Opinion ID: 1249586
Heading Depth: 1
Heading Rank: 7

Heading: Due Care Instruction

Text: Wardell contends that the trial court committed reversible error in giving the following instruction over his objection: The defendants rendered medical services to the plaintiff, Neal Wardell. Each defendant is entitled to the benefit of certain presumptions, and in this connection you are instructed as follows: 1. The law presumes that each defendant possessed reasonable knowledge and skill according to medical standards and that in the service undertaken and rendered by him, he discharged his full legal duty to the patient and exercised reasonable care, prudence and foresight in applying his skill and learning. 2. However, this presumption is disputable and may be overcome only by expert testimony which, taken together with other evidence, reasonably justifies a contrary conclusion. 3. This presumption continues throughout the trial unless and until the presumption is overcome. Wardell argues, among other things, that the trial court, by instructing the jury as to both Wardell's burden of proof and the physicians' presumption of due care, misled the jury into believing that Wardell had a double burden of proving his case. We agree that the trial court erred in giving the due-care instruction. We do not, however, reach the further issue of whether the error warrants reversal because of our decision to reverse this case on other grounds. The doctors rely primarily upon a statement extracted from Harris v. Grizzle, 625 P.2d 747 (Wyo.1981), to support their contention that the due-care instruction accurately reflects Wyoming law. In Harris, the Court stated: A physician or surgeon is presumed to have carefully and skillfully treated or operated upon a patient. 625 P.2d at 753. Taken out of context, this statement, along with similar statements made in prior cases, would appear to support the instruction given in this case. See Smith v. Beard, 56 Wyo. 375, 110 P.2d 260 (1941); and Rosson v. Hylton, 45 Wyo. 540, 22 P.2d 195 (1933). Harris, Smith, and Rosson were all medical malpractice cases wherein the plaintiffs were appealing either an adverse summary judgment or a directed verdict. The Court in each case affirmed the lower court's ruling on the basis of the plaintiff's failure to establish by competent evidence a prima facie case of professional negligence. A careful reading of the cases discloses that, in each instance when the alleged presumption of due care was mentioned, the Court was merely attempting to emphasize the burden of proof placed upon a plaintiff in a medical malpractice action. The real point the Court was making in each instance was that a presumption of negligence does not exist merely because unfavorable results follow medical treatment. The Court did not intimate in any of the cases that it intended to create an evidentiary presumption of due care for physicians upon which a jury should be instructed. Harris, 625 P.2d 747; Smith, 56 Wyo. 375, 110 P.2d 260; Rosson, 45 Wyo. 540, 22 P.2d 195. Addressing a similar instruction, an Arizona court captured the irony of literally interpreting language similar to that found in Harris: If the quoted language is intended to create a presumption in favor of a defendant physician, it is a strange species of presumption indeed. It does not fit the typical description of a presumption in a civil casethat is, a rule that shifts the burden of producing evidence to the party against whom the presumption operates. Rather, this presumption appears to do no more than merely restate the familiar rule that the plaintiff has the burden of proving the defendant negligent. Gaston v. Hunter, 121 Ariz. 33, 588 P.2d 326, 348 (Ct.App.1978) (citations omitted). Accordingly, we view this alleged due-care presumption as being merely the flip side of the plaintiff's burden of proof in a medical malpractice case. As stated by McMillan: The burden of proving `that the non-existence of the presumed fact [i.e., due care] is more probable than its existence,' is the same as the burden of proving defendants' negligence `by a preponderance of the evidence.' Consequently, once the jury has been adequately instructed on the plaintiff's burden of proof in a case, it is of no avail to further instruct the jury as to the alleged presumption of due care. To do so would serve only to confuse the jury. See id.; Richmond v. A.F. of L. Medical Service Plan of Phil., 421 Pa. 269, 218 A.2d 303 (1966); and Peacock v. Piper, 81 Wash.2d 731, 504 P.2d 1124 (1973); but see Crumbley v. Wyant, 188 Ga.App. 227, 372 S.E.2d 497 (Ct.App.1988). A review of the jury instructions given in this case discloses that the jury was adequately instructed regarding the plaintiff's burden of proof. That being the case, we perceive no reason why physicians, to the exclusion of everyone else, are entitled to a due-care instruction in a negligence case. Cf. Hoem v. State, 756 P.2d 780 (Wyo.1988) (Wyoming Medical Review Panel Act held unconstitutional on equal protection grounds). The trial court erred by so instructing the jury.