## Facts

- Betty J. Bly suffered female health problems for about eight years and received treatment from multiple physicians and institutions.
- In April 1970, she consulted Dr. John C. Rhoads, an obstetrician–gynecologist in Prince William County, Virginia, who recommended a laparotomy with a possible hysterectomy.
- Bly consented; Dr. Rhoads performed a hysterectomy.
- Bly later experienced significant complications requiring additional surgery.
- Bly sued alleging (1) failure to disclose the risks, complications, dangers, and alternatives associated with the hysterectomy (informed consent), and (2) negligent performance of the surgery (breach of the medical standard of care).
- Bly presented an expert physician from outside the local area; the trial court found the expert not sufficiently familiar with the medical practices in the same or a similar community to establish the applicable standard of care.
- With no other competent expert evidence, the trial court struck Bly’s evidence at the close of her case and entered judgment for Dr. Rhoads.

## Issues

1. Whether a plaintiff must present physician expert testimony to establish the existence and scope of a physician’s duty to disclose risks and alternatives under the informed-consent doctrine.
2. Whether malpractice by a medical specialist in Virginia should be judged by a national standard rather than the “same or similar community” standard.
3. Whether hospital medical-staff by-laws and hospital accreditation rules are admissible in a malpractice action against a physician who is a member of the hospital staff.

## Decision

- The Supreme Court of Virginia affirmed the judgment for Dr. Rhoads.
- The court held that, in an informed-consent claim, the plaintiff must prove through qualified medical experts the existence and extent of the disclosure duty in the particular case, including what information should be disclosed and to what extent.
- The court reaffirmed that Virginia applies the “same or similar community” standard to physicians, including specialists, and declined to adopt a national standard by judicial decision.
- The court did not decide the admissibility of hospital by-laws and accreditation rules because the issue was moot given the failure of proof on expert testimony.

## Legal Principles

- A physician has a general duty to disclose material risks and alternatives, but failure to warn is not established merely by a bad outcome; the plaintiff must prove the existence and scope of the duty in the particular circumstances.
- In informed-consent litigation, expert medical testimony is required to establish what a reasonably prudent physician would disclose under the applicable professional standard.
- In Virginia, the standard of care for malpractice—whether involving a general practitioner or a specialist—is measured by the practice in the same or a similar community, absent legislative change.
- Appellate courts will not decide evidentiary questions rendered irrelevant when the plaintiff’s case fails as a matter of law for lack of essential proof.

## Conclusion

The court upheld judgment for the defendant physician because the plaintiff failed to present competent expert testimony establishing the disclosure duty and the applicable standard of care, reaffirming Virginia’s same-or-similar-community rule for specialists and treating the hospital by-laws evidentiary issue as moot.


Bly v. Rhoads, 222 S.E.2d 783 (Va. 1976)