Opinion ID: 509579
Heading Depth: 3
Heading Rank: 2

Heading: Application of the Battery Exception

Text: 77 The district court concluded that it had no jurisdiction to consider plaintiffs' claims based upon the lack of consent to have Karen treated by an optometrist. The district court observed: 78 Under New Jersey law, informed consent is a negligence concept arising out of the duty of a health care provider to fairly disclose the appropriate risks to a patient who has consented to treatment. Ordinarily, the plaintiff must prove that a failure to disclose was negligent and that a reasonably prudent person would not have submitted to the procedure had the risks been adequately disclosed. Perna v. Pirozzi, [92 N.J. 446], 457 A.2d 431, 438 (N.J.1983). However, New Jersey makes a distinction between the concept of informed consent and the concept of a total absence of consent, which constitutes a battery. 79 J.A. 52. The district court concluded that the gravamen of plaintiffs' claim was not a lack of adequate disclosure of risks, but a total lack of consent for an optometrist to treat Karen. Under these circumstances, the district court concluded that plaintiffs' claim was one for battery, for which the United States has retained its immunity. 80 The district court correctly noted that 28 U.S.C. Sec. 2680(h) provides that the United States retains its immunity for suits in battery. However, the district court failed to recognize that 10 U.S.C. Sec. 1089(e) qualifies this provision in malpractice actions against military doctors. 4 Section 1089 was enacted to provide protection for military health care providers against malpractice actions, and it provides that in such cases, the exclusive remedy for the injured party is an action against the United States under the Federal Tort Claims Act. Section 1089(e) provides: 81 For purposes of this section, the provisions of section 2680(h) of title 28 shall not apply to any cause of action arising out of a negligent or wrongful act or omission in the performance of medical, dental, or related health care functions (including clinical studies and investigations). 82 The legislative history of this section clearly indicates that it was intended to include a waiver of immunity for malpractice actions even though, under state law, they might technically be characterized as a battery. 83 Subsection (e) would nullify a provision of the Federal Tort Claims Act which would otherwise exclude any action for assault and battery from the coverage of the Federal Tort Claims Act. In some jurisdictions it might be possible for a claimant to characterize negligence or a wrongful act as a tort of assault and battery. In this way, the claimant could sue the medical personnel in his individual capacity notwithstanding subsection (a) simply as a result of how he pleaded his case. In short, subsection (e) makes the Federal Tort Claims Act the exclusive remedy for any action, including assault and battery, that could be characterized as malpractice. 84 S.Rep. No. 94-1264, 94th Cong., 2d Sess. 9-10, reprinted in 1976 U.S.Code Cong. & Admin.News 4443, 4451. The malpractice immunity statute, 10 U.S.C. Sec. 1089(a) ... immunizes military physicians and makes tort claims against the government the exclusive remedy available in a malpractice action. Baker v. Barber, 673 F.2d 147, 148-49 (6th Cir.1982) (per curiam); see generally Lojuk v. Quandt, 706 F.2d 1456 (7th Cir.1983) (general discussion of section 1089(e)). 85 As the district court correctly indicated, New Jersey recognizes a distinction between claims based upon the total absence of consent and claims based upon lack of informed consent. 86 Informed consent is a negligence concept predicated on the duty of a physician to disclose to a patient information that will enable him to evaluate knowledgeably the options available and the risks attendant upon each before subjecting that patient to a course of treatment. Under the doctrine, the patient who consents to an operation is given the opportunity to show that the surgeon withheld information concerning the inherent and potential hazards of the proposed treatment, the alternatives to that treatment, if any, and the results likely if the patient remains untreated. 87 Perna v. Pirozzi, 92 N.J. 446, 459-60, 457 A.2d 431, 438 (1983) (citations omitted). However, when the claim is based upon a total absence of consent, as when an operation is performed by a physician other than the one to whom consent is given, a battery occurs, and the plaintiff is entitled to nominal damages even if no injury other than that foreseeably flowing from the operation occurs. Id. at 460-61, 457 A.2d at 438. 88 The district court in the present case characterized plaintiffs' claim as one for battery under New Jersey law. We disagree with this characterization. Our reading of plaintiffs' complaint indicates that it is grounded in the concept of negligence. In the pretrial order, the claim is identified as one based upon the absence of informed consent. J.A. 81. Dr. Channing's alleged failure to clarify his status as an optometrist is more closely akin to the failure to provide the patient with sufficient information to enable him to evaluate treatment risks. Under New Jersey law, such a claim represents a claim for negligence. 5 89