Culbertson v. Mernitz
1992 WL 310335, 602 N.E.2d 98, 1992 Ind. LEXIS 245 (1992)
Premium Feature
Subscribe to Lexplug to listen to the Case Podcast.
Rule of Law:
In Indiana, a plaintiff in a medical malpractice case based on lack of informed consent must present expert medical testimony to establish the standard of care for risk disclosure, unless the physician's failure to disclose is a matter commonly known by laypersons.
Facts:
- Patty Jo Culbertson visited Dr. Roland B. Mernitz for uncontrollable urine leakage and vaginal discharge.
- Dr. Mernitz diagnosed her with urinary stress incontinence and cervicitis, recommending a bladder suspension (MMK procedure) and cryosurgery.
- The parties dispute whether Dr. Mernitz explained general surgical risks, but both agree he did not disclose the specific risk that her cervix could adhere to her vaginal wall.
- Culbertson consented to and underwent the procedures.
- Post-surgery, Culbertson's cervix adhered to the wall of her vagina, a complication she had not been warned about.
- Dissatisfied with Dr. Mernitz's treatment for the complication, Culbertson sought care from another surgeon who performed a total hysterectomy.
Procedural Posture:
- Patty Jo and Mr. Culbertson filed a proposed complaint against Dr. Mernitz with the Indiana Department of Insurance.
- A medical review panel convened and issued an opinion finding that Dr. Mernitz's non-disclosure did not violate the appropriate standard of care.
- The Culbertsons filed a civil action against Dr. Mernitz in a state trial court.
- Dr. Mernitz moved for summary judgment, relying on the opinion of the medical review panel.
- The trial court granted summary judgment in favor of Dr. Mernitz.
- The Culbertsons, as appellants, appealed to the Indiana Court of Appeals (an intermediate appellate court).
- The Court of Appeals reversed the trial court's summary judgment, holding that the 'prudent patient' standard applied and expert testimony was not required.
- Dr. Mernitz, as appellee, petitioned for transfer to the Indiana Supreme Court, which was granted.
Premium Content
Subscribe to Lexplug to view the complete brief
You're viewing a preview with Rule of Law, Facts, and Procedural Posture
Issue:
Does a claim for lack of informed consent under Indiana law require expert medical testimony to establish the standard of care regarding what risks a physician must disclose?
Opinions:
Majority - Krahulik, Justice.
Yes. A claim for lack of informed consent requires expert medical testimony to establish the standard of care. Indiana law adheres to the 'prudent physician' standard, which requires a physician to disclose those risks that a reasonably prudent physician would disclose under the circumstances. The court reasoned that a physician should be judged against the standards of the medical profession, not required to guess what a hypothetical 'prudent patient' would want to know. Reviewing Indiana precedent, the court found a consistent requirement for expert testimony in such cases, except where the negligence is so obvious as to be within a layperson's comprehension. Because the Culbertsons failed to present any expert testimony to rebut the medical review panel's opinion that non-disclosure of this specific risk met the standard of care, they failed to create a genuine issue of material fact.
Dissenting - Dickson, Justice.
No. The court should adopt the 'prudent patient' standard, which does not require expert testimony to establish the materiality of a risk. The dissent argues that the majority's decision disregards the fundamental principle of patient autonomy and the right of self-determination, which is the foundation of the informed consent doctrine. While expert testimony is necessary to establish the existence and frequency of risks, a lay jury is capable of determining whether a reasonable person, in the patient's position, would have considered the risk material to their decision-making. The dissent contends that leaving the standard of disclosure to the medical profession is paternalistic and that the 'prudent patient' standard, adopted by a growing number of jurisdictions, better protects a patient's right to control their own body.
Analysis:
This decision solidifies Indiana's adherence to the 'prudent physician' standard for informed consent, contrasting it with jurisdictions that follow the 'prudent patient' standard. By requiring expert testimony to establish the standard of care for disclosure, the court significantly raises the evidentiary bar for plaintiffs in such medical malpractice cases. This precedent makes it more difficult and costly for patients to bring informed consent claims, as they must secure a medical expert willing to testify that the defendant physician's disclosure deviated from professional norms. The ruling reinforces the medical profession's role in setting its own standards of communication with patients, prioritizing professional judgment over patient-centered materiality.
Unlock the full brief for Culbertson v. Mernitz