Meyer v. United States

District Court, D. Colorado
464 F. Supp. 317 (1979)

ELI5:

Rule of Law:

Under Federal Rule of Evidence 406, evidence of a person's habit or an organization's routine practice is relevant to prove that their conduct on a particular occasion was in conformity with that habit. An injury that is a known risk of a medical procedure does not, by itself, establish negligence if the professional acted within the accepted standard of care.

Facts:

As the wife of a serviceman, Katherine Meyer was eligible for care at the Lowry Air Force Base Family Dental Clinic.
On March 29, 1974, Dr. Kent L. Aitkin examined Meyer, who was experiencing pain, and recommended the extraction of her impacted third molars (wisdom teeth).
On April 12, 1974, Dr. Aitkin performed the procedure, extracting Meyer's two right third molars.
Shortly after the extraction, Meyer began experiencing numbness on the right side of her tongue and gum line.
Meyer's condition was later confirmed to be permanent lingual nerve damage, resulting in loss of sensation and taste in the affected area.
Dr. Aitkin could not specifically recall his pre-operative conversation with Meyer regarding surgical risks.
Dr. Aitkin testified that he had a long-standing and consistent habit of informing all patients of the potential risks of third molar extractions, including nerve damage.

Procedural Posture:

Katherine Meyer filed an administrative claim against the United States government.
After the administrative process, Meyer (plaintiff) filed a lawsuit against the United States (defendant) in the U.S. District Court for the District of Colorado, proceeding under the Federal Tort Claims Act.
The case was tried on the merits before the district court judge in a bench trial.

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Issue:

Is the United States liable for medical malpractice under the Federal Tort Claims Act when a patient suffers permanent nerve damage following a wisdom tooth extraction, where the dentist cannot recall the specific consent conversation but testifies to a consistent habit of warning patients about such risks?

Opinions:

Majority - Finesilver, J.

No. The United States is not liable for medical malpractice because the plaintiff failed to prove either a lack of informed consent or a breach of the standard of care. Regarding informed consent, the court found that Dr. Aitkin's testimony about his routine practice of warning patients, corroborated by two dental assistants, was sufficient under Federal Rule of Evidence 406 to establish that he did, in conformity with his habit, inform Meyer of the potential for nerve damage. Regarding negligence, the court concluded that lingual nerve damage is a known risk of the procedure that can occur even in the absence of negligence. Expert testimony established that Dr. Aitkin's surgical technique met the community standard of care, and therefore, the plaintiff failed to prove that his actions were the proximate cause of her injury. The doctrine of res ipsa loquitur was inapplicable because this type of injury can occur without negligence.

Analysis:

This case provides a clear application of Federal Rule of Evidence 406, demonstrating how habit evidence can be decisive in resolving factual disputes, especially in 'he said, she said' scenarios like informed consent conversations where documentation may be sparse. The decision allows a party to prove their conduct conformed to a well-established routine, even without a specific recollection of the event. The case also reinforces the fundamental tort principle that an adverse outcome in a medical procedure does not automatically equate to malpractice; the plaintiff retains the burden of proving that the professional breached the standard of care and that this breach caused the injury.

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