Title: Jo-El Hanson v. American Family Mutual Insurance Company
Citation: 2006 WI 97
Docket Number: 2004AP002065
State: Wisconsin
Issuer: Wisconsin Supreme Court
Date: July 12, 2006

2006 WI 97 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2004AP2065 
 
 
COMPLETE TITLE: 
 
 
Jo-El Hanson, 
          Plaintiff-Appellant, 
 
Humana/Employers Health Insurance Company, 
          Subrogated-Plaintiff, 
     v. 
American Family Mutual Insurance Company, Kevin 
L. Caldwell and Lindell Motorsports, Inc., 
          Defendants-Respondents-Petitioners. 
 
 
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
Reported at: ___ Wis. 2d ___, 707 N.W.2d 579 
(Ct. App. 2005–Unpublished) 
 
 
OPINION FILED: 
July 12, 2006   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
April 25, 2006   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Milwaukee   
 
JUDGE: 
Michael Guolee 
 
 
 
JUSTICES: 
 
 
CONCURRED: 
ABRAHAMSON, C.J., concurs (opinion filed).   
 
DISSENTED: 
PROSSER, J., dissents (opinion filed).   
 
NOT PARTICIPATING:         
 
 
 
ATTORNEYS: 
 
For 
the 
defendants-respondents-petitioners, 
there 
were 
briefs by Randy S. Parlee and Peterson, Johnson & Murray, S.C., 
Milwaukee, and oral argument by Randy S. Parlee. 
 
For the plaintiff-appellant, there was a brief by Michael 
I. Tarnoff, Ted M. Warshafsky, Frank T. Crivello II, and 
Warshafsky, Rotter, Tarnoff & Bloch, S.C., Milwaukee, and oral 
argument by Michael I. Tarnoff. 
 
An amicus curiae brief was filed by Robert L. Jaskulski and 
Habush, Habush & Rottier, S.C., Milwaukee, on behalf of the 
Wisconsin Academy of Trial Lawyers. 
 
 
2006 WI 97
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2004AP2065  
(L.C. No. 
2001CV7524) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Jo-El Hanson, 
 
          Plaintiff-Appellant, 
 
Humana/Employers Health Insurance Company, 
 
          Subrogated-Plaintiff, 
 
     v. 
 
American Family Mutual Insurance Company, Kevin 
L. Caldwell and Lindell Motorsports, Inc., 
 
          Defendants-Respondents-Petitioners. 
 
 
 
FILED 
 
JUL 12, 2006 
 
Cornelia G. Clark 
Clerk of Supreme Court 
 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Affirmed.   
 
¶1 
JON P. WILCOX, J.   The defendants, American Family 
Mutual Insurance Company (American Family), Kevin L. Caldwell 
(Caldwell), 
and 
Lindell 
Motorsports, 
Inc. 
(Lindell) 
(collectively, the defendants), seek review of an unpublished 
decision of the court of appeals,1 which reversed an order of the 
                                                 
1 See Hanson v. Am. Family Mut. Ins. Co., No. 2004AP2065, 
unpublished slip op. (Wis. Ct. App. Nov. 8, 2005).  
No. 
2004AP2065   
 
2 
 
Milwaukee County Circuit Court, Michael D. Guolee, Judge, 
denying Jo-El Hanson's (Hanson) motion to change the verdict and 
increasing her award for past medical expenses from $25,000 to 
$78,338.97, as well as awarding her a new trial on the remaining 
damages. 
¶2 
We are presented with two issues on review.  First, is 
Hanson entitled to her expenses for a surgery, admittedly well-
done, but allegedly not necessitated by her injury, just as a 
plaintiff is entitled to her expenses when surgery necessitated 
by the injury was negligently performed and aggravates the 
injury?  Second, was the circuit court's own customized 
instruction on damages and causation appropriate in this case?  
¶3 
We hold that because the jury concluded that Hanson 
was injured in the accident, she was entitled to all of her past 
medical expenses, 
regardless 
of whether Hanson's treating 
physician performed an unnecessary surgery, under the rule first 
enunciated in Selleck v. Janesville, 100 Wis. 157, 75 N.W. 975 
(1898), as Hanson used ordinary care in selecting her doctor.  
Furthermore, we hold the jury's verdict arose from an erroneous 
and confusing jury instruction such that there is a reasonable 
probability of a different outcome on the remaining damages at 
issue.  As such, the decision of the court of appeals is 
affirmed.   
I 
¶4 
On June 22, 2000, Hanson was driving to work when she 
encountered heavy traffic.  She began to slow down and her car 
was hit in the back by a truck driven by Caldwell.  The truck 
No. 
2004AP2065   
 
3 
 
was owned by Lindell and insured by American Family.  Caldwell 
was traveling approximately five to seven miles per hour at the 
time of the accident.  It is undisputed that Caldwell was fully 
responsible for causing the accident.   
¶5 
The following day, Hanson developed lower back, neck, 
and rib pain.  Hanson saw her family physician, Dr. Kenneth 
Saydel, that same day.  She began going to physical therapy.  
According to Hanson's trial testimony, the rib pain went away 
after six to eight months, the lower back pain went away after 
four to six months, but the neck pain remained.  In July of 
2000, she was diagnosed with post-traumatic cervical dorsal 
strain, not improving.  Then in August of 2000 she was diagnosed 
with 
acute 
denervation 
activities 
of 
the 
lower 
cervical 
vertebrae (based on an electromyogram (EMG) performed by Dr. 
Lynn Ma); post-traumatic cervical dorsal strain, not improving 
with radiculopathy; and cervical thoracic spasm with cervical 
radiculopathy (based on the findings of an orthopedic surgeon).  
In November, another EMG performed by Dr. Ma revealed evidence 
of acute mild right C5-C6 radiculopathy.  Hanson was referred to 
a neurosurgeon, Dr. James Lloyd, who determined that the C4, C5, 
and C6 disks were causing the pain in Hanson's neck.  He 
recommended surgery and performed it on February 6, 2001, 
removing the disks specified and replacing them with bone graph 
material (metal plate squares).   
¶6 
Hanson filed a lawsuit against the defendants on 
August 13, 2001.  The case proceeded to trial, where the 
liability of the defendants was contested.  The two issues 
No. 
2004AP2065   
 
4 
 
before the court were whether Hanson was injured in the accident 
and, if injuries existed, the extent of those injuries.  The 
defendants argued that Hanson's surgery was unnecessary.  In 
support 
of 
this 
assertion, 
the 
defendants' 
expert, 
a 
neurosurgeon, Dr. Ronald Pawl, responded "no" when asked if 
Hanson's surgery was caused by the accident and stated, "I do 
not feel [the surgery] was [medically] necessary."  He also 
raised the possibility 
that 
the 
surgery was 
an act of 
malpractice in cross-examination.  In responding to plaintiff's 
counsel, Dr. Pawl stated that surgery which is clearly not 
indicated "can be malpractice, but it is not necessarily 
malpractice."  In further response to whether he thought Dr. 
Lloyd was incompetent in his diagnosis that led him to do the 
surgery, Dr. Pawl responded, "Yes, I clearly disagree with that, 
yes."  
¶7 
However, Dr. Pawl also agreed that Hanson initially 
went to the doctor as a direct consequence of the accident, and 
that 
she 
acted 
appropriately 
in 
following 
her 
doctor's 
recommendation 
to 
undergo 
surgery. 
 
