McLaughlin v. Sy
1991 Me. LEXIS 86, 589 A.2d 448 (1991)
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Rule of Law:
The standard of care for a general practitioner is that of an ordinarily competent physician under like circumstances. A jury instruction referring to the standard of care 'in the community' is not a reversible error applying the outdated 'locality rule' if the context makes it clear that 'community' is used synonymously with 'under all the relevant circumstances' and the instruction does not actually mislead the jury.
Facts:
- On June 23, 1987, James McLaughlin arrived at his summer home feeling ill with a sore throat.
- The next morning, his condition worsened, and his wife, Carol McLaughlin, took him to the emergency room at Redington-Fairview General Hospital.
- At the hospital, Mr. McLaughlin presented with a 103.2-degree fever, rapid pulse, difficulty swallowing, and was noted as being unable to speak above a whisper.
- Dr. Vincente L. Sy examined him, conducted a negative strep screen, and diagnosed an upper respiratory tract infection.
- Dr. Sy prescribed antibiotics and instructed the McLaughlins to call or return if Mr. McLaughlin's condition worsened.
- After returning home, Mr. McLaughlin's condition deteriorated significantly, with increasing difficulty breathing.
- A few hours later, while preparing to return to the hospital, Mr. McLaughlin collapsed and died.
- An autopsy revealed that the cause of death was acute epiglottitis, a rare condition in adults involving swelling that obstructs the airway.
Procedural Posture:
- Carol McLaughlin filed a Notice of Claim against Dr. Sy for medical malpractice.
- The parties mutually agreed to waive the medical malpractice screening panel process and proceed directly to litigation.
- McLaughlin, on behalf of her husband's estate and herself, sued Dr. Sy in the Superior Court (a state trial court) for wrongful death and negligent infliction of emotional distress.
- The case was tried before a jury, which returned a verdict in favor of the defendant, Dr. Sy.
- The trial court entered a judgment for Dr. Sy based on the jury's verdict.
- McLaughlin, as the appellant, appealed the judgment to the Supreme Judicial Court of Maine, the state's highest court.
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Issue:
Does a jury instruction in a medical malpractice case that refers to the standard of care 'in the community' constitute a reversible error by improperly applying the outdated 'locality rule'?
Opinions:
Majority - Collins, Justice
No. A jury instruction referring to the standard of care 'in the community' does not constitute reversible error where the phrase is used to mean 'under all the relevant circumstances' and does not improperly apply the 'locality rule.' Although Maine has rejected the strict locality rule, which judges a physician solely by the standards of their immediate geographic area, it has long used phrases like 'in the community' interchangeably with the proper standard of 'under like circumstances.' In this case, locality is merely one factor in the overall circumstances. Furthermore, even if the phrasing was potentially confusing, there was no prejudice because the expert witnesses for both parties testified to a general, national standard of care, not one specific to the local area. Therefore, the jury could not have been misled into applying an improper, geographically-limited standard.
Analysis:
This decision solidifies Maine's rejection of the strict 'locality rule' while clarifying the acceptable language for jury instructions on the medical standard of care. It establishes that the phrase 'in the community' is not per se erroneous, but its meaning must align with the broader 'under like circumstances' standard. The court's warning that such language has the 'potential to confuse a jury' signals to trial courts that more precise phrasing is preferable to avoid future appeals on this issue. The case reinforces that a physician's location is just one of many factors in determining the standard of care, which is ultimately based on what a reasonably competent practitioner would do, not just what local peers do.
