Armacost v. Davis
462 Md. 504
Md.2019Background
- Armacost sued neurosurgeon Dr. Reginald J. Davis (and employer GBMC) for medical malpractice and lack of informed consent after cervical surgery that led to postoperative infection and ongoing injury.
- Trial in Baltimore County (May 2016): three days of testimony; competing expert testimony on necessity of surgery, causation, and timeliness of diagnosis/treatment of infection.
- Jury instructions: court read general negligence (MPJI-Cv 19:1), foreseeability (MPJI-Cv 19:3), causation, then the health‑care‑provider standard (MPJI‑Cv 27:1), and informed‑consent instructions.
- During deliberations (after ~3 days) jury sent notes suggesting deadlock; court gave a modified Allen charge and told jurors it would ask them to deliberate one more hour and would not ask them to return the next day.
- Jury returned a verdict for plaintiff on negligence (no liability on informed‑consent count); judgment for $329,000. Court of Special Appeals reversed on instructions and coercion grounds; Maryland Court of Appeals granted certiorari.
Issues
| Issue | Plaintiff's Argument (Armacost) | Defendant's Argument (Davis) | Held |
|---|---|---|---|
| Whether giving general negligence and foreseeability pattern instructions before the professional‑standard instruction was improper in a medical malpractice trial | Prefatory general instructions are appropriate; they frame negligence principles and the jury was then told the physician standard | Prefatory general negligence/foreseeability instructions could mislead jury into applying a lay "reasonable person" standard (and confuse informed‑consent analysis) | Court affirmed trial court: prefatory general instructions are not erroneous per se; considered as a whole the charge did not mislead and defendant failed to show probable prejudice |
| Whether the foreseeability instruction improperly affected the informed‑consent claim | N/A (Armacost prevailed on negligence) | Foreseeability instruction was unnecessary/superfluous and could have confused the jury on informed‑consent issues | Court held foreseeability instruction was not reversible error and posed no probable prejudice given verdict and record |
| Whether giving a modified Allen charge was an abuse of discretion | N/A | Modified Allen charge coerces jurors and was inappropriate because jury had not explicitly declared itself deadlocked | Court held giving a modified Allen charge was within trial court discretion given notes, length of deliberations, and context |
| Whether informing jury it would deliberate only one more hour (after the Allen charge) rendered the charge coercive | N/A | Announcing the one‑hour limit, coupled with Allen charge, was unduly coercive and produced an unreliable verdict | Court held context mattered: informing jurors of schedule was not coercive here; not an abuse of discretion |
Key Cases Cited
- CSX Transp., Inc. v. Pitts, 430 Md. 431 (Md. 2013) (abuse‑of‑discretion review and harmless‑error/prejudice standard for jury instructions)
- Barksdale v. Wilkowsky, 419 Md. 649 (Md. 2011) (prejudice requirement for reversal of civil jury verdict based on instructional error)
- Kennelly v. Burgess, 337 Md. 562 (Md. 1995) (noting that general negligence principles apply in malpractice cases and courts should view charges as a whole)
- Burnette v. State, 280 Md. 88 (Md. 1977) (endorsing ABA‑style modified Allen language and need for careful scrutiny of deviations)
- Kelly v. State, 270 Md. 139 (Md. 1973) (discussing judicial discretion in using Allen‑type charges)
- Cromer v. Children’s Hosp. Med. Ctr., 29 N.E.3d 921 (Ohio 2015) (discussing role of foreseeability in medical negligence instructions)
- Allen v. United States, 164 U.S. 492 (U.S. 1896) (origin of Allen charge and jurisprudential background)