant to SupremeCourt Rule 304(a) making the dismissal order final and appealablewas made only to Superior. 155 Ill. 2d 304(a). Alden remains adefendant in the trial court and is not a party to this appeal.

We first consider whether a plaintiff's complaint is factuallysufficient under the doctrine of res ipsa loquitur where eachdefendant that allegedly caused her injuries has been named in thatcomplaint but did not jointly control the instrumentality thatcaused the injuries.

Laura Collins (Collins) was born May 8, 1916. In June of1999, she was 83 years old and lived with plaintiff, her daughterEva Collins, at 5113 South Marshfield Avenue, Chicago, Illinois. At the time, Collins was bedridden, her left leg had been amputateddue to diabetes, and she was unable to speak as a result of astroke. According to the record, she was fed through a "G-tube."

On June 7, 1999, plaintiff admitted her mother to Alden,located at 201 West 69th Street, Chicago, Illinois. On the sameday, Collins was transported to Alden by Superior. Plaintiff thenwent to Minnesota and returned to Chicago on June 12, 1999. Collins was returned home by Superior on June 12, 1999.

Upon her mother's return, plaintiff noticed that Collins wasin pain when her right leg was moved. She also observed that hermother was dehydrated. Plaintiff denied that her mother wasinjured before her admission to Alden and transport thereto.

After noticing her mother's condition, plaintiff called theChicago fire department and paramedics transported Collins to HolyCross Hospital. At the hospital, Collins was diagnosed with afractured right distal tibia and fibula, commonly known as a brokenright leg, and dehydration.

Attached to plaintiff's complaint was a supplementalphysician's report filed pursuant to section 2-622 of the IllinoisCode of Civil Procedure. 735 ILCS 5/2-622 (West 2000). In thereport, the reviewing physician opined that the dehydration andfracture to Collins' right leg would not have occurred in theabsence of negligence. He further found that, during the period ofJune 7, 1999, to June 12, 1999, Collins was under the control ofSuperior and Alden and that Superior and Alden controlled anyagency or instrumentation which caused Collins' dehydration andfractured right leg. According to the physician, in the normalcourse of events, the injuries to Collins would not have occurredif the defendants had used a reasonable standard of care whileCollins was under the defendants' control and management. Thephysician further found that either Superior and/or Aldennegligently moved or handled Collins and caused injury to her rightleg, failed to diagnose the injury to her right leg, and thereafterfailed to properly treat her injury by referring her to a properlyqualified physician.

As noted above, Superior and Alden filed motions to dismisscount II of plaintiff's complaint under section 2-615 of theIllinois Code of Civil Procedure (735 ILCS 5/2-615 (West 2000)),and, in an order dated September 17, 2001, the trial court grantedboth Superior and Alden's motions to dismiss on the basis that resipsa loquitur was inapplicable because the element of concurrentcontrol with regard to both defendants could not be established. Plaintiff appeals from that order.

Our standard of review on reviewing a motion to dismiss undersection 2-615 is de novo. Neade v. Portes, 193 Ill. 2d 433, 439,739 N.E.2d 496 (2000).

We begin our discussion with a statement concerning thedoctrine of res ipsa loquitur and its purpose. Our supreme courtsaid in Metz v. Central Illinois Electric & Gas Co., 32 Ill. 2d446, 448-49, 207 N.E.2d 305 (1965):

"When a thing which caused the injury isshown to be under the control or management ofthe party charged with negligence and theoccurrence is such as in the ordinary courseof things would not have happened if theperson so charged had used proper care, theaccident itself affords reasonable evidence,in the absence of an explanation by the partycharged, that it arose from want of propercare. [Citations.] This in essence is thedoctrine of res ipsa loquitur, and its purposeis to allow proof of negligence bycircumstantial evidence when the directevidence concerning cause of injury isprimarily within the knowledge and control ofthe defendant."

The appellate court also observed the following:

"Because Illinois requires fact pleading[citation] res ipsa loquitur is often pleadedas a separate claim [citation] and, therefore,has sometimes been referred to as a cause ofaction. [Citation.] Nevertheless, res ipsaloquitur is 'simply a rule of evidencerelating to the sufficiency of plaintiff'sproof.' [Citation.]" Darrough v. GlendaleHeights Community Hospital, 234 Ill. App. 3d1055, 1060, 600 N.E.2d 1248 (1992).

