Sullivan v. O'Connor
363 Mass. 579, 296 N.E.2d 183 (1973)
Rule of Law:
For a physician's breach of a contract to achieve a specific medical result, the appropriate measure of damages is the reliance interest, which seeks to restore the patient to their pre-contract position by awarding out-of-pocket expenses, damages for any worsening of their condition, pain and suffering from additional procedures necessitated by the breach, and resulting mental distress.
Facts:
- The plaintiff, a professional entertainer, contracted with the defendant surgeon for plastic surgery on her nose.
- The defendant promised to enhance the plaintiff's beauty and improve her appearance through two operations.
- Following the two operations, the plaintiff's nose was disfigured, with its appearance being worsened compared to its original state.
- The plaintiff was required to undergo a third, unsuccessful operation in an attempt to correct the disfigurement.
- The final result was that her appearance was permanently worsened and could not be improved by further surgery.
- The plaintiff paid the defendant's fee and related hospital expenses totaling $622.65.
Procedural Posture:
- The plaintiff sued the defendant surgeon in a state trial court.
- The plaintiff's complaint asserted two counts: breach of contract and negligence (malpractice).
- A jury found for the plaintiff on the breach of contract count but for the defendant on the negligence count.
- The jury awarded the plaintiff $13,500 in damages based on the trial judge's instructions.
- The defendant surgeon, as appellant, appealed to the Supreme Judicial Court of Massachusetts, challenging the trial judge's instructions on the measure of damages.
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Issue:
In an action for breach of contract against a surgeon who promised to produce a specific cosmetic result, does the appropriate measure of damages include compensation for the patient's pain, suffering, and mental distress, in addition to out-of-pocket costs?
Opinions:
Majority - Kaplan, J.
Yes. In an action for breach of contract against a surgeon who promised to produce a specific cosmetic result, the appropriate measure of damages is not limited to out-of-pocket costs but may also include compensation for the patient's pain, suffering, and mental distress. The court reasoned that while contracts for specific medical outcomes are enforceable, the traditional commercial 'expectancy' measure of damages (the value of the promised result minus the actual result) is often excessive and speculative in this non-commercial context. Conversely, a 'restitution' measure (refunding the fee) is too meager. Therefore, the court adopted a middle-ground 'reliance' measure, which compensates the patient for all detriments foreseeably flowing from the breach, including out-of-pocket expenses, the worsening of her condition, the pain and suffering of any additional operations required by the breach, and the associated mental distress.
Analysis:
This case is significant for establishing the 'reliance' measure of damages as the preferred standard in cases involving a physician's breach of a contract for a specific result. By rejecting the traditional 'expectancy' measure from commercial contract law, the court created a special rule for the sensitive, non-commercial patient-physician relationship. This approach balances the need to enforce valid promises against public policy concerns of disproportionately high damage awards against non-negligent physicians. The decision provides a framework for lower courts to award damages that are restorative rather than speculative, influencing how breach of contract claims in medical contexts are valued.
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