Stallings v. Ratliff
| Decision Date | 19 February 1987 |
| Docket Number | No. 0950,0950 |
| Citation | 292 S.C. 349,356 S.E.2d 414 |
| Court | South Carolina Court of Appeals |
| Parties | Naomi STALLINGS, Appellant, v. Dr. Jack RATLIFF, Respondent, and Daniel M. STALLINGS, Jr., Appellant, v. Dr. Jack RATLIFF, Respondent. . Heard |
Donald E. Jonas, Columbia, and Frampton W. Toole, Aiken, for appellants.
David A. Brown and James M. Holly, Aiken, for respondent.
Naomi Stallings brought this action for injuries she allegedly received as a result of the negligence of her physician, Dr. Jack Ratliff. The companion case involving a loss of consortium claim by her husband was consolidated for trial. Stallings alleges she suffered a perforation of her esophagus during an esophagoscopy undertaken without her informed consent. At the close of the evidence, the circuit court granted Ratliff's motion for a directed verdict. Stallings and her husband appeal. We reverse and remand.
Stallings works as a cook at a restaurant in Aiken. One day, while eating a piece of chicken, she felt what she thought was a small bone lodge in her throat. After Stallings experienced continued discomfort in her throat for the next few days, her employer, Vivian Jolly, took her to the emergency room of a local hospital where she was examined. No bone was discovered. When the discomfort persisted, Mrs. Jolly took Stallings to a physician, who examined her on two occasions without finding any object in her throat. The physician then referred Stallings to Ratliff, a thoracic surgeon, for further evaluation.
Mrs. Jolly accompanied Stallings to Ratliff's office and was present with her at all times. After examining Stallings, Ratliff recommended she undergo a laryngopharyngoscopy under general anesthesia. In this procedure, the physician inserts a rigid tube, called a rigid esophagoscope, into the esophagus. The esophagoscope has a light source which allows the physician to make a visual examination of the esophagus. One risk of the procedure is perforation of the esophagus.
Ratliff performed the laryngopharyngoscopy on Stallings a few days after their initial consultation. During the procedure, he perforated her esophagus. As a result, an emergency thoracotomy had to be performed to repair the perforation.
Stallings tried her case on the theory that Ratliff was under a duty to inform her before obtaining her consent that perforation of the esophagus is a risk of the procedure he was recommending and that he breached this duty by failing to disclose the risk.
The parties agree that a physician is required to disclose those risks which a reasonable medical practitioner in the same branch of medicine would disclose under the same or similar circumstances. Hook v. Rothstein, 281 S.C. 541, 316 S.E.2d 690 (Ct.App.), cert. denied, 283 S.C. 64, 320 S.E.2d 35 (1984). They also agree that both the standard of care and the physician's failure to conform to the required standard must ordinarily be established by expert testimony, unless the common knowledge or experience of laymen is comprehensive enough to permit the recognition or inference of negligence from the particular facts. Welch v. Whitaker, 282 S.C. 251, 317 S.E.2d 758 (Ct.App.1984); Botehlo v. Bycura, 282 S.C. 578, 320 S.E.2d 59 (Ct.App.1984). At issue is whether Stallings presented sufficient expert testimony to create a reasonable inference of negligence.
Ratliff argues a directed verdict was proper for two reasons: (1) there was no expert testimony establishing the standard of care; and (2) there was no expert testimony that Ratliff failed to conform to the required standard of care.
In deciding a motion for a directed verdict, the evidence and all reasonable inferences which can be drawn therefrom must be viewed in the light most favorable to the nonmoving party. Timmons v. McCutcheon, 284 S.C. 4, 324 S.E.2d 319 (Ct.App.1984). A motion for a directed verdict should not be granted if the evidence, so viewed, is susceptible of more than one reasonable inference. O'Neal v. Carolina Farm Supply of Johnston, Inc., 279 S.C. 490, 309 S.E.2d 776 (Ct.App.1983). Reviewing the evidence in the light most favorable to Stallings, we find it supports a reasonable inference of negligence by Ratliff. Consequently, the trial judge erred when he directed a verdict.
Stallings called as her expert witness Dr. Alan Howard Brill, an otolaryngologist with training and experience in the use of the rigid esophagoscope. Dr. Brill testified:
The main concern doing an esophagostomy [sic], as far as possible complications, would be perforation of the esophagus.
Q. And what warning would be appropriate to give to a patient regarding that risk?
A. I think the patient has to be aware, as in any surgical procedure, the possible complications of surgery.
On cross examination, Dr. Brill further stated:
Whether it's an esophagoscopy or not, the procedure has to be explained to the patient, no matter what the procedure is.
Q. ... [D]o you understand the standard of care to mean that the patient is to be informed of the risks?
A. Yes, I do.
When asked what he should have advised Stallings about the risks associated with the use of the rigid esophagoscope, Ratliff himself stated:
I should have explained to her the kinds of risks associated with this kind of procedure, with looking down a swallowing tube with a pipe with a light on the end of it, includ[ing] ... the risk of the instrument itself damaging the esophagus.
Viewing this testimony in the light most favorable to Stallings, we hold that Stallings presented sufficient expert testimony to go to the jury on the standard of care.
Ratliff next argues there was no competent evidence that he breached his duty to disclose the risk of a perforated esophagus to Stallings.
The testimony was in sharp conflict on this point. Ratliff testified that prior to obtaining her consent to the procedure, he informed Stallings in nontechnical language of the risks involved in a esophagoscopy, including the specific possibility the esophagus would be perforated. Stallings, on...
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