In Gatlin v. Ruder, 137 Ill. 2d 284, 295, 560 N.E.2d 586(1990)), the supreme court, quoting Spidle v. Steward, 79 Ill. 2d1, 10, 402 N.E.2d 216 (1980), stated:

" ' The res ipsa loquitur doctrine is aspecies of circumstantial evidence permittingthe trier of fact to draw an inference ofnegligence if plaintiff demonstrates that heor she was injured "(1) in an occurrence thatordinarily does not happen in the absence ofnegligence, (2) by an agency orinstrumentality within the defendant'sexclusive control ***." [Citations.] ' "

The supreme court has also stated, "[w]hen res ipsa loquitur isinvoked the plaintiff bears the burden of proving all of itselements." Dyback v. Weber, 114 Ill. 2d 232, 242, 500 N.E.2d 8(1986).

In the instant case, plaintiff claims that the trial courterred in dismissing count II when it held that res ipsa loquiturwas not applicable to the instant suit. Plaintiff claims that thefacts set forth in the complaint and accompanying physician'sreport were sufficient to satisfy the requisite pleading elementsfor the inference of negligence which arises under the doctrine ofres ipsa loquitur. Gatlin, 137 Ill. 2d at 295.

Superior responds that where the occurrence speaks, not ofSuperior's negligence, but of negligence imputable to someone else,res ipsa loquitur is not applicable. According to Superior,plaintiff's conclusions in count II that Collins' injuries occurredat some point between the time she left home on June 7, 1999, andthe time she returned home on June 12, 1999, do not speak toSuperior's negligence. During the time at issue, Superior suggeststhat Collins was treated by two different entities, Superior andAlden. For most of the six days complained of, Superior had nocontact with Collins. Thus, Superior claims that the allegedinjuring instrumentality could have been controlled by Superior,Alden, or a third party. Because it could not be inferred thatCollins was injured during her transport by Superior or by aninstrumentality controlled by Superior, Superior contends thatcount II did not support an inference of res ipsa loquiturnegligence against it.

When reviewing a section 2-615 motion to dismiss, we take astrue all well-pled facts and reasonable inferences therefrom andconsider only those facts in the pleading and included in theattached exhibits. Safeway Insurance Co. v. Daddono, 334 Ill. App.3d 215, 218, 777 N.E.2d 693 (2002). Further, when an exhibit isattached to a complaint it becomes part of the complaint. Bianchiv. Savino Del Bene International Freight Forwarders, Inc., 329 Ill.App. 3d 908, 921, 770 N.E.2d 684 (2002). As a result, the factsalleged in the physician's affidavit attached to the complaintpursuant to section 2-622 of the Illinois Code of Civil Procedureare part of the complaint. 735 ILCS 5/2-622 (West 2000). In thesupplemental physician's report filed pursuant to section 2-622,the reviewing physician, among other things, stated: "[I]t is myopinion, to a reasonable degree of medical certainty, that either[Superior] and/or [Alden], negligently moved or handled LauraCollins and thereby caused injury to her right distal tibia andfibula, failed to diagnose the injury to her right distal tibia andfibula, and thereafter failed to properly treat her injury byreferring her to a properly qualified physician."

In Gatlin v. Ruder, cited above, the plaintiff-mother filed anegligence action on behalf of her infant child against twodefendants, Bernard Ruder, an obstetrician, and Riverside MedicalCenter (Riverside), in connection with injuries sustained by thechild during or immediately after his birth. The facts revealedthat Ruder was directly involved in delivering the child. Afterthe delivery, the child was immediately admitted to the nursery atRiverside. Three hours after delivery, a notation was made on thechild's medical chart that he had several large scratches and abruise on the top of his head. Several days later, an X rayrevealed a fracture in the infant's skull. The child's cerebralpalsy was, according to one doctor, a result of the skull fracture.

The plaintiff later amended her complaint to include a countbased upon res ipsa loquitur. Ruder filed a motion for summaryjudgment contending that there was no evidence that he actednegligently. The trial court agreed with Ruder and granted Ruder'smotion for summary judgment on that ground.

During subsequent discovery, a medical school professor wasdeposed. Based on the professor's testimony, the plaintiff fileda motion to vacate the summary judgment motion which was denied. The appellate court affirmed the trial court's ruling on the motionto vacate and the plaintiff appealed.

