Pacheco v. Ames

110 Wash. App. 912
CourtCourt of Appeals of Washington
DecidedApril 4, 2002
DocketNo. 20144-9-III
StatusPublished
Cited by5 cases

This text of 110 Wash. App. 912 (Pacheco v. Ames) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pacheco v. Ames, 110 Wash. App. 912 (Wash. Ct. App. 2002).

Opinion

Sweeney, J.

— This is a dental negligence case. There is no mystery about what happened. The defendant, Dr. John R. Ames, operated on the lower left side of patient Keith A. Pacheco’s mouth in an attempt to extract a wisdom tooth. As it turns out, there was no wisdom tooth in the lower left portion of Mr. Pacheco’s mouth. The factual dispute presented to the jury was not over what happened — Dr. Ames operated on the wrong side of Mr. Pacheco’s mouth. The question for the jury was rather whether that conduct was excused by Dr. Ames’s reasonable reliance on x rays for[914]*914warded to his office by Mr. Pacheco’s primary dentist, Dr. Thomas Whitfield. And there was ample expert testimony from both sides on this factual dispute. The legal question before us is whether, given this factual scenario, the court erred by allowing the jury to infer negligence based on its res ipsa loquitur instruction. We conclude that it did and reverse and remand for retrial on the question of liability only.

FACTS

Keith Pacheco’s dentist, Dr. Thomas Whitfield, diagnosed Mr. Pacheco with three impacted wisdom teeth. As part of the process he x-rayed Mr. Pacheco’s mouth. He referred Mr. Pacheco to Dr. John Ames for extraction of the teeth. He also sent his x rays to Dr. Ames. The x rays contained an artifact. The artifact looked something like this:

[[Image here]]

See Plaintiff’s Ex. 17. Dr. Ames interpreted the artifact on the x ray as identifying the lower right jaw. He oriented the x ray according to this interpretation and operated on the lower left jaw. But Mr. Pacheco had no wisdom tooth in his lower left jaw. The surgery caused numbness to Mr. Pacheco’s lip and jaw.

Both Mr. Pacheco and Dr. Ames presented expert testimony. Dr. Ames’s expert testified that it was reasonable for Dr. Ames to rely on the x rays and that his interpretation of the ambiguous x-ray marking was not negligent. Mr. Pacheco’s expert testified that Dr. Ames violated the standard of care by not clarifying the x ray prior to the surgery. Clerk’s Papers (CP) at 63.

[915]*915At Mr. Pacheco’s request, the court instructed the jury on the elements of res ipsa loquitur. The jury returned a verdict in Mr. Pacheco’s favor.

RES IPSA LOQUITUR

Dr. Ames assigns error to the res ipsa loquitur instruction. He contends he showed that Mr. Pacheco’s injury could have occurred without his negligence. He also argues that the instrumentality causing the injury here was the x ray which Dr. Whitfield prepared. Mr. Pacheco counters that this is not the type of injury that normally occurs in the absence of someone’s negligence and therefore the res ipsa loquitur instruction was appropriate.

Standard of Review

The trial court has discretion whether to give a particular jury instruction. Boeing Co. v. Key, 101 Wn. App. 629, 632, 5 P.3d 16 (2000), review denied, 142 Wn.2d 1017 (2001); MacSuga v. Spokane County, 97 Wn. App. 435, 441, 983 P.2d 1167 (1999). But the question whether the doctrine of res ipsa loquitur is applicable to a specific factual scenario is a question of law. Zukowsky v. Brown, 79 Wn.2d 586, 592, 488 P.2d 269 (1971); Brown v. Dahl, 41 Wn. App. 565, 580, 705 P.2d 781 (1985). Our review is then de novo. State v. Munguia, 107 Wn. App. 328, 339, 26 P.3d 1017 (2001), review denied, 145 Wn.2d 1023 (2002).

Purpose of Res Ipsa Loquitur

Res ipsa loquitur allows an inference of negligence by a defendant. Kimball v. Otis Elevator Co., 89 Wn. App. 169, 177, 947 P.2d 1275 (1997). It does so when the plaintiff is not in a position to explain the mechanism of injury, and the defendant is. Morner v. Union Pac. R.R., 31 Wn.2d 282, 291, 196 P.2d 744 (1948). The instruction effectively requires the defendant do so. Murphy v. Montgomery Elevator Co., 65 Wn. App. 112, 114, 828 P.2d 584 (1992). The idea is that, because the defendant has the sole and exclusive control of the agency or instrumentality which caused the injury and is in the best position to explain the cause of injury, the [916]*916defendant should be required to produce evidence to explain the injury. Morner, 31 Wn.2d at 291. Res ipsa loquitur then uses circumstantial evidence to prove a defendant’s breach of duty. Douglas v. Bussabarger, 73 Wn.2d 476, 482, 438 P.2d 829 (1968); Tate v. Perry, 52 Wn. App. 257, 262, 758 P.2d 999 (1988).

For example, a patient who suffered a paralyzed arm after undergoing abdominal surgery was entitled to a res ipsa loquitur instruction, because her injury was an extraordinary occurrence and the defendant failed to explain how the accident occurred. Horner v. N. Pac. Beneficial Ass’n Hosps., Inc., 62 Wn.2d 351, 360, 382 P.2d 518 (1963). And waking from general anesthesia a month after surgery with apparent brain damage entitles the plaintiff to an inference of negligence. Pederson v. Dumouchel, 72 Wn.2d 73, 81-82, 431 P.2d 973 (1967). Likewise, a plaintiff whose property was damaged by a broken water main was entitled to a res ipsa loquitur instruction. Metro. Mortgage & Sec. Co. v. Wash. Water Power, 37 Wn. App. 241,244-47, 679 P.2d 943 (1984).

Elements of Res Ipsa Loquitur

To support a res ipsa loquitur instruction, a plaintiff must show that:

(1) the cause of the injury is of a kind that does not ordinarily happen without someone’s negligence,
(2) the injury was caused by an agency or instrumentality within the exclusive control of the defendant, and
(3) the plaintiff was in no way responsible for the cause of the injury.

Kimball, 89 Wn. App. at 177.

There is no dispute that the plaintiff did not contribute to the injury here. And, in fact, the necessity of this third element is questionable since the advent of comparative fault. Kimball, 89 Wn. App. at 177 n.2. At issue here are the first two elements.

[917]*917Here in Washington, three general situations have been identified as sufficient to establish the first element of res ipsa loquitur:

(1) the act causing the injury is so palpably negligent that negligence may be inferred as a matter of law,

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Related

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72 P.3d 244 (Court of Appeals of Washington, 2003)
Pacheco v. Ames
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43 P.3d 535 (Court of Appeals of Washington, 2002)

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