Clevenger v. Haling

Supreme Judicial Court of Massachusetts, Berkshire · 1979 · Contracts

ContractsPhysician contract liabilityExpress promise of medical resultcontractsmedical contractsphysician liabilityexpress promisespecific result

Facts

In December 1973, Carolyn C. Clevenger consulted the defendant obstetrician-gynecologist for a physical examination and to discuss having her tubes tied. The defendant performed a tubal ligation on January 10, 1974, but the plaintiff later gave birth to a third daughter on March 17, 1975. On the contract theory, the crucial evidence was the plaintiff's testimony that before surgery the defendant said the operation was permanent, there was no reversal, and she was not going to have any more children. There was also excluded evidence of postoperative statements by the defendant asserting that she could not be pregnant, but the court concluded that even considering that evidence, no enforceable promise of a specific result was shown.

Issue

Whether the evidence was sufficient to permit a jury to find that the defendant physician expressly contracted or guaranteed that the plaintiff would not have another child after the tubal ligation. More specifically, the question was whether the defendant's statements amounted to an enforceable promise of a specific medical result rather than reassurance or description of expected consequences of a successful procedure.

Rule

An action based on an alleged contract by a physician to achieve a particular medical result is permitted only on clear proof of an express promise to produce that result. Clear proof does not require special consideration or a heightened burden of proof, but it requires careful attention to whether, in context, the physician's words could reasonably be interpreted by the patient as a promise that a specific result or cure would be achieved. It is a negative factor, though not conclusive, that the physician and patient did not focus on whether the physician was undertaking to achieve a given result, and courts should not treat statements reasonably calculated only to reassure the patient or to describe the expected consequences of a successful procedure as contractual promises.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

In Portland, Maine, Dana Mercer met with Dr. Nolan Price about a cosmetic scar-revision procedure. Before surgery, Dr. Price told Dana, "I guarantee that when I am done, the scar will be completely invisible forever," and Dana agreed to proceed. The surgery was performed without negligence, but a visible scar remained.

If Dana sues Dr. Price for breach of contract based solely on these facts, which is the best result?

Explanation. A physician may be liable in contract when there is clear proof of an express promise to produce a particular medical result. Here, the doctor's statement was promissory in nature and specifically guaranteed a concrete outcome. The case rejects any rule requiring separate consideration, and nonnegligent performance does not itself defeat a properly proven express-result contract claim.