200 A.3d 859
Md.2019Background
- Plaintiff Mark Armacost sued neurosurgeon Dr. Reginald J. Davis and GBMC for medical malpractice and lack of informed consent after a 2012 cervical fusion followed by post‑operative infection; jury awarded $329,000 for negligence but found no lack of informed consent.
- At charge conference the court read pattern civil negligence instructions (MPJI‑Cv 19:1 general negligence and 19:3 foreseeability), then MPJI‑Cv 27:1 particularizing the professional standard for health care providers, and the informed‑consent instruction.
- Defense objected at trial only to the foreseeability instruction (arguing it could confuse the informed‑consent claim); did not object to the general negligence instruction but later challenged it on appeal.
- After ~3 days of deliberations the jury sent notes indicating they were “undecided” and asked what would happen if no verdict; the court gave a modified Allen charge (encouraging continued deliberation without surrendering honest conviction) and told the jury it would deliberate one more hour and would not be required to return the next day.
- The jury reached a verdict within that hour; Court of Special Appeals reversed on both instructional issues; the 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 specific professional standard was erroneous in a medical malpractice case | Court may properly instruct general negligence principles as context for the professional standard; no prejudice | Prefacing the professional standard with general negligence ("reasonable person") and foreseeability misled jury about applicable standard and could confuse informed consent analysis | Court of Appeals: No abuse of discretion; instructions considered as a whole were not misleading and defendant failed to show probable prejudice |
| Whether the trial court abused discretion by giving a modified Allen charge after jury notes suggesting deadlock | Modified Allen charge is permissible when jury shows difficulty reaching unanimity | Modified Allen charge (and timing) was coercive, particularly when coupled with a one‑hour deadline to finish deliberations | Court of Appeals: Giving the modified Allen charge was within discretion and, in context, advising jury it need only deliberate one more hour was not unduly coercive |
Key Cases Cited
- CSX Transp., Inc. v. Pitts, 430 Md. 431 (Md. 2013) (abuse‑of‑discretion review of jury instructions and harmless‑error principles)
- Barksdale v. Wilkowsky, 419 Md. 649 (Md. 2011) (party must show probable prejudice from erroneous civil jury instruction)
- Dehn v. Edgecombe, 384 Md. 606 (Md. 2005) (medical malpractice is a negligence action governed by general negligence principles)
- Shilkret v. Annapolis Emergency Hosp. Ass’n, 276 Md. 187 (Md. 1975) (physician’s duty measured against reasonably competent practitioner in same class and circumstances)
- Kennelly v. Burgess, 337 Md. 562 (Md. 1995) (review instructions as a whole; general negligence instruction used in medical malpractice context)
- Kelly v. State, 270 Md. 139 (Md. 1973) (trial judge has discretion regarding use, timing, and wording of Allen‑type charges)
- Allen v. United States, 164 U.S. 492 (U.S. 1896) (origin of the Allen charge doctrine)