Summary
The Supreme Court of Rhode Island affirmed a judgment for the defendant physician after a jury found that the plaintiff failed to prove medical negligence in the treatment of his right eye. The court held that the plaintiff's challenge concerning a loss-of-chance jury instruction was moot because the jury found no deviation from the applicable standard of care, and the loss-of-chance doctrine concerns causation.
Topics
Practice areas
Questions Presented
- Whether the trial justice erred by failing to instruct the jury on Rhode Island's loss-of-chance doctrine.
- Whether the Supreme Court should recognize loss of chance as an appropriate theory of recovery in this medical-malpractice case.
Holdings
- The issue was moot because the jury found that Dr. Prescod did not deviate from the applicable standard of care. The loss-of-chance doctrine affects causation, and causation is not reached unless the plaintiff first proves a breach of the standard of care.
- Loss of chance is not a distinct cause of action; it is an alternative to conventional causation principles that permits a plaintiff to establish that the defendant's negligence was a proximate cause of the lost chance to avoid the ultimate harm.
Key quotations
“The loss-of-chance doctrine differs from traditional negligence, but it does not represent a distinct cause of action. Rather, loss of chance is an alternative to conventional notions of causation, and requires a more expansive interpretation of causation.” (948 A.2d at 310)
“The threshold inquiry in a loss-of-chance analysis is whether the defendant has met the applicable standard of care. It is only after the plaintiff satisfies the burden of proving a deviation from that standard that a fact-finder must determine if there is a causal relationship between the breach and the injury suffered.” (948 A.2d at 310)
Factual background
Dr. Prescod performed a pars plana vitrectomy with membrane peeling on Mandros's right eye in January 1998 to treat macular pucker. During and after the surgery, Mandros developed subretinal bleeding and later a choroidal neovascular membrane, resulting in permanent central-vision loss. The evidence conflicted over whether Dr. Prescod should have performed a fluorescein angiogram earlier and whether earlier treatment would have improved the outcome. The jury found that Dr. Prescod was not negligent in failing to perform the test in March or April 1998.
Procedural history
Mandros sued Dr. Prescod and Koch Eye Surgicenter, Inc., alleging medical negligence and lack of informed consent. The claims against Mandros's wife, the informed-consent claim, and claims against Koch Eye Surgicenter were dismissed or withdrawn, leaving the medical-negligence claim against Dr. Prescod. The jury found that Dr. Prescod was not negligent, judgment entered for him, and Mandros appealed. The Supreme Court affirmed, concluding that the challenged loss-of-chance instruction issue was moot because the jury found no breach of the standard of care.
Remand instructions
The record was remanded to the Superior Court consistent with the affirmance.