Bradford v. Winter

215 Cal. App. 2d 448, 30 Cal. Rptr. 243, 1963 Cal. App. LEXIS 2519
CourtCalifornia Court of Appeal
DecidedApril 24, 1963
DocketCiv. 26648
StatusPublished
Cited by6 cases

This text of 215 Cal. App. 2d 448 (Bradford v. Winter) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bradford v. Winter, 215 Cal. App. 2d 448, 30 Cal. Rptr. 243, 1963 Cal. App. LEXIS 2519 (Cal. Ct. App. 1963).

Opinion

ASHBURN, J.

Plaintiff Thomas W. Bradford appeals from the judgment in favor of defendant Benjamin Winter, rendered by the trial court sitting without a jury. Plaintiff’s causes of action are based on alleged malpractice and battery.

Viewing the evidence in the manner most favorable to respondent, as we are required to do (Crawford v. Southern Pac. Co., 3 Cal.2d 427, 429 [45 P.2d 183]; Estate of Arstein, 56 Cal.2d 239, 240 [14 Cal.Rptr. 809, 364 P.2d 33]), the facts appear to be as follows. Plaintiff was referred by Dr. Rood, a general practitioner, to the defendant, a well-qualified and experienced thoracic surgeon. Plaintiff’s X-rays which came with him showed a mass in the right lung. Dr. Rood told plaintiff they showed a shadow on the lung and asked that the family come to see him. This they did and Dr. Rood advised them that tests were necessary to determine whether appellant had cancer of the lung. And when he went to the hospital he knew he was going to have a test made. Upon entry he signed an admittance sheet containing the following consent: “I hereby consent to any medical or surgical procedure, including operating and anesthesia which my physician(s) may consider necessary or advisable in the treatment of my ease.” From examination of the X-rays defendant Winter formed a tentative opinion that appellant had a cancer. The history and examination of the patient reinforced his tentative opinion. Defendant explained to the plaintiff that he wanted to do a bronchoscopy to help diagnose *451 the lesion and that in any event surgery would probably be necessary to remove all or part of the lung. Defendant told plaintiff that the bronchoscopy consisted of passing a brass tube down the plaintiff’s throat so that he could look inside the bronchial tubes to see if he could find anything abnormal and examine it if he did. Defendant said the mass was a threat to plaintiff and would have to be investigated and “this satisfied him completely.” “If it has to be done, let us get on with it.” Plaintiff signed a written consent which is hereinafter quoted.

A biopsy is part of the bronchoscopy when an abnormality is found during bronchoscopy.

The bronchoscope was passed down into the right bronchus. At one point in this area the tissues appeared abnormal, with narrowing of the bronchus extending concentrically around it and indicating that a tumor of some sort outside the bronchus was producing the narrowing. At one point it was indicated that the process had extended into the wall of the bronchus and perhaps the mucosal lining in which there did not appear to be any break.

Respondent decided to take a biopsy of the mucosa and the tissue in the wall of the bronchus just beneath it in order to see if a diagnosis of the disease process could be established by the pathologist.

It was advisable to obtain tissue below the mucosa, since there was no apparent defect in it and if the mucosa was normal a pathological diagnosis could only be established from the tissues beneath it. It was important in appellant’s ease to establish a diagnosis, if possible.

Accordingly, and at the point where the tissues appeared abnormal, respondent, using biopsy forceps specifically made for the purpose, attempted under direct vision to obtain a biopsy specimen. The point at which the biopsy bite was taken was on the posterior wall at the division of the main stem bronchus into additional bronchi. Respondent took the normal and usual biopsy bite just as he had done in hundreds of other cases without any complication. The bite did not perforate or go through the wall of the bronchus, was definitely within the wall, and was not a deep bite except in the descriptive sense indicating that it was intended to and did go below the mucosal lining, which is paper thin. The bronchial wall at this point is about one-eighth to three-sixteenths of an inch thick.

An unexpected sudden massive hemorrhage immediately *452 occurred, the hemorrhage coming from a relatively large vessel, probably a pulmonary artery of a size not normally encountered or expected in the bronchial wall, presenting a most unusual and rare situation.

There was no reason for respondent to believe, based upon his experience, that he would encounter at the biopsy site either a pulmonary artery or any other vessel of the size indicated by the type of hemorrhage which occurred. Dr. Prietto, a well-qualified expert, testified in substance that there probably was an anomalous artery pushing into or within the wall of the bronchus at the location of the biopsy, a place where it ordinarily would not be located and which there was no reason to suspect from the findings at bronchoscopy.

By application of adrenalin swabs and pressure through the bronchoscope bleeding into the bronchus was stopped but, because of the danger of a fatal rehemorrhage, an emergency thoracotomy (incision of the wall of the chest) was advisable and in respondent’s opinion the only sensible course under the circumstances.

Respondent then told appellant, who was conscious and able to comprehend, that an unexpected severe hemorrhage had occurred, that it was controlled for the time being, but that he thought it was in appellant’s best interests to proceed with the surgery previously discussed and appellant agreed.

Because any motion, including that involved in getting appellant to sign the consent to the proposed surgery, might cause fatal hemorrhaging, a nurse was instructed to contact appellant’s wife who came to the hospital where the matter was explained to her and she signed the consent to the proposed surgery.

At the surgery, when the right chest was opened, the right lung from its appearance and by palpation and feeling appeared malignant and the disease appeared not only to involve the main pulmonary artery to the lung but to have spread to the pleura. Respondent, in view of these findings, because the lower lobe of the lung had to be removed in any event due to the hemorrhage and because it was not technically possible to remove only the lower and upper lobes leaving the middle lobe, performed a pneumonectomy (excision) of the right lung.

The appellant makes the following arguments: (1) That a technical assault and battery was committed because appel *453 lant was not expressly told that a biopsy might be taken and, therefore, respondent did not obtain appellant’s consent to the biopsy; (2) that if there was consent to the biopsy, that consent was vitiated because respondent misled appellant and failed in a claimed duty to disclose information to appellant concerning the bronchoscopy and biopsy, but for which appellant would not have consented; (3) that respondent, as a matter of law, was guilty of malpractice.

The trial judge found that there was no negligence on defendant’s part and no battery. The ruling was based upon substantially conflicting evidence. Appellant approaches the appeal as if the court of review would reweigh the evidence, saying: “Plaintiff will limit the points on appeal to those wherein there is little or no conflict in the evidence.

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Cite This Page — Counsel Stack

Bluebook (online)
215 Cal. App. 2d 448, 30 Cal. Rptr. 243, 1963 Cal. App. LEXIS 2519, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bradford-v-winter-calctapp-1963.