Court Opinion

ID: 9896048
Source: CourtListenerOpinion
Date Created: 2023-11-09 15:08:01.828012+00
Date Added: 2024-06-11T09:13:27.206686
License: Public Domain

Corrected Opinion Filed 10/27/23 by Clerk of the Supreme Court                   FILED
                                                                            IN THE OFFICE OF THE
                  IN THE SUPREME COURT                                   CLERK OF SUPREME COURT
                                                                              OCTOBER 26, 2023

                  STATE OF NORTH DAKOTA                                   STATE OF NORTH DAKOTA

                                2023 ND 197

Randy Dean Severance,                                 Plaintiff and Appellant
      v.
Dr. Brenden Jeron Howe,                             Defendant and Appellee

                                No. 20230084

Appeal from the District Court of Ward County, North Central Judicial
District, the Honorable Douglas L. Mattson, Judge.

REVERSED AND REMANDED.

Opinion of the Court by Crothers, Justice.

Randy D. Severance, Ryder, ND, plaintiff and appellant.

Duane A. Lillehaug (argued), Fargo, ND, Meggi R. Ihland Pelton (appeared),
Bismarck, ND, and Daniel J. Dunn (on brief), Fargo, ND, for defendant and
appellee.

                                                Filed by Clerk of Supreme Court 10/27/23
                             Severance v. Howe
                                No. 20230084

Crothers, Justice.

[¶1] Randy Severance appeals from a judgment dismissing his personal
injury claim against Dr. Brenden Howe. The district court dismissed the case
because Severance did not submit an affidavit containing an expert opinion to
support a prima facie case of professional negligence as required by N.D.C.C.
§ 28-01-46. We hold Severance pleaded a cognizable claim for the intentional
tort of battery and that N.D.C.C. § 28-01-46 does not apply to intentional torts.
We reverse the dismissal judgment and remand for further proceedings.

                                       I

[¶2] Severance brought his claim against Howe in small claims court. His
claim affidavit stated in full:

      “I was a patient of Dr. Howe, seeking relief from occasional back
      and neck pain. On a personal whim, Dr. Howe decided that I also
      had an elbow problem. Without my consent, he performed
      unwanted        manipulations,      repeatedly    and     forcefully
      hyperextending my elbow. This resulted in a serious, traumatic
      elbow injury. My elbow was not in pain prior to Dr. Howe’s
      inappropriate and excessive manipulations, and I had no desire to
      have it manipulated. As a result of his actions, my right arm was
      virtually crippled for over 7 months, with serious pain upon light
      activity. After a period of recovery and extensive physical therapy,
      my arm still has ongoing pain, stiffness, and impaired
      functionality.”

Howe removed the claim to district court and filed an answer. Howe admitted
he performed chiropractic adjustments on Severance but denied they were
done without Severance’s consent. Severance did not amend his claim affidavit.

[¶3] More than a year after the case was removed, Howe moved to dismiss
under N.D.C.C. § 28-01-46 arguing Severance was required to produce an
expert opinion within three months of his claim and Severance failed to do so.
Severance admitted he did not provide an expert opinion. He sought leave to

                                       1
file an amended claim explicitly specifying a cause of action for medical battery.
He resisted the dismissal motion arguing in part that an expert opinion was
unnecessary because his claim constituted the intentional tort of medical
battery and § 28-01-46 only applies to professional negligence claims.

[¶4] The district court dismissed the case because Severance did not provide
a timely expert opinion as required by N.D.C.C. § 28-01-46. The court
explained “the North Dakota Supreme Court does not acknowledge a clear
difference between . . . ‘no consent’ and ‘inadequate consent,’” and “there is no
claim for any form of medical malpractice whereby a Plaintiff would not need
to disclose an expert for a lack of consent in a medical procedure.” The court
denied Severance’s motion for leave to amend his complaint and entered an
order dismissing the case without prejudice. Severance appeals.

                                       II

[¶5] A dismissal without prejudice is generally not appealable. Scheer v. Altru
Health Sys., 2007 ND 104, ¶ 9, 734 N.W.2d 778. Severance’s claim is for injuries
he allegedly sustained in 2019. Both parties agree the two-year statute of
limitations has run in this case. See N.D.C.C. § 28-01-18(1) and (3) (claims for
battery and malpractice must be commenced within two years after they
accrue). The dismissal judgment effectively forecloses future litigation of
Severance’s claim and is therefore appealable. See Cartwright v. Tong, 2017
ND 146, ¶¶ 5-7, 896 N.W.2d 638 (holding dismissal judgment under N.D.C.C.
§ 28-01-46 issued after expiration of limitation period was appealable).