Hanson 
stressed 
the 
existence of a causal nexus between the accident and the 
treatment received, relying on the testimony of Dr. Lloyd.  He 
testified that the surgery was "necessary" and the structural 
damage to her spine was caused by the accident.  According to 
the plaintiff, this connection, along with the fact that Hanson 
acted appropriately in finding a doctor and following his 
instructions, prevented any decrease in the damages awarded as a 
result of any mistakes in the medical treatment of Hanson.   
No. 
2004AP2065   
 
5 
 
¶8 
Prior to jury deliberation, Hanson moved for a 
directed verdict on the issue of past medical expenses.  The 
circuit court denied the motion.  Hanson also requested a 
special instruction that she be awarded all of her past medical 
expenses and related damages, even if the jury concluded that 
some of her damages were a result of her doctor's malpractice 
from the unnecessary surgery.  The circuit court refused to give 
this instruction.   
¶9 
At the instruction conference, Hanson also submitted a 
modified version of Wis JI——Civil 1710.  The circuit court, 
however, refused to give this instruction to the jury.  It 
instead gave its own instruction, which was a combination of Wis 
JI——Civil 1710 (aggravation of injury because of medical 
negligence), Wis JI——Civil 1500 (cause), and the court's own 
additional language added from the bench.   
¶10 The jury made the following award:  (1) past medical 
expenses: $25,000; (2) past loss of earning capacity: $7,250; 
(3) future medical expenses: $0; (4) past pain, suffering, 
disability: $15,000; and (5) future pain, suffering, disability: 
$0.  The $25,000 awarded for past medical expenses was 
approximately the amount of Hanson's medical expenses that were 
charged after the accident but before the surgery.   
¶11 Following the verdict, Hanson filed a post-verdict 
motion requesting the following: (1) an award of all past 
medical expenses totaling $79,123.97; (2) an award of past loss 
of earning capacity totaling $14,500; and (3) a "fair and 
reasonable" increase in the award for past pain, suffering and 
No. 
2004AP2065   
 
6 
 
disability.  As one alternative, Hanson requested a new trial on 
those damages that were not increased, or an entire new trial in 
the interest of justice.  As another alternative, Hanson asked 
the court to order a new trial on the grounds that the verdict 
was against the great weight and clear preponderance of the 
evidence.  The trial court denied Hanson's motions in an order 
filed on April 12, 2004.  Hanson subsequently appealed.   
¶12 Hanson renewed her arguments before the court of 
appeals.  The court of appeals agreed and reversed the circuit 
court's order, granting Hanson $78,338.972 in past medical 
expenses, instead of the $25,000 awarded by the jury.  The court 
of appeals also granted Hanson a new trial on the issues of her 
past and future pain and suffering and loss of earning capacity, 
based on what it believed was an erroneous jury instruction. 
¶13 The court of appeals ruled that the circuit court 
properly refused to affirm Hanson's pre-verdict motion to award 
all of her past medical expenses and related damages.  The 
defendants expressed the possibility at trial that Hanson was 
not injured at all, in which case the jury could agree and not 
award Hanson any past medical expenses or other damages.   
¶14 However, the court of appeals ruled that the circuit 
court mistakenly refused to grant Hanson's post-verdict motion 
to change the verdict answer to award her the full amount of her 
past medical expenses.  The jury found that Hanson was injured 
                                                 
2 Apparently, 
Hanson 
is 
not 
requesting 
$785.00 
in 
chiropractic fees in her appeal.   
No. 
2004AP2065   
 
7 
 
in the accident (a fact that the defendants did not appeal) and 
granted her $25,000, the cost of her medical expenses prior to 
the surgery.  Under Lievrouw v. Roth, 157 Wis. 2d 332, 459 
N.W.2d 850 (Ct. App. 1990), the court of appeals held that 
Hanson was entitled to "all of her medical expenses related to 
her original injury, provided that she exercised good faith and 
due care in selecting her treating physician."3  Hanson v. Am. 
Family Mut. Ins. Co., No. 2004AP2065, unpublished slip op., ¶21 
(Wis. Ct. App. Nov. 8, 2005).  The defendants' expert, Dr. Pawl, 
stipulated that Hanson exercised good faith and due care in 
selecting her physician.  Therefore, the court of appeals 
reversed the circuit court's order denying Hanson's post-verdict 
motion to change the verdict answer and remanded with directions 
to enter judgment for Hanson, awarding her the full amount of 
past medical expenses.   
¶15 The court of appeals also concluded that the circuit 
court's jury instructions misstated current law.  The special 
instruction ordered the jury not to consider any alleged 
malpractice, while at the same time telling the jury "it must 
find that all treatments were related to the accident."  Id.,   
                                                 
3 This rule originated in Selleck v. Janesville, 100 Wis. 
157, 163, 75 N.W. 975 (1898).  We note that the Selleck court 
used the term "ordinary care" when referring to the level of 
care that a plaintiff must exercise in selecting his or her 
physician.  In Fouse v. Persons, 80 Wis. 2d 390, 397-98, 259 
N.W.2d 92 (1977), we used the term "good faith and due care" 
when referring to the necessary level of care under Selleck.  
The terms "ordinary care" and "good faith and due care" are used 
synonymously, but for the sake of consistency, we use the term 
"ordinary care" in this opinion. 
No. 
2004AP2065   
 
8 
 
¶25.  "In effect, the trial court told the jury that regardless 
of whether the surgery was unnecessary, they could not award the 
cost of the surgery unless the jury 'relate[d] them to the 
accident, those injuries.'"  Id.  In the court of appeals' view, 
this 
instruction directly 
contradicted 
established law in 
Wisconsin, as detailed in such cases as Lievrouw and Fouse v. 
Persons, 80 Wis. 2d 390, 259 N.W.2d 92 (1977).   
¶16 Finally, the court of appeals concluded that there was 
a reasonable probability that the error in the jury instruction 
contributed to the outcome of the case.  In other words, the 
erroneous instruction was sufficient to undermine confidence in 
the case's outcome.  According to the court of appeals, "the 
inconsistent and erroneous instructions in this case probably 
caused jury confusion and probably affected the substantial 
rights of Hanson with respect to the damage questions in the 
special verdict."  Hanson, No. 2004AP2065, ¶31.  For these 
reasons, the court of appeals remanded for a new trial on the 
remaining damages issues. 
¶17 The defendants then filed a petition for review in 
this court, which we accepted. 
II 
¶18 When reviewing a trial court's denial of a motion to 
change a jury's special verdict "[i]f there is 'any credible 
evidence which under any reasonable view supports the jury 
finding especially when the verdict has the approval of the 
trial court, it should not be disturbed.'"  Carl v. Spickler 
Enters., Ltd., 165 Wis. 2d 611, 625, 478 N.W.2d 48 (Ct. App. 
No. 
2004AP2065   
 
9 
 
1991) (quoting Ostreng v. Lowrey, 37 Wis. 2d 556, 560, 155 
N.W.2d 558, 559 (1968)). 
¶19 As to the allegedly erroneous jury instructions, such 
a challenge "warrants reversal and a new trial only if the error 
was prejudicial.  An error is prejudicial if it probably and not 
merely possibly misled the jury."  Fischer v. Ganju, 168 
Wis. 2d 834, 849-50, 485 N.W.2d 10 (1992) (citing Lutz v. Shelby 
Mut. Ins. Co., 70 Wis. 2d 743, 750-51, 235 N.W.2d 426 (1975)).  
"If the overall meaning communicated by the instructions was a 
correct statement of the law, no grounds for reversal exist."  
Id. at 850 (citing White v. Leeder, 149 Wis. 2d 948, 954-55, 440 
N.W.2d 557 (1989); State v. Paulson, 106 Wis. 2d 96, 108, 315 
N.W.2d 350 (1982)).  
III  
¶20 The Selleck rule has been a part of Wisconsin case law 
since 1898.  This rule essentially states that when a tortfeasor 
causes 
an 
injury 
to 
another 
person 
who 
then 
undergoes 
unnecessary medical treatment of those injuries despite having 
exercised ordinary care in selecting her doctor, the tortfeasor 
is responsible for all of that person's damages arising from any 
mistaken or unnecessary surgery.  See Butzow v. Wausau Mem'l 
Hosp., 51 Wis. 2d 281, 285-86, 187 N.W.2d 349 (1971).4   
                                                 
