Court Opinion

ID: 9758576
Source: CourtListenerOpinion
Date Created: 2023-08-28 23:36:50.038103+00
Date Added: 2024-06-11T07:28:53.225130
License: Public Domain

COOPER, Justice,
dissenting.
The majority opinion affirms a summary judgment entered by the trial court. Because the majority opinion misstates cer*152tain material facts that are in the record and assumes other facts that are not in the record, it is appropriate to remember the standard by which summary judgments are reviewed.
Summary judgment is appropriate only if there is no genuine issue as to any material fact and the movant is entitled to judgment as a matter of law. CR 56.03. The motion may be granted only if it would be impossible for the respondent to prevail at trial. Steelvest, Inc. v. Scansteel Serv. Ctr., Inc., 807 S.W.2d 476, 480 (Ky.1991). The record must be viewed in a light most favorable to the respondent and all doubts are to be resolved in the respondent’s favor. Id. That includes all doubts as to the existence of questions of fact. Tillery v. Louisville & Nashville R.R. Co., 433 S.W.2d 623, 624 (Ky.1968); Estell v. Barrickman, 571 S.W.2d 650, 653 (Ky.App.1978). In ruling on a motion for summary judgment, it is the role of the judge to determine whether issues of fact exist, not to resolve them. James Graham Brown Found., Inc. v. St. Paul Fire & Marine Ins. Co., 814 S.W.2d 273, 276 (Ky.1991). Summary judgment is inappropriate where, “although the facts and evidence thus far developed do not establish the existence of a genuine issue of material fact, ... neither do they establish the nonexistence of such an issue.” Paintsville Hosp. Co. v. Rose, 683 S.W.2d 255, 256 (Ky.1985) (quotation omitted).
Appellant, Eva Hoofnel, brought this action in battery against the Appellees, Dr. Susan Galandiuk, a colorectal surgeon, and Dr. James Segal, an obstetrician and gynecologist, seeking damages for the unauthorized removal of her uterus and ovaries during surgery deemed necessary in order to remove a tumor from her colon. The evidence on which summary judgment was premised consists of (1) the depositions of Hoofnel, Galandiuk, Segal, and Carolyn Gowan, a nurse anesthetist; (2) answers to interrogatories and requests for admissions filed by both Galandiuk and Segal; and (3) Dr. Galandiuk’s operative report.
Appellant, then age 56 and with less than a high school education, was referred to Dr. Galandiuk for the removal of a tumor from the lower anterior portion of her colon. On January 2, 2001, Hoofnel met with Dr. Galandiuk and a surgical resident, Dr. William Rudolph, at Dr. Ga-landiuk’s office. Galandiuk testified by deposition that, because the removal of the tumor from Hoofnel’s colon required abdominal surgery, she recommended to Hoofnel that she also surgically remove Hoofnel’s appendix, uterus, and ovaries (appendectomy, hysterectomy, and bilateral oophorectomy). Hoofnel testified that she agreed to the appendectomy, did not agree to the hysterectomy, and that removal of her ovaries was never discussed (perhaps because Dr. Galandiuk did not explain to her the meaning of the word “oophorectomy”). Specifically, Hoofnel testified that she told Galandiuk that she “did not want any of my female parts removed.” Galandiuk wrote in her notes:
I had talked with her about oophorecto-my and she wishes not to pursue that. I have discussed with her the possible need for hysterectomy should there be tumor involvement and I’ve also discussed with her doing incidental appendectomy, which she wishes to be done.
(Emphasis added.) Dr. Rudolph’s notes reflect, inter alia: “Of note, the patient does not wish her ovaries removed, but we will do an appendectomy along with the low anterior resection.”
On January 5, 2001, Hoofnel reported to Norton Hospital for a preoperative workup. While there, she signed the “Consent to Operation” form which the majority opinion concludes entitles Galandiuk and Segal to summary judgments. That con*153sent form reads in pertinent part (handwritten portions underlined):
1. I hereby authorize Dr. Galandiuk and/or such associates, assistants and consultants as may be selected by him/ her to perform the following procedures or operations upon me (my child). Description of procedure in layman’s terms:
anterior resection colon with appendectomy and possible bilateral oophorec-tomy
2. Dr. Galandiuk has explained to me in terms I understand the following information:
A. The basic nature of the procedure(s) or operation(s) listed above;
B. The substantial risks and hazards of the procedure(s) or operation(s);
C. Alternative procedures or treatments; and
D. The probable outcome should the procedure(s) or operations(s) not be performed.
Both Dr. Galandiuk and Dr. Segal admitted that the description of the procedures on the consent form were not in “layman’s terms.” Hoofnel testified that she has “no clue” what the word “oophorectomy” means. Contrary to the assertion in the majority opinion that Hoofnel “underwent pre-operative testing at Norton Hospital where she met with Dr. Galandiuk’s nurse practitioner who described the risks of the surgical procedure,” ante, at 149, Dr. Ga-landiuk testified that someone from her office contacted someone at the hospital by telephone and informed that person what procedures Dr. Galandiuk intended to perform and that the “[description of procedure in layman’s terms” would have been added to the consent form based on that information. She admitted that she did not talk to Hoofnel during the period between the office visit on January 2, 2001, and the day of the surgery, January 17, 2001. She did not attempt to explain why the consent form contained the words “possible oophorectomy,” but did testify that she had originally recommended the oophorectomy to Hoofnel because colon cancer sometimes spreads to the ovaries. Finally, although the consent form states that “Dr. Galandiuk has explained to me in terms I understand the following information,” Galandiuk testified that she relies on hospital personnel to explain that information to the patient.
There exists a factual dispute as to whether Hoofnel verbally consented to the hysterectomy and oophorectomy immediately prior to the surgery. Nurse Gowan testified that when Hoofnel arrived at the preoperative area, she asked Hoofnel what procedures were to be performed and Ho-ofnel responded, “colon surgery and a hysterectomy.” Gowan stated that she was surprised by this response because she knew that Dr. Galandiuk does not do hysterectomies. (Dr. Galandiuk, however, testified that she frequently performs both hysterectomies and oophorectomies.) According to Gowan, when she informed Ho-ofnel that Dr. Galandiuk does not do hysterectomies, Hoofnel became angry and insisted that “all of those things be done at the same time.” Since there was no signed consent to a hysterectomy, Gowan paged Dr. Galandiuk, who advised Hoofnel in Gowan’s presence that she would only do a hysterectomy if it was “medically necessary.”
Dr. Galandiuk’s version of this conversation is that Hoofnel said: “I want you to take my ovaries out. I want you to do a hysterectomy. I want you to do everything that’s necessary, if you feel it’s necessary.”
Hoofnel’s version is that when she entered the preoperative area, Gowan asked her, “You are here for appendix and co-*154Ion?” Hoofnel responded, ‘Yes,” then took a pill given to her by Gowan and remembers nothing else until she awakened in the recovery room. She denies any conversation with Dr. Galandiuk on the day of the surgery. It was Dr. Segal who told her that he had removed her uterus and ovaries. After the surgery, Dr. Galandiuk made the following handwritten entry in her office notes: “1/17/01 — discussed w/ pt — she does indeed wish ovaries removed.” But even this belated entry does not reflect a consent to the hysterectomy.
Although Dr. Galandiuk testified that she found Hoofnel’s uterus and ovaries to be “grossly enlarged,” her operative report does not mention the word “uterus” and only states with respect to the ovaries:
The patient’s ovaries and fallopian tubes appeared normal. However, there were several endometrial fibroids including one very large one. We asked Dr. Shaffer [sic] of gynecology to take a look in. He felt because of the size of the mass that total abdominal hysterectomy was indicated.
Contrary to the statement made in the majority opinion, Dr. Galandiuk did not testify and her operative report does not reflect that she “believed the uterus may have been cancerous.” Ante, at 149. In her answers to interrogatories, Dr. Galan-diuk stated that Dr. Segal “made the determination that Plaintiff needed a hysterectomy and oophorectomy.” Dr. Segal’s version is substantially different.
Dr. Segal testified that on January 17, 2001, he was paged for a surgical consultation and proceeded to the operating room where Dr. Galandiuk’s surgery on Hoofnel was in progress. He testified that Dr. Galandiuk told him that Hoofnel “had requested that, if her uterus was abnormal, that it be removed ... [a]nd she asked me if her uterus was abnormal.” Dr. Segal testified that Hoofnel’s uterus was “abnormal” because it was more than double the normal size of the uterus of a 56-year-old woman “who is not taking hormones” and had “multiple benign leiomyomata,” ie., benign fibroid tumors. He further testified that there was no emergency reason to perform either a hysterectomy or an oophorectomy and that the benign fibroid tumors could have been removed without removing the uterus. According to Dr. Segal, there was never any fear that cancer had spread to the ovaries, and “cancer in the uterus was not a concern.” Rather, he performed the oophorectomy at Dr. Galandiuk’s request pursuant to the written consent form signed by Hoofnel and performed the hysterectomy because Dr. Galandiuk told him that Hoofnel wanted her uterus removed if it was “abnormal.” A subsequent pathology report confirmed that neither the uterus nor the ovaries were cancerous.
