Facts
- Ann Petriello, sixteen weeks pregnant, reported low back pain and vaginal bleeding to Dr. Roy E. Kalman on April 13, 1984, and was admitted to Griffin Hospital.
- An ultrasound confirmed intrauterine fetal death, and Kalman informed Petriello by telephone that he intended to perform a dilatation and curettage (D&C).
- A hospital nurse administered preoperative medication before a written informed-consent form was signed, contrary to hospital policy requiring written consent before pre-op drugs.
- Kalman performed the D&C believing consent had been obtained through prior discussions; he perforated Petriello’s uterus.
- Corrective surgery required bowel resection, causing adhesions and increasing Petriello’s lifetime risk of bowel obstruction; expert testimony quantified the increased risk.
- Petriello sued Kalman for malpractice and Griffin Hospital for negligence for (1) permitting surgery without informed consent and (2) failing to obtain informed consent before administering preoperative medication.
- The trial court directed a verdict for Griffin Hospital; the jury found for Petriello against Kalman and awarded damages including compensation for increased risk of future bowel obstruction and fear of that condition.
Issues
- Whether a hospital has a legal duty to obtain or ensure a patient’s informed consent to a physician’s procedure before administering preoperative medication or permitting the procedure to proceed.
- Whether expert testimony quantifying an increased risk of future injury is admissible, and whether a jury may award damages for (a) the increased risk itself and (b) the plaintiff’s rational fear of the future injury.
Decision
- The Supreme Court of Connecticut affirmed the directed verdict for Griffin Hospital, holding the hospital owed no duty to obtain or ensure informed consent under these circumstances.
- The court affirmed the judgment against Kalman, holding expert testimony on increased risk was properly admitted.
- The court approved jury instructions permitting damages for increased risk of future bowel obstruction (as a present injury component) and for rational fear of that future condition.
Legal Principles
- In the ordinary physician–hospital relationship, the duty to obtain informed consent for a procedure rests on the attending physician, particularly when the physician is an independent practitioner rather than a hospital employee or agent.
- A hospital policy requiring written consent before administering medication does not, by itself, create a tort duty for the hospital to ensure that informed consent has been obtained for the physician’s procedure.
- Expert testimony quantifying the probability of future harm may be admitted to show both (1) that a plaintiff’s fear of future harm is reasonable and (2) that an increased risk tied to an existing physical condition constitutes a present compensable injury.
- Damages for increased risk of future injury may be awarded on a proportional basis, reflecting the probability of the future harm rather than the full value of a harm that may never occur.
- A plaintiff may recover separately for present, rational fear of future injury when supported by evidence that the fear is genuine and medically grounded.
Conclusion
The court held that the informed-consent duty remained with the attending physician and did not shift to the hospital merely because hospital staff failed to follow an internal written-consent policy, and it affirmed a damages framework that permits recovery for medically supported increased risk of future injury and for rational fear of that injury.