Sargent v. Shaffer
467 S.W.3d 198
| Ky. | 2015Background
- Loretta Sargent underwent a risky lumbar laminectomy performed by Dr. William Shaffer and afterward suffered incontinence and permanent paralysis from the waist down.
- Sargent sued for medical negligence on two theories: negligent performance of surgery and lack of informed consent; both theories were submitted to a jury, which returned verdicts for Shaffer.
- At trial, Shaffer’s verbal and written disclosures listed general risks (e.g., “nerve injury”) but did not specifically say "paralysis" or "loss of bowel/bladder control." Experts disagreed whether "nerve injury" adequately communicated that specific risk.
- The trial court instructed the jury using a general professional-standard informed-consent instruction (duty = degree of care of a reasonably competent orthopedic spine surgeon) and submitted interrogatories on breach and causation; it omitted the statutory "reasonable individual/general understanding" element of KRS 304.40-320(2).
- On discretionary review, the Kentucky Supreme Court reviewed whether the instruction misstated the law of informed consent and whether that error required reversal and retrial of the informed-consent claim.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether jury instruction accurately stated informed-consent law under KRS 304.40-320 | Instruction was deficient because it omitted KRS 304.40-320(2)’s objective "reasonable individual/general understanding" element | General professional-standard instruction (subsection (1)) suffices; statute is not a separate jury-duty element or is merely a presumption/safe harbor | Court held instruction was legally incorrect for omitting KRS 304.40-320(2); reversal and remand for retrial on informed-consent claim |
| Standard of appellate review for instructional errors | N/A (procedural) | N/A (procedural) | Court clarified two-tier review: (1) trial court’s decision whether to give an instruction = abuse of discretion; (2) correctness of instruction language = de novo review |
| Whether omission was harmless error | Sargent argued prejudice because jury lacked statutory standard to assess whether "nerve injury" conveyed paralysis risk | Shaffer argued experts addressed comprehensibility and any omission was harmless; model instructions support general form | Court presumed prejudice from erroneous instruction and concluded Sargent likely prejudiced — harmlessness not shown; reversal required |
| Whether KRS 304.40-320 imposes a statutory duty or is only a presumption/safe harbor | KRS 304.40-320(1) and (2) together set the standard a jury must apply regarding informed consent | Shaffer (and dissent) argued statute is not a freestanding duty; it creates a presumption or safe harbor applied by the court | Majority: statute amplifies common-law duty and both subsections must be included in jury instruction; dissent would treat it as a presumption and affirm |
Key Cases Cited
- Goncalves v. Commonwealth, 404 S.W.3d 180 (Ky. 2013) (discusses inconsistency in standard of appellate review for jury-instruction claims)
- Holton v. Pfingst, 534 S.W.2d 786 (Ky. 1975) (articulates physician’s general duty to disclose risks — standard of care measure)
- Keel v. St. Elizabeth Medical Ctr., 842 S.W.2d 860 (Ky. 1992) (interpreting KRS 304.40-320 in informed-consent context)
- Commonwealth v. English, 993 S.W.2d 941 (Ky. 1999) (defines abuse of discretion standard)
- McKinney v. Heisel, 947 S.W.2d 32 (Ky. 1997) (erroneous jury instructions presumed prejudicial; burden on proponent to show harmlessness)
- Rogers v. Kasdan, 612 S.W.2d 133 (Ky. 1981) (warning against over-detailed statutory duties in jury instructions)