Mission Health, HCA settle Canton family’s delayed C-section lawsuit

Mission Health and HCA Healthcare have settled a medical malpractice lawsuit filed by a Canton family over a delayed C-section, ending a yearslong case tied to a 2020 birth at Mission Hospital. The case was dismissed with prejudice after mediation, closing the matter in its current form.

The lawsuit was filed in September 2022 by Ashley Smathers of Canton, the wife of Canton Mayor Zeb Smathers. It alleged that when she was admitted for labor and delivery on March 19, 2020, fetal-monitoring signs became concerning and a C-section was ordered but was not performed for nearly five hours. The complaint said accepted standards of care required the surgery to be completed as soon as possible and within 30 minutes.

The filing also alleged Mission had reduced the number of surgical teams working or available overnight, a claim that put staffing and operating-room readiness at the center of the dispute. Smathers’ complaint said she lost at least ten liters of blood and required an emergency hysterectomy. It also alleged the child suffered a permanent hypoxic brain injury, cerebral palsy, and associated delays and disabilities.

The settlement matters beyond one family because it lands in the middle of broader scrutiny of Mission Health and HCA’s stewardship of western North Carolina’s largest hospital system. HCA bought Mission Health in 2019 for $1.5 billion, and since then the hospital system has faced repeated criticism from doctors, nurses, patients, and regulators over staffing, service reductions, and safety problems.

That wider fight escalated in December 2023, when North Carolina Attorney General Josh Stein sued HCA Healthcare over alleged failures to provide promised emergency and cancer services at Mission Health. Buncombe County later sought to join that case, saying emergency-room delays and ambulance wait times had cost taxpayers more than $3 million since the start of 2020.

Mission Hospital has also faced intense regulatory pressure, including four immediate-jeopardy citations since HCA’s purchase, according to March 2026 reporting. For families in Buncombe County, Haywood County, and across western North Carolina, the settlement ends one lawsuit but leaves the larger question intact: whether the region’s dominant hospital system is delivering the level of maternity care, staffing, and transparency patients expect when seconds can shape a lifetime.