Court Opinion

ID: 9760436
Source: CourtListenerOpinion
Date Created: 2023-08-29 00:55:32.158868+00
Date Added: 2024-06-11T07:29:12.346971
License: Public Domain

WRIGHT, Justice,
dissenting.
Because I would conclude (1) cutting a vein in Margaret Tajehman’s (Tajchman) brain was an undisclosed “risk or hazard” of the DEP, and (2) there is an issue of material fact about whether a reasonable person might have been influenced in deciding whether to consent to the DEP, I respectfully dissent.
SUMMARY JUDGMENT
Standard of Review
The function of summary judgment is not to deprive a litigant of the right to a full hearing on the merits of any real issue of fact but to eliminate patently unmeritorious claims and untenable defenses. See Gulbenkian v. Penn, 151 Tex. 412, 416, 252 S.W.2d 929, 931 (1952). In reviewing a summary-judgment record, this Court applies the well-known summary judgment standards. See Nixon v. Mr. Property Management Co. Inc., 690 S.W.2d 546, 548-49 (Tex.1985).
When the defendant is the movant, summary judgment is proper only if the plaintiff cannot, as a matter of law, succeed upon any theory pleaded. Delgado v. Burns, 656 S.W.2d 428, 429 (Tex.1983). Thus, the defendant can prevail by conclusively establishing against the plaintiff at least one factual element of each theory pleaded by the plaintiff, Lear Siegler, Inc. v. Perez, 819 S.W.2d 470, 471 (Tex.1991), or by conclusively establishing each essential element of an affirmative defense. Swilley v. Hughes, 488 S.W.2d 64, 67 (Tex.1972). Conversely, the plaintiff can bar summary judgment by presenting evidence that creates a fact question on those elements of the plaintiffs case under attack by the defendant, or on at least one element of each affirmative defense advanced by the defendant. Torres v. Western Casualty & Sur. Co., 457 S.W.2d 50, 52 (Tex.1970).
Informed Consent
Informed consent, as it relates to a medical malpractice claim, is governed by the Medical Liability and Insurance Improvement Act. See Tex.Rev.Civ. Stat. Ann. art. 4590i, §§ 6.01-.07 (Vernon Supp.1996) (the Act). The Act created the Texas Medical Disclosure Panel (the Panel) to determine which risks and hazards must be disclosed to patients undergoing medical care and surgical procedures. The Panel evaluates medical treatments and surgical procedures and provides guidelines about disclosure of risks. The Panel formulates two lists, List A and List B. See Tex.Rev.Civ. Stat. Ann. art. 4590i, § 6.07 (Vernon Supp.1996). If a procedure is not on either List A or List B, then the doctor is under a duty to disclose all risks or hazards which could influence a reasonable person in making a decision to give or withhold consent to the procedure. Peterson v. Shields, 652 S.W.2d 929, 931 (Tex.1983).
In appellees’ motion for summary judgment, they contended they were entitled to summary judgment because they fully and completely informed Tajchman of the risks and hazards involved in the DEP procedure. Therefore, to bar summary judgment, appellants had to present expert testimony showing that the risk complained of: (1) was inherent to the medical or surgical procedure undertaken; and (2) was material, in that it could influence a reasonable person’s decision to consent to the procedure. See Barclay v. Campbell, 704 S.W.2d 8, 9 (Tex.1986); Knapp v. Eppright, 783 S.W.2d 293, 296 (Tex.App.—Houston [14th Dist.] 1989, no writ). Expert testimony that a risk was “small to extremely small” is some evidence that the risk was material enough to influence a reasonable person to give or withhold consent to treatment. See Barclay, 704 S.W.2d at 10.
Application of Law to Facts
In point of error one, appellants contend the trial court erred in granting summary *102judgment because there are material issues of fact about whether appellees adequately informed Tajehman of the risks and hazards associated with the DEP. I agree.
I disagree with the majority that the part of the DEP procedure that involved cutting the vein in Tajchman’s brain was not a “risk” or “hazard” as contemplated by the Act. The majority contends that because the cutting of the vein was a “part of the procedure itself and not a consequence of the procedure,” it was not a risk or hazard of the procedure. However, a risk may also be “a dangerous element or factor.” WebsteR’s 3rd INTERNATIONAL DICTIONARY 1961 (9th ed.1993). Although I agree with the majority that risks or hazards may be consequences of procedures, I do not believe the Act limits risks or hazards only to end results. For instance, the Disclosure Panel requires a patient undergoing an osteotomy, or surgical cutting of the bone, to be informed that the doctor may be required to remove or replace an existing implanted device in the bone while performing the procedure. Thus, I would conclude the Act contemplates that a risk may be a dangerous element or factor, as well as a set of negative consequences of each separate procedure performed. I would also conclude that the cutting of the vein, while admittedly not an end result, was nonetheless a dangerous element of the DEP procedure. I would further conclude that as a dangerous element or factor of the procedure, cutting the vein was a risk associated with the procedure which required disclosure.
Dr. Giller, the primary neurosurgeon, testified that Tajchman’s brain injury was caused by the deliberate cutting of a vein in the process of placing the probe. Giller testified that prior to Tajchman’s injury, he routinely cut veins that were in the way of probe placement because they were in an area where they could be safely cut. Giller testified it was “a very unusual circumstance” that Tajehman depended on the cut vein for drainage to a portion of her brain. Giller testified that after Tajchman’s injury, he no longer routinely cuts the veins. Thus, a change in his procedure has now reduced this risk. I would conclude that Giller’s expert testimony established that the risk was inherent to the DEP procedure as performed and created a fact issue about whether the risk was material enough to influence a reasonable person to give or withhold consent to treatment if it had been disclosed. I would sustain appellants’ first point of error, reverse the trial court’s summary judgment, and remand to the trial court for further proceedings.