Carbone v. Warburton

91 A.2d 518, 22 N.J. Super. 5
CourtNew Jersey Superior Court Appellate Division
DecidedOctober 6, 1952
StatusPublished
Cited by27 cases

This text of 91 A.2d 518 (Carbone v. Warburton) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carbone v. Warburton, 91 A.2d 518, 22 N.J. Super. 5 (N.J. Ct. App. 1952).

Opinion

22 N.J. Super. 5 (1952)
91 A.2d 518

FRANK CARBONE, PLAINTIFF-APPELLANT,
v.
JACK C. WARBURTON, DEFENDANT-RESPONDENT

Superior Court of New Jersey, Appellate Division.

Argued August 4, 1952.
Decided October 6, 1952.

*8 Before Judges WAESCHE, HUGHES and FRANCIS.

Mr. Leo Rosenblum argued the cause for plaintiff-appellant.

Mr. Frederick C. Vonhof argued the cause for the defendant-respondent (Mr. William P. Braun, attorney).

The opinion of the court was delivered by FRANCIS, J.C.C. (temporarily assigned).

Appellant, Carbone, sued respondent, Warburton, a medical doctor, charging malpractice. At the trial Carbone offered one Dr. Sidney D. Jacobson, a New York physician, as an expert witness. After direct and cross-examination as to his qualifications, the trial court declared that he was not qualified and declined, on objection, to allow him to testify. Counsel then informed the court for the record that he intended to prove through the witness, by way of answer to certain hypothetical questions, that the defendant's treatment of Carbone "was not in accordance with the standards of skill, care and knowledge usually exercised by members of his profession." No other expert being produced, the action was dismissed for lack of proof of defendant's negligence. From the consequent judgment this appeal was taken.

The complaint recites that on July 21, 1946 appellant suffered a comminuted fracture of the left tibia and fibula about six inches above the ankle joint and that the defendant treated him on that day at St. Joseph's Hospital, Paterson, New Jersey. The specifications of negligence against him, as set out in the pretrial order, are that he malaligned the fracture and that he failed: (1) to remove infectious and other substances from the site of the fracture, thus causing *9 the soft tissues and bone to become infected, (2) to administer anti-tetanus treatments, (3) to irrigate the fracture properly, (4) to make proper inspections of the fracture, and (5) to "supervise" the injury properly after the leg was placed in a cast.

It is admitted that respondent is a licensed medical doctor of New Jersey and that he treated appellant for a fractured left leg. Beyond this admission the appendix before us does not disclose whether the treatment was administered in the capacity of general practitioner or specialist, and therefore we assume that it was given as a general practitioner.

Accordingly, what duty did Dr. Warburton owe Carbone? The law is clear that when a physician accepts a patient he is required to have and to exercise in the diagnosis and treatment the skill normal to the average member of the profession. Hull v. Plume, 131 N.J.L. 511 (E. & A. 1944); Lolli v. Gray, 101 N.J.L. 337 (E. & A. 1925); Gramaldi v. Zeglio, 3 N.J. Misc. 669 (Sup. Ct. 1925); Klitch v. Betts, 89 N.J.L. 348, 353 (E. & A. 1916); Policastro v. Lahnecker, 12 N.J.L.J. 269 (Sup. Ct. 1889); Smith v. Corrigan, 100 N.J.L. 267, 272 (Sup. Ct. 1924); Restatement of the Law — Torts, sec. 299 d; 41 Am. Jur., Physicians and Surgeons, sec. 82, p. 200; sec. 87, p. 205. In application this general rule may be related to the grade or class or type of physician involved without difficulty. If he is a general practitioner he must use in the care of his patient the skill normal to the average member of his profession practicing as such. Policastro v. Lahnecker, supra. On the other hand, one who holds himself out as a specialist must employ not merely the skill of a general practitioner, but also that special degree of skill normally possessed by the average physician who devotes special study and attention to the particular organ or disease or injury involved, having regard to the present state of scientific knowledge. Coleman v. Wilson, 85 N.J.L. 203 (E. & A. 1913); Hopkins v. Heller, 59 Cal. App. 447, 210 P. 975, 976 (Dist. Ct. App. 1922).

*10 When a physician is charged with negligence in the diagnosis or treatment of a patient's condition it must appear that he departed from the degree of skill required of him. And in order to demonstrate this ultimate fact two elements of proof are essential. First, those standards must be established which are generally recognized and accepted by the branch of the profession to which he belongs as the customary and proper methods of diagnosis or treatment of the physical or mental condition concerned in the inquiry. Secondly, a departure from such standards under circumstances justifying the conclusion of want of the requisite degree of care. Hull v. Plume, supra; Sinz v. Owens, 33 Cal.2d 749, 205 P.2d 3, 8 A.L.R.2d 757 (Sup. Ct. 1949) McGraw v. Kerr, 23 Colo. App. 163, 128 P. 870 (Ct. App. 1912); Anderson v. Chasney, 4 D.L.R. 458 (K.B. 1948); Adolay v. Miller, 60 Ind. App. 656, 111 N.E. 313 (App. Ct. 1916); Adkins v. Ropp, 105 Ind. App. 331, 14 N.E.2d 727 (Ind. App. Ct. 1938); Hill v. Parker, 122 P.2d 476, 12 Wash.2d 517 (Sup. Ct. 1942); Fritz v. Horsfall, 163 P.2d 148, 24 Wash.2d 14 (Sup. Ct. 1945); 7 Wigmore on Evidence, sec. 2090 (a), p. 453; Rogers, Expert Testimony, sec. 165.

The establishment of the standards of practice and departure therefrom is a matter for expert testimony, except in those unusual cases where the conduct required by the particular circumstances is within the common knowledge of laymen. Hull v. Plume, supra; Sinz v. Owens, supra; McGraw v. Kerr, supra; Anderson v. Chasney, supra; 7 Wigmore on Evidence, sec. 2090 (a), p. 453; Rogers, Expert Testimony, sec. 153, p. 361. It seems plain that what constitutes proper treatment is a medical question to be presented by experts and that neither the courts nor jurors can be permitted to say or to speculate as to what technique should be utilized for a certain disease or injury or how a specific surgical operation should be conducted. As the King's Bench put it in Anderson v. Chasney, supra, the courts "are dependent upon the medical profession for evidence of the proper routine, *11 treatments and technique." If no standard is established through medical witnesses, then the jury has no standard by which to gauge the basic issue of fault of the physician. McGraw v. Kerr, supra.

In this connection the need for expert testimony does not mean that the witness must be a specialist, although the fact that he is not may be taken into consideration in weighing his testimony. 54 A.L.R. 860, 861; Rogers, Expert Testimony, sec. 156, p. 365. "Expert" here means skilled, that is, that the witness possesses special knowledge and skill upon the subject matter about which he is called to testify. 20 Am. Jur., Evidence, sec. 784. And, of course, it has long been established that a person may qualify as an expert in this sense through actual experience or theoretical knowledge based upon special study of the subject. Rogers, Expert Testimony, sec. 176, p. 384; 20 Am. Jur., Evidence, secs. 783, 784.

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