Luettke v. St. Vincent Mercy Med. Ctr.

MALPRACTICE – EVIDENCE

Luettke v. St. Vincent Mercy Med. Ctr., No. L-05-1190 (Ohio Ct. App. July
28, 2006)

An Ohio appeals court held that a hospital’s policies and medical
staff rules and regulations could be entered into evidence in a malpractice
case for the purpose of establishing the standard of care. In this case, a
patient sued her anesthesiologist, nurse anesthetist, and student nurse anesthetist
after her esophagus was punctured by the student, who was performing unsupervised
anesthesiology services for over an hour of the patient’s surgery. The patient
alleged medical malpractice and lack of informed consent. Among other things,
the patient complained that she was never told that a student would be participating
in her anesthesia. At trial, the lower court excluded evidence related to the
hospital’s internal policies regarding informed consent, patient rights, and
the supervision of anesthesia procedures performed by student nurses. Notably,
those policies required all anesthesia procedures to be performed in the presence
of an anesthesiologist and that all patients be informed of the name and professional
status of their health care providers, including whether the provider is engaged
in a clinical training program. In excluding those policies from evidence,
the court reasoned that expert testimony – not hospital documents – establishes
the standard of care in a medical setting. The patient appealed after losing
at the trial level. She argued that the hospital’s policies were crucial in
determining the proper standard of care. The Court of Appeals of Ohio agreed,
holding that expert testimony is not the exclusive basis for establishing the
standard of care. The court noted that the hospital’s rules and regulations
were promulgated to ensure that employees and contracting physicians followed
a consistent standard of quality care. The court also ruled that the consent
form used in this particular operation was clearly invalid since it referred
to the administration of anesthesia under the supervision of an anesthesiologist.