## Facts

- Judith Moore consulted Dr. Roy Baker, a neurosurgeon, for dizziness and fatigue; he diagnosed a partial blockage of her left common carotid artery and recommended carotid endarterectomy.
- Moore signed a written consent form, underwent the surgery on April 7, 1989, and afterward suffered a blood clot and severe, permanent brain damage.
- On April 8, 1991, Moore filed suit alleging medical malpractice based solely on lack of informed consent under Georgia law, claiming Baker failed to disclose EDTA chelation therapy as an alternative to surgery.
- Defendants included Baker and his practice, Neurological Institute of Savannah, P.C.; Memorial Medical Center was also named in the original complaint.
- After defendants moved for summary judgment on the informed-consent claim, Moore moved to amend her complaint to add claims that Baker was negligent in performing the surgery and in post-operative care.
- The district court granted summary judgment for defendants on the informed-consent theory and denied leave to amend, concluding the new negligence claims were time-barred and did not relate back.

## Issues

1. Whether Georgia’s informed-consent statute required disclosure of EDTA chelation therapy as an alternative to carotid endarterectomy, such that summary judgment for defendants was improper.
2. Whether the proposed amendment adding negligent performance and post-operative care claims related back to the original complaint under Federal Rule of Civil Procedure 15(c) and therefore was not barred by the statute of limitations.

## Decision

- The Eleventh Circuit affirmed summary judgment for defendants on the informed-consent claim.
- The court held EDTA chelation therapy was not a “generally recognized or accepted” alternative treatment at the relevant time, so there was no statutory duty to disclose it.
- The Eleventh Circuit affirmed the denial of leave to amend.
- The court held the new negligence claims did not arise out of the same “conduct, transaction, or occurrence” described in the original pleading and did not provide defendants notice of operative or post-operative negligence allegations.
- Because the statute of limitations had run, the proposed negligence claims were time-barred.

## Legal Principles

- Under Georgia’s informed-consent statute, a physician’s duty to disclose alternatives extends only to treatments “generally recognized or accepted” by reasonably prudent physicians.
- A plaintiff opposing summary judgment must present evidence creating a genuine dispute that an asserted alternative was generally recognized or accepted; evidence showing only minority support is insufficient.
- Under Federal Rule of Civil Procedure 15(c), an amended claim relates back only if it arises from the same conduct, transaction, or occurrence set out in the original pleading.
- The relation-back inquiry centers on notice: the original complaint must give the defendant fair warning of the type of claim later asserted.
- A complaint focused on pre-operative disclosure does not, without more, provide notice of claims based on negligent surgical performance or post-operative care, which depend on different facts and proof.

## Conclusion

The Eleventh Circuit held that Georgia informed-consent law did not require disclosure of EDTA chelation therapy because it was not generally accepted, and it also held that adding negligence-in-treatment claims after limitations expired was barred because the original informed-consent pleading did not place defendants on notice of those distinct allegations and therefore did not relate back under Rule 15(c).


Moore v. Baker, 989 F.2d 1129 (11th Cir. 1993)