## Facts

- Phoebe G. Kennedy consulted Dr. Fountain Parrott for abdominal pain; he diagnosed appendicitis and recommended an appendectomy.
- Kennedy consented to an operation for appendicitis requiring an abdominal incision.
- During the surgery, Dr. Parrott discovered enlarged ovarian cysts and punctured them, believing they were potentially dangerous.
- After surgery, Kennedy developed phlebitis in her leg and asserted the cyst puncture caused it.
- Kennedy sued alleging negligent performance of the operation and alleged the cyst puncture was unauthorized.
- Kennedy offered no expert testimony that Dr. Parrott lacked skill, departed from accepted practice, or caused her condition; the defense presented expert and medical-text evidence supporting the treatment and disputing causation.

## Issues

1. Whether the evidence was sufficient to submit a medical malpractice claim to the jury when the plaintiff offered no expert proof of breach of the standard of care or causation.
2. Whether puncturing ovarian cysts discovered during an appendectomy, without specific prior authorization for that additional procedure, constituted an actionable battery/trespass outside the scope of consent.

## Decision

- The Supreme Court of North Carolina affirmed the involuntary nonsuit for Dr. Parrott.
- The court held the malpractice evidence was legally insufficient to show negligent treatment or causation.
- The court held that consent to a major internal abdominal operation is generally construed to authorize additional procedures within the operative field that, in the surgeon’s sound judgment, are reasonably necessary for the patient’s health and safety; puncturing the cysts was within that scope and not a battery.

## Legal Principles

- In surgical malpractice, liability is not established by an error in medical judgment alone when the physician has the requisite skill and acts carefully and prudently.
- A plaintiff ordinarily must present competent medical evidence (commonly expert testimony) to prove breach of the applicable standard of care and medical causation.
- In evaluating nonsuit in malpractice cases, the court may consider generally accepted medical facts shown by expert testimony and authoritative medical texts when a plaintiff’s asserted causal theory is in direct conflict with scientific fact.
- Consent to a major internal operation is, absent proof to the contrary, treated as general consent permitting reasonably necessary additional procedures within the area of the original incision when discovered during the operation.
- Performing such reasonably necessary, related procedures within the operative field does not constitute an unauthorized touching actionable as battery.

## Conclusion

The court upheld dismissal of the patient’s claims because she failed to present medically competent proof of negligence or causation, and because her consent to a major abdominal operation implied authorization for the surgeon to treat additional conditions discovered in the operative field that reasonably required attention for her health and safety.


Kennedy v. Parrott, 243 N.C. 355, 90 S.E.2d 754 (1956)