Kaplan v. Mayo Clinic, 653 F.3d 720

Background

Kaplans sued Mayo Clinic Rochester and related entities and two Mayo doctors for negligent failure to diagnose and contract claims arising from Kaplan's erroneous pancreatic cancer diagnosis and Whipple surgery.
Initial district court rulings: JAML against Kaplans on breach-of-contract; jury verdict for Mayo and Burgart on negligent failure to diagnose; district court entered judgment accordingly.
Pathology initial diagnoses by Mayo pathologists proved incorrect after tissue analysis of the resected pancreas.
Kaplans alleged Dr. Nagorney promised intraoperative biopsy to verify cancer and that Mayo would ensure exhaustive/exact pathology, forming a contract; evidence of intraoperative biopsy was central.
Appellate court affirmed negligent failure to diagnose verdict and Burgart contract judgment but vacated Mayo's contract judgment and remanded for further proceedings.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether admitting Dr. Dunlap’s medical file was reversible error	Kaplans argue collateral-source materials prejudiced trial.	Mayo argues limited relevance; district court properly admitted.	No reversible error; lack of prejudice.
Whether photographs of biopsy slides were properly authenticated	Slides' chain of custody questionable; misauthentication possible.	Authentication can rely on circumstantial evidence; jury can resolve authenticity.	District court did not abuse discretion; no substantial authentication issue.
Whether omission of Burgart’s name from Instruction 13 was plain error	Instruction lacking Burgart’s name could confuse jury.	Other instructions identified Burgart; no plain error.	No plain-error basis; instruction was not reversible.
Whether summary judgment on contract claim against Mayo was proper; whether contract existed and damages proven	Kaplans alleged a definite contract to ensure exhaustive diagnosis including intraoperative biopsy; breach occurred.	No enforceable contract; breach not established without expert testimony.	JAML reversed as to Mayo; contract claim supported by evidence of promise and breach.
Whether expert testimony was required to support a contract-based claim in health care context	Promissory contract to ensure diagnostic accuracy is within lay understanding.	Minn. Stat. §145.682 requires expert testimony in some medical malpractice settings.	No expert affidavit required for this ordinary contract claim.

Key Cases Cited

Williams v. Kansas City, Mo., 223 F.3d 749 (8th Cir. 2000) (insufficient prejudice from evidence misstep can be harmless)
Jones v. National Am. Univ., 608 F.3d 1039 (8th Cir. 2010) (authentication threshold set; jury decides authenticity after basic showing)
Banghart v. Origoverken, A.B., 49 F.3d 1302 (8th Cir. 1995) (threshold authentication suffices; chain of custody generally for jury determination)
Csiszer v. Wren, 614 F.3d 866 (8th Cir. 2010) (plain-error review for trial-instruction omissions)
Rahn v. Hawkins, 464 F.3d 813 (8th Cir. 2006) (instructional error requires serious impact on fairness)
Mattis v. Carlon Elec. Prods., 295 F.3d 856 (8th Cir. 2002) (de novo standard for grant of judgment as a matter of law)
Briggs Transp. Co. v. Ranzenberger, 299 Minn. 127, 217 N.W.2d 198 (Minn. 1974) (contract elements: formation, breach, damages)
Costello v. Johnson, 265 Minn. 204, 121 N.W.2d 70 (Minn. 1963) (expert testimony may be unnecessary for certain lay-contract claims)
Tousignant v. St. Louis County, 615 N.W.2d 53 (Minn. 2000) (expert necessity depends on general knowledge of laypeople)
Dyson v. Schmidt, 260 Minn. 129, 109 N.W.2d 262 (Minn. 1961) (lay understanding of non-medical-contract claims)