## Facts

- Julie Ouellette became pregnant after unprotected intercourse in January 1977 and was treated throughout pregnancy by two family practitioners, Dr. Barbara H. Subak and Dr. Maxine O. Nelson.
- Dr. Subak estimated a due date of October 12, 1977; clinical findings during pregnancy did not consistently align with that date, but the physicians continued to rely on it.
- The pregnancy continued well beyond the estimated due date; despite indications of post-term status, the physicians did not timely induce labor or refer to a specialist until very late.
- On November 30, 1977, Mrs. Ouellette was admitted for an oxytocin challenge test and possible induction; the test was reported normal, and labor did not begin.
- After consultation with an obstetrician who recommended termination, another physician delivered Kristian Ouellette by Caesarean section on December 1, 1977.
- Kristian was born with severe, permanent brain damage causing profound physical and cognitive impairment.
- The Ouellettes alleged the physicians negligently allowed an excessively prolonged pregnancy, failed to induce labor in a timely manner, and inadequately responded to signs of fetal compromise; the physicians denied negligence and causation and characterized any mistake as an honest professional judgment error.

## Issues

1. Whether the trial court erred by refusing to give an “honest error in judgment” jury instruction in a medical malpractice case when requested and supported by the evidence.
2. Whether the trial court improperly admitted the plaintiff’s expert testimony on causation.
3. Whether the evidence was sufficient to support the jury’s negligence and causation findings.

## Decision

- The Minnesota Supreme Court held the trial court erred by refusing to give the requested “honest error in judgment” instruction.
- The omission rendered the standard-of-care instructions incomplete under Minnesota law and was not harmless given the centrality of medical judgment in the case.
- The court affirmed the appellate court’s order for a new trial on all issues.
- The court indicated that the expert-causation and sufficiency challenges did not change the disposition because retrial was required.

## Legal Principles

- In Minnesota medical malpractice cases, the standard of care includes the proposition that a physician is not liable for an honest error in professional judgment when the physician exercised the care and skill ordinarily possessed and used by practitioners in good standing under like circumstances.
- The “honest error in judgment” concept is not a separate defense; it clarifies that negligence is not established solely by a poor outcome or by differing medical opinions where multiple acceptable courses of treatment exist.
- When requested and supported by the evidence, the jury must be instructed on this component to fully and accurately state the physician’s standard of care.

## Conclusion

Because the case turned on competing views about pregnancy dating and management choices among acceptable medical alternatives, the jury should have been instructed that a physician is not liable for an honest error in judgment if reasonable care and skill were exercised; the failure to give that instruction required reversal and a new trial on all issues.


Ouellette by Ouellette v. Subak, 391 N.W.2d 810 (Minn. 1986)