Guilmet v. Campbell
188 N.W.2d 601, 43 A.L.R. 3d 1194, 385 Mich. 57 (1971)
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Rule of Law:
A physician's specific, clear, and express pre-operative promises to achieve a particular result, if reasonably contemplated and relied upon by the patient, can constitute a binding contract, leading to liability for breach of contract even without a finding of negligence.
Facts:
- In the fall of 1963, Richard Guilmet suffered near-fatal bleeding from a peptic ulcer and was treated by Dr. Klewicki.
- In January 1964, Dr. Klewicki recommended defendant surgeons Dr. Campbell and Dr. Arena to Richard Guilmet.
- During his first consultation with Dr. Campbell, Richard Guilmet discussed a potential operation, and Dr. Campbell, after reviewing Guilmet's records, made several statements including that the operation would "take care of all your troubles," allow him to "eat as you want to, you can drink as you want to, you can go as you please," was "very simple," had "no danger at all," he'd be "out of work three to four weeks at the most" and could "throw your pillbox away."
- Following this conversation, Richard Guilmet underwent the gastric resection operation.
- On March 4, 1964, the day after the operation, Dr. Wood, a thoracic surgeon, diagnosed Richard Guilmet with a ruptured esophagus due to surgical trauma during the vagotomy.
- Subsequently, Richard Guilmet endured three more operations, suffered hepatitis, experienced severe weight loss (from 170 lbs to 88 lbs), was unable to sleep or hold two jobs, became physically weak, lost athletic and social activity, and was left badly scarred.
Procedural Posture:
- Richard and Joan Guilmet filed a two-count complaint against Dr. Campbell and Dr. Arena in the trial court (a circuit court in Michigan), alleging negligence in performing an operation in one count and breach of contract in the other.
- At the conclusion of proofs, the defendants moved for a directed verdict, which the trial court denied.
- The trial court sent the case to the jury on both counts.
- The jury returned a verdict finding "no negligence" on the tort count but awarded the plaintiffs $50,000 on the breach of contract count.
- The defendants moved for judgment notwithstanding the verdict, which the trial court denied.
- The Michigan Court of Appeals affirmed the trial court's decision.
- The Supreme Court of Michigan granted leave to appeal.
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Issue:
Can a jury reasonably conclude that a physician's pre-operative statements regarding the outcome and simplicity of an operation, and the patient's recovery time, constitute a specific contract to achieve a particular result, making the physician liable for breach of contract if that result is not obtained, even if the jury finds no negligence?
Opinions:
Majority - T. G. Kavanagh, J.
Yes, a jury can reasonably conclude that a physician's pre-operative statements constitute a specific contract to achieve a particular result, making the physician liable for breach of contract if that result is not obtained, even without a finding of negligence. The Court affirmed the trial court's denial of judgment notwithstanding the verdict, emphasizing that the determination of contract terms, especially when based on oral proofs, is a question of fact for the jury. While acknowledging the sensitivity of the physician-patient relationship, the Court stated that it merely stresses the importance of circumstances in determining the effect of words in establishing a contract, not a different legal standard. The jury was properly instructed to determine if the doctors made a specific, clear, and express promise of a cure or specific result, which was reasonably contemplated and relied upon by the plaintiff. The jury's finding of "no negligence" on the tort count does not resolve the separate contract question; if a contract to effect a certain result existed and the result was not achieved, the contract was breached regardless of the skill employed.
Concurring - T. E. Brennan, J.
Yes, the verdict should be affirmed, but the jury's finding of "no negligence" did not necessarily mean the defendants were not negligent in performing the contract. Justice Brennan concurred in affirming the judgment but disagreed with the majority's interpretation of the jury's verdict. He noted that the contract count (Count I) included allegations of professional negligence (e.g., performing the operation in an unworkmanlike manner) in addition to the promise to cure. The trial judge had severely limited the jury's consideration of negligence regarding the separate malpractice count (Count II) but did not similarly restrict their consideration of negligence as a breach of contract under Count I. Therefore, the jury's statement of "no negligence" in response to the judge's clarifying question, while relevant to the tort count, did not negate the possibility that the jury found the defendants' conduct to be a breach of their agreement to exercise care and skill as alleged in the contract count. The law should generally presume that medical assurances do not constitute a contract to cure, but the verdict could be sustained based on a finding of contractual negligence.
Dissenting - Black, J.
No, the trial court erred in refusing to grant judgment notwithstanding the verdict because the jury explicitly acquitted the defendants of negligence, which was the fundamental basis of the alleged breach of contract. Justice Black vehemently dissented, warning that the majority's decision would launch an "unwarned, unprecedented, wholly gratuitous and destructively witless war of 'contract liability'" upon the medical profession. He argued that the plaintiffs' contract claim (Count I) was rooted in negligent performance, and since the jury found "no negligence" on the malpractice count (and by implication, on the underlying conduct), there was no basis for a breach of contract. He contended that holding surgeons liable for failure to achieve a promised result, despite being acquitted of negligence, is unprecedented and medically unsound, forcing doctors into "defensive medicine" and destroying the essential trust between physician and patient. He further detailed how the specific allegations of negligence in the contract count were disproven or not supported by evidence.
Analysis:
This case significantly impacts the physician-patient relationship by affirming that specific oral assurances made by a physician before an operation can be interpreted by a jury as a binding contract, leading to liability for breach even if the physician acted without negligence. It broadens avenues for patient recovery beyond traditional malpractice claims, potentially increasing litigation risks for medical professionals. The ruling underscores the importance for physicians to be precise and cautious in their pre-operative communications, distinguishing therapeutic reassurance from contractual promises of specific outcomes. The concurrence highlights an important distinction in how juries might interpret mixed contract/negligence claims, suggesting that even if general negligence is disproven, negligence as a breach of contract might still be found, further complicating defense strategies for physicians.
