Opinion ID: 1902827
Heading Depth: 1
Heading Rank: 7

Heading: Must the claims of medical malpractice and lack of informed consent accrue simultaneously?

Text: I have found no jurisdiction in which a subject of a medical experiment has had an informed consent claim dismissed without resolution of the question of when the patient had been informed of the experimental nature of the procedures involved. In Anderson v. George H. Lanier Memorial Hospital, 982 F. 2d 1513, 1519 (11th Cir. 1993), the medical provider argued that the nondisclosure claims were intertwined with medical malpractice claims and that the statute of limitations governing the malpractice claims should bar the informed consent claims. The court disagreed. It found the claim that the patients alleged was that the hospital did not obtain their informed consent concerning an experimental procedure. Id. at 1519. The court observed: The appellants may have been put on notice that [the physician] negligently performed their eye surgeries. The appellants, however, were not placed on notice that they were the victims of an experimental procedure. Id. at 1520. In Shadrick v. Coker, 963 S.W. 2d 726 (Tenn.1998), an orthopedic patient was never told that a certain type of screw put in his back was experimental. He was well aware that the operation was unsuccessful. For over three years following removal of the screws, he continued to have pain in his back. Id. at 729. It was not until December 17, 1993, that he saw a television program (20-20) containing a segment on pedicle screws. He learned from that program that the screws were experimental and had not been approved by the Food and Drug Administration for use in the spine. The television show also informed him that such screws had been found to cause a number of problems to patients. Id. at 729. The Tennessee court observed that the cause of action based on the lack of informed consent stems from the premise that a competent patient should be allowed to formulate an intelligent, informed decision about surgical or other treatment procedures the patient undertakes. Id. at 731. It found that the cause of action based on the lack of informed consent did not accrue until the patient viewed the 1993 television program disclosing the experimental nature of the treatment. It reached that conclusion even though Mr. Shadrick knew when he woke up from the surgery that screws had been implanted without his consent, and even though he learned just a few months later that one of the screws had broken. Id. at 734; see also Barrett v. United States, 689 F. 2d 324, 328-29 (2nd Cir.1982) (distinguishing claim based on negligent administration of a drug from claim based on concealment of fact that Army used decedent as a human guinea pig, and finding factual dispute as to when the latter claim accrued under the diligence-discovery rule). The majority reasons that the statute of limitations should start running on both claims when injured parties know of their injuries and of facts sufficient to support the institution of either a medical malpractice or an informed consent claim. Ante at 71, 713 A. 2d at 1027. The homogenization of the two claims is flawed. It is shattering to think that a person who was essentially a guinea pig should be deprived of her cause of action based on absence of informed consent because she knew something was wrong with her eyes after the surgery. The majority reasons that diligence requires an injured party, once he or she knows of one claim against the defendant, to investigate all other related claims. Ante at 71, 713 A. 2d at 1028. The proposition may be valid in other contexts, but its relevance to this case rests shakily on the unstated premise that plaintiff's malpractice and informed consent claims are inextricably related. I cannot accept that premise because the two claims share neither a legal nor a factual relationship. Legally, plaintiff's informed consent action derives from her rights of self-determination and personal integrity. Largey v. Rothman, 110 N.J. 204, 209, 540 A. 2d 504 (1988). It is a dignitary tort. Unlike the malpractice claim, a plaintiff suing under the informed consent theory may prevail without proving physical damage. Lugenbuhl v. Dowling, 701 So. 2d 447, 455 (La.1997). Factually, the informed consent action arises out of the alleged lack of disclosure prior to plaintiff's eye surgery. The malpractice claim on the other hand arises out of the operation itself. It is one thing to draw an inept surgeon. It is another thing to be treated as a human guinea pig. A most unfortunate example of such experimental medicine is that of the Tuskegee volunteers. In that case, the federal government withheld treatment from 400 men suffering from syphilis. Researchers had discovered that penicillin treated syphilis effectively, but government health officials, interested in tracking the natural course of the disease, treated the unwitting participants with placebos. See generally James H. Jones, Bad Blood: The Tuskegee Syphilis Experiment (1981). Let us assume that the victims of the placebo treatment knew that their condition was worsening, knew that something was going dreadfully wrong. Would their cause of action based on a lack of informed consent accrue when they first believed that their treatment was not working or would it accrue when they learned that important information concerning their health choices had been withheld from them? I would certainly hope that it would be the latter. I therefore would follow the panel of the Appellate Division that twice held that a cause of action for lack of informed consent to experimental medical treatment accrues when the plaintiff learns that the surgery was experimental, not when the plaintiff discovers that something is wrong with his or her physical condition. Baird v. American Med. Optics, 301 N.J.Super. 7, 11-12, 693 A. 2d 904 (App.Div.), certif. granted, 151 N.J. 467, 700 A.2d 879 (1997); Lombardo v. Borsky, 298 N.J.Super. 658, 667, 690 A. 2d 150 (App.Div.), certif. granted, 150 N.J. 28, 695 A. 2d 671 (1997), appeal dismissed, 153 N.J. 44, 707 A. 2d 149 (1998). [2] B.