On review, the supreme court reversed. The court held thatthe plaintiff need only present evidence on each of the res ipsaloquitur requirements to create an issue of material fact, andhaving done so, the plaintiff's motion to vacate Ruder's motion forsummary judgment should have been granted. Gatlin, 137 Ill. 2d at300. Regarding the first element, the court noted that theplaintiff's evidence established that the plaintiff's injurieswould not have occurred absent negligence. Gatlin, 137 Ill. 2d at296-97. Concerning the second element, the court stated:

"The second element - defendant's exclusivecontrol over the instrumentality which causedthe injury - is more problematic because twodefendants are involved. The appellate courtheld: '[The plaintiff] failed to establishthat it is more probable that Dr. Ruder causedhis injuries, and not the hospital personnel.' This statement, however, does not correctlystate [the plaintiff's] burden of proof on amotion for summary judgment. [The plaintiff]only had to present enough evidence to raisean issue of fact as to whether Ruder hadcontrol over the instrumentality which caused[the plaintiff's] injuries." Gatlin, 137 Ill.2d at 297.

The plaintiff argued and the court agreed that the plaintiffsuffered his injuries at the hand of either Ruder during thedelivery or Riverside's employees in the nursery immediately afterthe delivery. By presenting evidence on each of the res ipsaloquitur requirements, the court determined that the plaintiff hadpresented sufficient circumstantial evidence from which a jurycould infer negligence. Gatlin, 137 Ill. 2d at 300. Thus, Gatlinsupports a negligence claim under the doctrine of res ipsa loquiturwhere a plaintiff presents some evidence that the injuries couldhave occurred at the hands of a doctor delivering a baby or at thehands of hospital personnel while the baby was being cared for inthe nursery.

In the instant case we are evaluating whether count II ofplaintiff's complaint states a cause of action, not whethersufficient evidence was presented to avoid summary judgment.

As we noted above, the supplemental report of the reviewingphysician stated: "[I]t is my opinion, to a reasonable degree ofmedical certainty, that either [Superior] and/or [Alden],negligently moved or handled Laura Collins and thereby causedinjury ***." In Gatlin, the court noted that satisfying the secondprong - defendant's exclusive control over the instrumentality -was problematic because there were two defendants. Nonetheless,the court found that the plaintiff had presented enough evidence toraise an issue of fact as to whether Ruder or Riverside had controlover the instrumentality causing the injury. Gatlin, 137 Ill. 2dat 297. Based on the reasoning in Gatlin, we find that plaintiffhas sufficiently alleged Superior and/or Alden negligently moved orhandled Laura Collins, thereby causing injury, and the inference ofnegligence under res ipsa loquitur can arise from these pleadedfacts. Additionally, we find other authority to support ourconclusion.

In Barkei v. Delnor Hospital, 176 Ill. App. 3d 681, 688, 531N.E.2d 413 (1988), the defendant Delnor Hospital (Delnor) appealedfrom a jury verdict entered in favor of plaintiffs, BrittanyBarkei, a minor, and her parents Kathleen and Randall Barkei, forinjuries sustained by Barkei after her birth while being cared forin a hospital nursery. The plaintiffs initiated the action againstboth Delnor and Dr. John Lamiot, who performed the delivery ofBrittany at Delnor. In 1987, the plaintiffs filed an amendedcomplaint alleging that Brittany has sustained brain damage and aspinal cord injury as the result of the defendants' negligentconduct. In addition to a res ipsa loquitur count of negligence,Delnor was specifically charged with dropping Brittany, among otherthings. Lamiot reached a pretrial settlement and the caseproceeded against Delnor.

At trial, Lamiot testified for plaintiffs. He stated thatBrittany's birth had been normal for a breech birth, where thechild's posterior as opposed to head appears first, and that he didnot know of anything that occurred after Brittany was born to causeher to be injured.

Mary Lee Holland, the first pediatrician to examine Brittany,saw the baby approximately 12 hours after birth and found her to befree from abnormalities. The next day, however, Holland said thatthe baby had an irritable cry and held her head to the left side. Two days later, Holland found abnormal swelling to the infant'shead and that the baby's left arm, which appeared normal before,was now limp. She assessed that a spinal cord injury was probable.

Dr. Murphy, Brittany's regular pediatrician, did not examinethe baby until two days after she was born. He did not notice anyswelling at the time but found the baby to be irritable. The nextday, after observing some swelling between the baby's throat andspine, Murphy determined there might be a fracture of the baby'scervical spine.

Nurse Shulz assisted Dr. Lamiot during Brittany's delivery. She said she had no knowledge of how Brittany might have receivedany trauma to her head and there was no notation of such an injuryon Brittany's chart.

