Summary
The Minnesota Supreme Court affirmed a $600,000 judgment against a surgeon based on negligent nondisclosure of surgical risks and battery arising from breast surgery. The court held that the evidence supported submitting both theories to the jury, that the jury instructions on disclosure were proper, and that the damages award was not excessive.
Topics
Practice areas
Questions Presented
- Whether the evidence was sufficient to submit battery to the jury when the patient consented to an adenomammectomy but the surgeon performed a procedure involving substantially greater removal of breast tissue.
- Whether the trial court erred by refusing the surgeon's requested instruction based on Bang v. Charles T. Miller Hospital concerning extension of surgery to address an abnormal or diseased condition.
- Whether the negligent-nondisclosure claim was improperly submitted under Cornfeldt I because that cause of action was recognized after the surgery.
- Whether Cornfeldt II altered the applicable disclosure standard so as to require a new trial.
- Whether the $600,000 damages award was excessive.
Holdings
- The trial court did not err in submitting battery to the jury because the evidence conflicted concerning the nature and extent of the procedures and supported a finding that the patient consented to an adenomammectomy but received substantially the equivalent of breast removal.
- The trial court properly refused the surgeon's requested instruction because it expanded the rule in Bang beyond permitting an extension of surgery only when an unanticipated condition would endanger the patient's life or health.
- Although negligent nondisclosure alone would have been sufficient and submitting both theories may be redundant, the trial court did not err in submitting both battery and negligent nondisclosure under the facts of this case.
- Cornfeldt II did not reduce the scope of the physician's duty to disclose recognized in Cornfeldt I, and the trial court properly instructed the jury under Cornfeldt I.
- A patient's prior medical experience does not relieve a physician of the duty to disclose otherwise material risks, although proof that the patient actually knew the risk that materialized may defeat proximate cause.
- The $600,000 damages award was not excessive.
Key quotations
“It is undisputed that, after the biopsy, Mrs. Kinikin refused breast removal, a mastectomy, in the absence of proof of cancer. Yet what she received was, substantially, breast removal.” (at 593)
“Lastly, to the extent a doctor is or can be aware that his patient attaches particular significance to risks not generally considered by the medical profession serious enough to require discussion with the patient, these too must be brought out.” (at 595)
“We do not mean by this that a physician may be liable for nondisclosure of a risk of which the patient had actual knowledge.” (at 596)
Factual background
Harriet Kinikin underwent a biopsy after breast calcifications suggested possible cancer; the biopsy revealed benign but extensive fibrocystic disease. She consented in writing to a bilateral adenomammectomy, but Dr. Heupel performed surgery removing essentially all breast tissue, which he described in the discharge summary as a subcutaneous mastectomy. The remaining skin became necrotic, resulting in gangrene, pronounced scarring and deformity, restricted arm movement, and substantial psychological and physical harm. The jury credited Kinikin's testimony that she had not been adequately informed of the procedure's prophylactic purpose and risks, including skin necrosis, and that she had not consented to the procedure actually performed.
Procedural history
A jury found that Dr. Heupel was not negligent in the general care and treatment of Kinikin but was liable for battery and negligent nondisclosure of surgical risks. The trial court entered judgment for $600,000 and denied the doctor's post-trial motions. The Minnesota Supreme Court affirmed.