Bundrick v. Stewart

114 P.3d 1204, 128 Wash. App. 11
Court of Appeals of Washington·Decided May 2, 2005·No. No. 52001-6-I·Published·Cited by 19 cases

Opinion

¶1 When a patient consents to treatment but wishes to limit the individuals authorized to participate in her care, she must communicate the limitations of her consent. Lori Bundrick sustained serious injuries during surgery at Swedish Medical Center. Among other claims, Bundrick asserted that a University of Washington medical school resident participated in her surgery without her consent, and therefore committed medical battery. Under the facts presented, we affirm dismissal of this claim.

Ellington, A.C.J.

BACKGROUND

¶2 Lori Bundrick had had a tubal ligation to prevent pregnancy. When she and her second husband wished to conceive a child naturally, she attempted to reverse the tubal ligation through a procedure called tubal reanastomosis. Dr. Barry Stewart of Pacific Gynecology Specialists was to perform Bundrick’s surgery at Swedish [14]*14Hospital. Under an affiliation agreement with the University of Washington Medical School, University of Washington residents in training are supervised by doctors at Swedish. Dr. Stewart is a member of the University’s clinical faculty, and was one of the physicians responsible for supervising residents at Swedish.

|3 About a week before the operation, Bundrick met with Stewart. Stewart told her that a resident would be present during the surgery. According to Bundrick, she asked, “They are not going to do my surgery, are they?” and Stewart told her, “[N]o, I will do it all. They are just there to observe.” Clerk’s Papers at 77.1

¶4 Bundrick then signed two consent forms. Neither form indicated that a resident would participate in the surgery. One form, however, contains the following broad statement:

VERIFICATION OF MEDICAL CONSENT: I, the undersigned, hereby consent to all medical treatment or hospital services performed or prescribed by/or at the direction of the attending physician, and the administration and performance of any X-ray examinations, laboratory procedures, anesthesia or other procedures which are considered necessary or advisable. I understand that I or my authorized representative have the right to decide whether to accept or refuse medical care. I will ask for any information I want to have about my medical care and will make my wishes known to the attending physicians and hospital staff.

Clerk’s Papers at 91 (emphasis added).

f 5 Tarun Jain was a third year resident at the medical school. He assisted Stewart during Bundrick’s surgery. Jain testified in his deposition that he performed several tasks during the surgery at Stewart’s direction and under Stewart’s supervision.

¶6 During surgery, Stewart concluded Bundrick’s fallopian tubes could not be reattached, and after speaking [15]*15with Bundrick’s husband, aborted the reanastomosis. Stewart then discovered a tear in the mesentery lining of Bundrick’s bowel, which he and Jain attempted to repair with sutures. The sutures were improperly placed, compromising blood flow to the bowel. This ultimately resulted in massive infection when part of the bowel necrotized and perforated, spilling feculent fluid into the abdominal cavity. Bundrick suffered extreme pain, several hospitalizations, and two surgeries. She was unable to work in the business she owned with her husband, and they were forced to sell the business.

¶7 Bundrick sued Stewart, Pacific Gynecology Specialists, Swedish Medical Center, Swedish Health Services, Swedish Medical Services, the University of Washington, and the State of Washington, alleging injuries resulting from health care under chapter 7.70 RCW. She alleged the defendants were liable for failure to follow the accepted standard of care, failure to obtain consent (medical battery), and failure to obtain informed consent. She did not sue Jain, but alleged that others had vicarious liability for his negligence.

¶8 The University and the State (collectively, “the University”) filed a motion for summary judgment. The court granted the motion in part, dismissing all claims against the University for failure to obtain consent, failure to obtain informed consent, and vicarious liability for Stewart’s acts and omissions. The court denied the University’s motion insofar as it related to vicarious liability for Jain’s alleged failure to comply with the standard of care.

¶9 The case was tried to a jury. At the close of plaintiff’s case, the University moved to dismiss the claim that Jain failed to comply with the standard of care, and the court granted the motion. Thus, all claims against the University were dismissed before the case went to the jury.

¶10 The jury returned a verdict against Stewart and Pacific Gynecology Specialists, P.C. in the amount of $3.2 million. According to the special verdict form, the verdict [16]*16was based on Stewart’s negligence, not his failure to obtain Bundrick’s informed consent to Jain’s participation.

¶11 Stewart appealed. Bundrick filed a cross-appeal, and also appealed dismissal of certain claims against the University. The University cross-appealed. While these appeals were pending, Stewart and Bundrick settled for an amount less than the full judgment, and Bundrick filed a satisfaction of the judgment against Stewart.2

¶12 The issue remaining is Bundrick’s appeal from the summary judgment ruling3 that neither the University nor its resident had a duty to obtain her consent to the resident’s participation in her surgery.

DISCUSSION

¶13 The University first contends the medical malpractice statute, chapter 7.70 RCW, supersedes the common law cause of action for medical battery and replaces it with the statutory claim for failure to obtain informed consent. We disagree.

¶14 The statute authorizes three causes of action: breach of the standard of care, breach of promise that the injury suffered would not occur, and injury resulting “from health care to which the patient. . . did not consent.” RCW 7.70.030(3). This section announces a general cause of action for absence of consent. It makes no reference to informed consent, and nothing in its language indicates the [17]*17legislature intended to eliminate claims for injuries arising from health care to which the patient gave no consent. Elsewhere, the statute sets forth the requirements of informed consent, again without suggesting any limitation on claims for complete lack of consent. RCW 7.70.050.

¶15 An action for total lack of consent sounds in battery, while a claim for lack of informed consent is a medical malpractice action sounding in negligence.4 “The performance of an operation without first obtaining any consent thereto may fall within the concepts of assault and battery as an intentional tort, but the failure to tell the patient about the perils he faces is the breach of a duty and is appropriately considered under negligence concepts.” Miller v. Kennedy, 11 Wn. App. 272, 281-82, 522 P.2d 852 (1974). While Miller preceded the enactment of chapter 7.70 RCW, the legislature is presumed to know the existing state of case law, Price v. Kitsap Transit,

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Bundrick v. Stewart, 114 P.3d 1204, 128 Wash. App. 11 (Wash. Ct. App. 2005).

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