Brittany's parents testified that they did not know how thetrauma to Brittany occurred. Randall Barkei, Brittany's father,said that he was present in the delivery room and that nothingunusual had happened during delivery.

After plaintiff presented the testimony of three expertwitnesses, Delnor moved for a directed verdict, which was denied bythe trial court. Delnor then offered testimony from several nurseswho worked in Delnor's maternity wing at the time Brittany was inthe hospital nursery. The case was submitted to the jury withinstructions on specific negligence and res ipsa loquitur and thejury returned a general verdict in favor of plaintiffs.

Among other things, Delnor argued that plaintiffs failed topresent sufficient evidence to prove the elements of negligence on the basis of res ipsa loquitur. Specifically, Delnor claimed that plaintiffs did not show that the hospital had exclusive controlover the instrumentality which caused the trauma. The reviewingcourt found that the trial court correctly denied Delnor's motionfor a directed verdict as to the negligence count based on res ipsaloquitur. Barkei, 176 Ill. App. 3d at 691. Further, the courtnoted that the child was injured near her birth and could notpossibly have had knowledge or control of any of the possiblecauses of the trauma she suffered and could not eliminate them withany certainty, whereas the hospital's role in her injury was withwithin its exclusive knowledge. Barkei, 176 Ill. App. 3d at 689. The facts in the instant case are similar to those in Barkei. Here, Superior makes a claim like the one made by Delnor thatplaintiffs did not show that Superior had exclusive control overthe instrumentality that caused the injury. Further, like theinfant child in Barkei, Collins, who was elderly, could not speak,and was immobile, did not have knowledge or control over thepossible causes of the trauma she suffered and could notcommunicate them with any certainty, whereas Superior's involvementin the injury, or lack thereof, was within its exclusive knowledge. Certainly, it can be inferred from the facts as pled that theinstrumentality of the injury was the handling of Collins bySuperior and/or Alden. But for the alleged negligence of Superiorand/or Alden, it can also be inferred that Collins would not havebeen injured. Count II of the complaint alleges that the injuryoccurred sometime between Collins' transport to Alden and herreturn home. These allegations indicate that Collins was in theexclusive control of Superior and/or Alden from the time she lefther home until the time she was returned with her injuries. Wereject Superior's suggestion that Collins' injuries could have beeninflicted by a third party. The complaint neither alleged theinvolvement of a third party, nor do the pleadings evidence such aclaim. In our view, the allegations in count II of plaintiff'scomplaint are sufficiently pled to raise the inference ofnegligence under the doctrine of res ipsa loquitur againstSuperior.

In Samansky v. Rush-Presbyterian-St. Luke's Medical Center,208 Ill. App. 3d 377, 567 N.E.2d 386 (1990), the plaintiff soughtdamages for injuries associated with the surgical removal of acatheter that remained in the plaintiff's body during heartsurgery. The heart surgery, the removal of the catheter, and thepost-operative care associated with these procedures wereundertaken by defendant physicians, Dr. Javid and Dr. Goldin, withthe assistance of employees of Rush-Presbyterian-St.Luke's MedicalCenter (Rush). The catheter at issue was manufactured by defendantDeseret Medical, Inc. (Deseret), and sold to defendant Rush. Inhis complaint, the plaintiff filed claims for res ipsa loquituragainst defendant physicians, Rush, and Deseret. All of thedefendants claimed that plaintiff could not invoke res ipsaloquitur because the plaintiff failed to show the defendants hadjoint, concurrent control over the instrumentality causing theplaintiff's injuries. The plaintiff's res ipsa loquitur claimswere dismissed by the trial court with prejudice under section 2-619(a)(9) of the Illinois Code of Civil Procedure.

On review, the appellate court reversed, holding: "a plaintiffmay benefit from res ipsa loquitur principles if the plaintiff canpresent evidence tending to show that the defendants exercisedconsecutive management or control over the instrumentality thatcaused plaintiff's injuries." (Emphasis omitted.) Samansky, 208Ill. App. 3d at 386-87. The court, relying on the supreme court'sdecision in Gatlin, 137 Ill. 2d at 297-98, further found:

"[P]laintiff need not present conclusive proofof which of the defendants exercised controlover the [catheter] at the time that thecondition causing plaintiff's injuries wascreated. Plaintiff is also not required toshow that his injuries were more probablycaused by one defendant than by anotherdefendant. Nor must plaintiff eliminate allcauses of his injuries other than thenegligence of one or more of the defendants.[Citation]." Samansky, 208 Ill. App. 3d at388.

