Mitchell v. Kayem

Tennessee Court of Appeals · Torts

TortsMedical malpracticeInformed consentSummary judgmentinformed consentmedical malpracticeobjective standardcausation

Facts

Ms. Mitchell, who had a history of papillary carcinoma and prior neck surgeries, underwent a fine needle aspiration ordered by Dr. Kayem that confirmed cancer in a neck nodule. Dr. Kayem advised that surgery was necessary, and Ms. Mitchell signed a consent form both five days before surgery and again on the morning of surgery. During the surgery, Dr. Kayem removed malignant tissue, remaining thyroid tissue, and Ms. Mitchell's last parathyroid gland because it was inextricably involved in the malignant tissue; afterward, Ms. Mitchell experienced hypoparathyroidism and recurrent laryngeal nerve injury. Ms. Mitchell claimed she had not been informed of those risks and testified that, if informed, she still likely would have had surgery but would have sought a second opinion and treatment by another surgeon at a Nashville facility.

Issue

In an informed consent action, can a plaintiff establish causation by showing that, if properly informed of the risks, she would have undergone the same necessary surgery but would have sought a second opinion or chosen a different surgeon or facility? Also, was summary judgment for the physician proper on this record?

Rule

A plaintiff in an informed consent case must prove both that the physician's conduct fell below the applicable standard of care in disclosure and that a reasonably prudent person in the patient's position would not have consented to the procedure if suitably informed of the inherent risks. Under the objective standard, 'different course of treatment' refers to a different medical treatment or procedure, not merely the same procedure performed by a different surgeon.

🔒

See the holding & full analysis

Create a free KwikCourt account to unlock the rest of this brief — and practice the case.

The court's holding and reasoning
Doctrine tests, pitfalls & exam hypotheticals
10 practice questions + 4 AI-graded essays on this case

Free sample · practice this case

Test yourself

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

In Memphis, Dr. Nolan Price advised Tessa Rowan that a tumor pressing on her spinal cord required prompt surgery. After the operation, Tessa developed a known complication that had not been specifically discussed with her, and she testified that if she had known of that risk, she still would have had the surgery but would have traveled to Knoxville to have a different surgeon perform it.

If Tessa sues for lack of informed consent, which is the strongest argument for Dr. Price on causation?

Explanation. Under the majority opinion, informed-consent causation is judged by an objective standard: whether a reasonably prudent person in the patient's position would not have consented to the procedure if suitably informed. The court specifically held that a plaintiff cannot satisfy this requirement by showing only that she would have selected a different surgeon or facility to perform the same necessary procedure. That is not a different course of treatment. (Derived from Mitchell v. Kayem (n.d.).)