Court Opinion

ID: 9845061
Source: CourtListenerOpinion
Date Created: 2023-09-24 03:14:48.366786+00
Date Added: 2024-06-11T09:15:51.217068
License: Public Domain

BAKES, Chief Justice,
dissenting:
As the majority correctly notes, I.C. § 6-1012 sets forth the standard of care for physicians in medical malpractice cases. See Robertson v. Richards, 115 Idaho 628, 769 P.2d 505 (1987). I.C. § 6-1012 states in relevant part that “individual providers of health care shall be judged in such eases in comparison with similarly trained and qualified providers of the same class in the same community, taking into account his or her training, experience, and fields of medical specialization, if any.” The majority opinion also correctly acknowledges that, where a party requests an instruction in substantially the form as given, that party cannot complain “as it would have been invited error.” Ante at 906, 821 P.2d at 961; McBride v. Ford Motor Co., 105 Idaho 753, 673 P.2d 55 (1983).
I believe that the court’s Instruction No. 12 does set forth the “community standard” in I.C. § 6-1012. And to the extent that it incorporated the “best judgment” language of IDJI 205, it was the appellant who requested that language and who, at the instruction conference, advised the court that the “best judgment” language was a “correct” and “accurate” statement of the law. Therefore, if there was any error it was invited error and the appellant cannot now complain.
With regard to the Court’s conclusion that, “Both IDJI 205 and the jury instruction given apparently conflict with I.C. § 6-1012,” the majority’s analysis of IDJI 205 and given Instruction No. 12 focuses solely on one sentence in the instruction, and not upon the preceding and following sentences which clearly and unequivocally set out the standard from I.C. § 6-1012.
IDJI 205 reads as follows:
DUTY OF A PHYSICIAN
A physician or surgeon undertaking the [treatment] [care] of a patient has a duty to possess and exercise that degree of skill and learning ordinarily possessed and exercised by the members of his profession in good standing, practicing in the community in which he provided such [treatment] [care] (should have provided such [treatment] [care]). It is further his duty to use reasonable care, skill and diligence and to use his best judgment in the exercise of his skill and the application of his learning.
The term “community” means that geographical area ordinarily served by the licensed or general hospital at or nearest to which such [treatment] [care] [was] [should have been] provided. (Emphasis supplied.)
Given Instruction No. 12 reads as follows:
JURY INSTRUCTION NO. 12 — In performing professional services for a patient, a physician has the duty to have the degree of learning, skill, and quali*914fications ordinarily possessed by reputable physicians practicing in the same community, at the same time, and under similar circumstances.
A physician has a further duty to use the care and skill ordinarily exercised in like cases by reputable members of the profession practicing in the same community, at the same time, and under similar circumstances, and to use reasonable diligence and his or her best judgment in the exercise of skill and the application of learning and qualifications in an effort to accomplish the purpose for which the physician is employed.
If the physician holds himself out as a specialist in a particular field of medical, surgical, and other healing science, it also is his duty to have the knowledge, skill, and qualifications ordinarily possessed, and to use the care and skill ordinarily used, by reputable specialists practicing in the same field, in the same community, at the same time, and under similar circumstances.
A failure to fulfill the foregoing duty or standard of care is negligence.
A physician is not necessarily negligent because he errs in judgment or because his efforts prove unsuccessful. The physician is negligent only if the error in judgment or lack of success is due to a failure to perform any of his duties defined in these instructions.
Where there is more than one recognized method of diagnosis Or treatment, and no one of them is used exclusively and uniformly by all practitioners in good standing in the particular field of specialization, a physician is not negligent if, in exercising his best judgment, he selects one of the approved methods which later turns out to be a wrong selection or one not favored by certain other practitioners.
The underlined portions of IDJI 205 and given Instruction No. 12 state the correct community standard set out in I.C. § 6-1012. The advisory committee’s comment following the IDJI 205 instruction specifically cites I.C. § 6-1012 and our recent cases interpreting that section, LePelley v. Grefenson, 101 Idaho 422, 614 P.2d 962 (1980), and Maxwell v. Women’s Clinic, 102 Idaho 53, 625 P.2d 407 (1981), support this instruction. The majority opinion seemingly overlooks the other sentences and instead focuses upon the sentence which states, “It is further his duty to use reasonable care, skill and diligence and to use his best judgment in the exercise of his skill and the application of his learning.” It is that language, which was requested by appellant and which the trial court incorporated into the second paragraph of given Instruction 12, about which the appellant and the majority now complain in this case. However, the appellant never complained at trial.
In the trial court appellant requested the “best judgment” language in Plaintiff’s Requested Instruction No. 18. At the jury instruction conference appellant told the trial court that it was a correct statement of the law. The second paragraph of given Instruction No. 12 is practically identical to the Plaintiff’s Requested Instruction No. 18. Both included the “best judgment” language. The following comparison of Plaintiff’s Requested Instruction No. 18 and the second paragraph of given Instruction No. 12 demonstrates that. Plaintiff’s Requested Instruction No. 18 reads:
JURY INSTRUCTION NO__
A physician or surgeon undertaking the treatment of a patient has a duty to possess and exercise that degree of skill and learning ordinarily possessed and exercised by the members of his profession in good standing, practicing in the community in which he provided such treatment or should have provided such treatment. It is further his duty to use reasonable care, skill and diligence and to use his best judgment in the exercise of his skill and the application of his learning.
