Facts
- Hop Sang suffered a severe hand injury in a motor-car accident and was taken to a hospital.
- Dr. Mulloy, a surgeon, was asked to treat Hop Sang’s hand.
- Before surgery, Hop Sang expressly stated he did not want his hand amputated and indicated a wish to have his own doctor elsewhere involved.
- In the operating room, Hop Sang repeated that he did not want amputation.
- Mulloy stated he would act based on the condition found after anesthesia; Hop Sang did not clearly assent, and he had limited English proficiency.
- After anesthesia, Mulloy concluded the hand could not be saved and that immediate amputation was necessary to prevent blood poisoning; two other physicians supported the medical necessity.
- Mulloy sued Hop Sang for professional fees for the operation.
- Hop Sang counterclaimed for trespass to the person, seeking damages including general damages, lost wages, and the cost of an artificial hand.
- The trial judge found the amputation medically necessary and competently performed, but not properly authorized; Mulloy’s fee claim was dismissed, and Hop Sang was awarded $50 general damages for trespass while other damages were denied.
- Mulloy appealed; the Appellate Division affirmed.
Issues
- Whether an amputation performed after a patient’s express pre-operative refusal, without clear subsequent consent, constitutes trespass to the person (battery) despite medical necessity and competent performance.
- Whether claimed losses (lost wages and cost of an artificial hand) were legally caused by the unauthorized operation or by the original accident.
- Whether a physician may recover professional fees for a medically necessary but unauthorized surgical procedure.
Decision
- The Appellate Division affirmed the dismissal of Mulloy’s claim for professional fees.
- The court affirmed liability for trespass to the person and the $50 general damages award.
- The court affirmed the denial of lost wages and artificial-hand costs as not attributable to the unauthorized nature of the amputation.
Legal Principles
- Consent to medical treatment is procedure-specific; an express refusal of a particular procedure remains effective unless clearly withdrawn through informed agreement.
- A medically necessary and properly performed operation may still constitute battery if performed without valid consent.
- Medical necessity does not, by itself, supply legal authorization where the patient has expressly refused the procedure and the circumstances do not justify implied consent.
- A physician who commits battery in performing an unauthorized procedure may be barred from recovering fees for that procedure.
- Damages for battery may be limited where claimed economic losses are caused by the underlying accident or condition rather than by the unauthorized touching.
Conclusion
The court held that amputating a patient’s hand after an express refusal, without a clear and informed change in consent, is an actionable trespass to the person even if medically necessary and competently performed; the surgeon was denied fees, and damages were confined to modest general compensation because additional losses were attributed to the accident rather than the unauthorized amputation.