Based on the above, the court concluded that the trial court erredin dismissing plaintiff's res ipsa loquitur negligence claims. Samansky, 208 Ill. App. 3d at 388.

Here, Superior contends that Samansky's reference to"consecutive control" was not supported by the language in Gatlin,and that Samansky was an "aberrant decision." We disagree anddetermine that the facts in the instant case are analogous to thosein Samansky. As in Samansky, plaintiff alleged that defendantsexercised consecutive management or control over Laura Collins atthe time she was injured. While plaintiff does not use the word"consecutive," the allegations in count II make clear that Collinswas injured at some point between her transport by Superior toAlden, her stay at Alden, and her subsequent transport home.

Res ipsa loquitur applies when a thing which caused the injuryis shown to be under the management of the party charged withnegligence and the accident itself affords reasonable evidence inthe absence of an explanation by the party charged. Metz, 32 Ill.2d at 448-49. Further, as noted above, the plaintiff bears theburden of proving: (1) that the occurrence is one that ordinarilydoes not occur in the absence of negligence and (2) that thedefendant had the exclusive control of the instrumentality thatcaused the injury. Dyback, 114 Ill. 2d at 242. Under thedoctrine of res ipsa loquitur, the facts of the occurrence showprima facie evidence of the defendant's negligence if theseelements are established. Dyback, 114 Ill. 2d at 242.

Here, in count II, paragraph 10, of the complaint, plaintiffalleged that Collins' injury occurred during the period of timewhen she was under Superior's and/or Alden's management andcontrol. Further, the reviewing physician's supplemental reportstated, "[I]t is my opinion, to a reasonable degree of medicalcertainty, that either [Superior] and/or [Alden], negligently movedor handled Laura Collins and thereby caused injury ***." Based onthe injuries suffered, it can be inferred that the instrumentalitythat caused the injury in this case was Superior's and/or Alden's,handling of Collins while she was in their respective care. Superior argues that, because there were two defendants, plaintiffcannot, and does not, plead that it was Superior alone thatcontrolled the instrumentality of the injury, a requirementnecessary for a successful cause of action for res ipsa loquitur. However, this requirement frustrates the essence of res ipsaloquitur, which allows proof of negligence by circumstantialevidence when the direct evidence concerning the cause of injury isprimarily within the knowledge and control of the defendant. Metz,32 Ill. 2d at 448-49.

Further, as noted above, the Samansky decision, relying uponGatlin, holds that a plaintiff need not present conclusive proof ofwhich one of the defendants exercised control over theinstrumentality of the injury at the time that the conditioncausing the plaintiff's injuries was created. Samansky, 208 Ill.App. 3d at 388. Samansky further held that a plaintiff is neitherrequired to show that his injuries were more probably caused by onedefendant than the other defendant, nor must he eliminate allcauses of his injuries other than the negligence of one or more ofthe defendants. Samansky, 208 Ill. App. 3d at 388. Here,plaintiff has named Superior and Alden in her complaint. Count II,paragraph 10, of the complaint alleged that plaintiff's injuryoccurred during the period of time when she was under thedefendants' control and management. Under these specific facts, weconclude that where there are only two defendants who hadconsecutive control over plaintiff, and either one could havecaused plaintiff's injuries, and both are named in the complaint,the complaint is sufficient for pleading purposes to raise theinference of negligence under the doctrine of res ipsa loquitur.

In Kolakowski v. Voris, 83 Ill. 2d 388, 415 N.E.2d 397 (1980),the plaintiff, who had a history of chronic back problems, suedDrs. David Voris, K.S. Parameswar, and Leonard Smith and MercyHospital (Mercy) for injuries suffered in connection with a fusionoperation conducted on his back. Dr. Voris, a neurologist, wasengaged as a consultant to Dr. John Caserta, the plaintiff's familyphysician. When the plaintiff's back pain became unbearable, itwas recommended by Dr. Voris that the plaintiff undergo fusionsurgery. The surgery was performed August 24, 1973, with Drs.Voris and Parameswar removing a disc from the patient's spine. Dr.Smith, an orthopedic surgeon, implanted a "plug" of bone into thearea where the disc had been removed. As a result of the surgery,the plaintiff lost the use of his limbs and became a virtualquadriplegic.

