Brief Fact Summary. Defendant operated on Plaintiff twice to cure Plaintiff’s back pain. Plaintiff developed an infection and was diagnosed with discitis. Plaintiff sued Defendant for negligence.
Synopsis of Rule of Law. A doctor must use that degree of skill and learning which is normally possessed and used by doctors in good standing, in a similar practice, in a similar community, and under like circumstances.
Issue. Is Defendant required to use that degree of skill and learning which is normally possessed and used by doctors in good standing, in a similar practice, in a similar community, and under like circumstances?
Held. Yes. Judgment for Plaintiff affirmed.
* To establish a prima facie case of medical malpractice (negligence) Plaintiff must demonstrate: (1) the standard of care required by Defendant; (2) proof that Defendant failed to meet this standard of care; and, (3) a causal relation between the act or omission of Defendant and the injury suffered. To establish the applicable standard of care, expert testimony is usually required. Proof of causation is also more difficult because a jury must often grapple with scientific processes that are unfamiliar and involve inherent uncertainty. By a preponderance of the evidence, Plaintiff must prove that Defendant’s act or omission to act was the factor “most probable” in causing injury to Plaintiff.
* In addressing Defendant’s claim on appeal, that Plaintiff failed to introduce relevant standards of care or a causal link, the court focuses on Defendant’s failure to provide conservative treatment prior to the first operation.
* The standard practice is for a neurosurgeon to postpone lumbar disc surgery while the patient undergoes conservative treatment, with a period of absolute bed rest as the prime ingredient. An expert testified at trial, “all neurosurgeons go for [conservative treatment] before they finally decide on an operation.” Defendant neither prescribed nor attempted to enforce a conservative regime. There was sufficient evidence for the jury to conclude that Defendant failed to provide customary conservative treatment and thus breached the applicable standard of care.
* There are two issues in the chain of causation: (1) Did the surgery cause the infection; and (2) would conservative treatment have made surgery unnecessary. If a doctor negligently exposes a patient to risk-prone surgery, he is liable for the harm associated with a foreseeable risk. In this case, discitis was a foreseeable risk. Also, almost all of the experts testified that conservative treatment would eliminate the need for surgery. The jury could have reasonably found that Defendant’s failure to administer conservative treatment was the “most probable cause” of the first operation.
Discussion. This case discusses the complex issues that a plaintiff faces in a claim for negligent medical malpractice.