States v. Lourdes Hosp.
| Decision Date | 06 May 2003 |
| Citation | 762 N.Y.S.2d 1,100 N.Y.2d 208,792 N.E.2d 151 |
| Parties | KATHLEEN STATES et al., Appellants, v. LOURDES HOSPITAL, A DAUGHTER OF CHARITY HOSPITAL, et al., Defendants, and RIVERSIDE ASSOCIATES IN ANESTHESIA, P.C., et al., Respondents. |
| Court | New York Court of Appeals Court of Appeals |
Powers & Santola, LLP, Albany (Michael J. Hutter, Jr. of counsel), Cherundolo, Bottar & Leone, P.C., Syracuse, and Foley, McLane, Foley, McDonald & MacGregor, P.C., Scranton, Pennsylvania, for appellants.
Levene Gouldin & Thompson, LLP, Binghamton (David M. Gouldin, Margaret J. Fowler and Gary C. Tyler of counsel), for respondents.
The first prerequisite for invocation of the doctrine of res ipsa loquitur, and the inference of negligence it permits, is that the injury-causing event be of a kind that ordinarily does not occur in the absence of negligence. In Kambat v St. Francis Hosp., we held that res ipsa loquitur was available in "a narrow category of factually simple medical malpractice cases requir[ing] no expert to enable the jury reasonably to conclude that the accident would not happen without negligence" (89 NY2d 489, 496 [1997]), but left for another day the question of "whether expert testimony can be used to educate the jury as to the likelihood that the occurrence would take place without negligence where a basis of common knowledge is lacking" (id. at 495). Squarely presented with this question today, we conclude that it is proper to allow the use of expert medical testimony to inform the jury's decision on this element of res ipsa loquitur.
On July 25, 1995, plaintiff Kathleen States underwent surgery at Our Lady of Lourdes Hospital in Binghamton for removal of an ovarian cyst. The cyst was successfully removed. The surgeon, as well as the hospital, are no longer defendants in this action. However, plaintiff alleges that, during the operation, her anesthesiologist and his practice group (collectively "defendant") injured her right arm.
Prior to surgery, plaintiff's right arm was placed on a board, extended outward from her body and rotated. An IV tube was then inserted into her right hand in order to administer anesthesia. Plaintiff complained of pain and a burning sensation when the tube was inserted, but surgery proceeded and there is no record of any untoward event involving plaintiff's arm. Nonetheless, when plaintiff awoke, she complained of increasing pain in her right arm and shoulder. Plaintiff has since been diagnosed with right thoracic outlet syndrome and reflex sympathetic dystrophy. The cause of the injury is in dispute; however, plaintiff alleges negligence in the positioning of her arm during surgery. Specifically, plaintiff believes her arm was negligently hyperabducted beyond a 90-degree angle for an extended period of time.
At the close of discovery, defendant moved for summary judgment on the ground that there was no direct evidence that plaintiff's arm was hyperabducted during surgery and no evidence of any other negligence. Conceding the absence of direct evidence of negligence, plaintiff opposed the motion, submitting expert medical opinion that her injuries would not have occurred in the absence of negligence. Plaintiff claimed this testimony could be used by a jury in support of a res ipsa loquitur theory.
Supreme Court denied defendant's motion for summary judgment, citing Kambat in support of its conclusion that a jury could rely on the expert medical opinion to support the conclusion that the injury would not have occurred in the absence of negligence (188 Misc 2d 420, 425 [2001]). A divided Appellate Division reversed, the majority holding that the inference was not permitted since plaintiff's injury was not the sort as to which a jury could draw upon its common knowledge and experience to conclude that it would not have occurred in the absence of negligence (297 AD2d 450 [2002]). Plaintiff appeals as of right from the Appellate Division order based on a two-Justice dissent, and we now reverse.
Under appropriate circumstances, the evidentiary doctrine of res ipsa loquitur may be invoked to allow the factfinder to infer negligence from the mere happening of an event (see Restatement [Second] of Torts § 328D). Res ipsa loquitur, a doctrine of ancient origin (see Byrne v Boadle, 2 H & C 722, 159 Eng Rep 299 [1863]), derives from the understanding that some events ordinarily do not occur in the absence of negligence (id.; see also Dermatossian v New York City Tr. Auth., 67 NY2d 219, 226 [1986]
). In addition to this first prerequisite, plaintiff must establish, second, that the injury was caused by an agent or instrumentality within the exclusive control of defendant and, third, that no act or negligence on the plaintiff's part contributed to the happening of the event (see Ebanks v New York City Tr. Auth., 70 NY2d 621, 623 [1987]). Once plaintiff satisfies the burden of proof on these three elements, the res ipsa loquitur doctrine permits the jury to infer negligence from the mere fact of the occurrence.
This appeal concerns the first of the three required elements. Defendant contends that res ipsa loquitur cannot apply here because, in order to establish the first prerequisite—that the occurrence would not take place in the absence of negligence— plaintiff must rely on expert medical opinion, and the doctrinal foundation of res ipsa loquitur can only lie in everyday experience. Therefore, when expert testimony is necessary to provide the basis for concluding that the event would not occur in the absence of negligence, the matter is outside the ken of a layperson and res ipsa loquitur is inapplicable.
In the circumstances presented, we conclude that expert testimony may be properly used to help the jury "bridge the gap" between its own common knowledge, which does not encompass the specialized knowledge and experience necessary to reach a conclusion that the occurrence would not normally take place in the absence of negligence, and the common knowledge of physicians, which does (see Connors v University Assoc. in Obstetrics & Gynecology, Inc., 4 F3d 123, 128
[2d Cir 1993]). Our conclusion not only is supported by a majority of courts that have considered the question,1 but also is the approach adopted by the Restatement of Torts:
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Expert witnesses
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...supplement a jury’s understanding of whether an injury would normally occur in the absence of negligence. See States v. Lourdes Hospital, 100 N.Y.2d 208, 792 N.E. 2d 151, 154 (2003), which lists those courts that permit expert testimony even though the concept of res ipsa loquitur was also ......