The majority opinion states that “Appellant admitted the medical necessity of removing her ovaries and uterus during the surgical procedure.” Ante, at 148. Not so. Hoofnel never made such an admission, nor is such an admission contained in her brief. In fact, Hoofnel testified that (1) neither Dr. Galandiuk nor Dr. Segal ever told her why they removed her ovaries and uterus, and (2) she did not believe her life would be threatened today if her ovaries and uterus had not been removed. In an unsworn response to a request for admission, dated November 14, 2001, Dr. Galandiuk’s attorney wrote:
The procedures which Dr. Galandiuk performed could not be accomplished without the hysterectomy and oophorec-tomy performed by Dr. Segal. Because of concerns that Ms. Hoofnel may have *155extensive cancer, it was felt that that probably required emergency action.
As noted, Dr. Segal specifically refuted any claim that either he or Dr. Galandiuk believed the ovaries and uterus were cancerous or that emergency action was required to remove them. Dr. Galandiuk did not testify — and her operative record does not reflect — that the colon surgery could not have been accomplished without the hysterectomy and oophorectomy. In fact, Dr. Segal testified that when he arrived at the operating room, “[p]art of the bowel surgery had already been performed.” He did not testify to any complaints by Dr. Galandiuk that she could not perform the colon surgery because her access to the colon was blocked by the uterus and ovaries. The only mention of this theory is arguably found in Dr. Galandiuk’s January 14, 2002, answer to an interrogatory asking why she called Dr. Segal in for consultation:
After Dr. Segal was consulted because of the condition of Plaintiffs ovaries and uterus, both organs were grossly enlarged. Indeed, the uterus was of such size that the low anterior resection was stapled colorectal low, anterior resection colon J pouch could not be accomplished if the uterus remained. [Sic.]
This is the only statement in the record that advances this theory, which is otherwise unsupported by Dr. Galandiuk’s testimony, by her operative report, or by Dr. Segal. Dr. Galandiuk did not assert this alleged “necessity” in her brief in support of her motion for summary judgment, but raised it for the first time on appeal. Certainly, a jury was not required to believe this belated claim in the face of the substantial evidence to the contrary.
Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent commits an assault, for which he is liable in damages * * *. This is true, except in cases of emergency where the patient is unconscious, and where it is necessary to operate before consent can be obtained.
Tabor v. Scobee, 254 S.W.2d 474, 475 (Ky.1951) (citation and quotation omitted).
The majority opinion deems the Consent to Operate Form signed by Hoofnel to require summary judgments for both doctors despite the existence of substantial evidence that Hoofnel specifically told Dr. Galandiuk that she did not want her “female parts” removed, that Hoofnel did not know the meaning of the word “oophorec-tomy” when she signed the consent form, that the consent form did not purport to authorize a hysterectomy, and that there was no medical necessity for either the oophorectomy or the hysterectomy. Furthermore:
Consent is a process, not a document. Authorization for treatment is the culmination of a discussion between a patient and a health care provider, the disclosure of risk and benefit information, the disclosure of reasonable alternative forms of care, and the posing of questions and answers by both the patient and the provider. Once the patient has agreed to a specific course of treatment, the process is over_The documentation, the so-called consent form, is not the consent, for that lies instead in the conclusion of the discussion between the patient and the physician.
Kovacs v. Freeman, 957 S.W.2d 251, 254 (Ky.1997) (quotation omitted).
There were substantial issues of fact in this case that precluded summary judgment. The trial court, the Court of Appeals, and now this Court have simply resolved those factual issues in favor of the doctors, ignoring the evidence to the con*156trary. As noted at the outset of this opinion, a judge’s obligation on motion for summary judgment is to identify factual issues, not resolve them. Brown Found,., 814 S.W.2d at 276.
Accordingly, I dissent.
WINTERSHEIMER, J., joins.