Court Opinion

ID: 9681717
Source: CourtListenerOpinion
Date Created: 2023-08-24 07:55:14.909001+00
Date Added: 2024-06-11T18:17:35.038783
License: Public Domain

DIES, Chief Justice
(dissenting).
I respectfully dissent.
I would affirm the judgment of the trial court. In my judgment the evidence does not raise an issue of malpractice (ordinary negligence) by Physician.
Patient had a severe and incurable case of emphysema. He had been treated conservatively (medically) and his condition continued to worsen. He was told that the carotid surgery would not cure him but hopefully would make it easier for him to breathe. There is no evidence the surgery made his condition any worse. He lived some six years after the surgery; there is no evidence his death was in any way connected with the surgery. There is no allegation or evidence of unskillfulness in the surgery on the part of Physician. Thousands of these operations have and are being performed. Some patients report improvement from the surgery.
After diligent research, I am unable to find any case in America holding a physician guilty of malpractice under these circumstances.
Three physicians testified for the Patient. One, Dr. Longfield, based his conclusions that “[t]he main findings we made, there was no benefit from the operation” on ten patients. Another doctor, Dr. Thomas, testified, “The only thing I can say is what I have read and what I have heard at conventions.” admitted he didn’t “know anything about the operation.”
The third physician, Dr. Petty, from Denver, testified by deposition, but the deposition does not reveal whether he ever had any direct experience with the operation or examined patients who had undergone carotid surgery.
The majority opinion would absolve Physician if (1) the operation were experimental or (2) if a “respectable minority” of physicians supported it.
This rule brings into mind these questions: (1) When does surgery stop being experimental and (2) how many is a “respectable minority”?
This surgery, of course, as the majority opinion states, cannot be considered “experimental,” because thousands of these operations have been performed. There is no showing that the surgeons who performed them are not a “respectable minority.”
After a procedure is no longer “experimental” and until a “respectable minority” is accumulated, those physicians who use a new procedure do so on their own peril. This rule must surely inhibit and discourage new treatments and procedures.
Texas law presumes initially that physicians have discharged their duty to the patient which presumption can be defeated only by an affirmative showing of a specific breach of duty resulting in injury. Walker, Parker, and Williamson, The Application of Res Ipsa Loquitur in Texas Medical Professional Liability Actions, 12 Hous.L.Rev. 1045 (1975). Error in judgment by Physician is not a sufficient showing. Harle v. Krchnak, 422 S.W.2d 810, 814 (Tex.Civ.App.—Houston [1st Dist.] 1967, writ ref’d n. r. e.). Negligence is never imputed from unsatisfactory results. Hunter v. Robison, 488 S.W.2d 555, 560 (Tex.Civ.App.—Dallas 1972, writ ref’d n. r. e.); Floyd v. Michie, 11 S.W.2d 657, 658 (Tex.Civ.App.—Austin 1928, no writ); see also Hopkins v. United States, 152 F.Supp. 473, 476 (W.D.Mo.1957).
The law must recognize that by the nature of medicine there will always be differences of professional opinion as to diagnosis and treatment. See Hoglin v. Brown, 4 Wash.App. 366, 481 P.2d 458, 461 (1971). See also Schueler v. Strelinger, 43 N.J. 330, 204 A.2d 577, 584 (1964). See also: 70 C.J.S. Physicians and Surgeons § 48 at 959 (1951).
Unnecessary surgery is a very serious problem in America. See Unnecessary Surgery: Doctor and Hospital Liability, 61 Geo. L.J. 807 (1973).
*297But I question whether the way to correct it is by opening a new area of malpractice (as this opinion does) or by vigorous self-regulation by the medical proféssion. If the courts get into this problem some genuine abuses, of course, will be revealed, but I fear the long term effect would discourage new procedures and techniques, so necessary to improve health care. I want to emphasize that this dissent is strictly limited to the facts of this case, viz., where the procedure is thought by some physicians to be of help, where there is no showing of unskillfulness on the part of the physician, and where there is no showing of injury to the patient other than the normal injury attendant with any surgery.