Court Opinion

ID: 9678716
Source: CourtListenerOpinion
Date Created: 2023-08-24 06:29:56.481659+00
Date Added: 2024-06-11T12:30:07.749273
License: Public Domain

MICHOL O’CONNOR, Justice,
dissenting on rehearing.
I dissent. In addition to reversing in part on submitting issues to the jury, I would reverse in regard to the directed verdict on informed consent. Dora W. Crundwell sued Drs. Michael Becker and Richard Brown for medical malpractice. After the trial court granted Becker’s motion for a directed verdict on the issue of informed consent, a jury found for Becker and Brown on the issue of negligence. The trial court rendered a take-nothing judgment against Crundwell.
Informed Consent
In points of error six and seven, Crundwell argues the trial court erred in rendering a directed verdict for Becker on the issue of informed consent. Even though Crundwell signed a surgical consent form, she argues the court should have submitted the issue of informed consent. Crundwell’s argument is that she was not the ordinary patient facing surgery. Because of her compromised physical condition, Becker should have told her that she was more likely than most patients to suffer a tear or cut of the intestines.
In Texas, a physician is liable for negligent failure to disclose the risks involved in the medical care if the risks or hazards could have influenced a reasonable person in making a decision to give or withhold consent. Peterson v. Shields, 652 S.W.2d 929, 931 (Tex.1983); Gibson v. Methodist Hosp., 822 S.W.2d 95, 100 (Tex.App.—Houston [1st Dist.] 1991, writ denied); Tex.Rev.Civ. Stat. Ann. art. 4590i, §§6.02, 6.05.
Informed consent, as it relates to a medical malpractice claim, is governed by the Medical Liability and Insurance Improvement Act. Merckling v. Curtis, 911 S.W.2d 759, 768 (Tex.App.—Houston [1st Dist.] 1995, writ denied); see Tex.Rev.Civ. Stat. Ann. art. 4590i, §§6.02, 6.01-.08 (1997) (the Act). The Act created the Texas Medical Disclosure Panel to determine that risks and hazards must be disclosed to patients undergoing medical care and surgical procedures. The panel’s responsibility is to evaluate all medi*886cal and surgical procedures, determine whether disclosure of risks is required, and if so, how much disclosure is required. Tex. Rev.Civ. Stat. art. 4590i, §6.04(a); Peterson, 652 S.W.2d at 931; Merckling, 911 S.W.2d at 769. Once evaluated/ each procedure is placed on either List A or List B. List A procedures require some disclosure of the risks involved in the treatment; List B procedures do not require disclosure. Tex.Rev. Civ. Stat. art. 4590i, §6.04(b); Merckling, 911 S.W.2d at 769. If a procedure is not on either List A or List B, the doctor is under a duty to disclose all risks or hazards that could influence a reasonable person in making a decision to give or withhold consent to the procedure. Peterson, 652 S.W.2d at 931; Merckling, 911 S.W.2d at 769.
Proper disclosure of risks in medical procedures found on List A, or nondisclosure for medical procedures on List B, creates a re-buttable presumption the physician was not negligent. Tex.Rev.Civ. Stat. art. 4590i, §6.07; Peterson, 652 S.W.2d at 931. If a procedure is not on either list, the doctor is under the duty otherwise imposed by law. Tex.Rev.Civ. Stat. art. 4590i, §6.07(b). That duty is to disclose all risks and hazards that could influence, a reasonable person in making his or her decision to consent to the procedure. Peterson, 652 S.W.2d at 931.
The Act provides that if a patient signs a written consent to surgery that lists the risks of surgery, and the execution of the written consent is witnessed by a credible person, there is a “rebuttable presumption” that the physician obtained the patient’s informed consent. Tex.Rev.Civ. Stat. art. 4590i, §6.07. Thus, because Crundwell signed a consent form, we begin with the presumption she gave her informed consent to the surgery. The issue is whether Crundwell’s evidence rebutted the presumption of consent.
In Peterson, 652 S.W.2d at 931, the supreme court held that section 6.02 of the Act requires the doctor “to disclose the risks or hazards that could have influenced a reasonable person in making a decision to give or withhold consent.” The “reasonable person” standard under section 6.02 requires the doctor to provide information about the risks that are material to the decision to give or withhold consent to a particular medical procedure. Id.
According to Peterson, the plaintiff must meet two requirements to raise a fact issue. Peterson, 652 S.W.2d at 931; Barclay v. Campbell, 704 S.W.2d 8, 9 (Tex.1986). First, the plaintiff must introduce evidence to show the risk is inherent to the medical procedure undertaken. Barclay, 704 S.W.2d at 9. Second, the plaintiff must introduce evidence to show the risk is material in the sense that it could influence a reasonable person’s decision to consent to the procedure. Id. at 9-10. If the plaintiff meets both of these requirements, a fact issue is raised so that the plaintiff is entitled to the submission of two issues. Id. at 10.
Because the court directed a verdict against Crundwell on the issue of informed consent, the Court must reverse on that issue if Crundwell produced evidence that raised a fact issue regarding risks about which she should have been informed. Id. at 9; Peterson, 652 S.W.2d at 931.
Crundwell introduced more than sufficient evidence to raise a fact issue on the two elements outlined in Barclay. She introduced evidence of an expert who testified that, because of Crundwell’s earlier surgeries, there was a “high probability that she might suffer a bowel perforation,” and if she did, this injury might require “multiple surgeries, that she might get peritonitis, that she might require a colostomy again, or that she might die as a result of complications from surgical injury.” Crundwell testified that Dr. Becker did not tell her about any risks, complications, or hazards to her health if he performed the surgery to remove her uterus, fallopian tubes, and ovaries.
On this record, Crundwell raised a fact issue about informed consent, and the trial court should not have directed a verdict against her on this issue.
I would sustain points of error six and seven.