Morrison v. MacNamara
407 A.2d 555 (1979)
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Rule of Law:
Nationally certified health care providers, such as medical laboratories, are held to a national standard of care, not the standard of the particular community in which they practice.
Facts:
- Upon his physician's orders, Morrison went to Oscar B. Hunter Memorial Laboratories, Inc., a nationally certified medical laboratory, for a urethral smear test.
- Tom MacNamara, a clinical technician, administered the first test while Morrison was in a standing position.
- Following the completion of the first test, Morrison complained of feeling faint.
- MacNamara instructed Morrison to sit and rest but did not conduct a medical evaluation to determine the source or extent of his complaint.
- Approximately two to three minutes later, MacNamara asked Morrison if he was okay to proceed with a second test, to which Morrison replied 'yes.'
- MacNamara then administered a second test, again with Morrison in a standing position.
- During the second test, Morrison fainted, striking his head on a metal stand and the floor.
- As a result of the fall, Morrison sustained permanent injuries, including a loss of his sense of smell and a partial loss of his sense of taste.
Procedural Posture:
- Morrison filed a medical malpractice action against Oscar B. Hunter Memorial Laboratories, Inc. and Tom MacNamara in the trial court.
- At trial, the court denied Morrison's request for a jury instruction based on a national standard of care.
- The trial court instructed the jury to measure the defendants' conduct by the standard of care 'in the same community.'
- Over Morrison's objection, the trial court also instructed the jury on the affirmative defense of assumption of the risk.
- The jury returned a verdict in favor of the defendants (appellees).
- Morrison (appellant) appealed the judgment to the District of Columbia Court of Appeals.
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Issue:
Does a nationally certified medical laboratory have a duty to adhere to a national standard of care, rather than the standard of care of the local community?
Opinions:
Majority - Chief Judge Newman
Yes. A nationally certified medical laboratory must adhere to a national standard of care. The historical justifications for the 'locality rule,' which measured a provider's conduct against that of others in the same community, are no longer relevant due to the standardization of medical education, national accreditation and certification, and modern means of communication that keep practitioners informed of nationwide standards. Holding providers to a local standard could immunize substandard care. Therefore, the trial court erred by instructing the jury to apply a local standard, which effectively required them to disregard the plaintiff's expert testimony on the national standard. Furthermore, the trial court erred in submitting the defense of assumption of the risk to the jury. For this defense to apply, a plaintiff must have actual knowledge and full appreciation of the risk created by the defendant's negligence and voluntarily expose themselves to it. Given the disparity in knowledge between a patient and a medical professional, a patient generally cannot appreciate the risks of negligent treatment and thus cannot be held to have assumed them; there was no evidence Morrison knew or understood the risk of fainting from a second test performed negligently.
Analysis:
This decision formally abandons the antiquated 'locality rule' for nationally certified health care providers in the District of Columbia, aligning the jurisdiction with the modern majority trend. By adopting a national standard of care, the court acknowledges the uniformity of modern medical training and practice, preventing a 'conspiracy of silence' where local experts may be unwilling to testify against each other. This ruling raises the bar for medical providers, ensuring they are judged against nationwide best practices rather than potentially lower local customs. It also reinforces the high threshold for the assumption of risk defense in medical malpractice cases, protecting patients who must rely on the superior knowledge and judgment of professionals.
