Court Opinion

ID: 9540480
Source: CourtListenerOpinion
Date Created: 2023-08-07 16:16:30.894694+00
Date Added: 2024-06-11T14:59:52.639711
License: Public Domain

TRAYNOR, J.
I dissent.
The doctrine of res ipsa loquitur is not applicable unless the accident is of a kind that ordinarily does not occur in *312the absence of someone’s negligence. (See Prosser, Torts, p. 295.) Since the determination whether the accident is of that kind is usually made in the light of common experience and since medical knowledge is not within common experience, the doctrine of res ipsa loquitur is usually held inapplicable in cases of malpractice. It can be invoked, however, “where a layman is able to say as a matter of common knowledge and observation that the consequences of professional treatment were not such as ordinarily would have followed if due care had been exercised.” (Engelking v. Carlson, 13 Cal.2d 216, 221 [88 P.2d 695].)
In Escola v. Coca Cola Bottling Co., 24 Cal.2d 453 [150 P.2d 436], the court recognized that the doctrine may apply even though expert testimony is necessary to establish that the accident was of a kind that ordinarily does not occur in' the absence of someone’s negligence. The court noted that in Honea v. City Dairy, Inc., 22 Cal.2d 614 [140 P.2d 369], it refused to take judicial notice of the technical practices of the bottling industry and therefore could not determine whether it could reasonably be concluded that a defect in a bottle was more probably than not the result of negligence. In the Escola case, however, there was expert testimony as to such practices and on the basis of that evidence the court held it could reasonably be concluded that it was more probable than not that the bottle exploded as the result of negligence. Thus, while ordinarily the occurrence of an accident is not in itself evidence of negligence, it may he evidence thereof when it can be said in the light of common experience that the accident would not ordinarily have occurred in the absence of negligence, or when experts in the field are able to conclude on the basis of their knowledge and experience that there is a balance of probabilities in favor of negligence as the cause.
There is no valid objection to permitting proof of negligence in malpractice cases by such circumstantial evidence. The law requires that physicians and surgeons shall “ ‘possess and exercise that reasonable degree of skill, knowledge, and care ordinarily possessed and exercised by members of their profession under similar circumstances. ’ ” (Sinz v. Owens, 33 Cal.2d 749, 753 [205 P.2d 3, 8 A.L.R 757].) Experts may testify that the procedure followed by the defendant fell short of that commonly employed, and thus provide direct evidence of negligence. Apart from the fact that a certain procedure failed, however, what actually happened is often in doubt. In *313such situations experts may know as laymen would not, that it is more probable than not that the accident was the result of negligence. If they so testify the jury may properly be instructed that if they find on the basis of the expert testimony that ordinarily an accident of the kind in question does not occur in the absence of negligence, they may infer that the particular accident was the result of negligence.
In the present case a child died on the operating table during a tonsillectomy. An instruction on the doctrine of res ipsa loquitur would be proper only if it may be said in the light of common experience that such deaths do not ordinarily occur in the absence of negligence or if medical experts had testified to that fact. Neither basis for the application of the doctrine is present. Common experience teaches only that ordinarily persons do not die during the course of minor operations. In the rare cases where deaths occur the layman is without knowledge or experience to weigh the probabilities of and against negligent conduct as the cause of death. It has therefore generally been held that the doctrine does not apply when a patient dies under anesthesia during a minor operation such as a tonsillectomy or tooth extraction. (Mitchell v. Atkins, 36 Del. (6 W.W.Harr.) 451 [178 A. 593, 595]; Dolan v. O’Rourke, 56 N.D. 416 [217 N.W. 666, 668]; Johnson v. Arndt, 186 Minn. 253, 257 [243 N.W. 67]; Loudon v. Scott, 58 Mont. 645, 656 [194 P. 488, 12 A.L.R. 1487]; see, also, Nemer v. Oreen, 316 Mich. 307 [25 N.W.2d 207]; Eggert v. Dramburg, 197 Wis. 153 [221 N.W. 732]; anno’s., 12 A.L.R. 1493; 162 A.L.R. 1265, 1282-1284.)
There was nothing in the expert testimony relied upon in the majority opinion to support a conclusion that ordinarily deaths do not occur in the course of tonsillectomies in the absence of negligence. Dr. Null testified that she had performed “hundreds of these tonsillectomies” and that this was “the first case in which a death had ever occurred.” Her testimony establishes only that such accidents are rare; it was silent on the question as to what are the probable causes when such deaths do occur. On the other hand, there was evidence that all anesthetics are dangerous; that the hazards of anesthesia are so well known to the medical profession that many of its members have specialized in that field; and that it is always a delicate procedure to produce anesthesia.
From the foregoing expert testimony the jury would be warranted in concluding, not that an anesthetic death was more probably than not the result of negligence, but that it *314resulted from unavoidable hazards attendant upon any anesthetization. (See Loudon v. Scott, 58 Mont. 645, 656 [194 P. 488, 12 A.L.R. 1487].) Nevertheless the majority opinion holds that it was proper to instruct the jury that as a matter of law the occurrence of the accident gave rise to an inference of negligence against all the defendants, an inference that could be overcome only by affirmative evidence on their part explaining the cause of death or showing that it could not have occurred from any cause that due care on their part might have prevented.
By approving the instruction, the court in effect holds that solely because an accident is rare it was more probably than not caused by negligence. There is a fatal hiatus in such reasoning. The fact that an accident is rare establishes only that the possible causes seldom occur. It sheds no light on the question of which of the possible causes is the more probable when 'an accident does happen. Since common knowledge and experience shed no light on this question when a death occurs during the course of a tonsillectomy and since the record is devoid of expert testimony bearing on the subject, the doctrine of res ipsa loquitur is not applicable. I would therefore reverse the judgment.
Edmonds, J., concurred.
Appellant’s petition for a rehearing was denied November 27,1950. Edmonds, J., and Traynor, J., voted for a rehearing.