As noted above, the plaintiff brought a negligence actionagainst Voris, Parameswar, and Smith. Mercy was sued on separatecounts based on res ipsa loquitur. Mercy moved for summaryjudgment, which was granted by the trial court and the appellatecourt reversed. On appeal to the supreme court, Mercy, among otherthings, claimed that res ipsa loquitur was inapplicable because itdid not have exclusive control over the injuring instrumentality,a requirement for applying the doctrine.

Quoting the Supreme Court of California's decision to apply res ipsa loquitur in Ybarra v. Spangard, 25 Cal. 2d 486, 490-92,154 P.2d 687, 689-90 (1944), our supreme court stated:

" 'The present case is of a type whichcomes within the reason and spirit of thedoctrine more fully perhaps than any other ***[I]t is difficult to see how the doctrine can,with any justification, be so restricted inits statement as to become inapplicable to apatient who submits himself to the care andcustody of doctors and nurses, is renderedunconscious, and receives some injury frominstrumentalities used in his treatment. Without the aid of the doctrine a patient whoreceived permanent injuries of a seriouscharacter, obviously the result of someone'snegligence, would be entirely unable torecover unless the doctors and nurses inattendance voluntarily chose to disclose theidentity of the negligent person and the factsestablishing liability.

* * *

*** The control, at one time or another,of one or more of the various agencies orinstrumentalities which might have harmed theplaintiff was in the hands of every defendantor of his employees or temporary servants. This, we think, places upon them the burden ofinitial explanation.' [Citation.]" Kolakowski, 83 Ill. 2d at 397-98.

Relying upon this language, the court found that theplaintiff, at the time of the alleged injury, was placed in thecare and custody of the named defendants. Kolakowski, 83 Ill. 2dat 396. The court also rejected Mercy's theory that whenever adoctor acting in the capacity of an independent contractorparticipates in a surgery in a defendant hospital, the element ofexclusive control by the hospital ceases. At the time of surgery,each owed an independent duty to the patient and exercisedconcurrent control over the operation and equipment. Kolakowski,83 Ill. 2d at 396. As a result, the court found that the controlnecessary to apply res ipsa loquitur had been met and that theburden shifted to the hospital to dispel the inference ofnegligence. Kolakowski, 83 Ill. 2d at 396.

Like the plaintiff in Kolakowski, plaintiff's decedent wasplaced in the care and custody of the named defendants. Thecontrol, at one time or another, of one or more of theinstrumentalities that might have harmed plaintiff was in the handsof each defendant here. While plaintiff's decedent in the instantcase was not rendered unconscious during an operation, she lackedthe knowledge, control, and ability to identify the injuringinstrumentality. As in Kolakowski, Superior and Alden each owed aduty to Laura Collins. Each exercised "consecutive" control overher care, first Superior, then Alden, and then Superior again. We,too, think the burden of initial explanation rests with defendants. Therefore, we find that the element of control necessary for theapplication of res ipsa loquitur was pled in the instant case.

In support of its argument, Superior relies on Loizzo v. St.Francis Hospital, 121 Ill. App. 3d 172, 459 N.E.2d 314 (1984), andGolden v. Kishwaukee Community Health Services Center, Inc., 269Ill. App. 3d 37, 645 N.E.2d 319 (1994). According to Superior,Loizzo and Golden addressed res ipsa loquitur negligence theoriesasserted against two or more independent, different defendants thatprovided different treatment at different times in differentlocations during the time period in which the alleged injuriesoccurred.

In Loizzo, the plaintiff sought damages for personal injuriessuffered by a catheter that was negligently left in his body duringsurgery. On March 30, 1977, the catheter was discovered atdefendant St. Francis Hospital by defendants Dr. Edward Pinsel andDr. A. Jerald Rothenberg. The plaintiff had been previouslyhospitalized at defendant Northwest Community Hospital on December16, 1976, December 25, 1976, and March 21, 1977, for severe chestpain. At the time of these hospitalizations, the plaintiff wasunder the care of defendants Dr. Miles Lynch, Dr. John Lynch andDr. Joseph Franger. On the latter two occasions, the plaintiff wasadmitted through the emergency room of Northwest CommunityHospital, which was staffed by physician employees of defendantMedical Emergency Associates.