4 In Butzow v. Wausau Memorial Hospital, 51 Wis. 2d 281, 
285-86, 187 N.W.2d 349 (1971), we cited to the Restatement 
(Second) of Torts § 457 (1965) in discussing the principle that 
a tortfeasor is liable for the consequences of treatment that 
aggravates the original injury.  Section 457 is entitled 
"Additional Harm Resulting From Efforts to Mitigate Harm Caused 
by Negligence" and reads as follows: 
No. 
2004AP2065   
 
10 
 
¶21 In Selleck, 100 Wis. at 159, the plaintiff sustained 
injuries by reason of an allegedly defective sidewalk.  The City 
contended that the circuit court erroneously gave the jury the 
following charge: 
"The plaintiff is not held responsible for the errors 
or mistakes of a physician or surgeon in treating an 
injury received by a defect in the street or sidewalk, 
providing she exercises ordinary care in procuring the 
services of such physician.  Where one is injured by 
the negligence of another, or by negligence of a town 
or city, if her damages have not been increased by her 
own subsequent want of ordinary care she will be 
entitled to recover in consequence of the wrong done, 
and the full extent of damage, although the physician 
that she employed omitted to employ the remedies most 
approved in similar cases, and by reason thereof the 
damage to the injured party was not diminished as much 
as it otherwise should have been." 
Id. at 163 (list of cited cases omitted).  The court concluded 
this charge was supported by authority as well as reason.  The 
court further found "'where personal injuries result proximately 
from negligence or other tort, the wrongdoer is liable for the 
damages actually sustained, although they are increased by a 
tendency to disease on the part of the person injured.'"  Id. at 
                                                                                                                                                             
If the negligent actor is liable for another's bodily 
injury, he is also subject to liability for any 
additional bodily harm resulting from normal efforts 
of third persons in rendering aid which the other's 
injury reasonably requires, irrespective of whether 
such acts are done in a proper or a negligent manner. 
Id. at 286 (quoting Restatement (Second) of Torts § 457).  As 
stated in Butzow, this doctrine was adopted by Wisconsin in 
Selleck.        
No. 
2004AP2065   
 
11 
 
164 (quoting McNamara v. Clintonville, 62 Wis. 207, 22 N.W. 472 
(1885)).   
¶22 This court last cited the Selleck rule almost 30 years 
ago in Fouse.  In that case, the plaintiff sought damages 
totaling $5,400, which included all medical and hospital 
expenses, including the surgery in question.  Fouse, 80 
Wis. 2d at 396.  The defendant challenged the necessity of the 
surgery, the cost of which was included in the total.  Id. at 
397.  The circuit court determined that even if the jury agreed 
with the defendant's theory, the damages should have been for 
$393——the amount of expenses incurred up to the surgery——and 
therefore the amount of $1,750 the jury actually awarded was 
perverse.  Id.  This court then stated the following:   
[T]he fault in the award may go deeper.  The theory of 
the defense is that some of the damages resulted from 
mistaken medical treatment.  The rule for awarding 
damages for injuries aggravated by subsequent mistaken 
medical treatment 
was 
established 
in 
Selleck v. 
Janesville in 1898, and has been followed since.  
Assuming that the plaintiff exercised good faith and 
due care in the selection of his treating physician, 
an assumption borne out by the record in this case, 
under the Selleck rule the defendants are liable for 
the full amount of damages caused by the aggravation.  
However, 
the 
plaintiff 
did 
not 
request 
a 
jury 
instruction regarding the defendants' liability for 
damages aggravated by malpractice or mistake and has 
not challenged the instructions as given on appeal.  
We therefore confine our review to the fault found by 
the trial court. . . .    
Id. at 397-98.  The implication of this statement is clear:  had 
the plaintiff requested a Wis JI——Civil 1710 instruction, as a 
matter of law he would have been entitled to the full $5,400 
No. 
2004AP2065   
 
12 
 
under Selleck.  As noted by the court of appeals, this case is 
"eerily similar" to Fouse.  We agree and conclude the Selleck 
rule should apply in this case as it did in Fouse. 
¶23 The defendants argue that there is a difference 
between unnecessary medical treatment, as opposed to medical 
malpractice that causes aggravation of injuries.  In this case, 
the defendants contend that there is no causal relationship 
between the accident and the surgery performed by Dr. Lloyd.  
Therefore, in the defendant's view, this case should not be 
subject to a Wis JI——Civil 1710 instruction, because such an 
instruction "is to be used in cases where there is at issue 
aggravation of damages because of subsequent negligent medical 
treatment of injuries sustained in the accident."  Wis JI——Civil 
1710 Comment.  In support of its argument, the defendants point 
to the testimony of Dr. Pawl who found no spinal pathology 
causally related to the accident.  Additionally, the defendants 
contend the jury verdict, which awarded solely pre-surgery past 
medical expenses, demonstrates the jury concluded that the 
surgery was not causally related to the accident.   
¶24 Contrary to the defendants' argument, the jury's award 
of pre-surgery past medical expenses demonstrates that it 
believed Hanson was injured in the accident, as there was no 
evidence presented at trial that she had any neck pain prior to 
the 
accident. 
 
Thus, 
the 
jury 
rejected 
the 
defendants' 
contention at trial that Hanson was not injured in the accident.  
Applying the Selleck rule to the jury's findings, Hanson was 
No. 
2004AP2065   
 
13 
 
entitled to all of her past medical expenses, if she used  
ordinary care in selecting her physicians.     
¶25 One of the defendants' main arguments at trial was 
that the accident was not causally related to the surgery.  The 
important questions are whether the surgery arose from an 
initial injury that itself was caused by the accident and 
whether Hanson used ordinary care in selecting her physician.   
Here, the jury determined that Hanson was injured in the 
accident, and while seeking treatment with ordinary care she had 
an allegedly unnecessary surgery performed.  These facts are 
sufficient to bring this case under the ambit of the Selleck 
rule. 
¶26 The defendants also argued at trial that Hanson tends 
to exaggerate her injuries and has a demonstrated history of 
medical complaints with no organic cause.  The jury rejected 
this theory and concluded that she did in fact suffer an injury 
in the accident.  For purposes of the Selleck rule, it does not 
matter if Hanson is a person who is very focused on her physical 
pain, as long as Hanson used ordinary care in selecting Dr. 
Lloyd.  In this case, there was no dispute that Hanson exercised 
ordinary care in selecting Dr. Lloyd. 
¶27 Hanson was referred to Dr. Lloyd by her family doctor 
because an EMG showed evidence of an acute mild right C5-C6 
radiculopathy.  Dr. Ma determined that no surgery was indicated, 
but Dr. Lloyd disagreed.  In Dr. Lloyd's opinion, this injury 
was caused by the automobile accident.  Dr. Lloyd may have 
misdiagnosed those injuries, but they were the reason she was 
No. 
2004AP2065   
 
14 
 
treated.  Dr. Pawl even admitted as such.  Because Hanson used 
ordinary care in selecting her physician and that physician 
subsequently 
performed 
an 
allegedly 
unnecessary 
surgery, 
although one still arising from the original injury caused by 
Caldwell, the defendants are responsible for the expense of the 
surgery, consistent with the Selleck rule.   
¶28 As further support for this conclusion, we cite to 
Honthaners Restaurants, Inc. v. Labor and Industry Review 
Commission, 2000 WI App 273, 240 Wis. 2d 234, 621 N.W.2d 660.  
In that case, Dawn Stanislowski (Stanislowski) injured her arm 
while working at a George Webb's Restaurant, owned by Honthaners 
Restaurants, Inc. (Honthaners).  Id., ¶3.  Stanislowski was 
awarded temporary total disability and a payment of her accrued 
medical expenses for approximately a six-month time period.  Id.  
Later, she sought additional disability benefits and payment for 
additional medical expenses.  Id., ¶4.  The Labor and Industry 
Review 
Commission 
ordered 
Stanislowski's 
employer 
to 
pay 
temporary total disability and certain medical expenses for 
another 13 months.  Id., ¶7.  On appeal, Honthaners argued 
Stanislowski was not entitled to additional benefits because her 
additional medical treatment and expenses were unnecessary and 
unreasonable.  The court of appeals disagreed, and the order was 
affirmed.   
¶29 The court noted that there were two conflicting 
medical opinions concerning the injury.  Id., ¶22.  One doctor 
felt that Stanislowski needed prolonged treatment, while the 
other believed the injury had healed.  Id.  While we recognize 
No. 
2004AP2065   
 
