Ybarra v. Spangard

Supreme Court of California · 1944 · Torts

Tortsres ipsa loquiturmedical malpracticemultiple defendantsunconscious plaintiffres ipsa loquiturmedical treatmentunconscious patient

Facts

Plaintiff entered a hospital for an appendectomy arranged by Dr. Tilley, to be performed by Dr. Spangard at a hospital owned and managed by Dr. Swift. After being positioned on the operating table by the anesthetist and rendered unconscious, plaintiff awoke the next morning with sharp pain in his right shoulder area, a part of his body not involved in the appendectomy, and he later developed paralysis and muscle atrophy in the arm and shoulder. Plaintiff had no prior pain or injury in that area, and medical testimony indicated the condition was caused by trauma or pressure or strain between the shoulder and neck. Plaintiff could not identify which defendant or instrumentality caused the injury while he was unconscious.

Issue

Whether res ipsa loquitur can be invoked when an unconscious patient suffers an unusual injury to a healthy part of the body during medical treatment, even though the plaintiff cannot identify the specific defendant or instrumentality that caused the injury. More specifically, the question was whether the doctrine may apply against multiple medical defendants who had control over the plaintiff's body or possible instrumentalities during the period of unconsciousness.

Rule

Res ipsa loquitur ordinarily requires that (1) the accident be of a kind that ordinarily does not occur absent negligence, (2) it be caused by an agency or instrumentality within the defendant's exclusive control, and (3) it not be due to any voluntary action or contribution by the plaintiff. In the setting of an unconscious patient receiving medical treatment, where the plaintiff suffers an unusual injury to a healthy part of the body, all defendants who had any control over the plaintiff's body or the instrumentalities that might have caused the injury may be called upon to explain their conduct, even if the plaintiff cannot identify the particular defendant or instrumentality.

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

Nina Patel entered a surgical center in Phoenix for wrist surgery. After anesthesia was administered, she lost consciousness, and when she awoke she had a deep bruise and nerve damage in her left thigh, a healthy area unrelated to the operation; she cannot identify whether the surgeon, anesthetist, circulating nurse, or recovery nurse caused it.

May Nina rely on res ipsa loquitur against all of those medical defendants at the outset?

Explanation. The majority held that when a plaintiff is unconscious during medical treatment and suffers an unusual injury to a healthy part of the body outside the treatment area, res ipsa loquitur may apply even though the plaintiff cannot identify the specific negligent actor or instrumentality. All defendants who had any control over the plaintiff's body or possible instrumentalities may be called on to explain. The doctrine is not defeated merely because multiple defendants or multiple possible instrumentalities are involved.