Also known as: medical standards of care · standard of care
Written by attorneys — see sources below.
A professional duty requiring a physician to possess and exercise the degree of skill, care, and diligence that is customarily exercised by competent practitioners in the same specialty under similar circumstances. Expert testimony is ordinarily required to establish the content of that standard and to show whether the physician met it.
Mina Mehta, an emergency physician, left a patient with clear signs of internal bleeding unattended for hours while she handled routine paperwork. The patient died. Prosecutors charged Mehta with involuntary manslaughter, alleging her inaction constituted a gross deviation from the medical standard of care that created a high risk of death.
Melissa Mills, a general surgeon, failed to order a preoperative blood-type cross-match despite the patient's known clotting disorder and the scheduled major abdominal procedure. The patient hemorrhaged on the table and died. The state charged Mills with negligent homicide, claiming she should have perceived the substantial risk that her omission created.
Monica Morgan, a seventeen-year-old hospital orderly, was permitted to transport a critically ill infant between units without supervision. The infant suffered permanent brain damage when the oxygen tank ran empty. The family sued, and the court applied the adult reasonable-person standard because transporting unstable patients is an adult medical activity.
Meredith Maxwell underwent robotic surgery performed by Dr. Miguel Mendoza. Mendoza never disclosed the known risk of bowel perforation that occurs in five percent of such procedures at his hospital. After suffering that exact complication, Maxwell sued for lack of informed consent, claiming Mendoza violated the medical standard of care by failing to discuss material risks.
Mrs. Scott’s physician advised her she had several fibroid tumors on her uterus and referred her to defendant surgeon. Defendant admitted her to the hospital where she signed a routine consent form prior to defendant’s performing a hysterectomy. After surgery, Mrs. Scott experienced problems with incontinence. She visited another physician who discovered she had a vesico-vaginal fistula which permitted urine to leak from her bladder into the vagina. This physician referred her to an urologist who, after three surgeries, succeeded in correcting her problems. Mrs. Scott, joined by her husband, filed the present action alleging medical malpractice, claiming defendant failed to advise her of the risks involved or of available alternatives to surgery. She further maintained had she been properly informed she would have refused the surgery. The case was submitted to the jury with instructions to which plaintiffs objected. The jury found for defendant and plaintiffs appeal. In plaintiffs’ amended appeal brief it is suggested that the trial court erred in failing to instruct the jury on the issue of defendant’s abandonment of plaintiff post surgery. Although plaintiffs did offer two requested instructions on this issue, not given, they did not set them out in their brief as required by the rules of this Court, 12 O.S. 1971, Ch. 15, App. 1, Rule 15.
View caseMonarch Pharmaceuticals sold a pacemaker lead whose design complied with federal manufacturing regulations. A patient suffered lead fracture and sued, alleging the design fell below the medical standard of care. The manufacturer moved for summary judgment on preemption grounds, arguing federal requirements displaced any state tort standard.
In 1976, Congress enacted the Medical Device Amendments to the Federal Food, Drug, and Cosmetic Act in response to concerns over defective devices such as the Dalkon Shield intrauterine contraceptive. The amendments established a regulatory framework classifying devices into three classes based on risk, with Class III devices like pacemakers requiring premarket approval unless they qualified for an exemption. In October 1982, Medtronic, Inc. notified the FDA that its Model 4011 pacemaker lead was substantially equivalent to pre-1976 devices, and the FDA cleared it for marketing under the §510(k) process. In 1982, Lora Lohr underwent surgery in Florida to receive a Medtronic pacemaker equipped with the Model 4011 lead. Five years later, on December 30, 1990, the device failed, allegedly causing a complete heart block that required emergency surgery; her physician attributed the failure to a defect in the lead. Lohr and her husband subsequently filed suit in Florida state court in 1993, asserting claims for negligent design, negligent manufacture, failure to warn, and strict liability based on an unreasonably dangerous product. Medtronic removed the action to the United States District Court for the Middle District of Florida. The district court initially denied Medtronic's motion for summary judgment but later dismissed the entire complaint after the Eleventh Circuit's decision in a related case, concluding that the claims were preempted by the MDA. On appeal, the Court of Appeals for the Eleventh Circuit affirmed in part and reversed in part, holding that the design defect claims were not preempted while the manufacturing and failure-to-warn claims were preempted by general federal regulations. The Lohrs and Medtronic both petitioned for certiorari, and the Supreme Court granted review to address the conflict among the circuits regarding the preemptive scope of the MDA's preemption provision. The case was argued on April 23, 1996, and decided on June 26, 1996.
