Court Opinion

ID: 9733033
Source: CourtListenerOpinion
Date Created: 2023-08-26 16:50:31.333263+00
Date Added: 2024-06-11T15:27:00.975399
License: Public Domain

*443SNELL, Justice
(dissenting).
I respectfully dissent.
The majority has ignored our law and has effectively expanded the application of the res ipsa loquitur doctrine well beyond its recognized purpose. Ever closer does the goal appear that any unexpected bad result from surgery must have been due to a surgeon’s negligence. The “thing speaking for itself” has taken on a life of its own multiplying into the field of medicine with the self assurance of a crusader.
Because the inference of negligence is without specific proof, we have said the doctrine of res ipsa loquitur should be used sparingly. Mogensen v. Hicks, 253 Iowa 139, 143, 110 N.W.2d 563, 565 (1961). This is especially true in medical malpractice cases. See Lagerpusch v. Lindley, 253 Iowa 1033, 1038, 115 N.W.2d 207, 210 (1962) (res ipsa “should be used very rarely in medical cases” and “in many medical cases, the doctrine of res ipsa loquitur has been rejected”); Shinofield v. Curtis, 245 Iowa 1352, 1361, 66 N.W.2d 465, 471 (1954).
The doctrine is most often applied to medical injuries occurring when a surgeon either leaves an object in a patient’s body or damages a portion of the body wholly unrelated to the surgery. See generally, 1 D. Louisell and H. Williams, Medical Malpractice § 14.02, at 14-37 to 14-38 (1990). Neither is the case here.
We have held that the mere fact that an occurrence is rare does not alone warrant an application of res ipsa loquitur. Reilly v. Straub, 282 N.W.2d 688, 695 (Iowa 1979); Cronin v. Hagen, 221 N.W.2d 748, 753 (Iowa 1974); Perin v. Hayne, 210 N.W.2d 609, 613 (Iowa 1973). Further, the common experience exception to the expert testimony rule applies only where the injury suffered is an obvious violation of accepted medical standards. See, e.g., Oswald v. LeGrand, 453 N.W.2d 634, 639-401 (Iowa 1990); Daiker v. Martin, 250 Iowa 75, 91 N.W.2d 747, 752 (1958). In Perin, we decided that experts will be required to establish res ipsa’s second foundational fact — that the injury would not have occurred in the ordinary course of events if reasonable care had been used — where the injury sustained lies outside the common knowledge of laypersons.
The common knowledge of laypersons hardly includes an understanding of the nature of sodium pentothal or what would happen if the sedative escaped from a vein to surrounding tissue. Nor is it commonly known how a needle is inserted into a vein, or how far it should be thrust. The majority’s analysis is that the common knowledge exception is satisfied because people know that intravenous injections are often done. The misapprehension here is that knowledge of the frequency of an operative procedure equals knowledge that an unfavorable medical result must have been due to negligence. These two spheres of knowledge are not correlatives.
With the standard applied by the majority, will every appendicitis operation involve an inference of negligence whenever a perfect result is not achieved? How soon will the res ipsa loquitur doctrine be applied to heart surgery cases? There are certainly many cases where a superb surgeon has performed the best operation possible and, nevertheless, experienced a tragic result. The fact that his skills were not enough to save the patient should not translate to an inference of negligence. It is for the jury to decide whether the evidence shows a negligent surgeon or not. But the surgeon hasn’t promised perfection to the patient and should not have it hung like an albatross about his neck, as the inference of negligence truly does, in the courtroom.
In Cronin, 221 N.W.2d at 753, we said:
There is no basis in the record for contending the occurrence would not have happened in the ordinary course of things if reasonable care had been used. Indeed, it seems this occurrence was an inherent risk of the operation and, though rare, could happen even with the exercising of due care.
The evidence is insufficient to generate a jury question as to the existence of this foundational fact. This essential of the doctrine being absent the doctrine does not apply.
*444I believe that expert testimony was required in the instant case as in Cronin. When none was proffered by the plaintiff, Dr. Bello was entitled to summary judgment on this issue.
The majority’s claim that Dr. Bello supplied the expert testimony to skewer himself is unrealistically technical. His statement in response to an interrogatory was one of scientific fact that sodium pentothal has caustic and burning effects. Dr. Maxwell’s was similar. Both fell far short of supplying the expert testimony that plaintiff’s injury would not occur absent negligence.
The majority’s reversal of the jury’s absolution of Mercy Hospital again elevates “common experience” to lofty heights. Plaintiff Welte did receive the benefit of the res ipsa loquitur doctrine in the case against Mercy Hospital. Even so, the majority decides that the jury must infer negligence without judging the resulting injury against the standard of care recognized by those most knowledgeable in the field — the health care professionals. Thus, to the majority, the jurors’ “common knowledge” of negligence, even if totally erroneous, is adequate to find liability since no expert testimony is required. This construction misuses the res ipsa loquitur principle.
The trial court carefully and correctly applied the doctrine and should be affirmed.
HARRIS, J., joins this dissent.