Stover v. Association of Thoracic

635 A.2d 1047, 431 Pa. Super. 11, 1993 Pa. Super. LEXIS 3801
CourtSuperior Court of Pennsylvania
DecidedNovember 8, 1993
Docket1180
StatusPublished
Cited by27 cases

This text of 635 A.2d 1047 (Stover v. Association of Thoracic) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stover v. Association of Thoracic, 635 A.2d 1047, 431 Pa. Super. 11, 1993 Pa. Super. LEXIS 3801 (Pa. Ct. App. 1993).

Opinion

FORD ELLIOTT, Judge:

Appellants bring the instant appeal following the trial court’s denial of their post-trial motions for judgment n.o.v. *14 and for a new trial. Additionally, the court added delay damages to the jury’s verdict. Judgment in the amount of $1,347,609.53 was thereafter entered on June 23, 1992.

Appellee brought suit against appellants for failure to obtain her informed consent prior to an operation. This was the only legal theory pursued at trial and negligence was not at issue.

Appellee contracted rheumatic fever as a child. This illness can, and in appellee’s case actually did, result in damage to the valves of the heart. Appellee’s condition had deteriorated to the point that she sought medical attention from appellants, an association of surgeons. A physician with appellants, Dr. William B. Ford, informed appellee that she would need a heart valve replacement.

Dr. Ford only briefly reviewed the details of the necessary surgery with appellee. He testified that he discussed replacement valves with appellee, mentioning tissue valves and a mechanical valve known as the Beall valve. 1 He indicated that the tissue valve was relatively new and that the Beall valve had been used for many years. It was the Beall valve which was implanted in appellee. Appellee stated that she was apprised by Dr. Ford only that mechanical valves outlasted natural tissue valves. She denied that she was ever told of the risks attendant to the implantation of mechanical valves, and in particular the Beall valve, including the danger of the development of dangerous thromboemboli and strokes, as well as the consequent need to submit to a lifelong regimen of anticoagulents.

*15 Dr. Ford did not perform appellee’s surgery. Another physician associated with appellants, Dr. Emir Zikria, actually conducted the implantation procedure. Dr. Zikria testified that he did not recall his meeting with appellee. Dr. Zikria did testify at some length as to the clotting risks involved with the mechanical valve implantation and with the need to take blood thinning agents thereafter. Dr. Zikria asserted that these risks would have been explained to the patient in the ordinary course of pre-surgical consultations, but that it was his customary practice to reiterate the risks immediately prior to surgery. He did not specifically recall reviewing these risks with appellee. Dr. Zikria also reviewed the consent form which appellee signed. His testimony notes that the form mentions neither the threat of thromboemboli, nor the need for anti-coagulents.

Following appellee’s operation, she suffered multiple episodes of debilitating thromboemboli. These occurrences were found to be caused by the valve implanted in appellee. Appellee was left with severe, permanent brain damage. Subsequently, a natural tissue heart valve was implanted.

Appellee brought suit against appellants solely on the basis of lack of informed consent. Negligence was not pleaded. The jury returned a verdict for appellee to which the court added delay damages. Post-trial motions were denied and appellants appealed. On appeal, appellants’ request for relief is limited to a new trial.

Appellants raise the following issues on appeal:

I. In an action based solely on the doctrine of informed consent, is it error for the trial court to permit evidence of distinctions between different types of replacement heart valves and of the knowledge thereof in the medical community?
II. Is evidence regarding what replacement heart valves are or are not in ‘general use’ relevant to an action based on the doctrine of informed consent?
III. Should the trial court have answered in the negative the jury’s question asking whether doctors are legally *16 bound to explain all the aspects of informed consent to the patient even if the patient waives that they do so?

We will address these matters seriatim.

Preliminarily, we note our standard of review as pertains to the review of a denial of a motion for a new trial:

We may not reverse an order denying a motion for a new trial unless the trial court clearly and palpably abused its discretion or committed an error of law that controlled the outcome of the case. See Thompson v. City of Philadelphia, 507 Pa. 592, 493 A.2d 669 (1985); Gray v. H.C. Duke and Sons, Inc., 387 Pa.Super. 95, 563 A.2d 1201 (1989).

Sundlun v. Shoemaker, 421 Pa.Super. 353, 358, 617 A.2d 1330, 1333 (1992).

Furthermore, as two of appellants’ issues involve the admission of evidence, we observe:

The admission of evidence is within the sound discretion of the court and the court’s decision will not be reversed in the absence of a clear abuse of discretion. Lewis v. Pruitt, 337 Pa.Super. 419, 487 A.2d 16 (1985); McCrery v. Scioli, 336 Pa.Super. 455, 485 A.2d 1170 (1984).

Hatbob v. Brown, 394 Pa.Super. 234, 575 A.2d 607, 613 (1990).

The most difficult question presented by appellants in this appeal is that which they pose initially. Appellants couch the issue in terms of whether the trial court properly admitted evidence regarding the distinctions between various replacement heart valves because such evidence is irrelevant and prejudicial. However, the real issue which appellants pursue in the argument portion of their brief is that such evidence is inadmissible because the selection of a particular heart valve and its subsequent complications do not involve an issue of informed consent under Pennsylvania law. 2 Appellants rely on a recent case from this court, Wu v. Spence, 413 Pa.Super. 352, 605 A.2d 395 (1992), allocatur granted, 533 Pa. 613, 618 A.2d 402 (1992), to be addressed infra in support of *17 this proposition. 3 Moreover, the trial court characterized the central issue on appeal as follows:

The major legal issue in this case is whether the doctrine of informed consent reaches the selection of the valve to be installed in the patient. Defendant contends that its physicians were required only to obtain the patient’s informed consent to undergo open-heart surgery. The selection of the valve to be installed in the patient is a matter for the physician rather than the patient under Pennsylvania informed consent law.

Trial court opinion at 11.

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Bluebook (online)
635 A.2d 1047, 431 Pa. Super. 11, 1993 Pa. Super. LEXIS 3801, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stover-v-association-of-thoracic-pasuperct-1993.