[¶6] “We have not precisely defined the standard of review to be employed by
this court in reviewing a trial court’s dismissal of a medical malpractice action
under § 28-01-46, N.D.C.C., or the standard to be used by the trial court in
making its initial determination on the motion.” Larsen v. Zarrett, 498 N.W.2d
191, 195 n. 2 (N.D. 1993). We have repeatedly noted the standard to be applied
when reviewing decisions under N.D.C.C. § 28-01-46 “may vary depending on
the posture of the case before us.” Greene v. Matthys, 2017 ND 107, ¶ 8, 893
N.W.2d 179 (collecting cases).

                                        2
[¶7] The district court dismissed this case assuming Severance’s “claims were
properly plead.” The court held there is not a “specific unique claim of medical
battery in North Dakota” and “there is no claim for any form of medical
malpractice whereby a Plaintiff would not need to disclose an expert for a lack
of consent in a medical procedure.” Given the court dismissed Severance’s
claim as it was pled on legal grounds, we apply the N.D.R.Civ.P. 12(b)(6)
standard of review.

[¶8] “The legal sufficiency of a claim is tested by a motion to dismiss under
N.D.R.Civ.P. 12(b)(6).” Puklich v. Puklich, 2022 ND 158, ¶ 7, 978 N.W.2d 668.

      “[W]e construe the complaint in the light most favorable to the
      plaintiff and accept as true the well-pleaded allegations in the
      complaint. A district court’s decision granting a Rule 12(b)(6)
      motion to dismiss a complaint will be affirmed if we cannot discern
      a potential for proof to support it. We review a district court’s
      decision granting a motion to dismiss under N.D.R.Civ.P. 12(b)(6)
      de novo on appeal.”

Id. (alteration in original) (quoting Atkins v. State, 2021 ND 83, ¶ 9, 959 N.W.2d
588).

                                       III

[¶9] Resolution of this appeal turns on the distinction between the tort of
medical battery and medical malpractice. We have noted the distinction
between a medical battery claim, “which involves a total lack of consent for an
act,” and a negligent non-disclosure claim “involving the absence of informed
consent.” Hopfauf v. Hieb, 2006 ND 72, ¶ 11 n. 2, 712 N.W2d 333. Many
jurisdictions, “including our own,” have “blurred” the differences between the
doctrines. Id. Based on the posture of previous appeals, we have left
“clarification of these concepts” for “another day.” Id.; see also Cartwright, 2017
ND 146, ¶ 9 n. 1 (noting claims arguably should have been analyzed as medical
battery but declining to do so under the law of the case doctrine).

[¶10] The torts of battery and negligence serve different functions and provide
different avenues for recovery. Mayr v. Osborne, 795 S.E.2d 731, 735-36 (Va.

                                        3
2017). Battery protects a person’s physical integrity and control over his body.
Id. at 736. At its core, the tort of battery operates to protect an individual’s
right to avoid intentional bodily contact. Id. On the other hand, the tort of
negligence serves to encourage the exercise of reasonable care. Id. Obtaining a
patient’s informed consent relates to a doctor’s duty of care, specifically the
“duty of a doctor to disclose pertinent information to a patient,” including
“available choices for treatment and the material and known risks involved
with each treatment.” Cartwright, 2017 ND 146, ¶ 15.

[¶11] The difference between the torts implicates whether a plaintiff is
required to present expert testimony to prove his claim. Humboldt Gen. Hosp.
v. Sixth Jud. Dist. Ct., 376 P.3d 167, 172 (Nev. 2016). In lack of informed
consent cases, the plaintiff must prove a doctor failed to provide information
the medical community would require a patient to know before giving consent.
Id. This involves assessing a doctor’s degree of care and skill, which is often
beyond the knowledge of a lay jury and requires expert evidence. Mayr, 795
S.E.2d at 736; see also Winkjer v. Herr, 277 N.W.2d 579, 585 (N.D. 1979)
(holding expert evidence is generally required for medical malpractice claims
under the common law). Expert evidence is not required for a plaintiff to prove
medical battery because a lay jury can determine whether a person provided
no consent at all to a touching. Humboldt Gen Hosp., at 172. The differences
between the torts are clear in theory. The differences become blurry in practice
when cases present scope-of-consent fact patterns. See, e.g., Kohoutek v.
Hafner, 383 N.W.2d 295, 298 (Minn. 1986) (stating battery exists when a
physician fails to disclose “a very material aspect of the nature and character”
of a procedure).

