Court Opinion

ID: 9688031
Source: CourtListenerOpinion
Date Created: 2023-08-24 16:58:10.550351+00
Date Added: 2024-06-11T18:18:34.475604
License: Public Domain

D. E. Shelton, J.
Plaintiff Raquel Blair was a twenty-two-year-old pregnant woman who was treated at defendant Hutzel Hospital. She filed this action against the hospital, alleging that the defendant negligently failed to offer her maternal serum alphafetoprotein (msafp) screening during the second trimester of her pregnancy. She alleges that the screening test would have provided a substantial opportunity to discover that her fetus had Down’s syndrome and that by failing to administer the test the hospital thereby negligently deprived her of the ability to make an informed decision to terminate her pregnancy, causing her to deliver Delano Blair, a child bom with Down’s syndrome, on May 10, 1992.* 1
Defendant filed its first motion for summary disposition, pursuant to MCR 2.116(C)(8) and (10) , arguing that plaintiff’s wrongful birth2 action was contrary to *505the public policy of the State of Michigan. The trial court denied the motion.
Defendant filed a second motion for summary disposition, pursuant to MCR 2.116(C)(10), arguing that plaintiff could not prove proximate causation beyond mere conjecture. Although there was evidence that there was a twenty-five percent to thirty percent chance that MSAFP would have identified the fetus as suffering from Down’s syndrome, the trial court nevertheless granted defendant’s motion. Plaintiff has appealed and defendant has cross appealed from the trial court rulings.
Two issues are presented for appeal. First, defendant asks this Court to hold that the tort of wrongful birth is no longer valid in Michigan. Second, defendant maintains that the doctrine that the loss of a substantial opportunity to avoid physical harm should not be applied to a wrongful birth cause of action.
I. WRONGFUL BIRTH
This Court first expressly recognized the wrongful birth cause of action in Eisbrenner v Stanley, 106 Mich App 357; 308 NW2d 209 (1981), a case involving rubella-caused birth defects. In Proffitt v Bartolo, 162 Mich App 35, 40-41; 412 NW2d 232 (1987), this Court *506again held that wrongful birth is a cognizable claim in Michigan:
The term “wrongful birth” is a shorthand name given to actions brought by the parents of a child bom with severe defects against a physician (or other responsible party) who negligently fails to inform them in a timely fashion of the risk that the mother will give birth to such a child, effectively precluding an informed decision as to whether the pregnancy should be avoided or terminated. A “wrongful life” claim, on the other hand, is brought on behalf of a child with birth defects who claims that, but for the negligent advice to the parents, the child would not have been bom.
In rejecting that earlier challenge to the wrongful birth concept, we noted at p 42:
The jurisdictions considering the issue have now almost uniformly adopted the wrongful birth cause of action. See generally James G v Caserta, 332 SE2d 872, 875, n 6 (W Va, 1985), and Anno: Tort liability for wrongfully causing one to be born, 83 ALR 3d 15.
And concluded at pp 46-47:
Against this backdrop, we conclude that the Eisbrenner holding with regard to wrongful birth remains the law in Michigan until changed by the Legislature or the Supreme Court. The issue of whether abortion should be allowed and all the related moral, religious, and policy arguments are not before us following the line of privacy cases culminating in Roe v Wade, [410 US 113; 93 S Ct 705; 35 L Ed 2d 147 (1973)]. The issue is instead whether physicians have a duty to ascertain and advise parents of information necessary for the parents to exercise the options provided by Roe, whatever the physician personally believes. If a physician breaches the appropriate duty under the facts of a case, and it can be established that the parents would have avoided or terminated the pregnancy, the necessary causal connec*507tion is established. The parents should recover for their extraordinary medical expenses and the extraordinary costs of raising the child, as well as the emotional harm they have suffered.
As long as abortion remains an option allowed by law, the physician owes a duty to furnish patients with adequate information for them to be able to decide whether to choose that course of action. Those who would eliminate such a right of recovery must first abolish the right to have an abortion — a matter not germane to this appeal.
We have continued to recognize the wrongful birth cause of action in subsequent cases, and neither the Supreme Court nor the Legislature has acted to change our holdings. See Rinard v Biczak, 177 Mich App 287; 441 NW2d 441 (1989),3 and Rouse v Wesley, 196 Mich App 624; 494 NW2d 7 (1992).4
*508The defendant asserts that the adoption of MCL 400.109a; MSA 16.490(19a) and the holding of the Supreme Court in Doe v Dep’t of Social Services, 439 Mich 650; 487 NW2d 166 (1992), indicate a contrary public policy. That statute whose constitutionality was upheld by the Supreme Court in Doe, prohibits the use of Medicaid funds to pay for an abortion unless the abortion was necessary to save the life of the mother. Such a funding decision does not affect or change the principle that abortions are lawful in this country, or the principle that a physician owes a duty to furnish a patient with adequate information so the patient may decide whether to choose to have an abortion or to be exposed to the possibility of producing a disabled or deformed child.
The trial court properly denied summary disposition of the wrongful birth claim because that is still a viable cause of action in this state.
II. THE SUBSTANTIAL OPPORTUNITY RULE
In Falcon v Memorial Hosp, 436 Mich 443; 462 NW2d 44 (1990), the Supreme Court held that the family of a decedent could maintain an action for malpractice where the malpractice had denied the *509decedent a substantial opportunity to survive, even when that opportunity was less than fifty percent. The Michigan Supreme Court held that the trial court erred in granting summary disposition where the plaintiff could show that the defendants’ medical malpractice had deprived the plaintiff’s decedent of a substantial opportunity to avoid dying as a result of cancer. The plaintiff in Falcon presented evidence that, absent the defendants’ negligence, the plaintiff’s decedent would have had a 37.5 percent chance of survival. The Court held that this was a “substantial” opportunity and that the plaintiff could maintain an action against the defendants for their failure to preserve the decedent’s opportunity to live.
