## Facts

- A mammogram revealed a breast mass and enlarged lymph nodes in Janice Largey.
- Largey consulted Dr. Donald Rothman, who recommended a surgical biopsy; she agreed to the procedure.
- During surgery, Dr. Rothman removed part of the breast mass and also removed axillary lymph nodes.
- Pathology results showed the mass and lymph nodes were benign.
- About six weeks later, Largey developed lymphedema, a swelling associated with impaired drainage after lymph-node removal.
- Largey alleged Dr. Rothman did not disclose the risk of lymphedema and did not obtain informed consent for lymph-node removal, asserting negligence and battery theories.
- Dr. Rothman contended disclosure was unnecessary because the risk of lymphedema was very small.
- The litigation centered on informed consent, not the technical performance of the surgery.

## Issues

1. Whether the duty to disclose in informed-consent cases is governed by a professional “reasonable physician” standard or a patient-centered “prudent patient/material risk” standard.
2. What causation standard applies in informed-consent cases: a subjective patient-specific test or an objective reasonable-patient test.

## Decision

- The Supreme Court of New Jersey rejected the professional “reasonable physician” disclosure standard previously applied in New Jersey.
- The court adopted the Canterbury “reasonable patient” (prudent patient/materiality of risk) standard for informed consent.
- The court endorsed an objective causation inquiry: whether a reasonable patient, fully informed of material risks, would have declined the procedure.
- The judgment for Dr. Rothman was reversed, and the matter was remanded for further proceedings under the new standard.

## Legal Principles

- A physician must disclose information that a reasonable patient in the plaintiff’s position would consider material to deciding whether to undergo the proposed treatment.
- A risk is material if a reasonable patient would be likely to attach significance to it when choosing among treatment options.
- Disclosure must include material risks of the proposed treatment, feasible alternatives, and the likely consequences of accepting or declining those alternatives.
- Informed consent doctrine is grounded in patient self-determination; disclosure is not defined by medical custom alone.
- Proximate cause is assessed objectively: whether a reasonable patient, adequately informed, would have refused the treatment.

## Conclusion

New Jersey shifted informed-consent law from a physician-centered custom standard to a reasonable-patient material-risk standard and required an objective reasonable-patient causation test, necessitating a new trial framework when disclosure is disputed.


Largey v. Rothman, 110 N.J. 204, 540 A.2d 504 (N.J. 1988)