15 
 
there was no dispute between the parties that Stanislowski 
suffered an injury, she allegedly took a course of unnecessary 
treatment.  Id.  The court of appeals, however, decided she 
should still be compensated for her alleged additional medical 
treatment because she accepted the additional treatment in good 
faith.  Id.  Similarly, Hanson arguably underwent unnecessary 
treatment, and in our view, because the jury decided she was 
injured, she should likewise be compensated for her past medical 
expenses. 
¶30 For all of the above reasons, we affirm the court of 
appeals as to this issue and conclude as a matter of law that 
Hanson is entitled to all of her past medical expenses.  
IV 
¶31 We next turn to the disputed jury instruction.  The 
court of appeals concluded that the circuit court's instruction 
on "Damages and Causation" was erroneous and confusing.  This 
instruction created by the circuit court was based on Wis JI——
Civil 1710 and Wis JI——Civil 1500.  Although defense counsel 
argued that no aspect of Wis JI——Civil 1710 was necessary, 
counsel did believe the version was a correct statement of the 
law.  The defendants argue that there was nothing wrong with the 
instruction, and if there is a problem, it lies with the fact 
that the trial court may have stated too much.   
¶32 As read to the jury, the instruction was as follows:5 
                                                 
5 The emphasized portions indicate the relevant deviations 
the circuit court made from its written instruction. 
No. 
2004AP2065   
 
16 
 
You must decide whether the defendant, Kevin L. 
Caldwell's, negligence caused the injury suffered by 
the 
plaintiff, 
Jo-El 
Hanson. 
 
The 
defendant's 
negligence caused the injury if it was a substantial 
factor in producing the injuries. 
One of the issues in this case for you to decide is 
whether the medical procedures and treatments used by 
her treating doctors related to the injuries she 
received in the accident.  Were the injuries treated 
by her doctors a part of the original injuries, and/or 
the 
natural 
and 
probable 
consequence 
of 
the 
defendant's negligence, and/or the normal incidence of 
medical 
care 
necessitated 
by 
the 
defendant's 
negligence.   
If there is a causal connection between the accident 
and the treatment she received and her damages, your 
answer to the question on damages for her personal 
injuries should be for the entire amount of damages 
sustained and should not be decreased because a 
defense doctor questions the procedure used by the 
plaintiff's treating doctors.  I think that is a very 
important comment. 
Now there's been talk here about malpractice law, and 
I've told you there is no issue of malpractice in this 
case. It is a difference of opinion as to whether or 
not the injuries were caused by the accident.  It's a 
superfluous matter about one doctor talking about what 
another doctor should have done.  It is improper in 
this case as far as I am concerned and should not be 
considered by you.  Any reduction should be——would be—
—any reduction would be contrary to long, established 
principles that a defendant who causes injury is 
responsible for any aggravation that results from 
improper——the alleged improper medical treatment for 
that injury as long as the plaintiff has exercised 
good faith and due care in selecting the treating 
physicians. 
The evidence in this case indicates that the plaintiff 
used ordinary care in selecting her treating doctors.  
So what does this basically say?  It says, she went to 
her 
doctor, 
the 
doctor 
used 
a 
procedure, 
the 
procedures were done and they followed.  If you relate 
them to the accident, those injuries, she should 
No. 
2004AP2065   
 
17 
 
receive the entire amount of damages she sustained for 
that, those procedures.  
¶33 The Comment to Wis JI——Civil 1710 reveals that the 
instruction is generally used in situations "where there is at 
issue the aggravation of damages because of subsequent negligent 
medical treatment of injuries sustained in the accident."  Wis 
JI——Civil 1710 Comment.   
¶34 This 
instruction 
conveys 
the 
"long-established 
principle that a defendant who causes injury is responsible for 
any aggravation that results from improper medical treatment, as 
long as the plaintiff has 'exercised good faith and due care' in 
selecting his or her treating physicians."  Lievrouw, 157 
Wis. 2d at 358.    
¶35 In Lievrouw, an expert for the defense, in an action 
for personal injuries arising out of an automobile accident, 
testified that the plaintiff "would have had a better recovery 
if he had been 
treated 
earlier 
and 
differently by his 
physicians."  Id. at 357.  The expert, however, said he was not 
accusing the treating physicians of malpractice.  Id.  The 
circuit court gave Wis JI——Civil 1710 as a jury instruction, and 
the defendants claimed that such an instruction was improper 
because there was no expert testimony concluding that the 
treating physicians were guilty of malpractice.  Id.  
¶36 The court of appeals disagreed, and held that the 
expert's testimony was "designed to leave the jury with the 
impression that part of [the plaintiff's] injuries were caused 
by his treating physicians and not by the accident," which could 
No. 
2004AP2065   
 
18 
 
have led the jury to reduce damages contrary to the Selleck 
rule.  Id. at 358.    
¶37 In this case, the circuit court faced a similar 
problem with regard to the testimony of Dr. Pawl, the defense 
expert.  His video testimony played to the jury, included the 
following: 
MR. PARLEE: And doctor, to a reasonable degree of 
medical certainty, given all the data you have 
reviewed in this case, including the medical records, 
the 
radiological 
films, 
test 
results, 
deposition 
transcripts, was Ms. Hanson's cervical fusion and 
related treatment caused by the accident on June 22 of 
2000? 
DR. PAWL: No. 
MR. PARLEE: Did that accident in any way render the 
fusion and related treatment medically necessary? 
DR. PAWL: No, absolutely not. 
MR. PARLEE: Do you feel that the surgery on Ms. Hanson 
was in and of itself medically necessary? 
DR. PAWL: No, I do not.  I do not feel it was 
necessary.   
¶38 On cross-examination, Hanson's counsel asked Dr. Pawl 
the following: 
MR. 
WARSHAFSKY: 
You 
think 
Dr. 
Lloyd 
committed 
malpractice, isn't that true? 
DR. PAWL: I didn't review it to the extent of 
answering that question, but there is no question in 
my mind it is my opinion that that surgery was not 
indicated. 
MR. WARSHAFSKY: If a doctor does surgery that's 
clearly not indicated, isn't it malpractice? 
No. 
2004AP2065   
 
19 
 
MR. PARLEE: I object in that calls for a legal 
conclusion.  It is also irrelevant to the case. 
DR. PAWL: It can be malpractice, but it is not 
necessarily malpractice. 
MR. WARSHAFSKY: Do you think Dr. Lloyd was negligent, 
or incompetent, or what? 
DR. PAWL: No, I think he did a very good job on the 
surgery. 
MR. WARSHAFSKY: A good job on the surgery.  Do you 
think he was incompetent doing the surgery to start 
with? 
DR. PAWL: No, if he were incompetent he wouldn't have 
done a good job with the surgery. 
MR. WARSHAFSKY: Do you think he was incompetent in his 
diagnosis that led him to do surgery? 
DR. PAWL: Yes, I clearly disagree with that, yes.  
¶39 Although the defendants may not have intended to raise 
an issue of medical malpractice with this questioning of Dr. 
Pawl, that is what happened.  Clearly though, malpractice was 
not an issue in the case, as no doctors were named in the 
lawsuit, and the circuit court believed a curative instruction 
was necessary.  In other words, Dr. Pawl's testimony might have 
left the jury with the impression that part of Hanson's injuries 
were caused by Dr. Lloyd and not by the accident.  "If believed, 
this testimony could have led the jury to reduce the award of 
compensatory damages to [Hanson] accordingly.  Such a reduction 
would have been contrary to the [Selleck rule.]"  Lievrouw, 157 
Wis. 2d at 358.  Thus, the circuit court, in its discretion, 
concluded that using Wis JI——Civil 1710 was appropriate.   
No. 
2004AP2065   
 
