Martin v. Lahti, 809 S.E.2d 644

Margaret Starr was diagnosed with acute pancreatitis with gallstones and Dr. Gary Lahti recommended cholecystectomy; her daughter Wanda Martin signed the consent form for her mother.
Surgery began laparoscopically but was converted to open after a bowel injury; Starr died about a week later from surgical complications.
Martin sued for medical malpractice, including a count for lack of informed consent, alleging Starr would have declined surgery if told nonoperative alternatives were reasonable.
At a hearing on causation Martin and Starr’s sister Rachel Meeks testified they were close to Starr, that Starr generally disliked surgery, and that, based on their conversations, Starr would not have consented if properly informed; neither witness heard the doctor’s preoperative conversation with Starr.
The trial court excluded (a) the witnesses’ lay-opinion testimony about what Starr would have done as speculative/hearsay and (b) Starr’s post-op statement “I thought that this would be an easy operation” as irrelevant; the court then dismissed the informed-consent count. Martin appealed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Admissibility of lay-opinion testimony under Va. R. Evid. 2:701 on whether Starr would have declined surgery if informed of alternatives	Martin: her and Meeks’ extensive personal observations of Starr’s attitudes and pre-op contact with her mother provide a permissible lay basis to opine Starr would have refused surgery	Defendants: witnesses lacked firsthand knowledge of the doctor–patient exchange and their opinion is speculative hearsay	Court: testimony was speculative, not grounded in the witnesses’ personal perception of the decisive event, and properly excluded (abuse of discretion standard)
Admissibility of decedent’s post-op remark (“I thought that this would be an easy operation”) under relevance and Deadman’s Statute (Code § 8.01-397)	Martin: statement shows Starr was misled about risk and supports inference she would have chosen a non-surgical alternative	Defendants: statement is irrelevant and/or hearsay; trial court excluded on relevance (and earlier characterized proffer as hearsay/speculative)	Court: plaintiff failed to assign error to the trial court’s relevance ruling; issue waived and exclusion affirmed

Allison v. Brown, 293 Va. 617 (discusses elements required to prove informed consent)
Harman v. Honeywell, 288 Va. 84 (standard of review and limits on lay opinion admissibility)
United States v. Marshall, 173 F.3d 1312 (lay opinion admissible only when based on firsthand knowledge)
MCI Telecomms. Corp. v. Wanzer, 897 F.2d 703 (modern trend permits lay opinion when founded on personal knowledge)
Canterbury v. Spence, 464 F.2d 772 (articulates objective approach to causation in informed-consent cases)