Johnson v. Armstrong
211 N.E.3d 355
Ill.2022Background:
- Plaintiff William "Wes" Johnson underwent a left total hip arthroplasty performed by Dr. Lucas Armstrong with surgical technicians Sarah Harden and Pamela Rolf; postoperatively he sustained severe, permanent femoral nerve palsy.
- Johnson sued: Count I (specific negligence) and Count III (res ipsa loquitur) against Dr. Armstrong; Count III also named Harden and Rolf; respondeat superior claims named their employers.
- Depositions: Armstrong was sole person authorized to position/move instruments; Harden held instruments (including retractors) as directed; Rolf handed instruments; Rolf was voluntarily dismissed.
- Plaintiff offered a single expert, Dr. Sonny Bal, who testified that the specific severe femoral neuropathy here ordinarily does not occur absent negligence and opined the retractor was the most likely cause; he did not offer a separate standard of care for Harden.
- The circuit court granted summary judgment for Harden/Advocate (finding lack of expert on technician standard, lack of control, no evidence of negligence) and later granted summary judgment to Armstrong on the res ipsa count; the appellate court reversed as to both.
- The Illinois Supreme Court dismissed the appeal as to Armstrong (Rule 304(a) interlocutory jurisdiction improper because res ipsa is an evidentiary theory in the same negligence claim), exercised supervisory authority to review Harden’s oral dismissal, and held res ipsa applied as to Harden — reversing and remanding.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| 1) Was the Rule 304(a) interlocutory appeal of Armstrong's res ipsa summary judgment proper? | Johnson: appealable order under Rule 304(a). | Armstrong: order was nonfinal because specific-negligence claim remained. | Held: Appeal dismissed — res ipsa ruling was an issue within the same negligence claim, not a final judgment under Rule 304(a). |
| 2) Does the injury meet res ipsa's probability element (does this nerve injury ordinarily not occur absent negligence)? | Johnson (via Dr. Bal): this pattern of severe, permanent femoral neuropathy does not ordinarily occur absent negligence. | Defendants: nerve palsies can be recognized nonnegligent complications; causation uncertain. | Held: Probability element satisfied — expert testimony established injury unusually implicative of negligence. |
| 3) Does Harden satisfy the control element for res ipsa despite joint control with surgeon? | Johnson: plaintiff need only show defendants were responsible for all reasonable causes while patient under their care; Harden helped control instrumentality. | Harden: she only held retractors as instructed and lacked authority to place/move them; thus no control. | Held: Control element satisfied — joint or actual control while instrumentality in patient justified res ipsa against Harden. |
| 4) Was additional expert testimony as to a surgical technician's standard of care required to invoke res ipsa here? | Johnson: no separate technician standard necessary where res ipsa elements are met and the injury is of a kind not ordinarily occurring absent negligence. | Harden: plaintiff failed to present expert proof of a technician standard; surgeon's testimony cannot establish technician standard. | Held: No additional expert required — res ipsa supplies the evidentiary basis for the standard of care when the injury and control elements are met. |
Key Cases Cited
- Heastie v. Roberts, 226 Ill. 2d 515 (Illinois 2007) (explains res ipsa elements and that it is an evidentiary doctrine, not a separate claim)
- Imig v. Beck, 115 Ill. 2d 18 (Illinois 1986) (res ipsa permits inference of negligence; trial court decides applicability)
- Kolakowski v. Voris, 83 Ill. 2d 388 (Illinois 1980) (res ipsa appropriate where patient is in defendants' care and instrumentality unknown)
- Spidle v. Steward, 79 Ill. 2d 1 (Illinois 1980) (expert testimony may be required on the probability element; equivocal expert testimony can suffice)
- Walski v. Tiesenga, 72 Ill. 2d 249 (Illinois 1978) (standard of care in medical negligence normally requires expert proof; common-knowledge exception limited)
- Armstead v. National Freight, Inc., 2021 IL 126730 (Illinois 2021) (distinguishes final orders from interlocutory rulings for Rule 304(a))
- Jones v. Chicago HMO Ltd. of Illinois, 191 Ill. 2d 278 (Illinois 2000) (discusses duty and standard of care in medical negligence)
- Sullivan v. Edward Hospital, 209 Ill. 2d 100 (Illinois 2004) (addresses who qualifies to testify regarding medical standard of care)