                                       A

[¶12] Severance asserts his battery claim is a viable cause of action recognized
by the common law. The district court rejected his argument because this Court
has not acknowledged “a clear difference” between “no consent” and
“inadequate consent,” and the law “pertaining to medical battery” is currently
“unsettled.”

                                       4
[¶13] The tort of battery exists at common law. Felder v. Casey, 487 U.S. 131,
146 n. 3 (1988); see also Mills v. Rogers, 457 U.S. 291, 294 n. 4 (1982) (stating
the right to refuse medical treatment emerged in part from the common law
tort of battery). “No right is held more sacred, or is more carefully guarded by
the common law, than the right of every individual to the possession and
control of his own person. . . .” Union Pac. Ry. Co. v. Botsford, 141 U.S. 250,
251-52 (1891) (discussing battery in context of the common law). The common
law is “the basic law applicable to civil rights and remedies not defined by [ ]
statute.” Estate of Conley, 2008 ND 148, ¶ 25, 753 N.W.2d 384 (quoting Tarpo
v. Bowman Pub. Sch. Dist., 232 N.W.2d 67, 70 (N.D. 1975)). Battery is not
defined by statute in North Dakota. Under our case law, a person is civilly
liable for offensive-contact battery if he or she (1) “acts intending to cause a
harmful or offensive contact with the person of the other or a third person, or
an imminent apprehension of such a contact,” and (2) “an offensive contact with
the person of the other directly or indirectly results.” Wishnatsky v. Huey, 1998
ND App 8, ¶ 7, 584 N.W.2d 859 (quoting Restatement (Second) of Torts § 18
(1965)). Although we have yet to review an appeal dealing with a claim of
battery in the medical context, absent a statute to the contrary, it exists as a
cause of action in this state. See N.D.C.C. § 1-01-03 (incorporating the common
law); N.D.C.C. § 1-01-06 (there is no common law in cases where the law is
declared by code).

[¶14] The district court also rejected Severance’s battery claim because he did
not provide “a definition or the elements of a proposed medical battery claim
in North Dakota,” and given “the lack of argument presented,” the court was
not persuaded “to adopt a new area of law.” North Dakota is a notice-pleading
state. Estate of Hill, 492 N.W.2d 288, 296 (N.D. 1992). “North Dakota’s rules
do not require plaintiffs to ‘allege every element of their claim.’” Tibert v. Minto
Grain, LLC, 2004 ND 133, ¶ 18, 682 N.W.2d 294 (quoting Kaler v. Kraemer,
1998 ND 56, ¶ 7, 574 N.W.2d 588). “With the adoption of notice pleading in
North Dakota, the formal character of the complaint no longer strictly
determines the cause of action.” Estate of Hill, at 296.

[¶15] Severance pled he “had no desire” for his elbow to be manipulated by
Howe, and “[w]ithout my consent, he performed unwanted manipulations,

                                         5
repeatedly and forcefully hyperextending my elbow.” Severance argues “Howe’s
actions . . . constitute a willful disregard of Severance’s previous refusal . . . to
have his elbow treated by Howe.” Howe presents a different version of the
events. But these factual disagreements have no bearing on whether a claim
for medical battery exists in North Dakota or whether Severance pleaded facts
to support such a claim. Battery is a common law tort, and under our notice
pleading rules, Severance pleaded facts sufficient to raise a battery claim.

