Court Opinion

ID: 9673412
Source: CourtListenerOpinion
Date Created: 2023-08-24 04:11:20.5402+00
Date Added: 2024-06-11T18:16:22.035259
License: Public Domain

AMIDEI, Justice,
dissenting on motion for rehearing.
I respectfully dissent. I agree with the majority that appellee had the duty to disclose only those risks that could influence a reasonable person in making a decision to consent to the procedure in question. Peterson v. Shields, 652 S.W.2d 929, 931 (Tex.1983). This case, however, was not submitted in such a way as to permit the jury to determine whether those risks were disclosed.
I would instead conclude that the procedure performed in this case was not one for which risks have been promulgated by the Disclosure Panel. The second surgery in this case was not an arthroplasty, or joint replacement, but instead a procedure to repair or cement an artificial knee. The type of procedure filled in the blank on the pre-printed form signed in this case was “redo right knee.” The disclosure form listed the risks found on the Panel’s Disclosure List A, under the heading “Musculoskeletal system treatments and procedures,” and under the sub-heading for “Arthroplasty of all joints with mechanical device.” 6 Tex.Reg. 4668, 4672 (1981). As arthroplasty was not performed during the second surgery, this procedure might be classified instead under List B, which also includes procedures to the “Musculoskeletal system.” 6 Tex.Reg. 4668, 4677 (1981).
Nowhere does the disclosure form mention that a tourniquet would be used during the procedure, or that the risk of amputation accompanies the use of a tourniquet. Yet a *319tourniquet was used, and appellant’s leg was amputated. It is undisputed that appellee never advised appellant of the risk of amputation. Because this was revision surgery, appellant’s risk for amputation had increased. Appellant’s expert testified that because of her pre-existing vascular problems in her leg, appellant was at an increased risk for amputation if she was required to have revision surgery. Appellant testified that if she had been aware of the risks associated with use of a tourniquet, including possible amputation, she would not have submitted to either the original surgery or the revision surgery. This risk is clearly one that “could influence a reasonable person in making a decision to consent to the procedure.” Peterson, 652 S.W.2d at 931. Because the Disclosure Panel has not established required disclosures for the use of a tourniquet, Peterson controls the issue of informed consent. See id. Appellant supplied the expert testimony entitling her to a jury question on whether disclosure of the risk of amputation was necessary under these facts.
As submitted, the charge in this case did not permit the jury to find that the risk of amputation should have been disclosed. Question One asked whether appellee failed to disclose the risks of appellant’s second surgery. The jury was instructed that a signed disclosure form, with the risks as listed on the form, was presumed to be in compliance with the law. Thus, the instructions accompanying Question One required the jury to answer “No” if there was a signed disclosure form. The court failed to instruct the jury that the presumption of full disclosure could be rebutted by a showing that other risks, not included on the form, should have been disclosed. Appellant objected to the charge, specifically pointing out that the presumption instruction was prejudicial. Appellant’s counsel argued that the court was “instructing the jury as a matter of law rather than submitting a matter of fact to the jury.” Question One, with its instructions, constituted a highly prejudicial comment on the weight of the evidence. Appellant submitted two alternative questions, either of which should have been submitted by the trial court.1
In addition, appellant objected to the conditioning of Questions Two and Three on an affirmative answer to Question One. Because the jury had no choice but to answer “No” to Question One, it never had the opportunity to answer Question Two, compounding the error in the charge. Question Two asked whether a reasonable person would have refused surgery “if those risks had been disclosed,” referring only to the list of risks for “Arthroplasty” in Question One. Once again the jury was not permitted to consider whether the risk of amputation could have influenced a reasonable person’s decision to undergo surgery.
The errors in the charge are fundamental to appellant’s entire theory that she did not receive a proper disclosure of the risks involved in undergoing yet another surgery on her knee, particularly in light of her previous vascular problems. It is clear that these errors amount to such a denial of appellant’s rights as to cause the rendition of an improper judgment. Tex.RApp.P. 81(b)(1).
I would grant rehearing of this cause, sustain appellant’s points fifteen through eighteen complaining of charge error, and reverse and remand for a new trial.

. Refused Question No. 3: Do you find that a reasonable patient, under the same or similar circumstances as involved in the case of Joy Winkle, would have refused to undergo the surgery in question if advised that there existed a risk of amputation of the patient’s leg? Refused Question No. 6: Do you find that a reasonable person would have refused the surgery in question if the patient had been fully advised as to all risks, dangers, hazards or complications in connection with the surgeiy, together with the alternatives to such surgical treatment.