Opinion ID: 3134232
Heading Depth: 2
Heading Rank: 12

Heading: Ill Rev. Stat. 1983, ch. 111½, par. 5102. Clearly, these services

Text: do not compare to the recognized broad range of administrative activities of modern hospitals contemplated by Darling and its progeny. Clearly, also, by their very nature, the services of such blood providers, under the Act, more closely involve medical judgments than do the diverse administrative and managerial activities performed by hospitals. Furthermore, even though administration may be necessarily a part of a blood service provider's provision of services in a given case, that fact does not argue against the construction of a professional standard of care in section 3. As mentioned previously, where conduct is within the common knowledge of a jury, expert opinion testimony is not required to establish a professional standard of care. See IPI Civil 3d No. 105.01, Notes on Use. We therefore conclude that the common law is not contravened by construing section 3 to require application of a professional standard of care to blood banks. That hospital administration entails some matters involving medical judgment does not support a construction of section 3 requiring a reasonableness standard of care. There also exists sufficient distinctions between the situations of hospitals and blood banks to warrant the conclusion that Darling's reasonableness standard of care need not be the standard of care intended by the legislature in section 3. We are convinced that common law considerations and the terms of the Blood Shield Act establish that conduct within the Act's purview was intended to be evaluated against the standard of care applicable to professional conduct. Neither are we persuaded that the instant case demonstrates that a construction of section 3 requiring the professional standard of care is ill-founded. While the announcement of UBS's policy and procedural decisions regarding the screening of donated blood was disseminated via corporate memoranda and the screening procedures at the instant blood drive were conducted by nonprofessionals, the corporate decisions and implementation of procedures yet resulted from initial review by UBS's medical director, Dr. Earnest Simon. Dr. Simon's judgments concerned developing an effective methodology for procuring an adequate human blood supply for the nation balanced against the unknown risks of a highly infectious, newly discovered, and fatal disease. As such, Dr. Simon's judgments required the balancing of competing medical policies and procedures and was an exercise of medical judgment with vast public health implications. We are not prepared to say that such undertakings did not involve medical judgments as compared against, for example, a hospital's administration of X-ray therapy, which plaintiff here relies on as a medical judgment. In this case, the record reflects that UBS's decision to refrain from possibly premature or ill-advised surrogate testing and to employ education and self-deferral of donors as opposed to directly questioning them about their sexual preferences involved scientific and professional judgments contemplated by the Act. The application of a professional standard of care to the conduct of blood banking organizations in collecting blood comports with a majority of jurisdictions which have considered this issue, in a variety of contexts. See Brown v. United Blood Services, 109 Nev. 758, 766, 858 P.2d 391, 396 (1993) (joining a clear and growing consensus of jurisdictions that view production and safeguarding of nation's blood supply as professional activity, entitled to professional standard of care); Giorno v. Temple University Hospital, 875 F. Supp. 267 (E.D. Pa. 1995); Doe v. American National Red Cross, 848 F. Supp. 1228 (S.D. W. Va. 1994); Smith v. Paslode Corp., 799 F. Supp. 960 (E.D. Mo. 1992), aff'd in part & rev'd in part, 7 F.3d 116 (8th Cir. 1993); Smythe v. American Red Cross Blood Services Northeastern New York Region, 797 F. Supp. 147 (N.D. N.Y. 1992); Zaccone v. American Red Cross, 872 F. Supp. 457 (N.D. Ohio 1994); Seitzinger v. American Red Cross, Nos. 90--0046, 90--3890 cons. (E.D. Pa. November 30, 1992) (mem.); Wilson v. American Red Cross, 600 So. 2d 216 (Ala. 1992); Spann v. Irwin Memorial Blood Centers, 34 Cal. App. 4th 644, 40 Cal. Rptr. 2d 360 (1995); Wilson v. Irwin Memorial Blood Bank, 14 Cal. App. 4th 1315, 1317, 18 Cal. Rptr. 2d 517, 518 (1993); Osborn v. Irwin