20 
 
¶40 However, Wis JI——Civil 1710 was not used by the 
circuit court in this case.  Instead, the circuit court gave the 
instruction quoted above.  The court of appeals interpreted this 
instruction as follows:   
By telling the jury that it could not consider the 
doctor's alleged malpractice, and at the same time 
telling the jury it must find that all treatments were 
related to the accident, the trial court let the jury 
decide that the treatment it concluded was unnecessary 
was not 'caused' by the accident, and was therefore 
not 
compensable. 
 
That 
is 
not 
the 
law 
in 
Wisconsin. . . . In effect, the trial court told the 
jury that regardless of whether the surgery was 
unnecessary, they could not award the cost of the 
surgery unless the jury 'relate[d] them to the 
accident, those injuries.' 
Hanson, No. 2004AP2065, ¶25.  We agree with the court of appeals 
that the instruction, as read to the jury, was an erroneous 
statement of Wisconsin law.  The modified version created by the 
court was unnecessary and only brought serious confusion into 
play.   
¶41 Having 
concluded 
that 
the 
jury 
instruction 
was 
erroneous because it was directly at odds with current Wisconsin 
law, we must determine whether a new trial is necessary.   
¶42 We conclude that based on the jury's awarding of only 
pre-surgery past medical expenses, this instruction probably 
misled the jury.  That is, although the jury determined that 
Hanson had been injured in the accident, it granted her only 
$25,000 in past medical expenses, as opposed to the full amount 
of $78,123.97.  It appears that the amounts awarded for the 
remaining damages were also limited to damages incurred prior to 
No. 
2004AP2065   
 
21 
 
the surgery.  Because the jury misapplied the law as to past 
medical expenses, there is a reasonable probability of a 
different outcome with respect to the remaining damages at issue 
if the jury is correctly instructed on the law.   Therefore, we 
agree with the court of appeals that a new trial is necessary on 
the remaining damages at issue. 
V 
¶43 We hold that because the jury concluded that Hanson 
was injured in the accident, she was entitled to all of her past 
medical expenses, 
regardless 
of whether Hanson's treating 
physician performed an unnecessary surgery, under the rule first 
enunciated in Selleck, 100 Wis. 157, as Hanson used ordinary 
care in selecting her doctor.  Furthermore, we hold the jury's  
verdict arose from an erroneous and confusing jury instruction 
such that there is a reasonable probability of a different 
outcome on the remaining damages at issue.  As such, the 
decision of the court of appeals is affirmed.   
By the Court.—The decision of the court of appeals is 
affirmed. 
 
 
 
No.  2004AP2065.ssa 
 
1 
 
 
¶44 SHIRLEY S. ABRAHAMSON, C.J.   (concurring).  I agree 
that the cause should be remanded for a new trial on damages. 
¶45 Our case law and the Restatement (Second) of Torts, 
upon which our case law substantially relies, make clear, as the 
majority opinion explains, that a tortfeasor is liable for 
damages sustained by an injured plaintiff when being treated for 
an injury sustained in the collision at issue. 
¶46 The problem in the instant case is that Caldwell et 
al., the defendants, may have tried to put forth two different 
theories of nonliability.  Under one theory, the surgery was 
performed as treatment for injuries sustained in the collision, 
but the surgery was unnecessary.  Selleck clearly forecloses 
this defense. 
¶47 The defendants may have also tried to advance a second 
theory, that is, that the surgery, necessary or not, was 
performed not to treat the injuries Hanson, the plaintiff, 
sustained in the collision at issue, but, rather, to treat an 
injury Hanson sustained at some other time.  This theory, 
however, was not well developed by the defendants and was 
blended 
with 
the 
argument 
that 
the 
surgery 
was 
simply 
unnecessary.  See majority op., ¶¶37-38 and the trial transcript 
quoted therein.  The court of appeals clearly saw that the 
defendants' 
arguments 
were 
intertwined, 
overlapping, 
and 
confusing, and ultimately concluded, as has the majority 
opinion, that the record raised the Selleck issue:  "The only 
issues were whether Hanson was injured by the accident, and the 
No.  2004AP2065.ssa 
 
2 
 
extent of those alleged injuries.  Caldwell's theory of the case 
was that the impact could have been great enough to cause a 
strain, but was not great enough to cause structural damage 
necessitating surgery.  Thus, Caldwell argued, the surgery was 
unnecessary."  Hanson v. Am. Family Mut. Ins. Co., No. 
2004AP2065, unpublished slip op., ¶6 (Wis. Ct. App. Nov. 8, 
2005). 
¶48 We are thus left with a muddled defense and a muddled 
record.  I am therefore satisfied that the majority opinion 
correctly concludes that on the record before the court, the 
Selleck rule applies and the plaintiff is entitled to a new 
trial on the issue of damages. 
¶49 For the reasons set forth, I concur. 
 
 
 
 
No.  2004AP2065.dtp 
 
1 
 
 
¶50 DAVID T. PROSSER, J.   (dissenting).   
¶51 "Post hoc, ergo propter hoc" is Latin for: "after 
this, therefore because of this."  Black's Law Dictionary 1186 
(7th ed. 1999). 
¶52 "Post hoc, ergo propter hoc" is a logical fallacy that 
assumes that if one event occurs after another, then the first 
event caused the second event. 
I. INTRODUCTION 
¶53 The majority purportedly applies the rule set forth in 
Selleck v. Janesville, 100 Wis. 157, 75 N.W. 975 (1898).  The 
Selleck rule provides that "a defendant who causes injury is 
responsible for any aggravation that results from improper 
medical treatment, as long as the plaintiff has 'exercised good 
faith 
and 
due 
care' 
in 
selecting 
his 
or 
her 
treating 
physicians."  Lievrouw v. Roth, 157 Wis. 2d 332, 358, 459 
N.W.2d 850 
(Ct. 
App. 
1990). 
 
In 
Fouse 
v. 
Persons, 
80 
Wis. 2d 390, 259 N.W.2d 92 (1977), the court commented that 
"[t]he rule for awarding damages for injuries aggravated by 
subsequent 
mistaken 
medical 
treatment 
was 
established 
in 
Selleck."  Id. at 397 (emphasis added); see Selleck, 100 Wis. at 
163. 
¶54 Although the Selleck rule remains good law, the issue 
presented 
in 
this 
case 
is 
whether 
the 
Selleck rule is 
applicable.  In my view, the Selleck rule does not apply until 
the plaintiff establishes a causal connection between the 
defendant's negligence and the injury or condition for which a 
No.  2004AP2065.dtp 
 
2 
 
physician 
renders 
improper 
medical 
treatment. 
 
