Anderson v. Eli Lilly & Co.
2015 Ohio 5239
Ohio Ct. App.2015Background
- Dwight Anderson, who has chronic Hepatitis C, was prescribed the antidepressant Cymbalta by Dr. Jeffrey Hunter; Dr. Ahmed Ghany consulted during a later hospitalization and did not stop the prescription.
- Anderson experienced new, serious medical problems after starting Cymbalta; Cleveland Clinic physician Michelle Inkster, M.D., recommended discontinuing Cymbalta as a possible cause, and the drug was weaned off.
- The Andersons sued Hunter and Ghany for medical negligence and failure to obtain informed consent, alleging Cymbalta was contraindicated for patients with liver disease.
- Plaintiffs' counsel announced at opening statement that no medical expert witness would be called to testify about standard of care or causation; defendants moved for a directed verdict on that basis.
- The trial court granted a directed verdict after opening statements under Civ.R. 50(A); plaintiffs appealed, arguing (1) common-knowledge exception obviated need for expert testimony, (2) informed-consent claim requires only a reasonable-patient standard, (3) Dr. Inkster's report sufficed, and (4) defendants could be cross-examined to establish breach.
- The appellate court affirmed the directed verdict, concluding expert testimony was required both to prove deviation from the medical standard and to establish the materiality of undisclosed risks.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether common-knowledge exception permits juror inference of negligence without expert testimony when FDA label warns against use in liver disease | Anderson: FDA contraindication makes negligence apparent to lay jurors; no expert required | Defendants: Medical judgment (weighing risks/benefits) is technical and requires expert proof of standard and breach | Court: Overruled — expert required; prescribing decisions involve technical medical judgment beyond lay knowledge |
| Whether informed-consent claim can be proven without expert testimony because it uses a reasonable-patient standard | Anderson: Reasonable-patient standard governs disclosure; expert unnecessary to identify material risks | Defendants: Expert testimony is necessary to identify material risks and what should have been disclosed | Court: Overruled — expert testimony required to establish material risks and informed-consent breach |
| Whether Dr. Inkster's report alone (or as non-hearsay that Dr. Hunter relied on it) establishes defendants' negligence | Anderson: Inkster's recommendation and anticipated testimony of defendants adopting it would show breach | Defendants: Inkster's letter is not expert proof of the defendants' standard or breach; defendants did not admit negligence in depositions | Court: Overruled — the report insufficient to substitute for required expert malpractice proof |
| Whether plaintiffs could rely on cross-examination of defendant physicians to supply required expert testimony after opening statement | Anderson: Defendants could be cross-examined to show they violated the standard; Parrish requires caution before directing verdict | Defendants: No indication defendants would concede breach; plaintiffs did not proffer that testimony or amend opening statement | Court: Overruled — plaintiffs failed to preserve/offer testimony that defendants would admit negligence; directed verdict proper |
Key Cases Cited
- Bruni v. Tatsumi, 46 Ohio St.2d 127 (sets elements of medical malpractice; requires expert proof of standard and breach)
- Parrish v. Jones, 138 Ohio St.3d 23 (trial courts may grant directed verdict after opening statement only when plaintiff cannot sustain cause of action)
- Nickell v. Gonzalez, 17 Ohio St.3d 136 (adopts reasonable-patient standard for informed consent)
- White v. Leimbach, 131 Ohio St.3d 21 (expert testimony required to establish material risks in informed-consent claims)