Defendant here maintains that this substantial opportunity rule should be limited to wrongful death actions. There is no merit to that position. Although Falcon involved a claim of wrongful death, Justice Levin stated in a footnote that
[t]he accrual of a cause of action for loss of an opportunity of achieving a better result does not.. . depend on whether death ensues as a result. The cause of action accrues when harm and damages result from the loss of a substantial opportunity for a better result. The plaintiff has the burden of establishing through expert testimony the difference between the course of the disease and treatment had there been a correct diagnosis, and the course of the disease and treatment as a result of failure to diagnose or misdiagnosis. [Id. at 470, n 43.]
Moreover, this Court has very recently held that the substantial opportunity rule applies to all medical malpractice actions. In Weymers v Khera, 210 Mich App 231; 533 NW2d 334 (1995), lv gtd 451 Mich 898 (1996), the plaintiff claimed that her physician’s negli*510gence deprived her of a thirty percent to forty percent opportunity to save her kidney function. Judge Smolensk! eloquently stated at pp 236-237:
We hold that the loss of a substantial opportunity to avoid physical harm is harm distinct from the underlying injury for which tort law should allow recovery in proportion to the extent of the lost opportunity, provided that the negligence of the defendant, more probably than not, caused the loss of opportunity.
We believe that the arguments for allowing a cause of action for the loss of an opportunity to survive apply equally to allowing a cause of action for the loss of an opportunity to avoid lesser physical harm. In recognizing such harm, the traditional rule that the plaintiff must prove that the defendant’s negligent conduct, more likely than not, caused the harm is not contradicted. Falcon, supra at 462-463 (Levin, J.), 472-473 (Boyle, J.); Harris v Kissling, 80 Or App 5; 721 P2d 838 (1986); but see Falcon, supra at 473-495 (Riley, C.J., dissenting).
Allowing recovery for the loss of a substantial opportunity to avoid physical harm is an equitable approach. DeBurkarte v Louvar, 393 NW2d 131, 137 (Iowa, 1986). In this case, defendants undertook to protect plaintiff from the type of harm that occurred. Falcon, supra at 461 (Levin, J.). As Justice Levin stated in Falcon, an actor’s negligent omission in cases like this prevents the plaintiff from being able to prove the defendant’s liability, and destroys the ability to allow fate to run its course. Id. at 456-457, ns 20, 21. Here, assuming for the purpose of argument only that defendants should have diagnosed and treated plaintiff for Goodpasture’s Syndrome upon her admission to the hospital, plaintiff might still have lost kidney function, but she would know that it was because of “fate,” i.e., the natural progression of the disease, and not because of any failure by defendants.
If the lost opportunity doctrine is limited to cases only involving death, potentially flagrant examples of malpractice could go uncompensated in cases in which the same negligent failure to diagnose or treat results in a lost oppor*511tunity to avoid egregious harm, i.e., paralysis or coma. Thus, the deterrent and loss-allocation functions of tort law would be undermined if defendants could escape liability for the effects of negligent conduct that cause demonstrable losses. DeBurkarte, supra at 137 (citing King, Causation, valuation, and chance in personal injury torts involving preexisting conditions and future consequences, 90 Yale L J 1353, 1377-1378 [1981]); but see Falcon, supra at 494-495 (Riley, C.J., dissenting).
Defendant nevertheless contends that the wrongful birth tort should somehow be carved out as an exception to the substantial opportunity rule. The only authority cited for this unusual proposition is the 1989 California case of Simmons v West Covina Medical Clinic, 212 Cal App 3d 696; 260 Cal Rptr 772 (1989). The rationale of Simmons is inapplicable in this state, however, because California is one of the minority of states that does not recognize the substantial opportunity rule in any type of tort. See Dumas v Coone, 235 Cal App 3d 1593, 1600-1601; 1 Cal Rptr 2d 584 (1991).
The substantial opportunity rule is the law of Michigan that applies to this case. A patient goes to a physician in order to improve opportunities of avoiding, ameliorating, or reducing physical harm, as well as pain and suffering. A pregnant patient goes to a physician in order to obtain the best possible care during her pregnancy and the best possible outcome of the pregnancy. We have consistently held, as we did in Proffitt, that a physician has a duty to ensure that a woman makes informed decisions regarding her procreative options, including the option of abortion. The failure to so inform a woman is a breach of that duty. The element of causation is satisfied if a plaintiff can show that the defendant’s negligence in providing that *512information deprived her of a substantial opportunity to leam of the risks of bearing a child with birth defects and that had she been provided with such information, she would have obtained an abortion.
In Falcon, a 37.5 percent chance of survival was held to be substantial as a matter of law. In Weymers, a thirty percent to forty percent chance was held to be substantial. In this case, plaintiffs expert testified that there was a twenty-five percent to thirty percent chance that MSAFP screening would have identified plaintiff’s fetus as being affected by Down’s syndrome. Plaintiff testified that she would have undergone an abortion had she been provided with the information. Under these circumstances, we hold that plaintiff’s claim that she was deprived of a substantial opportunity to leam of the defective condition of her fetus when her physician negligently failed to provide MSAFP screening stated a cause of action. Further, such evidence created a question of fact. The defendant denies that the failure to provide the screening was a breach of the standard of care and denies that such screening would have provided a substantial opportunity to achieve a better result. We hold that both of those issues are questions of fact for a jury to resolve.
The trial court’s granting of defendant’s second motion for summary disposition was in error.
The grant of summary disposition for defendant is reversed, and this matter is remanded for trial on plaintiff’s wrongful birth complaint.
Reilly, J. concurred.