IDJI 205
Plaintiffs’ Requested Jury Instruction No. 18.
(Emphasis supplied.)
The second paragraph of given Instruction No. 12 reads as follows:
*915A physician has a further duty to use the care and skill ordinarily exercised in like cases by reputable members of the profession practicing in the same community, at the same time, and under similar circumstances, and to use reasonable diligence and his or her best judgment in the exercise of skill and the application of learning and qualifications in an effort to accomplish the purpose for which the physician is employed. (Emphasis supplied.)
Both require the physician to use his best judgment in the exercise of skill and the application of his learning. At the jury instruction conference the appellant, although he made it clear that he was objecting to the last two paragraphs of given Instruction No. 12, also made it clear that he was not objecting to the first four paragraphs of Instruction No. 12, which contained the “best judgment” language in the second paragraph, which was the same language which appellant had requested in Instruction No. 18.
A review of the reporter’s transcript of that instruction conference confirms that the appellant was not objecting to the “best judgment” language in given Instruction No. 12. Appellant’s counsel stated with regard to his objection to Instruction No. 12 the following:
My objection isn’t to the entire instruction. In fact, I think that the portion of it that comes down to line 23 that says, ‘the failure to fulfill the foregoing duty is negligence,’ I think that is correct. It’s about half way through your stack, I think. That is not the exact language of 205, IDJI 205, but it’s very close. It paraphrases it, adds a few things, and I think capsulizes the law of medical negligence.
Appellant’s counsel told the trial court that the portion of Instruction No. 12 “down to line 23,” which is at the end of the fourth paragraph, was “correct.” A copy of Instruction No. 12 is attached as Appendix A. He pointed out to the trial court that the second paragraph of Instruction No. 12 “is not the exact language of 205, IDJI 205, but it’s very close. It paraphrases it, adds a few things, and I think capsulizes the law of medical negligence.”
Later on in the colloquy at the instruction conference, plaintiff appellant’s counsel again approved the second paragraph of given Instruction No. 12, stating the physician must use “his or her ‘best judgment ’ in the skill, exercise of skill and the application of learning. That’s accurate and that does provide the exact language from IDJI 205.”
From the foregoing it is readily apparent that the appellant requested the “best judgment” language by proposing Plaintiff’s Requested Instruction No. 18, and advising the trial court at the instruction conference that the first 23 lines of Instruction No. 12, which contained the “best judgment” language in the second paragraph of given Instruction No. 12, was “correct,” “capsulizes the law of medical negligence,” and that it was “accurate and [it] does provide the exact language from IDJI 205.” Accordingly, the “best judgment” language in Instruction No. 12, if it is error, is invited error, as the Court’s opinion recognizes on page 6, when it says, “The appellant requested an instruction in substantially the form of IDJI 205 and had that instruction been given, the appellant could not now complain as it would have been invited error.” Ante at 906, 821 P.2d at 961. Plaintiff's requested instruction was given. It is the second paragraph of given Instruction No. 12. Plaintiff-appellant should not now be heard to complain of the trial court using the “best judgment” language in Instruction No. 12. McBride v. Ford Motor Co., 105 Idaho 753, 673 P.2d 55 (1983).
What, then, was the plaintiff-appellant objecting to at the instruction conference with regard to the court’s given Instruction No. 12? A close reading of the transcript of the jury instruction conference indicates that appellant was objecting to the language of the sixth paragraph of given Instruction No. 12, because he thought it was an inaccurate comment on the evidence. The part of that sixth paragraph, which the objection focuses on, is as follows:
*916Where there is more than one recognized method of diagnosis or treatment, and no one of them is used exclusively and uniformly by all practitioners in good standing in the particular field of specialization, a physician in not negligent if, in exercising his best judgment, he selects one of the approved methods which later turns out to be a wrong selection or one not favored by certain other practitioners. (Emphasis supplied.)
As to that language, the appellant stated:
They can argue that from the above instruction. In other words, you’ve already said he has to use reasonable diligence in line 11 [the second paragraph of Instruction No. 12] and his or her best judgment in the skill, exercise of skill and the application of learning. That’s accurate and that does provide the exact language from IDJI 205. It’s the same sentence as ‘it is further to use his duty to use reasonable care, skill and diligence and to use his best judgment in the exercise of his skill and the application of his learning.’ [Plaintiff’s Requested Instruction No. 18.] So you have already advised on it. Counsel can comment and fair comment will include the comments to the effect of what comes from line 23 down.
Moreover, the remainder of the paragraph isn’t applicable to this case in that there has been no testimony that there is, quote ‘more than one recognized method of diagnosis and/or treatment. ’ All the surgeons, all the experts have agreed as to diagnostic testing or what is available and what the treatment should be.