The plaintiff filed an amended complaint alleging res ipsaloquitur against all of the defendants. However, the amendedcomplaint did not allege that the plaintiff's hospitalizations atSt. Francis Hospital and Northwest Community Hospital were the onlyoccasions where he underwent invasive procedures at a hospital. Tothe contrary, the plaintiff had been hospitalized at NorwegianAmerican Hospital for a bladder ailment. The defendants deniedplacing the catheter in the plaintiff's body and denied knowledgeof the person or persons who inserted the catheter. The plaintiffproffered no evidence contrary to the defendants' contentions.

Each defendant moved for summary judgment based upon theplaintiff's failure to show when, where, or by whom he was injuredand the defendants' contentions that they had not placed thecatheter in the plaintiff's body. The trial court denied each ofthe defendants' motions, but the defendants renewed their motionsfor summary judgment under the supreme court's holding in Spidle v.Steward, 79 Ill. 2d 1, 402 N.E.2d 216 (1980). This time, the trialcourt, finding that the plaintiff failed to show the requisiteexclusiveness of control of the instrumentality causing theplaintiff's injuries, granted summary judgment in favor of thedefendants. The plaintiff appealed.

The appellate court stated:

"In cases of medical malpractice againstmultiple defendants the doctrine has been heldapplicable where the defendants were in jointcontrol of the agency causing the injury. Conversely, the doctrine has been held notapplicable against multiple defendants whereit was not shown that they were in joint orexclusive control of the injuring agency.[Citations.]" Loizzo, 121 Ill. App. 3d at 179.

It further found that the defendants were not acting jointly witheach other. Specifically, the court held:

"The situation here involves differenttreatment by different entities at differenttimes in different locations. Neitherplaintiff nor the defendants have knowledge ofthe who, when, or where questions surroundingplaintiff's injury. Without knowledge of theevent causing the injury, it cannot be saidunder the facts here that any medicalpersonnel who treated plaintiff was moreprobably negligent than any other. [Citation.] Further complicating the matteris the fact that the catheter may have beeninserted by a non named medical provider." Loizzo, 121 Ill. App. 3d at 180.

We find Loizzo distinguishable for several reasons. First,the Loizzo court recognized that the plaintiff's amended complaint"[did] not allege that plaintiff's hospitalizations at St. Francisand Northwest Community hospitals were the only occasions in whichhe was treated at a hospital or in which he underwent invasiveprocedures." Loizzo, 121 Ill. App. 3d at 175. Instead, theevidence showed that the plaintiff had been treated for a bladderailment at Norwegian American Hospital, a party not named in theplaintiff's amended complaint. Here, unlike Loizzo where a knownmedical provider was not named, the plaintiff named Superior andAlden. Thus, all of the parties allegedly responsible for Collins'injuries were named in the complaint. The instant record providesno evidence of an unnamed third party.

Second, Loizzo was a summary judgment case where thedefendants affirmatively asserted that they had no control over thecatheter and these assertions were not contradicted by any evidence proffered by the plaintiff. Here, we must only determine whetherthe allegations in count II of the complaint as pled raised theinference of negligence under the doctrine of res ipsa loquitur tosurvive a dismissal under section 2-615 of the Illinois Code ofCivil Procedure. 735 ILCS 5/2-615 (West 2000). To do so,plaintiff was required to establish a prima facie showing ofSuperior's negligence by demonstrating that the injury does notusually happen in the absence of negligence and that Superior wasin exclusive control of the instrumentality that caused the injury. Barkei, 176 Ill. App. 3d at 688. Our review of the allegations incount II and accompanying supplemental physician's report indicatesplaintiff alleged that the injuries to Collins would not haveoccurred in the absence of negligence by Superior and/or Alden andthat the injuries to Collins occurred while under Superior and/orAlden's control. Thus, we find that count II alleged a prima facieshowing of Superior's negligence.

Third, the court in Loizzo noted that the defendants were notacting jointly and that the situation involved "different treatmentby different entities at different times in different locations." Loizzo, 121 Ill. App. 3d at 180. Superior suggests that the factsin the instant case are analogous to those in Loizzo becauseSuperior merely transported Collins to and from Alden and could notbe responsible for anything that happened to Collins while atAlden. Thus, Superior claims that it was providing differentservices at different times and different locations.

In our view, the facts in Loizzo are different in this regard. In Loizzo, the plaintiff was hospitalized on five separateoccasions at both St. Francis Hospital and Northwest CommunityHospital and was seen by numerous doctors during these visits. Inthe instant case, Collins was transported by Superior to Alden andback home within a six-day period. While Superior and Aldenprovided different services, they both exercised consecutivecontrol over Collins during the entire period of time alleged inplaintiff's complaint. Further, in count II of the same pleading,plaintiff alleged that Collins' injuries "occurred during theperiod of time when she was under defendants' control andmanagement." Thus, an inference of res ipsa loquitur negligencewas alleged against Superior and Alden, the only defendants chargedwith the transport and care of Collins. For the reasons above, wefind Loizzo distinguishable.

