Matthies v. Mastromonaco

Brief Fact Summary.

Matthies (Plaintiff) sued her doctor, Mastromonaco (Defendant) when he treated her broken hip by bed rest without telling her about a surgical alternative.

Synopsis of Rule of Law.

In order for a patient to give informed consent to a treatment recommendation, a physician must explain medically reasonable invasive and noninvasive treatments, even when the recommended treatment is noninvasive.

Facts.

Plaintiff broke her hip when she was eighty-three years old. Defendant was her doctor. When he reviewed her medical history, Defendant decided not to operate on her hip. As a result of this decision, Plaintiff lost her ability to walk and was confined to a nursing home. Plaintiff sued for medical malpractice, claiming that Defendant was negligent in failing to consult with her or her family about the possibility of surgery and that she would not have consented to treatment by bed rest had she known the probable effect on her quality of life. The jury found for Defendant, but the appellate division reversed because the jury was not instructed on informed consent. Defendant appealed, arguing that the informed consent doctrine did not apply when the recommended treatment was noninvasive.

Issue.

In order for a patient to give informed consent to a treatment recommendation, must a physician explain medically reasonable invasive and noninvasive treatments, even when the recommended treatment is noninvasive?

Held.

(Pollock, J.) Yes. In order for a patient to give informed consent to a treatment recommendation, a physician must explain medically reasonable invasive and noninvasive treatments, even when the recommended treatment is noninvasive. The physician should discuss the material risks inherent in a procedure or course of treatment. Material risks are those a reasonable patient in the patient’s position would consider material. Physicians cannot substitute their own values for their patient’s. The jury should consider informed consent on retrial. Affirmed. 

Discussion.

In some jurisdictions, a plaintiff must present expert testimony that inadequate information was provided when alleging lack of informed consent. Other jurisdictions treat a medical malpractice claim essentially as a battery. Here, the court found that the physician’s deviation from the standard of care was essential to deciding informed consent cases.