[¶16] Howe argues we should follow Linog v. Yampolsky, 656 S.E.2d 355, 358
(S.C. 2008), which held “no independent cause of action for medical battery
exists in South Carolina” and claims against medical providers “involving lack
of or revocation of consent” for “a physical touching within the medical context”
require expert testimony. We decline to follow Linog to the extent it would
foreclose all battery claims based on lack of consent in the medical context.
Medical providers are capable of committing battery within the context of the
provider-patient relationship. See, e.g., Doe v. Nassar, Case No. 8:18-cv-1117,
2018 WL 6430543, at *1 (C.D. Cal. Aug. 2, 2018) (“Nassar was convicted of
sexually molesting minors while serving as a doctor for USA Gymnastics, and
Plaintiffs are among his many victims.”); Appell v. Muguerza, 329 S.W.3d 104,
107 (Tex. Ct. App. 2010) (patient alleged doctor punched her in an examination
room at the doctor’s office); Dunford v. Tryhus, 2009 ND 212, ¶ 2, 776 N.W.2d
539 (plaintiff alleged dentist sexually abused him as a child). We decline to
remove claims for battery in the medical context from our common law.
Whether to abrogate some or all of such common law claims is a policy matter
for the Legislature to decide.

                                         B

[¶17] Severance argues the expert disclosure requirement under N.D.C.C. §
28-01-46 does not apply to his claim for medical battery. We agree.

[¶18] Section 28-01-46, N.D.C.C., applies to medical malpractice negligence
actions: It states:

      “Any action for injury or death alleging professional negligence by
      [various healthcare providers and institutions] must be dismissed

                                         6
      without prejudice on motion unless the plaintiff serves upon the
      defendant an affidavit containing an admissible expert opinion to
      support a prima facie case of professional negligence within three
      months of the commencement of the action. . . . This section does
      not apply to unintentional failure to remove a foreign substance
      from within the body of a patient, or performance of a medical
      procedure upon the wrong patient, organ, limb, or other part of the
      patient’s body, or other obvious occurrence.”

[¶19] Statutory interpretation presents a question of law that is fully
reviewable on appeal. Gonzales v. Perales, 2023 ND 145, ¶ 4, 994 N.W.2d 183.

      “Our primary goal in interpreting statutes is to ascertain the
      Legislature’s intentions. In ascertaining legislative intent, we first
      look to the statutory language and give the language its plain,
      ordinary and commonly understood meaning. We interpret
      statutes to give meaning and effect to every word, phrase, and
      sentence, and do not adopt a construction which would render part
      of the statute mere surplusage.”

State v. Gardner, 2023 ND 116, ¶ 7, 992 N.W.2d 535 (quoting State v. Gaddie,
2022 ND 44, ¶ 17, 971 N.W.2d 811).

[¶20] Howe does not challenge the district court’s holding that N.D.C.C. § 28-
01-46 applies to chiropractors. Section 28-01-46 was amended in 2005. See
2005 N.D. Sess. Laws ch. 280, § 1. The amendments added the language
“alleging professional negligence” to qualify the words “[any] action for injury
or death.” The amendments make clear § 28-01-46 applies only to actions
“alleging professional negligence.” Battery is an intentional tort. It does not
require a finding of negligence. “A physician may perform an operation with
great skill and nevertheless be liable for a battery if the patient did not
consent.” Mayr, 795 S.E.2d at 736. By its plain language § 28-01-46 does not
apply to Severance’s claim for battery.

[¶21] Howe argues that even if N.D.C.C. § 28-01-06 does not apply, the case
should be dismissed because Severance cannot prove causation and damages
without expert testimony. Howe relies on negligence cases and a no-fault
insurance decision to support his argument. However, evidence of causation

                                        7
and damages is not required for Severence to prove a battery. See Wishnatsky,
1998 ND App 8, ¶¶ 6-7 (discussing the elements of battery and noting the tort
does not require proof of physical harm); see also Reynolds v. MacFarlane, 322
P.3d 755, 760 (Utah Ct. App. 2014) (stating common law battery does not
require an injury and if successful a plaintiff is entitled to at least nominal
damages); Banks v. Fritsch, 39 S.W.3d 474, 480 (Ky. Ct. App. 2001) (same). The
absence of an expert opinion to prove causation and damages is not grounds
for dismissing Severance’s battery claim.

                                     IV

[¶22] We reverse the dismissal judgment and remand the case for further
proceedings.

[¶23] Jon J. Jensen, C.J.
      Daniel J. Crothers
      Lisa Fair McEvers
      Jerod E. Tufte
      Douglas A. Bahr

                                      8