## Facts

- Jessica Dardeau (age 28) sought gynecological care from Dr. James A. Ardoin for routine examinations.
- Dardeau alleged Ardoin recommended and performed extensive pelvic surgery (including bladder suspension, cystocele and rectocele repairs, hysterectomy, and oophorectomy) and that the cystocele procedure injured her obturator nerve, causing permanent right-leg paralysis.
- The defense contended Dardeau reported stress urinary incontinence and other pelvic complaints; Ardoin’s exam documented cystocele, rectocele, and uterine descent.
- Ardoin initially recommended conservative treatment and follow-up; after persistent complaints and diagnostic studies, he recommended surgery to address urinary incontinence and pelvic defects.
- Ardoin died in 1994; Dardeau proceeded against his malpractice insurer, Louisiana Medical Mutual Insurance Company (LAMMICO), after related estate defendants were dismissed without prejudice.
- At trial, the court admitted Ardoin’s office chart and progress notes; a receptionist testified the records were kept in the regular course of the practice and entries were made contemporaneously by Ardoin based on his personal knowledge.
- A jury found for LAMMICO, determining Dardeau consented to the surgery and that Ardoin did not commit malpractice.

## Issues

1. Whether the trial court erred in admitting Ardoin’s office chart and progress notes as hearsay, given his unavailability due to death.
2. Whether the trial court committed reversible legal error by failing to instruct the jury on (a) res ipsa loquitur and (b) informed-consent requirements, thereby requiring de novo review rather than manifest-error review.

## Decision

- The court of appeal affirmed the judgment for LAMMICO.
- The medical chart and progress notes were properly admitted under the business-records exception; Ardoin’s death did not make the records inadmissible once foundation was established.
- The court rejected de novo review because no legal error interdicted the jury’s fact-finding process.
- The trial court did not err in refusing a res ipsa loquitur instruction given the evidence and competing explanations for the injury.
- The jury instructions on informed consent, considered as a whole, adequately stated the applicable law and did not mislead the jury.

## Legal Principles

- Properly authenticated medical charts and progress notes made and kept in the regular course of a medical practice and recorded contemporaneously based on personal knowledge are admissible as business records.
- A witness with knowledge of recordkeeping practices may lay the foundation for admission of business records; the author’s unavailability does not alone bar admission.
- Appellate courts apply manifest-error review to jury fact findings unless a legal error materially affects the fact-finding process; only then is de novo review appropriate.
- Res ipsa loquitur is a limited circumstantial-evidence doctrine and generally does not apply when the defendant offers plausible non-negligent explanations and the record contains conflicting expert testimony.
- Jury charges are reviewed in their entirety; failure to give a party’s requested wording is not reversible error absent misleading, incomplete, or legally incorrect instructions that likely affected the verdict.

## Conclusion

The appellate court upheld a defense verdict in a medical malpractice and consent dispute, finding no reversible error in admitting the deceased physician’s office records as business records and no prejudicial error in the refusal to charge res ipsa loquitur or in the informed-consent instructions, and therefore deferred to the jury’s factual determinations under manifest-error review.


Dardeau v. Ardoin, 703 So. 2d 695 (La. Ct. App. 3d Cir. 1997)