Opinion ID: 867533
Heading Depth: 3
Heading Rank: 3

Heading: Consent Obtained by Misrepresentation

Text: ¶ 19 Even assuming arguendo that there was consent to this procedure, there would remain the question of whether that consent was obtained by misrepresentation and thus invalid. The court of appeals relied on comment f to Restatement § 18 and found that Duncan's consent was valid, even if obtained by the nurse's misrepresentation. The court found that Duncan's only remedy was an action for the conduct of the person who procured her consent. The court of appeals erred in its application of the Restatement. ¶ 20 According to Restatement § 892B(2), consent is ineffective if obtained by another's misrepresentation: If the person consenting to the conduct of another is induced to consent by a substantial mistake concerning the nature of the invasion of his interests or the extent of the harm to be expected from it and the mistake is known to the other or is induced by the other's misrepresentation, the consent is not effective for the unexpected invasion or harm. (Emphasis added.) So long as a patient's mistake concerning the nature of the invasion was induced by the health care provider's misrepresentation, the Restatement provides that a patient may either bring an action against the health care provider for misrepresentation or treat the consent as invalid and maintain any tort action open to [her] in the absence of consent. Restatement § 892B cmt. h. Accordingly, we hold that if a patient's consent is obtained by a health care provider's fraud or misrepresentation, a cause of action for battery is appropriate. See 6 Am.Jur.2d Assault and Battery § 127 (1999). ¶ 21 On this record, Duncan's case falls squarely within Restatement § 892B because the alleged facts, taken in the most favorable light, support her claim that SMI and its agents obtained consent for the injection by express misrepresentation. Duncan told Nurse Fink on three separate occasions that she would accept only morphine or demerol. Nurse Fink told Duncan the medication had been changed to morphine and then gave her fentanyl regardless. Duncan's consent was thus ineffective because Nurse Fink's alleged misrepresentation led Duncan to believe she would receive a morphine shot, not a fentanyl shot. ¶ 22 Further, the scenario addressed in comment f to Restatement § 18, on which the court of appeals relied, is distinguishable from the instant case because Duncan was not fully aware of the particular character of the contact. Section 18, comment f reads, in part: The rule stated in § 892B, that a consent to a contact the particular character of which the other is fully aware, is not made ineffective by reason of the fraudulent misrepresentations which induce the other to give the consent, is of peculiar importance in determining the existence of liability for a merely offensive contact. Under the rule stated in that Section, the consent, though fraudulently procured, prevents the infliction of the contact from being itself a wrong and as such actionable. The other's only possible remedy is an action based upon the fraudulent and, therefore, tortious character of the conduct of the actor by which he has procured the consent. (Emphasis added.) This comment addresses only those situations in which a patient is fully aware of the nature of an invasion and agrees to it. ¶ 23 In contrast, comment h to Restatement § 892B addresses those situations in which the patient is mistaken about the nature of the invasion and the mistake is induced by a health care provider's misrepresentation. Nurse Fink allegedly told Duncan she would receive a morphine injection, when in fact he knew it to be fentanyl. Duncan, unaware of the true nature of the invasion, agreed to proceed based on Nurse Fink's misrepresentation. This provides the elements of a claim for battery. ¶ 24 SMI contends a health care provider must be aware that the patient made a substantial mistake as to the nature of the invasion for the consent to be ineffective. But the Restatement test is written in the disjunctive: the patient's mistake regarding the nature of the invasion must either be known to the health care provider or must be induced by the provider's misrepresentation. See Restatement § 892B(2). Moreover, § 892B, comment h, which specifically addresses misrepresentation, provides as follows: The mistake having been produced by the misrepresentation of the actor[,] he will normally be aware of its existence, but his knowledge of the mistake is not necessary.  (Emphasis added.) Here, Fink allegedly induced Duncan to consent by misrepresenting that the painkiller to be used was morphine. Having met one prong of the test, Duncan is not required to establish that Fink knew of her mistaken belief regarding the nature of the injection to prove fraudulently obtained consent. ¶ 25 SMI further contends that under Restatement § 892B(2) Duncan must prove that SMI or its agents knew or should have known that she made a substantial mistake as to the extent of harm reasonably to be expected from administration of fentanyl. Here again, the Restatement is worded in the disjunctive: A patient's consent is ineffective so long as she makes a substantial mistake concerning the nature of the invasion of [her] interests or the extent of harm to be expected from it. Restatement § 892B(2) (emphasis added). Duncan need not prove that SMI knew or should have known she was mistaken about the extent of harm to be expected from the injection because she has alleged her mistake was induced by Nurse Fink's misrepresentation. ¶ 26 Duncan's evidence supports the claim for battery because she alleges SMI and/or its agents administered fentanyl without consent. We now address whether she may bring that cause of action under Arizona law.