Stated 
differently, it is not enough to show that the defendant caused 
an injury.  The plaintiff must establish a chain of causation 
between the defendant's negligence and any injuries for which 
the defendant seeks damages.  A coincidental correlation is not 
sufficient. 
¶55 These principles are recognized in existing jury 
instructions.  (1) If a defendant causes injury A, the defendant 
is responsible for all the damages arising from injury A, 
including improper medical treatment that aggravates injury A.  
See Wis JI——Civil 1710.  (2) If a defendant causes injury A and 
injury A aggravates existing injury or condition B, the 
defendant is responsible for all resulting damages.  See Wis JI—
—Civil 1715.  (3)  If a defendant causes injury A, the defendant 
is responsible for all damages arising from injury A but not 
damages arising from injuries that are not in the chain of 
causation.  See Wis JI——Civil 1720, which provides: 
[Y]ou cannot award any damages for any (pre-
existing 
disease, 
condition, 
or 
ailment) 
(predisposition to disease) except insofar as you are 
satisfied that the (disease, condition, or ailment) 
(predisposition to disease) has been (aggravated) 
(activated) by the injuries received in the accident 
on (date).  If you find that the plaintiff had a (pre-
existing disease or condition which was dormant) 
(predisposition to disease) before the accident but 
that such (disease or condition) (predisposition to 
disease) was (aggravated) (brought into activity) 
because of the injuries received in the accident, then 
you should include an amount which will fairly and 
reasonably compensate (plaintiff) for such damages 
(plaintiff) suffered as a result of such (aggravation) 
(activation) of the condition. 
No.  2004AP2065.dtp 
 
3 
 
 
Any ailment or disability that the plaintiff may 
have had, or has, or may later have, which is not the 
natural result of the injuries received in this 
accident, is not to be considered by you in assessing 
damages.  You cannot award damages for any condition 
which has resulted, or will result, from the natural 
progress of the pre-existing disease or ailment or 
from consequences which are attributable to causes 
other than the accident. 
 
If the plaintiff was more susceptible to serious 
results from the injuries received in this accident by 
reason of 
a 
(pre-existing disease 
or 
condition) 
(predisposition to disease) and that the resulting 
damages have been increased because of this condition, 
this should not prevent you from awarding damages to 
the extent of any increase and to the extent such 
damages were actually sustained as a natural result of 
the accident. 
Wis JI——Civil 1720 (emphasis added). 
 
¶56 This case is changing the law.  If a defendant causes 
injury A, is the defendant responsible not only for injury A but 
also for injury or condition B, which is not related to injury 
A, simply because injury or condition B was treated after injury 
A?  The majority's answer appears to be "yes."  Notably absent 
from the majority opinion is any discussion of whether the 
accident caused the injury for which Hanson received surgery.  
Instead, the majority directs its analysis to two questions: 
"[1] whether the surgery arose from an initial injury that 
itself was caused by the accident and [2] whether Hanson used 
ordinary care in selecting her physician."  Majority op., ¶25.1 
 
¶57 The second question is not critical in this case, the 
first question is.  Wisconsin JI——Civil 1720 unquestionably 
                                                 
1 Stated otherwise, the majority's opinion means that if a 
plaintiff can prove a coincidental correlation she can satisfy 
the causation element of a negligence claim. 
No.  2004AP2065.dtp 
 
4 
 
creates a jury question about whether the surgery "arose from an 
initial injury."  In this case, credible evidence supports the 
jury verdict.  The jury verdict is consistent with the inference 
to a finding that the bodily injury or condition for which Jo-El 
Hanson underwent surgery was not caused by the defendant's 
negligence. 
 
¶58 The majority disagrees.  The majority concludes that 
because the plaintiff experienced neck pain after an accident, 
the accident caused the neck pain.  Post hoc, ergo propter hoc. 
 
¶59 Consequently, the majority opinion either absolves the 
plaintiff from proving causation as an element of her negligence 
claim as a matter of law, or it completely undermines the 
sanctity of the jury verdict.  To respect trial by jury, the 
court ought to draw all reasonable inferences in favor of the 
verdict instead of substituting its own inferences and fact 
determinations 
for 
those 
of 
the 
jury. 
 
See 
Wis. Stat. § 805.14(1); Morden v. Cont'l AG, 2000 WI 51, ¶38, 
235 Wis. 2d 325, 611 N.W.2d 659. 
II. BACKGROUND 
¶60 The facts of this case are as follows.  On June 22, 
2000, Kevin Caldwell, while driving a truck, struck Jo-El 
Hanson's car in the rear at a speed of five to seven miles per 
hour.  The next day, Hanson visited her doctor, Dr. Kenneth 
Saydel, because she was experiencing lower back, neck, and rib 
pain.  About a month after the accident, in July 2000, she was 
diagnosed with post-traumatic cervical dorsal strain.  Although 
the rib and lower back pain went away after some months with 
No.  2004AP2065.dtp 
 
5 
 
physical therapy, the neck pain remained.  In November 2000 Dr. 
Lynn Ma diagnosed the plaintiff with acute mild right C5-C6 
radiculopathy and referred the plaintiff to a neurosurgeon, Dr. 
James Lloyd.  Dr. Lloyd recommended surgery and performed the 
surgery in February 2001.  
¶61 The plaintiff filed a lawsuit against the defendants, 
and the case proceeded to trial.  The issues before the court 
were whether Hanson was injured in the accident and, if so, the 
extent of those injuries.  The evidence adduced at trial reveals 
conflicting testimony from various doctors as to whether the 
accident caused the structural damage (the radiculopathy) in 
Hanson's neck, which led to the surgery. 
¶62 The jury awarded Hanson past medical expenses in the 
amount of $25,000——roughly the amount of her medical expenses 
incurred after the accident but before the surgery.  Hanson 
filed a post-verdict motion requesting that she be awarded all 
past medical expenses, $79,123.97, including the expenses of 
surgery.  After the trial court denied Hanson's motion, she 
appealed.  Applying the Selleck rule, the court of appeals 
reversed the circuit court's order and granted Hanson all her 
medical expenses, including the cost of surgery, and granted a 
new trial on the issue of other damages. 
III. SUFFICIENCY OF THE EVIDENCE 
¶63 This case requires the court to decide whether the 
evidence is sufficient to sustain the jury's determination.  The 
standard of review for sufficiency of the evidence is narrow: 
"Appellate courts in Wisconsin will sustain a jury verdict if 
No.  2004AP2065.dtp 
 
6 
 
there is any credible evidence to support it."  Morden, 235 
Wis. 2d 325, ¶38.  Thus, "if the evidence gives rise to more 
than one reasonable inference, [the court must] accept the 
particular 
inference 
reached 
by 
the 
jury." 
 
Id., 
¶39.  
Similarly, the court must accept the jury's inference even if 
stronger and more convincing evidence supports a contradictory 
inference.  Id. 
¶64 In this case, the standard of review "is even more 
stringent 
because 
the 
circuit 
court 
approved 
the 
jury’s 
verdict."  Id., ¶40. Thus: 
We afford special deference to a jury determination in 
those situations in which the trial court approves the 
finding of a jury.  In such cases, this court will not 
overturn the jury’s verdict unless "there is such a 
complete failure of proof that the verdict must be 
based on speculation." 
Id. 
(quoting 
Coryell 
v. 
Conn, 
88 
Wis. 2d 310, 
315, 
276 
N.W.2d 723 (1979)). 
¶65 With this standard of review firmly in mind, an 
appellate court must "search the record for credible evidence 
that sustains the jury's verdict, not for evidence to support a 
verdict that the jury could have reached but did not."  Morden, 
235 Wis. 2d 325, ¶39.  After having reviewed the record, I 
conclude credible evidence supports the jury verdict.2 
                                                 
2 Although the majority correctly states the standard of 
review, it fails to apply the standard.  Instead, the majority 
replaces its own inferences for those of the jury.  By doing so, 
the majority undermines the function of the civil jury trial, a 
function that has long been stated "as an essential bulwark of 
civil liberty."  Galloway v. United States, 319 U.S. 372, 397 
(1943). 
No.  2004AP2065.dtp 
 
