Rice v. Brakel
310 P.3d 16 (2013)
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Rule of Law:
A surgeon's failure to disclose a personal condition, such as a drug dependency, does not vitiate a patient's consent to a medical procedure so as to constitute medical battery. Claims based on a doctor's failure to provide information must be brought as negligence actions under a theory of lack of informed consent.
Facts:
- Jay Rice was experiencing pain in both his right and left legs before undergoing surgery.
- On July 30, 2007, neurosurgeon Dr. Arlo Brakel performed spinal surgery on Rice to relieve pain in his right leg.
- While the surgery successfully relieved the pain in Rice's right leg, the pain in his left leg increased post-operation.
- Around the time of the surgery, Dr. Brakel had an undisclosed dependency on unprescribed prescription drugs, including morphine and Dilaudid, some of which he obtained by stealing from patients.
- In July 2010, approximately three years after the surgery, Rice discovered Dr. Brakel's drug dependency and related disciplinary history on the Board of Medical Examiners' website.
Procedural Posture:
- Jay and Betty Rice sued Dr. Arlo Brakel and the Center for Neurosciences for battery, negligence, and breach of contract in the Pima County Superior Court (trial court).
- Rice moved for partial summary judgment on his claims of battery and negligent supervision.
- Brakel and the Center filed cross-motions for summary judgment, arguing Rice had failed to establish a prima facie case for any of his claims.
- The trial court denied Rice's motion for summary judgment.
- The trial court granted the summary judgment motions filed by Brakel and the Center, dismissing all of Rice's claims.
- The trial court denied Rice's subsequent motion for a new trial.
- Rice, as the appellant, appealed the summary judgment ruling to the Arizona Court of Appeals, Division Two.
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Issue:
Does a surgeon's failure to disclose his prescription drug dependency to a patient before a procedure invalidate the patient's consent, thereby turning the consented-to surgery into a medical battery?
Opinions:
Majority - Chief Judge Howard
No. A surgeon's failure to disclose his prescription drug dependency does not invalidate a patient's consent and therefore does not constitute medical battery. The court held that medical battery is reserved for circumstances where a doctor performs a procedure to which the patient has not consented at all, such as operating on a different body part or performing a different procedure. Claims involving a doctor's failure to disclose information relevant to a patient's decision, even personal information about the surgeon's condition, fall under the doctrine of negligence or lack of informed consent, not battery. The court, relying on the precedent set in Duncan v. Scottsdale Med. Imaging, reasoned that expanding battery to cover such non-disclosures would improperly transform medical malpractice claims into intentional tort claims, undermining established public policy and legal frameworks. A plaintiff pursuing a negligence claim for lack of informed consent must prove that adequate disclosure would have caused them to decline the treatment and that the treatment proximately caused their injury.
Analysis:
This decision reinforces the narrow scope of medical battery in Arizona, strictly limiting it to cases involving a complete lack of consent to the procedure performed. It clarifies that a physician's personal impairments or characteristics, while potentially relevant to a negligence claim for lack of informed consent, do not automatically invalidate consent for the purpose of a battery claim. The ruling prevents the expansion of battery, an intentional tort with consequences like punitive damages and potential exclusion from malpractice insurance coverage, into the realm of medical malpractice, thereby preserving the distinct legal theories and their respective burdens of proof.
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