Memorial Blood Bank, 5 Cal. App. 4th 234, 7 Cal. Rptr. 2d 101 (1992); United Blood Services v. Quintana, 827 P.2d 509 (Colo. 1992); Bradway v. American National Red Cross, 263 Ga. 19, 426 S.E.2d 849 (1993); Anonymous Blood Recipient v. William Beamont Hospital & Southeastern Michigan Chapter American Red Cross, No. 89--363705--NH (Cir. Ct. Oakland County, Mi. 1991); Doe v. American Red Cross Blood Services, 297 S.C. 430, 377 S.E.2d 323 (1989); but see Kozop v. Georgetown University, 663 F. Supp. 1048 (D.D.C. 1987); Snyder v. American Ass'n of Blood Banks & Mekhjian, 144 N.J. 269, 676 A.2d 1036 (1996); Gilmore v. St. Anthony Hospital, 598 P.2d 1200 (Okla. 1979); The Brown court explained very well the rationale for viewing blood banking as a profession: We are convinced that determinations concerning the testing of donated blood and the exclusion of categories of donors are better suited to professionally-trained members of the industry rather than laypersons. Such determinations require professional expertise in adopting procedures necessary for securing healthy blood and blood products without dangerously impacting the availability of adequate blood supplies. Brown, 109 Nev. at 766, 858 P.2d at 396. Finally, UBS makes the argument that under the terms of section 3, only the noncompliance with professional standards of care can give rise to liability. UBS asserts that a blood bank warrants to exercise due care in following the standards of the profession which are each in accord with the current state of the medical arts. UBS posits that use of such language indicates that custom and practice within the profession are therefore conclusive of the entire duty owed. UBS's argument requires that the word in be inserted into the phrase followed professional standards of care. Introducing this word creates the impression that the entire measure of due care is found by following professional standards of care. We reject this interpretation, finding no indication, whatsoever, within section 3 that following professional standards of care fulfills the general duty to exercise due care. In the absence of any such indication within section 3, we again turn to the common law as a construction aid to determine whether the legislature intended that conformance to professional standards of care necessarily satisfies a blood bank's entire duty. In the area of ordinary negligence as well as in professional negligence, including hospital institutional negligence, custom and practice play a significant role. Generally speaking, custom and practice assist in determining the standard of care, whether the standard is that of a layperson, a health care institution, or a professional. Barth v. Reagan, 139 Ill. 2d 399 (1990) (attorney's professional negligence); Darling, 33 Ill. 2d at 331 (hospital institutional negligence); Walski v. Tiesenga, 72 Ill. 2d 249 (1978) (medical professional negligence); Denniston v. Skelly Oil Co., 47 Ill. App. 3d 1054 (1977) (ordinary negligence); Martin v. Central Engineering Co., 350 Ill. App. 589 (1953) (engineer's professional negligence). In Illinois negligence law, while custom and practice can assist in determining what is proper conduct, they are not conclusive necessarily of it. See Darling, 33 Ill. 2d at 331-32 (health care institutional negligence); Petrowsky v. Family Service of Decatur, Inc., 165 Ill. App. 3d 32 (1987) (negligence claim against adoption agency). This precept holds true even in the area of medical professional negligence. In a professional malpractice case, where expert testimony is required to establish the requisite professional standard of care, evidence that a defendant's conduct conformed with local usage or general custom indicates due care, but may not be conclusive of it. Such evidence may be overcome by contrary expert testimony (or its equivalent) that the prevailing professional standard of care, itself, constitutes negligence. See Chiero v. Chicago Osteopathic Hospital, 74 Ill. App. 3d 166 (1979); Lundahl v. Rockford Memorial Hospital Ass'n, 93 Ill. App. 2d 461 (1968)); but see Sheahan v. Dexter, 136 Ill. App. 3d 241, 248 (1985). Under Illinois common law, although uncommon, parties may dispute both the prevailing professional standard of care (see Wilsman v. Sloniewicz, 172 Ill App. 3d 492 (1988)) and whether the prevailing professional standard was deficient (see T. LeBlang & W. Bonantra, The Law of Medical Practice in Illinois §4:13, at 425-26 (1986)). This does not mean that such professionals (or blood handlers) are therefore subjected to both a professional standard of care and a lay reasonableness standard of care. It means that, ultimately, the professional standard must be one which provides care which is due or reasonable. This means that the professional standard of care, itself, must be shown to be sufficient or lacking in this regard by means of expert testimony or other relevant proofs, but not that the defendant's conduct be measured against what a lay jury considers as reasonable. While the Act did away with common law strict liability, there is no indication within the statute that the legislature intended to further deviate in this area from the common law. Accordingly, we hold that, under section 3, conformance with professional standards of care, proven by expert testimony or other evidence of professional standards, is indicative but not conclusive of due care. Such evidence may be overcome by a sufficient showing of contrary expert opinion testimony (or its equivalent) that the prevailing professional custom or usage itself constitutes negligence. See Chiero, 74 Ill. App. 3d at 174. Our construction of section 3 comports with rules adopted in this area by courts in other jurisdictions. See United Blood Services v. Quintana, 827 P.2d 509 (Colo. 1992) (while defendant blood bank judged by professional standard of care imposed under blood shield statute, evidence of compliance not conclusive proof of due care); Doe v. American National Red Cross, 848 F. Supp. 1228 (S.D.W. Va. 1994) (professional standard of care applied, but not conclusive of due care). UBS makes one final claim, however, that permitting a jury to find professional standards to be themselves negligent, as urged by plaintiff, allows for the imposition of strict liability, contrary to the express legislative intent in section 3. According to UBS's strict liability argument, if a blood bank conforms to professional standards by refraining from using unproven surrogate testing, it may nonetheless be found negligent under a conflicting due care standard of care for failing to institute such tests. UBS's strict liability argument presupposes an incorrect construction of section 3 premised on a conflict between the phrases followed due care and exercised professional standards of care. As previously discussed, a proper construction of section 3 reveals that these two phrases do not conflict. Thus, we disagree with UBS that section 3 allows for the imposition of strict liability. The construction of the disputed language in section 3 is complete. Based on the express statement in section 3 that blood service providers warrant that they have follow[ed] professional standards of care, the statute as a whole, and statutory construction principles, we conclude that the legislature intended that a blood bank's conduct be measured against a professional standard of care. Section 3 does not allow a blood bank's conduct to be measured against merely a lay reasonableness standard of care. Blood banks must nonetheless generally exercise that degree of care known as due care. Section 3 simply does not indicate, nor does Illinois common law agree, that conforming to professional standards of care in all instances equates with due care. Our decision regarding this issue requires reversal and remand for retrial. See Tankersley v. Peabody Coal Co., 31 Ill. 2d 496, 501 (1964); see also Lazarus v. Pascucci, 74 Ill. App. 3d 633, 640 (1979). The trial court misinterpreted section 3 to allow for application of merely a reasonableness standard of care, rather than a professional standard of care. In this case, despite that expert opinion testimony was presented and that UBS's conduct was measured against similar entities, the jury was free to disregard that evidence and/or decide the reasonableness of UBS's conduct based on the jury's own knowledge as well. The trial court's ruling represented a clear error of law impacting not only on the legal standard against which UBS's conduct was measured, but on the plaintiff's burden of proof, the scope and qualification of expert opinion testimony, and the application of the standard of care by way of instruction to the jury (cf. Roberts v. Sisters of St. Francis Health Services, Inc., 198 Ill. App. 3d 891, 903 (1990)). In sum, the entire trial was affected by this error. Fairness mandates that the cause be reversed and remanded for retrial.