7 
 
¶66 At 
trial, 
the 
defendants 
contested 
the 
causal 
connection between the accident and Hanson's radiculopathy.  
Causation turns on "whether the defendant's negligence was a 
substantial factor in producing the injury."  Nieuwendorp v. Am. 
Family Ins. Co., 191 Wis. 2d 462, 475, 529 N.W.2d 594 (1995).  
The jury's decision to limit Hanson's recovery of medical 
expenses to pre-surgery medical expenses is consistent with a 
finding that the accident caused some of Hanson's medical 
problems, but that neither the accident nor Dr. Lloyd's 
allegedly 
negligent 
treatment 
of 
Hanson's 
accident-related 
injury caused the structural damage (radiculopathy), which 
prompted Dr. Lloyd to operate.   
¶67 Credible evidence presented at trial supports the 
inference that the jury determined the accident caused temporary 
soft tissue damage but did not cause, and was otherwise 
completely unrelated to, any structural damage.  Accordingly, 
the jury could have correctly awarded Hanson the medical 
expenses she incurred after the accident but before the surgery 
without violating the rule set forth in Selleck.   
¶68 In his closing argument, defense counsel forcefully 
argued that Hanson suffered two distinct injuries or conditions 
caused by two different sources.  He stated: 
[I]t is from a biomechanical standpoint impossible 
that she could have had any structural damage causing 
surgery.  It may be your judgment as a jury that she 
had some temporary soft tissue discomfort as a result 
of the accident.  We are not saying, we are not trying 
to claim that that's impossible.  But if that's the 
case, her damages should be limited accordingly.  
(Emphasis added.) 
No.  2004AP2065.dtp 
 
8 
 
 
¶69 The closing argument was not the first instance where 
the record displays evidence of two distinct injuries.  In 
defense counsel's opening statement, he stated: "The evidence is 
going to show with someone like [the plaintiff], an accident 
like this at the most is going to cause some temporary soft 
tissue soreness in the neck. . . .  And that's the extent of 
what this accident had caused."  Defense counsel also stated to 
the jury that he was going to present a witness, Dr. Alfred 
Bowles, who was going to testify that, "from a physical 
standpoint . . . there was [not] enough force or even injury in 
the accident to cause any sort of structural problem in the 
spine that would give rise to surgery."  
 
¶70 Defense counsel fulfilled the promise he made to the 
jury in his opening statement.  The record is replete with 
evidence that the plaintiff suffered from two distinct injuries 
or conditions.  For instance: 
(A) When cross-examined, Dr. Lloyd stated that the initial 
injury from the accident was "post-traumatic cervical dorsal 
strain" or muscle strain.  The muscle strain was of the type one 
would receive by lifting something too heavy, but it did not 
involve any problems with the spinal cord or nerve root 
associated with structural damage.  From this evidence, the jury 
could have inferred that there were two distinct injuries, one 
caused by the accident and one not caused by the accident. 
(B) During re-direct examination, Dr. Lloyd stated that 
Hanson had two distinct injuries: permanent nerve root injury 
No.  2004AP2065.dtp 
 
9 
 
and muscle and soft tissue injury.  Again, the jury could have 
found different causes for each distinct injury. 
¶71 The record also contains evidence that the accident 
did not cause or lead to treatment that caused the structural 
damage: 
(A) Hanson testified that she had done some horseback 
riding and sledding before the accident and had done some 
shoveling after the accident.  From this statement, the jury 
could have inferred that these other activities, not the 
accident, caused the structural damage that led to the surgery. 
(B) Upon direct examination, Dr. Lloyd stated that since 
the time of the accident, Hanson had "complained of posterior 
neck pain radiat[ing] into her right arm and numbness into her 
hand, and that she also noticed weakness of her right arm."  
Upon cross-examination, however, Dr. Lloyd acknowledged that 
even before the accident, Hanson had complained of some hand 
numbness.  The jury could have inferred from these statements 
that because Hanson experienced some of the same symptoms of 
structural damage before the accident, the structural damage 
existed before the accident, and that the accident did not cause 
the structural damage. 
(C) Upon 
direct examination, 
one of 
the 
defendant's 
experts, Dr. Bowles, stated that there was no evidence of a 
causal relationship between the accident and the structural 
damage: 
I can't find a . . . causal relationship between the 
impact, the impact related movement of the car and her 
body that would lead to the types of medical problems 
that are seen and treated down the road, especially 
No.  2004AP2065.dtp 
 
10 
 
related to the cervical spine and cervical nerve roots 
and pain and symptoms in the upper extremity. 
He acknowledged, however, that the accident could have caused 
some kind of minor injury, such as muscle strain.  The jury 
could have determined that the accident caused the muscle strain 
but not the structural damage. 
 
(D) Upon cross-examination, Dr. Bowles stated that the 
structural damage could have been caused by an impact-related 
injury, but that it could also have been caused by a non-impact-
related injury.  Dr. Bowles stated that there are other factors 
that cause nerves not to conduct well. 
¶72 While the record contains evidence contrary to the 
inference that the accident caused structural damage,3  an 
appellate court must "view[] the evidence in a light most 
favorable to the jury verdict and . . . accept[] the particular 
inferences drawn by the jury."  Morden, 235 Wis. 2d 325, ¶41.  
The majority fails to search the record for evidence supportive 
of the jury verdict and dismisses the possibility that the jury 
could have reasonably found that there were two distinct 
injuries or conditions, one caused by the accident and one 
unrelated to the accident or the subsequent treatment.  By 
ignoring this possibility and awarding full damages as a matter 
of law, the majority either usurps the role of the jury or 
                                                 
3 Interestingly, it was not until the plaintiff's closing 
argument that the plaintiff asserted the theory that negligent 
treatment of the muscle strain caused the structural damage to 
the neck.  The evidence adduced at trial does not support this 
assertion. 
No.  2004AP2065.dtp 
 
11 
 
effectively eliminates one element of negligence: causation.4  By 
allowing Hanson to recover damages for an injury that may not 
have been caused by the accident or by subsequent treatment of 
an accident-related injury, the majority expands the Selleck 
rule and embraces a fallacy. 
¶73 The Selleck court stated: "The plaintiff is not held 
responsible for the errors or mistakes of a physician or surgeon 
in treating an injury received by a defect in the street or 
sidewalk, providing she exercises ordinary care in procuring the 
services of such physician."  Selleck, 100 Wis. at 163 (emphasis 
added).  The Selleck rule, therefore, recognizes liability for 
unnecessary medical treatment, but only for treatment of 
injuries caused or aggravated by the accident. 
¶74 The 
importance 
of 
first 
establishing 
a 
causal 
connection between the defendant's negligence and the injury 
aggravated or caused by a treating physician's negligence was 
made 
clear 
in 
Butzow 
v. 
Wausau 
Memorial 
Hospital, 
51 
Wis. 2d 281, 285-86, 187 N.W.2d 349 (1971).  The court explained 
that the Selleck rule reflects a public policy determination as 
to "where the line of causation should end."  Id. at 286.  Thus, 
the Selleck rule presupposes causation and becomes relevant once 
a 
plaintiff 
establishes 
a 
causal 
connection 
between 
the 
                                                 
4 The majority's view of this case stands in stark contrast 
to how the circuit court perceived this case.  After hearing all 
the evidence at trial and before instructing the jury, the 
circuit court judge explained: "[T]his court has an obligation 
to direct this jury and keep their eye on the ball here and this 
is a causation case.  It's nothing more than that on these 
facts."  (Emphasis added.) 
No.  2004AP2065.dtp 
 
