Court Opinion

ID: 9595764
Source: CourtListenerOpinion
Date Created: 2023-08-22 00:43:14.267401+00
Date Added: 2024-06-11T18:01:30.910216
License: Public Domain

Nicholas S. Chanak, Justice,*
(dissenting).
I dissent from the majority opinion to the extent it denies a new trial against defendant doctors, Donald and Roger Larson. The majority properly concedes that a jury instruction based on Mulder v. Parke Davis & Co. 288 Minn. 332, 181 N. W. 2d 882 (1970), would be appropriate in another case, but finds that the trial court committed no reversible error in refusing such an instruction here because (1) the drug manufacturers’ recommendations were not sufficiently clear and explicit to support the requested instruction, and (2) the requested instruction would not have changed the verdict since Tina Lhotka’s condition could have been the result of numerous other causes. I disagree on both of these grounds.
First, with respect to the clarity of the manufacturers’ recommendations, the evidence is undisputed that Tina Lhotka was born prematurely; that Dr. Donald Larson knew or should have known from package inserts that “fetal immaturity constitutes a relative contraindication” for administration of Seconal by injection (Plaintiffs’ exhibit K); that Dr. Donald Larson knew from the Physician’s Desk Reference that Seconal, at least when administered by injection, is “generally” contraindicated if the fetus is immature; and that Dr. Donald Larson nevertheless prescribed the drug. The problem is that the Seconal was administered orally and the manufacturer’s recommendations on oral administration (Plaintiffs’ exhibit L) contain no explicit contraindication relative to fetal immaturity. In my view, a Mulder instruction should be given, contingent for its application upon *132a prior finding by the jury as to whether the manufacturer’s recommendations were sufficiently clear to put the reasonably prudent physician on notice that oral administration of Seconal was also contraindicated.
Jury instructions are often contingent upon prior findings of fact. The majority has apparently decided that such a contingent instruction is not justified here because there is not sufficient evidence from which a jury could find that a reasonably prudent physician would receive adequate notice from the manufacturer’s recommendations. Yet, Dr. Roger Larson admitted that Seconal has “the same chemical composition” whether administered orally or by injection. Further, expert witness Dr. Milton Alter testified that the effect of the drug is known by the practicing physician to be the same, although the drug would metabolize more slowly when administered orally. On the basis of this evidence, a jury could find that Dr. Donald Larson should have known from the manufacturer’s recommendations that oral administration of Seconal was also contraindicated. A Mulder instruction would then have been appropriate if the jury could make the further finding that Dr. Donald Larson’s deviation from the manufacturer’s recommendations on Seconal, alone or in combination with the subsequent administration of Demerol and Phenergan, caused Tina Lhotka’s condition.
In this connection, the majority opinion states that a Mulder instruction was not required here because Tina Lhotka’s condition may have been the result of other causes. However, Mulder only requires “competent medical testimony that his patient’s injury or death resulted from the doctor’s failure to adhere to the recommendations.” 288 Minn. 340, 181 N. W. 2d 887. There was such competent testimony here in the expert opinion of Dr. Milton Alter. In effect, the majority concludes from the mere possibility of other causes that no jury could believe this competent expert opinion. This conclusion finds no support in the verdict below. The case was submitted to the jury on special interrogatories. The jury never reached the causation issue because *133it found that Dr. Donald Larson had not been negligent in administering the drugs. On the negligence issue, a Mulder instruction could very well change the result by permitting the jury to measure Dr. Donald Larson’s conduct against a higher standard of care.
For these reasons, I would reverse as to defendant doctors, Donald and Eoger Larson, and remand for a new trial at which plaintiffs would be entitled to the following jury instruction:
1. You are instructed that before the plaintiff may recover he (she) must establish the following:
(a) A professional standard of conduct;
(b) That the defendant breached that professional standard;
(c) That defendant’s breach in fact caused plaintiff’s injuries;
(d) That plaintiff has in fact been injured.
2. You are instructed that where a drug manufacturer or other recognized authority clearly recommends to the medical profession (1) the conditions under which the drug should be prescribed; (2) the disorder it is designed to relieve; (3) the precautionary measures which should be observed; and (4) warns of the dangers which are inherent in its use, then you may consider such manufacturer’s recommendations as establishing a professional standard of care.
3. You are further instructed that if the plaintiff has persuaded you by a preponderance of the evidence that the defendant has deviated from those recommendations then you may find that the defendant has breached his professional standard of care unless the defendant persuades you that such a deviation was justified under the circumstances of this particular case.
4. You are further instructed that if you find that defendant has breached his professional standard of care, and if you are persuaded by a preponderance of the evidence that this breach did in fact cause the plaintiff’s injuries, then you may find defendant negligent.
*134Kelly, Justice (dissenting).
I join in Mr. Justice Chanak’s dissent.
Todd, Justice (dissenting.)
I join in the dissent of Mr. Justice Chanak.
Scott, Justice (dissenting).
I agree with the dissent of Mr. Justice Chanak.
Mr. Justice Otis took no part in the consideration or decision of this case.

 Acting as Justice of the Supreme Court by appointment pursuant to Minn. Const. art. 6, § 3, and Minn. St. 2.724, subd. 2.