In Golden, also relied upon by Superior, the plaintiff wasseverely injured in a motorcycle accident. After the accident,paramedics transported the plaintiff to Kiswaukee CommunityHospital (Kishwaukee). At the Kishwaukee trauma room, theplaintiff was treated by Dr. Brandon, Dr. Biscan, nurse Jan Heal,and nurse anesthetist James Dionisopoulos. Dr. Brandon laterdecided to transfer the plaintiff to Skokie Valley Hospital (SkokieValley) in the plaintiff's hometown because it was close toplaintiff's family and it had long-term care facilities and medicalspecialists that Kishwaukee could not provide. Hospital personnelat Kishwaukee were unable to contact plaintiff's family.

The plaintiff was taken to Skokie Valley by ambulance. At thetime, he could move his limbs to a degree and was responsive. Hewas seen at Skokie Valley by Dr. Peckler, Dr. Rich, Dr. Stilp, andDr. Goldin. The next morning, the plaintiff was unable to move hisextremities and remained paralyzed from the neck down.

The plaintiff ultimately filed a second amended complaintwhich contained res ipsa loquitur counts alleging that thetreatment he received from Kishwaukee, Skokie Valley and theaforementioned doctors either caused or contributed to hisparalysis. The plaintiff maintained that all defendants exercisedjoint control because Kishwaukee improperly transferred him toSkokie Valley, a hospital that was incapable of treating hisinjuries. The trial court struck the res ipsa loquitur counts inthe plaintiff's second amended complaint on the basis that theplaintiff failed to establish "exclusive control." Golden, 269Ill. App. 3d at 43. The plaintiff appealed.

On review, the appellate court found that the plaintiff failedto demonstrate that the defendants acted jointly. Citing Loizzo,the Golden court found that because the plaintiff had received"different treatment by different entities and persons at differenttimes in different locations[,] the requisite control was not shownas to permit application of the res ipsa loquitur doctrine." Golden, 269 Ill. App. 3d at 43.

Golden is also distinguishable from the instant case. First,the appellate court noted that the plaintiff did not add the resipsa loquitur counts until nine years after the case had been filedand had already been assigned for trial. It also found that thetrial court, within its discretion, should have determined that theplaintiff's untimely motion prevented the defendants fromcompleting the necessary discovery and preparation of a res ipsaloquitur defense in time for trial. Golden, 269 Ill. App. 3d at43. Thus, the appellate court opined that leave to amend thecomplaint to add the res ipsa loquitur counts should never havebeen granted.

Second, at least some evidence in the Golden demonstrated thatthe sole cause of the plaintiff's injury occurred at Skokie Valley.It is clear that the plaintiff received treatment from differentmedical personnel at Skokie Valley. The plaintiff's own expertwitness opined that the plaintiff became a quadriplegic at SkokieValley under the care of its doctors. Such facts demonstrated thatthe injuring instrumentality was under the control of medicalpersonnel at Skokie Valley.

Superior suggests that the facts in Golden are analogous tothose in this case because Superior and Alden were providingdifferent treatment at different times at different facilities. While Superior and Alden provided different treatment at differenttimes at different facilities, they each exercised consecutivecontrol over Collins at the time she was allegedly injured.

Plaintiff alleged that her mother's injury occurred whileunder Superior and Alden's management and control. Plaintiff wasnot required to eliminate all possible causes of her mother'sinjuries. Gatlin, 137 Ill. 2d at 298. Instead, she was requiredto plead the requisite elements for the doctrine of res ipsaloquitur to apply. Here, as we noted above, plaintiff has done soand we find Golden to be inapposite.

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[The preceding material is non-publishable pursuant to SupremeCourt Rule 23.]

For the reasons above, we reverse the trial court and remandthis matter for further proceedings consistent with this opinion.

Reversed and remanded.

BURKE and GARCIA, JJ., concur.

1. Laura Collins was the original plaintiff in this action. On December 14, 2001, Laura Collins died. On July 3, 2002, EvaCollins, special administrator of Laura Collins' estate, wassubstituted as plaintiff-appellant.