813 N.W.2d 627
Wis.2012Background
- Emergency room visit for acute facial weakness, slurred speech, and suspected Bell's palsy; differential diagnosis included stroke/TIA but final diagnosis was Bell's palsy.
- No carotid ultrasound was performed; carotid bruit was absent and CT scan was normal but could not rule out ischemic stroke.
- Symptoms and differential acknowledged ischemic causes; Jandre later suffered a full stroke after initial evaluation.
- Two experts testified carotid ultrasound would have definitively ruled out ischemic stroke; later ultrasound revealed 95% carotid blockage.
- Plaintiffs argued failure to inform about carotid ultrasound violated Wis. Stat. § 448.30; verdict found negligence in informed consent but not in diagnosis.
- Circuit court entered verdict consistent with jury; court of appeals affirmed; PIC sought review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Scope of duty to inform under Wis. 448.30 (diagnosis vs. tests) | Jandre: duty extends to diagnostic tests | Bullis/PIC: duty limited to final diagnosis | Not limited; reasonable patient standard governs disclosure |
| Bright-line rule forbidding disclosure of unrelated conditions | Jandre should recover under broader disclosure | PIC seeks bright-line limitation | Rejected; rely on reasonable patient standard |
| Relation to Martin, Kuklinski, and Bubb precedents | Martin/Bubb control; disclosure includes diagnosis tests | Defendants urge limiting to related conditions | Martin/Bubb control; standard remains objective and patient-centered |
| Consistency of verdicts (negligence vs informed consent) | Informed consent verdict consistent with duty to inform | Verdicts conflated two liability theories | Verdicts not inconsistent; informed consent duty separate from treatment negligence |
| Public policy and medical practice impact | Expanded duty necessary for patient autonomy | Expansion risks defensive medicine and costs | No policy-based overreach; maintains established standard |
Key Cases Cited
- Scaria v. St. Paul Fire & Marine Ins. Co., 68 Wis.2d 1, 227 N.W.2d 647 (Wis. 1975) (codifies reasonable patient standard in informed consent)
- Martin v. Richards, 192 Wis.2d 156, 531 N.W.2d 70 (Wis. 1995) (duty to inform driven by patient’s condition, not diagnosis; includes diagnosis as feasible alternatives)
- Kuklinski v. Rodriguez, 203 Wis.2d 324, 552 N.W.2d 869 (Ct. App. 1996) (tests the duty to inform is triggered by patient’s condition at time, not final diagnosis)
- Bubb v. Brusky, 321 Wis.2d 1, 768 N.W.2d 903 (Wis. 2009) (duty to inform includes alternative diagnostic modes; case supports reasonable patient standard)
- Martin v. Richards (cited as authoritative precedent), 192 Wis.2d 156, 531 N.W.2d 70 (Wis. 1995) (establishes informed consent framework governing diagnosis-related information)