Court Opinion

ID: 9766524
Source: CourtListenerOpinion
Date Created: 2023-08-29 04:52:08.689353+00
Date Added: 2024-06-11T07:30:23.574009
License: Public Domain

Dissenting Opinion by
Mr. Chief Justice Bell:
This is an action of trespass for a battery, and not the usual action for malpractice. The majority Opin*168ion admits that there was no negligence on the part of the defendant either in his surgical operation, or in his preoperative diagnosis, or in his postoperative care. Moreover, plaintiff signed a “consent to operation” agreement and admitted that he knew defendant was going to make an exploratory operation on his back.
Plaintiff bases, and the majority of this Court sustain, his right to recover damages on the alleged fact that he did not understandingly consent to the serious operation which defendant performed and for which, we repeat, plaintiff signed the “consent to operation” agreement. This “consent to operation” agreement is so broad and so clear and so unquestionably applicable to and inclusive of the operation which defendant performed, that it is impossible for me to understand how the majority can permit it to be evaded and nullified. It reads:
“Allegheny General Hospital
Pittsburgh, Pa.
Consent To Operation, Adult
“Whereas, I, /s/ Chas. B. Gray residing at No. Street,
(City and State)
and now in the Allegheny General Hospital of Pittsburgh, Pa.; and of full age, have been informed by the physicians* of said hospital that in their opinion an operation on me is necessary for the proper treatment of my illness. I hereby consent to the same and said physicians are hereby authorized to employ whatever operative procedure they deem necessary, using their best skill and judgment. .
*169“Witness, my hand and seal, at said hospital, in the City of Pittsburgh, Pennsylvania, this 18th day of Jan., A.D. 1960.
Attest:

M

/s/ Charles B. Gray ”
The majority sustain the jury’s verdict not on the important question of what the written agreement covered, but on the oral testimony of plaintiff as to what he believed the defendant intended to do. The majority make the critical issue not what the doctor actually told the patient in advance of the operation but what the latter, a layman, understood or should have understood from what the surgeon said, in explaining what he contemplated doing.
Defendant relies upon plaintiff’s written consent agreement which specifically authorizes the physicians of that hospital to perform “whatever operative procedures they deem necessary.” Plaintiffs own doctor, Dr. John B. Blakley, who brought defendant in to perform the operation, testified that he had explained to plaintiff prior to the operation that the proposed operation was a serious one, and not as plaintiff claims only a minor one. Defendant also testified substantially to the same effect.
The trial Judge in his charge to the jury placed the issue (and realistically, the verdict) on this purely subjective basis: “Did the plaintiff consent to major or serious surgery, or did he anticipate only minor surgery, and did he believe that there was practically nothing to this operation, as he testified; and that’s the only issue in the case. We know, of course, that *170he did consent to an operation. The only question is did he consent to major surgery.”
The decision by the majority of this Court opens wide the door (1) to fraud and (2) to the belief or understanding or guess of one party to “a consent agreement” as to exactly what it covered and meant and (3) most important of all, it amounts to an alteration and virtual nullification of a wi’itten instrument by parol evidence of defendant’s (admittedly) non-fraudulent oral statements concerning the proposed operation. The admission of such parol evidence flies in the teeth of the long and well established law, which is applicable to written instruments, viz., in the absence of fraud, accident or mutual mistake, prior oral statements or oral understandings or inducements or agreements are merged in a subsequent written agreement.* McWilliams v. McCabe, 406 Pa. 644, 179 A. 2d 222; United Refining Company v. Jenkins, 410. Pa. 126, 189 A. 2d 574; Smith v. Yohe and Gailey, 412 Pa. 94, 194 A. 2d 167.
In United Refining Company v. Jenkins, 410 Pa., supra, the court said (page 134): “The rule enunciated in Gianni v. Russell & Co., Inc., supra, is firmly embedded in the law of Pennsylvania and from that rule we will not permit a deviation for it is essential that the integrity of written contracts be maintained. In Grubb v. Rockey, 366 Pa. 592, 597, 79 A. 2d 255, we said: ‘The modern Pennsylvania Parol Evidence Rule is well stated by Mr. Justice Stearne in Walker v. Saricks, 360 Pa. 594, 598, 63 A. 2d 9: “This Court said in Gianni v. Russell & Co., Inc., 281 Pa. 320, 323, 126 A. 791: Where parties, without any fraud or mistake, have deliberately put their engagements in writing, the law declares the writing to be not only the best, but the only, evidence of their agreement: [citing cases]. All *171preliminary negotiations, conversations and verbal agreements are merged in and superseded by the subsequent written contract . . . and unless fraud, accident or mistalce be averred, the writing constitutes the agreement between the parties, and its terms cannot be added to nor subtracted from by parol evidence: [citing cases].’ ” ’ See also: O’Brien et al. v. O’Brien, supra; Bokser v. Lewis, 383 Pa. 507,119 A. 2d. 67; Keleher v. LaSalle College, 394 Pa. 545, 147 A. 2d 835.”
The trial in this case took place about five years after the questioned operation. Until surgeons open the human body, they cannot be sure of what conditions they will find, or determine in advance with certainty what surgical or operative procedures or other treatments are wise or necessary, or exactly what operation (s) they will perform when the actual conditions within the patient’s body can be seen and more accurately diagnosed and determined. If the majority adhere to their new rule, malpractice and trespass claims will hereafter be made countless times, irrespective of what written consent or release is signed by a patient.
Plaintiff is not aided — in view of the aforesaid consent to operation agreement — either by his legally inadmissible and (in any event) legally insufficient testimony, or as he claims by defendant’s testimony. Defendant, who has performed more than 4,000 major operations, when called as of cross-examination, testified that he always told a patient (especially a patient with a back condition) of the seriousness of and the risks involved in any operation on the back, but he could not remember the exact words he used to explain it to the plaintiff five years before. How could any doctor honestly remember exactly what he said to a particular patient five years before the trial? Plaintiff’s signed written consent to whatever operation the physicians deem necessary should not be permitted to be repudiated by his oral testimony that he thought an *172exploratory operation loas not a serious operation or indeed any operation at all. The practical effect of the majority Opinion would require a surgeon to be not only (1) an able surgeon but also (2) a prophet, and (3) a highly technical lawyer, and (4) an insurer, or in the alternative, a perjurer — although realistically speaking, even perjury would rarely ever suffice to win a jury’s verdict against a plaintiff-patient in a pitiful condition. To impose on a surgeon such a burdensome test is very unrealistic, very unfair, and very unjustifiable.
In Smith v. Yohe and Gailey, 412 Pa. 94, 194 A. 2d 167, the court, in affirming a compulsory nonsuit in plaintiff’s action against Gailey, aptly said (pages 106, 107-108) :
“Smith v. Dr. Gailey
“A. Was An Unauthorized Operation Performed by Dr. Gailey?
“Smith charges that Dr. Gailey performed an unauthorized operation on (Mr. Smith) by inserting a Steinman Pin in his tibia.
“The principles of law applicable to this phase of the litigation are clear. Such principles are: (a) where a patient is mentally and physically able to consult about his condition, in the absence of an emergency, the consent of the patient is ‘ “ ‘a prerequisite to a surgical operation by his physician’ ” ’ and an operation without the patient’s consent is a technical assault (Moscicki v. Shor, 107 Pa. Superior Ct. 192, 195, 163 A. 341; Dicenzo v. Berg, 340 Pa. 305, 307, 16 A. 2d 15) ; (b) the burden is on plaintiff to prove ‘that the operation performed, or substantially that operation, was not authorized by him’: Dicenzo v. Berg, supra, 307.
“ ‘In the first place, when Mr. Smith first was admitted to the hospital, [Smith] signed the following statement which was admitted in evidence: “This is to *173certify that I (we) the undersigned consent to any treatment or to the administration of whatever anesthetic and the performing of whatever operation or medical procedure deemed necessary or advisable in the diagnosis and treatment of this patient.” This would seem to furnish a complete answer to [Smith’s] claim of lack of authority.
“ ‘However, [Smith] infers that the conversation between him and [Dr. Gailey] prior to the questioned procedure constituted a withdrawal or limitation of the prior blanket authorization, and that [Dr. Gailey] then agreed to limitations which he thereafter exceeded: [Smith] described this conversation as follows: “I said, ‘What is it with these manipulations? What are they like?’ He said, ‘Very painless; a little sodium pentothal and we pull the patient’s limbs and try to snap his prosthesis back into place.’ ... I said, ‘Is this all you are going to do, a manipulation?’ And he said, ‘Yes.’ My brother and I looked at each other and said, ‘We will go along with that.’ ”
“ ‘We fail to see that the insertion of the Steinman pin was a procedure exceeding any limitations [Smith] may have imposed. . . .’ ”
For each and all of these reasons I would affirm the judgment which was entered by the lower court, namely, judgment for defendant non obstante veredicto.

 Italics throughout, ours.

 which, as here, contains the entire agreement of the parties.