Facts
- Martha Duncan underwent an MRI requiring sedation and, due to prior adverse reactions, limited her consent to receiving only Demerol or morphine.
- Before the procedure, an imaging-center nurse allegedly assured Duncan that only Demerol or morphine would be administered.
- On the day of the MRI, Duncan was told fentanyl would be used; she repeatedly and categorically refused fentanyl and stated she would proceed only if given morphine or Demerol.
- Duncan agreed to proceed after being assured she would receive morphine instead of fentanyl.
- A nurse administered fentanyl without Duncan’s knowledge, and Duncan experienced significant medical complications.
- Duncan sued the imaging providers asserting multiple theories, later dismissing negligence and informed-consent claims and proceeding only on common-law battery.
- The trial court treated the claim as medical malpractice under the Medical Malpractice Act (MMA), required expert testimony, and granted summary judgment for lack of an expert; the court of appeals affirmed.
Issues
- Whether administering a drug contrary to a patient’s express, specific limitations on consent constitutes common-law battery.
- Whether A.R.S. § 12-562(B), which barred assault and battery claims against licensed health care providers for medical treatment, violates Article 18, § 6 of the Arizona Constitution by abrogating a common-law right of action.
Decision
- The Arizona Supreme Court reversed and remanded.
- The court held Duncan stated a viable battery claim because fentanyl was administered outside the scope of her expressly limited consent.
- The court held A.R.S. § 12-562(B) unconstitutional because it eliminated common-law battery claims in the medical-treatment setting, violating Arizona’s constitutional prohibition on abrogating the right to recover damages for injuries.
- Because the claim sounded in battery rather than malpractice negligence, Duncan’s failure to provide malpractice expert testimony did not warrant summary judgment on the battery theory.
Legal Principles
- Battery requires intentional harmful or offensive contact without effective consent; in medical settings, treatment exceeding the scope of a patient’s consent may constitute battery.
- A patient’s consent may be conditional and specific; administering a procedure or drug the patient expressly refused falls outside consent and supports battery rather than negligent lack of informed consent.
- Lack of informed consent generally concerns inadequate disclosure of risks for a treatment the patient agreed to and typically sounds in negligence; express refusal of a treatment or drug sounds in battery.
- Under Article 18, § 6 of the Arizona Constitution, the legislature may regulate causes of action but may not abolish an established common-law claim without a meaningful substitute; converting intentional, unauthorized-treatment claims into malpractice negligence impermissibly abrogates battery.
Conclusion
The court held that administering fentanyl after the patient expressly limited consent to other sedatives could constitute medical battery, and it invalidated the MMA provision barring medical battery claims as an unconstitutional abrogation of a common-law right of action, remanding for further proceedings.