Duttry v. Patterson
771 A.2d 1255, 2001 Pa. LEXIS 1072, 565 Pa. 130 (2001)
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Rule of Law:
Under Pennsylvania law, the doctrine of informed consent requires a physician to disclose only information material to the surgical or operative procedure itself, not information regarding the physician's personal qualifications, experience, or attributes, even if specifically requested by the patient.
Facts:
- In February 1989, Cloma Duttry was diagnosed with esophageal cancer.
- Cloma Duttry consulted with Dr. Lewis T. Patterson regarding surgery to treat her cancer.
- During the consultation, Cloma Duttry allegedly asked Dr. Patterson about his experience, and he told her he performed the recommended procedure approximately once every month.
- Cloma Duttry consented to Dr. Patterson performing the surgery.
- On June 5, 1989, Dr. Patterson performed the esophageal and stomach resection surgery on Cloma Duttry.
- Three days after surgery, a leak developed at the surgical site, which worsened into a rupture and necessitated emergency surgery.
- As a result of complications from the rupture, Cloma Duttry developed adult respiratory disease syndrome and permanent lung damage, rendering her unable to work.
- Evidence later revealed that Dr. Patterson had performed the specific type of surgery only nine times in the preceding five years, a frequency far below the 'once a month' figure he allegedly stated.
Procedural Posture:
- Cloma Duttry and her husband (Appellees) filed suit against Dr. Lewis T. Patterson, Patterson Associates, and Polyclinic Medical Center (Appellants) in a trial court, alleging medical malpractice and lack of informed consent.
- The trial court ruled that evidence regarding Dr. Patterson's experience was inadmissible for the informed consent claim, reasoning it was not relevant to the risks of the procedure itself.
- The jury returned a verdict in favor of Appellants.
- Appellees' post-trial motions were denied by the trial court.
- Appellees appealed the decision to the Superior Court of Pennsylvania.
- A divided panel of the Superior Court vacated the trial court's judgment and remanded for a new trial, holding that evidence relating to Dr. Patterson's experience and alleged misrepresentations was relevant to informed consent.
- Appellants filed a Petition for Allowance of Appeal with the Supreme Court of Pennsylvania, which was granted (allocatur).
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Issue:
Does the doctrine of informed consent in Pennsylvania require a physician to disclose information regarding their personal qualifications and experience in performing a specific surgical procedure, particularly when such information is specifically requested by the patient?
Opinions:
Majority - CAPPY, Justice
No, the doctrine of informed consent in Pennsylvania does not require a physician to disclose information regarding their personal qualifications and experience, even if specifically requested by the patient. The Court held that the informed consent doctrine is limited to providing patients with “material information necessary to determine whether to proceed with the surgical or operative procedure or to remain in the present condition.” This material information pertains to “the nature of the operation to be performed, the seriousness of it, the organs of the body involved, the disease or incapacity sought to be cured, and the possible results,” including risks, complications, and alternatives (citing Gray v. Grunnagle and Gouse v. Cassel). The Court explicitly stated that personal attributes or experience of the physician are not relevant to an informed consent claim. It rejected the Superior Court’s distinction that such information becomes material if specifically requested by the patient, emphasizing that the 'reasonable person' standard for materiality is objective and does not shift based on a particular patient’s inquisitiveness. The Court concluded that expanding the doctrine to include personal characteristics would go beyond its traditional boundaries and is unnecessary, as other causes of action, such as negligence or misrepresentation, provide avenues for redress against inexperienced or deceptive physicians.
Dissenting - NIGRO, Justice
Yes, information concerning a surgeon’s personal qualifications and experience, particularly when specifically requested and misrepresented, is relevant to an informed consent claim. Justice Nigro dissented, arguing that a patient who specifically asks her physician about the number of times he has performed a surgical procedure cannot be said to have given informed consent when the physician grossly exaggerates his experience. Citing Gouse v. Cassel, the dissent noted that the informed consent doctrine requires a physician to “advise the patient of those material facts, risks, complications and alternatives to surgery that a reasonable person in the patient’s situation would consider significant in deciding whether to have the operation.” In Justice Nigro’s view, evidence that Dr. Patterson misled Cloma Duttry by claiming he had performed the surgery sixty times when he had only done so nine times is clearly a material fact that a reasonable person would consider significant in making a surgical decision. Therefore, the Superior Court’s order for a new trial should have been affirmed.
Analysis:
This case significantly narrows the scope of the informed consent doctrine in Pennsylvania, clarifying that it does not extend to a physician's personal qualifications or experience. By adhering to an objective 'reasonable person' standard, the Court reinforces that a patient's specific inquiries do not expand the legally mandated disclosures for informed consent. The decision directs plaintiffs alleging physician incompetence or dishonesty toward other tort theories like negligence or misrepresentation, rather than expanding the battery-based informed consent claim, thereby limiting the types of information required for valid consent in the medical context.
