## Facts

- Laurel S. Tisdale sought care for pregnancy-related problems from her longtime physician, Dr. Murphy, who recommended a dilation and curettage (D&C) and arranged hospital admission under general anesthesia.
- Tisdale’s insurer required a second opinion and referred her to Dr. A. Bert Pruitt, an obstetrician-gynecologist.
- At Pruitt’s office, Tisdale stated she was there only for a second opinion; the office chart noted “second opinion” in two places, and Pruitt admitted he did not read it.
- During the office visit, Pruitt proceeded to perform a D&C without general anesthesia; Tisdale experienced pain and testified she wanted any procedure done by Dr. Murphy, not Pruitt.
- Pruitt’s D&C was inadequately performed, and Dr. Murphy later performed another D&C under general anesthesia.
- Tisdale sued alleging assault and battery, negligence, recklessness, and willfulness based on an unauthorized D&C and lack of informed consent.
- The trial court directed a verdict for Pruitt on assault and battery on statute-of-limitations grounds; the remaining claims went to the jury.
- The jury awarded $5,000 actual damages and $25,000 punitive damages; Pruitt appealed, arguing for an implied-consent instruction and challenging sufficiency of the evidence on causation and damages.

## Issues

1. Whether the trial court erred by refusing to instruct the jury on implied consent where Pruitt argued Tisdale’s silence or acquiescence during the office visit constituted consent to the D&C.
2. Whether the evidence was sufficient on proximate cause and on actual and punitive damages to submit negligence, recklessness, and willfulness to the jury and to support the verdict.

## Decision

- The Court of Appeals affirmed the judgment for Tisdale.
- The trial court properly refused to charge implied consent because the evidence did not reasonably support that theory beyond the consent and informed-consent instructions given.
- The evidence supported submission to the jury and supported both actual and punitive damages, including proof of injury and proximate cause.

## Legal Principles

- A party is entitled to a jury instruction only when the requested charge is supported by the pleadings and evidence; a court may refuse a charge that lacks evidentiary support or is adequately covered by other instructions.
- Consent to medical treatment may be an issue framed as performance of a procedure without consent or without informed consent; an implied-consent theory requires circumstances showing consent can fairly be inferred from the patient’s conduct.
- Pain from an unauthorized procedure, deprivation of the right to choose the treating physician, and resulting emotional distress may constitute compensable injury and support actual damages.
- Punitive damages may be upheld where evidence permits a finding of reckless or willful disregard of a patient’s rights in proceeding with an invasive procedure without proper consent.

## Conclusion

The court upheld a malpractice verdict arising from an office D&C performed during a visit documented as being for a second opinion, holding that the facts did not warrant an implied-consent instruction and that evidence of pain, loss of choice of physician, emotional injury, and reckless or willful conduct supported both actual and punitive damages.


Tisdale v. Pruitt, 302 S.C. 238, 394 S.E.2d 857 (Ct. App. 1990)