Gonsalves v. Sharp Healthcare (Summary)

NEGLIGENCE:  INFORMED CONSENT

Gonsalves v. Sharp Healthcare, No. D060514 (Cal. Ct. App. Jan. 30, 2013)

In this medical malpractice case, the California Court of Appeal reversed a trial court’s grant of summary judgment to a hospital.  A patient underwent open heart surgery at the hospital.  Days later, she developed fluid around her lungs.  Her pulmonologist ordered insertion of a tube to drain the fluid, but expected the practitioner who performed the procedure to discuss it with the patient.  Nurses from the hospital called the patient to obtain her consent to the procedure.  Since the patient had dementia, her daughter consented to the procedure for her, allegedly without being informed of the risks or benefits associated with it.  The physician who inserted the tube also did not discuss it with the patient before beginning.  During surgery, he punctured her aorta.  The patient died two years later, allegedly due in part to the physiological stress caused by the puncture and related injuries.  The family of the deceased patient then sued the hospital and doctors for malpractice, wrongful death, and battery.

As to the medical malpractice and wrongful death claims, the hospital challenged the causal connection between the puncture and the patient’s death two years later.  As to the battery claim, it argued that there was no evidence that anyone but the doctor who performed the procedure had touched the patient.  Finally, the hospital also argued that it was the doctor, not the nurses, who should have provided informed consent.  Therefore, it reasoned that it could not be liable, since it could only be liable for the acts of the nurses, as employees, not the acts of the doctor, an independent contractor.  The trial court accepted these arguments and granted summary judgment in favor of the hospital.

The appellate court reversed, finding that it was possible that the puncture and related injuries caused the patient’s death. Because touching a patient without informed consent constitutes medical negligence in California, rather than battery, and because wrongful death claims are essentially medical malpractice claims, where the alleged negligence results in the death of the patient, the appellate court analyzed all of the claims under the umbrella of medical malpractice. First, it reviewed the trial court’s decision to see if there was evidence of a causal connection between the puncture and the patient’s death. To show a causal connection, the patient’s family needed to provide evidence that a reasonable person would not have undergone the procedure, if aware of the risk of the puncture. Thereafter, the hospital had the chance to show that the particular patient still would have gone ahead with the procedure, even if informed of the risks. The patient’s family and the hospital presented conflicting evidence as to whether a reasonable person would have gone through with the procedure after being informed of the risk of puncture. Since an issue of fact remained with respect to causation, the appellate court reversed the grant of summary judgment in favor of the hospital and remanded the case for further proceedings.