Christman v. Davis
889 A.2d 746 (2005)
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Rule of Law:
A medical professional does not commit battery when they perform a less invasive procedure that involves the same preliminary steps as a more invasive procedure to which the patient had already consented.
Facts:
- Paul Christman consulted Dr. Gordon Davis, a periodontist, for treatment of his gum recession and root exposure.
- Dr. Davis discussed a tissue graft procedure with Christman to treat the condition.
- Christman consented to undergo the tissue graft procedure.
- After administering anesthesia and making the initial incisions required for the graft, Dr. Davis determined he would perform a flap procedure instead.
- The flap procedure uses the same initial incisions as a graft but applies a protein to the gum instead of grafting donor tissue, making it a less invasive procedure.
- After the surgery, Christman learned he had received the flap procedure instead of the tissue graft he expected.
- The flap procedure did not achieve full results, and Christman was later informed that he would still need to undergo a tissue graft.
Procedural Posture:
- Paul Christman sued Dr. Gordon Davis and his practice in a Vermont superior court (trial court) for dental malpractice, lack of informed consent, and battery.
- Christman later voluntarily dismissed his claims for malpractice and lack of informed consent, proceeding only on the battery claim.
- The defendants filed a motion for summary judgment on the battery claim.
- The trial court granted the defendants' motion for summary judgment.
- Christman, as the appellant, appealed the trial court's grant of summary judgment to the Supreme Court of Vermont.
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Issue:
Does a medical professional commit battery when, after obtaining consent for a specific surgical procedure, they perform a less invasive procedure that is a necessary preliminary component of the consented-to operation?
Opinions:
Majority - Dooley, J.
No, a medical professional does not commit battery in this situation because the performed procedure was not substantially different from the one for which consent was given. A claim of battery is reserved for cases where a doctor performs an operation to which the patient has not consented at all, or performs a substantially different one. Consent is effective if it is for the particular conduct or 'substantially the same conduct.' Here, the flap procedure was a less extensive operation that involved the same initial steps as the more extensive tissue graft procedure to which the patient consented. Performing less than what was authorized, where the actions taken were a component of the authorized procedure, falls within the scope of the patient's consent. This protects a doctor's ability to exercise medical judgment during a procedure. Any claim Christman might have had regarding the failure to disclose the flap procedure as an alternative would fall under a theory of lack of informed consent, which is based in negligence, not the intentional tort of battery.
Analysis:
This decision reinforces the critical distinction between medical battery and lack of informed consent, clarifying that they are separate causes of action with different elements. By holding that a less invasive, component procedure falls within the scope of consent given for a more invasive one, the court protects a physician's ability to exercise intra-operative medical judgment. This precedent makes it more difficult for plaintiffs to frame cases involving deviations in treatment as battery, pushing such claims toward the negligence-based framework of informed consent, which often has a higher burden of proof, including the need for expert testimony.
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