## Facts

- Patty Jo Culbertson consulted gynecologist Dr. Roland B. Mernitz for urinary leakage and vaginal discharge.
- Dr. Mernitz diagnosed stress incontinence associated with a mild cystocele, cervicitis, and multiple uterine fibroid tumors.
- He recommended a Marshall–Marchetti–Krantz bladder suspension and cervical cryosurgery (as an alternative to hysterectomy for cervicitis).
- The parties disputed whether Dr. Mernitz explained general and procedure-specific risks, but agreed he did not disclose a risk that the cervix could adhere to the vaginal wall.
- Culbertson consented and underwent the bladder suspension and cryosurgery.
- After surgery, her cervix adhered to the vaginal wall; another surgeon later performed a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and a second bladder suspension.
- A medical review panel concluded that cervical adhesion was not a risk a reasonably prudent physician would normally disclose for these procedures and found Dr. Mernitz met the informed-consent standard of care.

## Issues

1. Whether Indiana informed-consent liability is governed by a physician-oriented disclosure standard or a “prudent patient” materiality standard.
2. Whether expert medical testimony is required to establish the applicable disclosure standard of care and breach in an informed-consent claim, and whether any common-knowledge exception applies.

## Decision

- The Indiana Supreme Court held Indiana follows a physician-oriented informed-consent standard: the duty is to disclose risks a reasonably prudent physician would disclose under similar circumstances.
- The Court held expert medical testimony is ordinarily required to prove the disclosure standard of care and its breach in informed-consent claims, subject to a narrow common-knowledge exception.
- The Court ruled the alleged nondisclosure of cervix-to-vaginal-wall adhesion was not within lay common knowledge.
- Because the plaintiffs presented no expert evidence to rebut the medical review panel’s opinion, summary judgment for Dr. Mernitz was proper.
- The Court reversed the Court of Appeals and reinstated the trial court’s summary judgment for the defendant.

## Legal Principles

- In Indiana, informed consent is measured by professional medical standards: what a reasonably prudent physician would disclose in the same or similar circumstances.
- Expert medical testimony is generally necessary to establish (1) the scope of the physician’s disclosure duty and (2) whether the physician’s disclosures complied with that duty.
- A medical review panel opinion may serve as expert evidence supporting summary judgment if uncontradicted by competent counter-expert testimony.
- The common-knowledge exception to expert testimony applies only when the alleged lack of care is so obvious that laypersons can evaluate it without medical expertise; technical questions about which risks are ordinarily disclosed typically fall outside the exception.

## Conclusion

Indiana treats informed consent as a malpractice claim governed by a physician-based disclosure standard, and plaintiffs generally must present expert medical testimony to establish and prove breach of that standard; without such evidence, a defense-supported panel opinion can justify summary judgment.


Culbertson v. Mernitz, 602 N.E.2d 98 (Ind. 1992)