Ray v. KAPIOLANI MEDICAL SPECIALISTS
259 P.3d 569
Haw.2011Background
- Alyssa Ray, 14, with lupus and brain involvement, was treated at Kapi`olani Medical Specialists for lupus with brain involvement.
- Dr. Yamamoto proposed four-week IV Solu-Medrol pulses with a three-day on/three-day off cycle and prednisone maintenance.
- Alyssa’s condition improved after pulses but later developed significant muscle weakness attributed to steroids.
- New York physicians later diagnosed steroid myopathy as the cause of Alyssa’s weakness; Alyssa was rehabilitated for months.
- In July 2003, the Rays filed suit against KMS and KMCWC for negligent treatment and failure to obtain informed consent; the circuit court later entered damages and the Rays appealed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Judgment as a matter of law on negligent treatment | Ray(s) contended no substantial evidence that Yamamoto’s treatment caused injury | KMS argued evidence supported no-causation finding | JMOL for Rays on negligence reversed; new trial required due to irreconcilable verdict |
| Informed consent JMOL | Failure to disclose alternative dosing was a breach of duty under 671-3(b) | Rays must prove injury from undisclosed risk; alternative dosing not required | Circuit court did not err in denying JMOL on informed consent |
| Admission of Dr. Bernstein's testimony on experience | Testimony about physician’s experience with treatment was admissible as part of informed consent | Testimony was improper inference of standard of care | Admission of Bernstein’s testimony was erroneous and not cured by instructions; reversible error |
| Effect of irreconcilable verdict | No-causation finding conflicts with informed consent finding; require new trial | Could be reconciled or deemed error | Verdict irreconcilable; case remanded for a new trial |
Key Cases Cited
- Barcai v. Betwee, 98 Hawai`i 470 (Haw. 2002) (informed consent elements include alternative treatments, causation standard)
- Carr v. Strode, 79 Hawai`i 475 (Haw. 1995) (discusses patient-focused standard for informed consent)
- Barcai v. Betwee, 98 Hawai`i 470 (Haw. 2002) (reiterates duty to disclose alternatives under 671-3)
- Keomaka v. Zakaib, 8 Haw. App. 518 (Haw. App. 1991) (disclosure requirements under informed consent statute)
- Dunbar v. Thompson, 79 Hawai`i 306 (App. 1995) (irreconcilable verdict standard for new trial vs. remand)