Opinion ID: 1968425
Heading Depth: 1
Heading Rank: 1

Heading: Alleged Malpractice of Dr. Donlin.

Text: Plaintiffs contend that the evidence discloses that Dr. Donlin was negligent in the following respects: (1) Failure to diagnose the burn as a third-degree burn; (2) failure to use antibiotics as prophylaxis against possible infection; (3) failure to provide around-the-clock care; and (4) failure to change dressings as often as necessary. It is true that Dr. Donlin diagnosed Jimmy's burn as a second-degree burn while both Dr. Dollard and Dr. Bernard diagnosed it as a third-degree burn. The difference between a deep second-degree burn and a third-degree burn is that skin will regenerate over the burned area of the former while it will not in the case of a third-degree burn. Dr. Bernard testified that a second-degree burn may be converted into a third-degree burn by infection. Furthermore, the depth of a burn cannot be determined by the physician looking at it, so he would not know at once whether it was a deep second-degree burn or a third-degree burn. We find it unnecessary, however, to determine whether there was sufficient evidence for a jury to find that Dr. Donlin improperly diagnosed Jimmy's condition. An incorrect diagnosis is not actionable unless followed by improper treatment. Hill v. Boughton  (1941), 146 Fla. 505, 1 So. (2d) 610; Willard v. Hutson (1963), 234 Or. 148, 378 Pac. (2d) 966; Skodje v. Hardy (1955), 47 Wash. (2d) 557, 288 Pac. (2d) 471; 41 Am. Jur., Physicians and Surgeons, p. 210, sec. 92; 70 C. J. S., Physicians and Surgeons, p. 961, sec. 48 d. The evidence discloses no improper treatment on Dr. Donlin's part. As to the use of antibiotics in treating the burn, Dr. Bernard, plaintiffs' expert medical witness, testified as follows: With respect to using antibiotics before any infection had manifested itself, this is a matter of personal opinion of physicians, some do and others do not. It takes considerable time before it can be determined whether skin will be regenerated over the burned area, and that during such time the treatment is the same for a third-degree burn as it would be for a second-degree burn. Sometimes it is a month or even six or eight weeks before a general practitioner in the Madison area will send a third-degree burn patient to a plastic surgeon for skin-grafting treatment. The method of treatment by Dr. Donlin, namely, an ointment with a closed type of dressing, as distinguished from an open treatment with no dressing, is one of the acceptable methods of treatment for third-degree burns. The evidence further establishes that the wet or soaked dressing type of treatment is recommended when infection has already set in. It is this type of dressing which requires an application of solution every couple of hours that is commonly spoken of as around-the-clock care. As soon as infection did make its appearance, Dr. Donlin had Jimmy placed in a hospital and turned his care over to Dr. Dollard, a specialist. Plaintiffs rely on an answer given by Dr. Dollard on his adverse examination that it is good medical practice, under the standard prevailing in Dane county, to change dressings where the burn wound has been contaminated with pus. Dr. Donlin, however, did change the dressing  on May 4th. The next day Jimmy was admitted to St. Mary's Hospital, and Dr. Donlin's treatment then ended. When a physician exercises that degree of care, judgment, and skill which physicians in good standing of the same school of medicine usually exercise in the same or similar localities under like or similar circumstances, having due regard to the advanced state of medical science at the time, he has discharged his legal duty to his patient. Ahola v. Sincock (1959), 6 Wis. (2d) 332, 348, 94 N. W. (2d) 566; Kuehnemann v. Boyd (1927), 193 Wis. 588, 591, 214 N. W. 326, 215 N. W. 455; Jaeger v. Stratton (1920), 170 Wis. 579, 581, 176 N. W. 61. Prior to our recent decision in Fehrman v. Smirl (1963), 20 Wis. (2d) 1, 121 N. W. (2d) 255, 122 N. W. (2d) 439, this degree of care and skill could only be proved by the testimony of experts. See last cited cases and Krueger v. Chase (1920), 172 Wis. 163, 177 N. W. 510. The Fehrman Case relaxed this rule in situations where medical or surgical errors are of such nature that any layman is competent to pass judgment thereon and conclude from common experience that such things do not happen if there has been proper skill and care. The instant case clearly does not fall within this exception to the rule that expert testimony is required to establish medical malpractice. Plaintiffs wholly failed to establish by expert testimony that the treatment of Jimmy by Dr. Donlin constituted a failure to exercise that degree of care, diligence, judgment, and skill which was required of him. Therefore, the trial court properly entered the judgment of nonsuit with respect to this defendant.