Berger v. Ogden Regional Medical Center, 469 P.3d 1127

May 31, 2011: Bonnie Berger underwent robotic lung surgery; she suffered arterial bleeding, became hypotensive, sustained an anoxic brain injury, emerged unresponsive, and died a week later.
Bergers sued in 2014 alleging multiple departures from the standard of care related to preop preparation, intraoperative monitoring/response, hemorrhage resuscitation, blood availability/IV access, and anesthesia continuity.
Fact discovery closed February 22, 2018; expert disclosure deadline was March 1, 2018. One day before that deadline the Bergers moved to stay expert designations pending a ruling on whether res ipsa loquitur applied.
The district court denied the res ipsa instruction, finding the injury and procedures medically complex and not within lay understanding, and denied Bergers’ motion to extend expert-disclosure deadlines for lack of good cause.
Because Bergers failed to designate experts and res ipsa was unavailable, the district court granted summary judgment for defendants; the court of appeals affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether res ipsa loquitur supported a jury instruction	Brain injury after lung surgery is not a common result and lay jurors can infer negligence without expert proof	Medical issues (robotic lung surgery, anesthesia, blood management) are complex and not within ordinary knowledge; experts required	Res ipsa inapplicable: medical complexity and physiological link between lung surgery and brain injury place the case outside lay understanding; no instruction
Whether the court abused its discretion by denying an extension to disclose experts	Good cause existed to wait for a res ipsa ruling so expert discovery might be unnecessary or targeted; short delay would not prejudice defendants	Bergers had ample time (case pending years, many prior extensions); failure to disclose prejudiced defendants and disrupted sequencing of expert disclosures	No abuse of discretion: court reasonably found no good cause and that failure to disclose was not harmless
Whether summary judgment was proper because Bergers had no expert evidence	If res ipsa applied, experts would be unnecessary; otherwise plaintiffs needed experts and should have been allowed discovery time	Without expert testimony plaintiffs cannot establish standard of care, breach, or causation in a medically complex malpractice case	Affirmed: res ipsa unavailable and plaintiffs introduced no experts, so they could not create a triable issue on malpractice elements

Dalley v. Utah Valley Reg’l Med. Ctr., 791 P.2d 193 (Utah 1990) (res ipsa can apply when an operating-room injury involves a healthy, uninvolved body part)
Nixdorf v. Hicken, 612 P.2d 348 (Utah 1980) (elements and evidentiary foundation for res ipsa; expert testimony generally required absent common-knowledge exception)
King v. Searle Pharm., Inc., 832 P.2d 858 (Utah 1992) (res ipsa creates a rebuttable inference of negligence; example of foreign object left in body)
Baczuk v. Salt Lake Reg’l Med. Ctr., 8 P.3d 1037 (Utah Ct. App. 2000) (res ipsa appropriate for a simple, nontechnical injury—burn from a heating pad—where lay understanding suffices)
Morgan v. Intermountain Health Care, Inc., 263 P.3d 405 (Utah Ct. App. 2011) (elements of medical malpractice and need for expert proof of standard of care, breach, and causation)