There might be a divergence of opinion as to when treatment and when diagnosis should be done, but there is no divergence of opinion as to what should be done. So in that respect, it is also simply surplusage.
That is really my only objection to the ones that the court is now going to give. (Emphasis supplied.)
A careful reading of the objection indicates that the plaintiff-appellant was not objecting to the use of the "best judgment” language per se, because plaintiff’s counsel stated, “In other words, you’ve already said he has to use reasonable diligence in line 11 [which was paragraph 2 of given Instruction No. 12] and his or her best judgment in the skill, exercise of skill and the application of learning. That’s accurate and that does provide the exact language from IDJI 205.” (Emphasis supplied.) However, reading on, it becomes apparent that plaintiff-appellant’s objection to the last paragraph of given Instruction No. 12 was a claim essentially that the last paragraph was an inaccurate comment on the evidence. After stating that the court had already instructed in paragraph 2 of given Instruction No. 12 on the “best judgment” standard, plaintiff-appellant’s counsel stated:
So you have already advised on it. Counsel can comment and fair comment will include comments to the effect of what comes from line 23 down [paragraphs 5 and 6 of given Instruction No. 12]. Moreover, the remainder of the paragraph isn’t applicable to this case in that there has been no testimony that there is, quote ‘more than one recognized method of diagnosis and/or treatment.’
While the rationale for plaintiff’s objection to Instruction No. 12 is not entirely clear, a fair review of the plaintiff’s counsel’s entire statement at the jury instruction conference is that he had no objection to the first four paragraphs of given Instruction No. 12. Plaintiff recognized that the second paragraph of Instruction No. 12, which included the “best judgment” language, was “very close” to Plaintiff’s Requested Instruction No. 18 and IDJI 205, and that the second paragraph was “correct,” “accurate,” and “capsulizes the law of medical negligence.” However, plaintiff’s counsel was objecting to the sixth paragraph of given Instruction No. 12 on the ground that the trial court had already once instructed the jury using the “best judgment” language in paragraph 2, and that the sixth paragraph’s statement about using the “best judgment” in selecting between alternate methods of diagnosis or treatment was not supported by the testimony and was an inaccurate comment on the evi*917dence. Plaintiff-appellant’s counsel admitted that, “Counsel can comment and fair comment will include comments to the effect of what comes from line 23 down [the fifth and sixth paragraphs of given Instruction No. 12].” But he objected to the court instructing about alternate methods of diagnosis.
In conclusion, given Instruction No. 12 correctly instructed the jury that a physician must “have” the degree of learning possessed by reputable physicians in the “same community.” Paragraph 2 of given Instruction No. 12 instructed the jury that a physician has a further duty to “use” the care and skill ordinarily exercised “in the same community,” and to use reasonable diligence and “best judgment” in the exercise of that skill to accomplish the purpose for which the physician is employed. Paragraph 3 of Instruction No. 12 told the jury that if the physician held himself out as a specialist he had the duty to use the skill ordinarily used by specialists in the “same community.” Those first three paragraphs of Instruction No. 12 instruct the jury on the community standard of care set out in I.C. § 6-1012, as required by Robertson v. Richards, supra.
If there was any error by including the “best judgment” language in Instruction No. 12, it was invited by the plaintiff-appellant who requested that language in Plaintiff’s Requested Instruction No. 18, and who advised the trial court at the jury instruction conference that he had no objection to the best judgment language in paragraph 2 of Instruction No. 12. He stated that the language was “correct,” “accurate” and “capsulizes the law of medical negligence.” We should not reverse because of the inclusion of the “best judgment” language in Instruction No. 12. McBride v. Ford Motor Co., 105 Idaho 753, 673 P.2d 55 (1983).
APPENDIX A
JURY INSTRUCTIONS
INSTRUCTION NO. 12
In performing professional services for a patient, a physician has the duty to have the degree of learning, skill, and qualifications ordinarily possessed by reputable physicians practicing in the same community, at the same time, and under similar circumstances.
A physician has a further duty to use the care and skill ordinarily exercised in like cases by reputable members of the profession practicing in the same community, at the same time, and under similar circumstances, and to use reasonable diligence and his or her best judgment in the exercise of skill and the application of learning and qualifications in an effort to accomplish the purpose for which the physician is employed.
If the physician holds himself out as a specialist in a particular field of medical, surgical, or other healing science, it also is his duty to have the knowledge, skill, and qualifications ordinarily possessed, and to use the care and skill ordinarily used, by reputable specialists practicing in the same field, in the same community, at the same time, and under similar circumstances.
A failure to fulfill the foregoing duty or standard of care is negligence.
A physician is not necessarily negligent because he errs in judgment or because his efforts prove unsuccessful. The physician is negligent only if the error in judgment or lack of success is due to a failure to perform any of his duties defined in these instructions.
Where there is more than one recognized method of diagnosis or treatment, and no one of them is used exclusively and uniformly by all practitioners in good standing in the particular field of specialization, a physician is not negligent if, in exercising his best judgment, he selects one of the approved methods which later turns out to be a wrong selection or one not favored by certain other practitioners.