View caseMatrix Technologies hired Michelle Murphy, a paid workflow consultant, to redesign an operating-room layout. Murphy omitted standard sponge-count and instrument-tracking procedures used by comparable hospitals. A retained sponge caused a patient's fatal infection. The hospital sued Murphy, alleging breach of the professional standard of care expected of a compensated medical-systems consultant.
Osborne Computer Corporation was founded in 1980 by entrepreneur Adam Osborne and began manufacturing the Osborne I portable personal computer for the mass market, with shipments starting in 1981. By fall 1982, sales of the company's sole product had reached $10 million per month, making the company one of the fastest growing enterprises in the history of American business. In 1981 and again in 1982, the company retained Arthur Young & Company to audit its financial statements and issue audit reports. Arthur Young issued unqualified audit opinions on the company's 1981 and 1982 financial statements. The 1982 opinion was issued on February 11, 1983, appeared on Arthur Young's letterhead addressed to the company, and 100 copies of the professionally printed opinion were personally delivered to the company. The 1982 financial statements reported a modest net operating profit of $69,000 on sales of more than $68 million. In late 1982 the company postponed a planned initial public offering and instead issued warrants to investors in exchange for bridge financing loans or letters of credit. Plaintiffs, a group that included individuals as well as pension and venture capital funds, invested in the company in early 1983; one plaintiff, Robert Bily, purchased 37,500 shares of stock from Adam Osborne for $1.5 million. With one exception, plaintiffs testified that they made their investments in reliance on Arthur Young's unqualified 1982 audit opinion. After the warrant transaction closed on April 8, 1983, sales declined sharply because of manufacturing problems with the company's new Executive model computer, the public offering never occurred, and the company filed for bankruptcy on September 13, 1983, causing plaintiffs to lose their investments. Plaintiffs brought separate lawsuits against Arthur Young in Santa Clara County Superior Court that were consolidated for trial. Plaintiffs' expert witness identified more than 40 deficiencies in the 1982 audit amounting to gross professional negligence, including an understatement of liabilities by approximately $3 million that turned the reported $69,000 profit into a loss of more than $3 million, and testified that Arthur Young had discovered but failed to disclose material weaknesses in the company's internal accounting controls. After a 13-week trial the jury returned a verdict for plaintiffs on the professional negligence claim and awarded approximately $4.3 million in compensatory damages, but found for Arthur Young on the fraud and negligent misrepresentation claims. The trial court granted Arthur Young's motion for judgment notwithstanding the verdict on the negligence claim. The Court of Appeal reversed the judgment in favor of Arthur Young. The Supreme Court of California granted review.
View caseThe traditional rule looked only to the local medical community where the physician practiced. Most courts now apply a broader standard drawn from the same or similar communities, and some jurisdictions have adopted a national standard.
Yes. Because the standard is defined by medical custom rather than ordinary reasonable-person care, expert testimony is necessary to establish both the content of the standard and whether the defendant physician met it.
Yes. A specialist must meet the standard of care customarily exercised by competent practitioners in that same specialty, not merely the standard applicable to general practitioners.
…concluded that the States could constitutionally allow private individuals to recover damages for defamation on the basis of any standard of care except liability without fault. MR. JUSTICE MARSHALL dissented in Rosenbloom in an opinion joined by MR. JUSTICE STEWART. Id., at 78 . He thought that the plurality's "public or general…