12 
 
defendant's negligence and the plaintiff's bodily injury for 
which treatment is provided.  See id. 
¶75 Whether 
the 
defendant's 
negligence 
caused 
the 
structural damage to Hanson's cervical vertebrae was hotly 
disputed at trial.  Nevertheless, the majority assiduously 
avoids the question of whether the surgery was causally related 
to the accident.  Rather, the majority focuses its discussion on 
"whether the surgery arose from an initial injury that itself 
was caused by the accident."  Id.  Under this extension of the 
Selleck rule, a plaintiff is able to recover damages for any 
medical treatment as long as the treatment was prescribed as a 
result of inquiry about an accident-related injury. 
¶76 To illustrate, imagine that a plaintiff is injured in 
a car accident and immediately experiences pain in her big toe 
and then, a couple days later, experiences inflammation and 
discomfort in the ball of her foot.  She visits a doctor who 
finds that she has fractured her big toe, and who diagnoses her 
as in need of surgery to remove an extra bone in the ball of her 
foot.5  The doctor reasons that the accident probably aggravated 
the tendon that attaches to this extra bone.  It turns out, 
though, that the doctor was wrong in two regards: (1) the 
surgery was not necessary, and (2) the aggravation of the 
plaintiff's tendon was caused not by the accident but by the 
plaintiff having run a marathon three days before the accident. 
                                                 
5 This is an actual medical condition called accessory 
navicular syndrome. 
No.  2004AP2065.dtp 
 
13 
 
¶77 Under the majority's interpretation, if the jury were 
to find that the accident caused the fractured toe, then, as a 
matter of law, the defendant would be liable not only for the 
damages associated with the fractured toe, but also for the 
damages associated with the inflamed tendon, including the 
resulting surgery, even though there was no causal connection 
between the accident and the presence of the extra bone.6 
¶78 Thus, the majority effectively eliminates the need to 
prove causation in certain situations.  This makes Wis JI——Civil 
1720 a dead letter, replacing it with the reasoning of post hoc, 
ergo propter hoc.   
IV. THE JURY INSTRUCTIONS 
¶79 The majority concludes the jury instruction "was an 
erroneous statement of Wisconsin law[]" and that it "probably 
misled the jury."  Majority op., ¶¶40, 42.  Ultimately, its 
analysis of this issue proves conclusory and unconvincing. 
¶80 A circuit court "has broad discretion when instructing 
a jury."  Fischer v. Ganju, 168 Wis. 2d 834, 849, 485 N.W.2d 10 
(1992).  "A challenge to an allegedly erroneous jury instruction 
warrants reversal and a new trial only if the error was 
prejudicial."  Id.  "An error is prejudicial if it probably and 
not merely possibly misled the jury."  Id. at 850.  "If the 
                                                 
6 This scenario is different from a scenario where the 
doctor was negligent and aggravated the tendon while treating 
the fractured toe.  In that case, the defendant would be liable 
for the damage to the tendon under the Selleck rule because the 
doctor aggravated a pre-existing injury while treating an 
accident-related injury. 
No.  2004AP2065.dtp 
 
14 
 
overall meaning communicated by the instructions was a correct 
statement of the law, no grounds for reversal exist."  Id. 
¶81 The majority uncritically adopts the court of appeals' 
analysis that the jury instruction misstated Wisconsin law 
because it allowed the jury to "decide that the treatment [the 
jury] concluded was unnecessary was not caused by the accident, 
and was therefore not compensable."  Majority op., ¶40 (quoting 
Hanson v. Am. Family Mut. Ins. Co., No. 2004AP2065, unpublished 
slip op., ¶25 (Wis. Ct. App. Nov. 8, 2005)). 
¶82 The jury instruction did not misstate Wisconsin law.  
Wisconsin JI——Civil 1710 sets forth the rule that a defendant is 
liable for the damages for injuries aggravated by subsequent 
mistaken medical treatment.  See also Fouse, 80 Wis. 2d at 397.  
Instruction 1710 includes three concepts: (1) The plaintiff must 
have exercised ordinary care in selecting the doctor who 
allegedly committed malpractice; (2) The doctor's malpractice 
must 
have 
aggravated 
injuries 
caused 
by 
the 
defendant's 
negligence; and (3) The defendant is liable for the entire 
amount of damages, including damages attributable to the 
doctor's malpractice. 
¶83 All three of these concepts were clearly present in 
the instructions read to the jury. 
(1) The jury was told Hanson "used ordinary care in 
selecting 
her 
treating 
doctors." 
 
The 
first 
concept 
in 
Instruction 1710 was conveyed to the jury. 
(2) The jury was told "that a defendant who causes injury 
is responsible for any aggravation that results from . . . the 
No.  2004AP2065.dtp 
 
15 
 
alleged 
improper 
medical 
treatment 
for 
that 
injury[.]"  
(Emphasis added.)  The second concept in Instruction 1710 was 
conveyed to the jury. 
(3) The jury was told, "[i]f you relate them to the 
accident, the injuries, she should receive the entire amount of 
damages she sustained for that, those procedures."  Moreover, 
the jury was told that the damages "should not be decreased 
because a defense doctor questions the procedure used by the 
plaintiff's treating doctors."  In other words, even if there 
were testimony that the surgery was unnecessary, the jury would 
have to award damages for the surgery if the injury for which 
the surgery was performed were caused by the defendant's 
negligence.  The third concept in Instruction 1710 was conveyed 
to the jury. 
¶84 Although the circuit court did not read Instruction 
1710 word-for-word, its content was adequately conveyed to the 
jury.   
¶85 The fault the majority finds in the jury instructions 
reflects its failure to acknowledge that there are more than two 
possible causes for Hanson's structural damage.  While the 
accident or subsequent negligent treatment of the muscle strain 
could have caused or aggravated the structural damage, something 
unrelated to the accident or to treatment of the accident-
related injury also could have caused the structural damage. 
¶86 Before the Selleck rule even comes into play, there 
must be a causal relationship between the injury for which 
treatment is given (i.e. the radiculopathy) and the defendant's 
No.  2004AP2065.dtp 
 
16 
 
negligence. 
 
It 
is 
not 
sufficient 
that 
the 
defendant's 
negligence 
caused 
"an 
injury," 
majority 
op., 
¶20; 
the 
defendant's negligence must have caused the injury that the 
doctor's malpractice aggravates, or the doctor's malpractice in 
treating the accident-related injury must cause another injury.  
When the majority concludes that the jury instructions probably 
misled the jury, it effectively absolves Hanson of proving that 
the accident caused the radiculopathy. 
¶87 The instructions advised the jury to award damages 
only if the jury found a causal connection between the accident 
and the injury for which Dr. Lloyd performed surgery and not to 
reduce damages if it found that Dr. Lloyd was negligent in his 
treatment of that injury.  Contrary to the majority's conclusory 
statement, the instruction was a correct statement of the law.  
Accordingly, I disagree that the jury instructions "probably 
misled the jury." 
V. REMEDY 
 
¶88 The majority remands for a new trial on Hanson's 
damages for past and future pain and suffering and loss of 
earning capacity.  The majority concludes, "the jury's verdict 
arose from an erroneous and confusing jury instruction such that 
there is a reasonable probability of a different outcome on the 
remaining damages at issue."  Majority op., ¶3.  The majority 
remands for a new trial on damages only, even though the part of 
the jury instructions the majority condemns deals with causation 
and even though there was sufficient trial testimony to allow 
the jury to conclude that the accident did not cause Hanson's 
No.  2004AP2065.dtp 
 
17 
 
radiculopathy.  If the case is to be remanded, it should be 
remanded for a new trial on liability and damages. 
VI. CONCLUSION 
 
¶89 In its decision, the majority significantly expands 
the Selleck rule, transforming it into another exception to the 
need to prove causation in a negligence claim.  The smokescreen 
put up by the concurrence cannot obscure the fact that the 
majority creates a new rule of law. 
¶90 On these facts and under the law of negligence as it 
existed prior to today's decision, there is no justification for 
an appellate court to award damages not awarded by the jury or 
the circuit court.  In my view, the judgment of the circuit 
court should be affirmed. 
 
¶91 For the reasons stated, I respectfully dissent. 
 
 
 
No.  2004AP2065.dtp 
 
 
 
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