 This cause of action arose after the Supreme Court decision in Falcon v Memorial Hosp, 436 Mich 443; 462 NW2d 44 (1990), and before the April 1, 1994, legislative change to Falcon brought about by MCL 600.2912a(2); MSA 27A.2912(1)(2). That statute does not control, and has no relevance to, the issues in this case. The Legislature did not attempt to make its statutory rescission of Falcon retroactive, and plaintiffs cause of action is therefore governed by Falcon and its progeny.

 We have previously defined the meaning of a wrongful birth claim as distinguished from a wrongful life claim in Proffitt v Bartolo, 162 Mich App 35; 40-41; 412 NW2d 232 (1987):
The term “wrongful birth” is a shorthand name given to actions brought by the parents of a child bom with severe defects against a physician (or other responsible party) who negligently fails to *505inform them in a timely fashion of the risk that the mother will give birth to such a child, effectively precluding an informed decision as to whether the pregnancy should be avoided or terminated. A “wrongful life” claim, on the other hand, is brought on behalf of a child with birth defects who claims that, but for the negligent advice to the parents, the child would not have been bom. See Smith v Cote, 128 NH 231; 513 A2d 341, 344 (1986); Procanik v Cillo, 97 NJ 339, 347-348; 478 A2d 755 (1984). Both causes of action involve claims of professional negligence.
A stipulation was filed in this case dismissing the wrongful life claim and that claim is not part of this appeal.

 Rinard held that an action did lie for a physician’s failure to diagnose a pregnancy. The Court, at pp 290-291, stated:
A cause of action can be maintained in Michigan for failure to diagnose pregnancy. In Proffitt v Bartolo, 162 Mich App 35, 46-47; 412 NW2d 232 (1987), lv den 430 Mich 860 (1988), this Court stated that as long as abortion remains an option allowed by law, physicians owe a duty to furnish patients with adequate information for them to be able to decide whether to choose that course of action. Proffitt was a wrongful birth case. The term “wrongful birth” is a shorthand name given to actions brought by the parents of a child bom with severe defects against a physician, or other responsible party, who negligently fails to inform them in a timely fashion of the risk that the mother will give birth to such a child, effectively precluding an informed decision as to whether the pregnancy should be avoided or terminated. 162 Mich App 40. The instant case does not involve a wrongful birth cause of action. However, the claim asserted in this case is more analogous to that cause of action than to other causes of action such as wrongful life or wrongful pregnancy which Michigan courts have addressed. See Proffitt, supra at 40-41.

 Rouse arose from a pregnancy caused by an unsuccessful tubal ligation, and this Court held that the parents could not make what amounted to a “wrongful life” claim. The Court, at pp 626-627, stated:
*508In Michigan, causes of action are recognized for what has been labeled wrongful birth and wrongful pregnancy, but there exists no cause of action for wrongful life. Wrongful birth is a tort action brought by parents of a child with a birth defect against a doctor or other person whose negligent failure to inform the parents of the risk of the birth defect deprived the parents of the opportunity to make an informed decision to avoid or terminate the pregnancy. Rinard, supra at 290-291; Proffitt v Bartolo, 162 Mich App 35, 40; 412 NW2d 232 (1987). The cause of action for wrongful birth is available to parents to recover the extraordinary medical expenses and costs of raising the child, as well as emotional harm. Rinard, supra at 296.