Hook Ex Rel. Estate of Summers v. Rothstein
281 S.C. 541, 1984 S.C. App. LEXIS 449, 316 S.E. 2d 690 (1984)
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Rule of Law:
In South Carolina, a physician's duty to disclose risks under the doctrine of informed consent is measured by the professional standard, which requires the disclosure that a reasonable medical practitioner in the same branch of medicine would make under similar circumstances. The plaintiff must ordinarily prove this standard and its breach through expert medical testimony.
Facts:
- In December 1971, Jack Summers experienced persistent stomach pains, and medical tests revealed a potential mass in his intestines.
- A consultation between Summers's family doctor, a surgeon, and a radiologist, Dr. Jerry C. Rothstein, led to the recommendation that Summers undergo an intravenous pyelogram (IVP) for further diagnosis.
- The IVP procedure involved injecting a contrast material that carried a 1-in-40,000 risk of a fatal reaction.
- On January 24, 1972, before the procedure, Dr. Rothstein asked Summers about allergies, but Summers, who had a long history of allergies, did not disclose them.
- Dr. Rothstein did not inform Summers of the possibility of a fatal reaction, believing that patient apprehension could increase the likelihood of an adverse reaction.
- Shortly after the IVP procedure began, Summers suffered a severe reaction to the contrast material and died.
Procedural Posture:
- Judith L. Summers Hook, as Administratrix of the Estate of Jack R. Summers, filed a wrongful death lawsuit against Dr. Jerry C. Rothstein in a state trial court.
- The trial court granted summary judgment in favor of the plaintiff, Hook.
- On appeal by Dr. Rothstein, the South Carolina Supreme Court reversed the summary judgment, ruling that a genuine issue of material fact existed, and remanded the case for trial.
- Following a trial, the jury returned a verdict in favor of the defendant, Dr. Rothstein.
- The plaintiff, Hook, appealed the judgment entered on the jury's verdict to the Court of Appeals of South Carolina.
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Issue:
Does South Carolina law measure a physician's duty to disclose risks under the doctrine of informed consent by what a reasonable medical practitioner would disclose (the professional standard), rather than by what a reasonable patient would want to know (the lay standard)?
Opinions:
Majority - Goolsby, Judge
Yes. A physician's duty to disclose risks in an informed consent case is measured by the professional standard of care, requiring the physician to make disclosures that a reasonable medical practitioner would make under similar circumstances. The court formally adopted this standard for South Carolina, rejecting the patient-centric 'lay standard.' The court reasoned that determining which risks to disclose is a complex medical judgment involving the patient's health, mental state, and the potential negative impact of the disclosure itself, matters which are beyond the realm of ordinary lay knowledge. Therefore, expert medical testimony is typically required to establish both the standard of care and the defendant's deviation from it. The court also adopted an objective test for causation, holding that a plaintiff must prove that a reasonable person in the patient's position would have refused the procedure if properly informed of the risk.
Analysis:
This case is significant for establishing the governing legal framework for informed consent claims in South Carolina. By adopting the doctor-centric 'professional standard,' the court placed a higher burden on plaintiffs, requiring them to produce expert testimony to establish a breach of duty. This decision aligns South Carolina with a more traditional, physician-protective approach to medical malpractice, in contrast to the growing number of jurisdictions at the time adopting the more patient-centric 'lay standard.' The adoption of the objective test for causation further solidifies this stance, preventing claims from succeeding based solely on a patient's self-serving hindsight testimony.
