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Court rules on incurred risk in malpractice suit

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The Indiana Supreme Court ruled today that, in general, incurred risk isn't a defense to medical malpractice based on negligence or lack of informed consent. It also ruled a patient's prior consents to similar surgeries were relevant and admissible at trial.

In Brenda Spar v. Jin S. Cha, M.D., No. 45S05-0906-CV-273, Brenda Spar brought a medical malpractice action against Dr. Jin Cha after she suffered complications from a laparoscopy to determine fertility issues. Spar signed a consent form to "Video Laparoscopy Possible Laparotomy," which stated she had been told risks and benefits and possible complications of the surgery. The morning of her surgery, Cha explained the surgery and possible complications. Cha performed a laparoscopy instead of laparotomy based on comments from Spar prior to surgery.

Spar had previous surgeries to her abdomen following a severe car accident and to remove her gallbladder and gallstones. After the surgery by Cha, she developed post-operative complications and had to have part of her bowel removed during emergency surgery. She was hospitalized for nearly six weeks and developed peritonitis, cysts, and fistulas.

A medical review panel found Cha failed to meet the standard of care and the case proceeded to trial under two theories: negligence in failing to employ alternative diagnostic procedures in lieu of surgery, and failure to obtain Spar's informed consent to the chosen course of treatment.

The trial court admitted evidence by Cha over Spar's objection that he obtained Spar's informed consent for the laparoscopy based on her informed consent to previous surgeries by other doctors. The trial court denied Spar's motion for judgment on the evidence on the issue of incurred risk and gave a jury instruction on it. The jury returned a general verdict in favor of Cha.

On appeal, Spar argued the evidence at trial didn't establish any form of incurred risk as to either her claim for negligent advice or her claim for lack of informed consent. The Supreme Court agreed with the Indiana Court of Appeals that assumption of risk has little legitimate application in the medical malpractice context. A patient is entitled to expect the services will be rendered in accordance with the standard of care, no matter how risky the procedure may be, wrote Justice Theodore Boehm. The disparity in knowledge between professionals and their clients generally precludes recipients from knowing whether a professional's conduct is in fact negligent.

Even if incurred risk is an available defense in some cases, the record in the instant case is devoid of any evidence Spar somehow incurred the risk of negligent care. The doctor's incurred-risk defense to Spar's claim of negligent advice shouldn't have been submitted to the jury.

Incurred risk was also not a defense to Spar's lack-of-informed-consent claim. A waiver of informed consent doesn't assume risks associated with negligent performance of the underlying procedure or treatment, the justice wrote. And, there's no evidence Spar waived her right to informed consent or otherwise assumed risks related to negligent nondisclosure. The Supreme Court reversed and remanded for a new trial.

The justices also determined the trial court properly admitted evidence of Spar's consent to prior surgeries by other doctors.

"If Spar had been made aware of typical complications by Dr. McKinnon and Dr. Shabeeb and already had a thorough appreciation of the common risks from invasive abdominal procedures, the jury was entitled to take her knowledge into consideration when assessing whether she would have declined surgery in light of more comprehensive disclosure," wrote Justice Boehm.

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  1. YES I WENT THROUGH THIS BEFORE IN A DIFFERENT SITUATION WITH MY YOUNGEST SON PEOPLE NEED TO LEAVE US ALONE WITH DCS IF WE ARE NOT HURTING OR NEGLECT OUR CHILDREN WHY ARE THEY EVEN CALLED OUT AND THE PEOPLE MAKING FALSE REPORTS NEED TO GO TO JAIL AND HAVE A CLASS D FELONY ON THERE RECORD TO SEE HOW IT FEELS. I WENT THREW ALOT WHEN HE WAS TAKEN WHAT ELSE DOES THESE SCHOOL WANT ME TO SERVE 25 YEARS TO LIFE ON LIES THERE TELLING OR EVEN LE SAME THING LIED TO THE COUNTY PROSECUTOR JUST SO I WOULD GET ARRESTED AND GET TIME HE THOUGHT AND IT TURNED OUT I DID WHAT I HAD TO DO NOT PROUD OF WHAT HAPPEN AND SHOULD KNOW ABOUT SEEKING MEDICAL ATTENTION FOR MY CHILD I AM DISABLED AND SICK OF GETTING TREATED BADLY HOW WOULD THEY LIKE IT IF I CALLED APS ON THEM FOR A CHANGE THEN THEY CAN COME AND ARREST THEM RIGHT OUT OF THE SCHOOL. NOW WE ARE HOMELESS AND THE CHILDREN ARE STAYING WITH A RELATIVE AND GUARDIAN AND THE SCHOOL WON'T LET THEM GO TO SCHOOL THERE BUT WANT THEM TO GO TO SCHOOL WHERE BULLYING IS ALLOWED REAL SMART THINKING ON A SCHOOL STAFF.

  2. Family court judges never fail to surprise me with their irrational thinking. First of all any man who abuses his wife is not fit to be a parent. A man who can't control his anger should not be allowed around his child unsupervised period. Just because he's never been convicted of abusing his child doesn't mean he won't and maybe he hasn't but a man that has such poor judgement and control is not fit to parent without oversight - only a moron would think otherwise. Secondly, why should the mother have to pay? He's the one who made the poor decisions to abuse and he should be the one to pay the price - monetarily and otherwise. Yes it's sad that the little girl may be deprived of her father, but really what kind of father is he - the one that abuses her mother the one that can't even step up and do what's necessary on his own instead the abused mother is to pay for him???? What is this Judge thinking? Another example of how this world rewards bad behavior and punishes those who do right. Way to go Judge - NOT.

  3. Right on. Legalize it. We can take billions away from the drug cartels and help reduce violence in central America and more unwanted illegal immigration all in one fell swoop. cut taxes on the savings from needless incarcerations. On and stop eroding our fourth amendment freedom or whatever's left of it.

  4. "...a switch from crop production to hog production "does not constitute a significant change."??? REALLY?!?! Any judge that cannot see a significant difference between a plant and an animal needs to find another line of work.

  5. Why do so many lawyers get away with lying in court, Jamie Yoak?

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