## Facts

- Norma Jo Scott was diagnosed with fibroid uterine tumors and was referred to surgeon Dr. Vance A. Bradford.
- Dr. Bradford performed a hysterectomy after Mrs. Scott signed a routine consent form.
- Mrs. Scott developed continuous urinary leakage after surgery.
- Another physician diagnosed a vesico-vaginal fistula, allowing urine to leak from the bladder into the vagina.
- A urologist performed three additional surgeries to correct the condition.
- Mrs. Scott and her husband sued for (1) negligent performance of the hysterectomy and (2) failure to obtain informed consent by not disclosing the risk of the complication, alternatives to surgery, and the option of no treatment.
- Dr. Bradford contended the fistula was a recognized complication of hysterectomy and that the consent form satisfied any disclosure duty.
- A jury returned a verdict for Dr. Bradford; judgment was entered, and the Scotts appealed, challenging the informed-consent instructions.

## Issues

1. What standard governs a physician’s pre-treatment disclosure duty: professional custom or a patient-oriented materiality standard?
2. What elements must a plaintiff plead and prove to recover for lack of informed consent?
3. Whether the jury instructions and related rulings required reversal in this case in light of the disclosure rule announced on appeal.

## Decision

- The Oklahoma Supreme Court adopted a patient-oriented “materiality” standard requiring disclosure of all material information needed for an informed choice, including alternatives and risks of each option, as well as risks of no treatment.
- The court held this disclosure rule would apply prospectively from the date of the opinion.
- The court articulated required elements for an informed-consent claim, including consent without full information, decision causation, materialization of the undisclosed risk, and resulting injury.
- The court affirmed the judgment for Dr. Bradford, finding no reversible instructional error under the law applicable at the time of trial and rejecting demands for additional or verbatim requested instructions.

## Legal Principles

- A physician must disclose material information a reasonable patient would consider significant in deciding whether to accept or reject the proposed treatment, including:
  - Available alternatives; and
  - Risks of each course of action, including risks inherent in foregoing treatment.
- An informed-consent plaintiff must plead and prove:
  - The patient consented without being fully informed of attendant risks;
  - The patient would not have consented if fully informed (tested by an objective prudent-patient measure);
  - The undisclosed risk materialized; and
  - The patient was injured as a result of undergoing the treatment.
- Causation depends on whether adequate disclosure would have led a reasonably prudent patient in the plaintiff’s position to decline the treatment or choose a different course.
- Recognized limits on the duty to disclose include:
  - Risks that are common knowledge or already known to the patient;
  - Emergency situations requiring immediate action when the patient cannot decide; and
  - Limited “therapeutic privilege” where disclosure would seriously harm an emotionally fragile patient’s ability to receive care.

## Conclusion

The court recognized informed consent as a distinct basis of liability and prospectively required patient-centered disclosure of material risks and alternatives, while affirming the defendant’s verdict because the trial court’s instructions were not reversible error under then-existing standards.


Scott v. Bradford, 606 P.2d 554 (Okla. 1979)