One-Sentence Takeaway: The California Supreme Court applied res ipsa loquitur to hold that a patient who suffered an injury while unconscious during surgery could sue all doctors and hospital employees involved without specifying which one was negligent, shifting the burden to defendants to explain the injury.
Summary: This case presents the special problem of multiple potential tortfeasors.
While plaintiff was under the care of defendant physicians and nurses for an appendectomy, he suffered injury to his shoulder. Although it seemed likely that his injury resulted from the negligence of one or more of his caretakers, he could not prove any direct evidence that the act of any particular defendant (or any particular instrumentality) was responsible.
Because there was a division of responsibility (as well as time, space, and instrumentalities) among defendants from the operation to the recovery room, one could not say that, as to any one defendant, it was more likely than not that plaintiff’s injury was caused by him or her.
For several reasons, however, the court stretched the doctrine of res ipsa loquitur to allow plaintiff to make out a prima facie case. Those reasons included:
- the need to compensate an innocent victim who had submitted himself totally to the care of the defendants;
- the fiduciary relationship between defendants and plaintiff; and
- the judgment that, as between the parties, defendants should bear the risk of unexplained injuries because they were in a better position to avoid the injuries, to spread the cost, and to have access to information about its causes.
The last point was especially important. There was a sense in the case that at least some of the defendants knew who was responsible and were deploying a “conspiracy of silence” to protect each other. Application of res ipsa loquitur in such circumstances gave plaintiff an added ability to “smoke out” the facts.
REFERENCE DESK
Leuer v. Johnson, 450 N.W.2d 363 (Minn. App. 1990):
Ybarra v. Spangard . . . extended res ipsa loquitur to a plaintiff who had been injured while unconscious on the operating table by an unidentifiable instrumentality in the control of an unidentifiable tortfeasor. “If the doctrine is to continue to serve a useful purpose, we should not forget that the particular force and justice of the rule, regarded as a presumption throwing upon the party charged the duty of producing evidence, consists in the circumstance that the chief evidence of the true cause, whether culpable or innocent, is practically accessible to him but inaccessible to the injured person.” This passage is quoted in Summers v. Tice as the basis for its application of res ipsa loquitur when exclusive control of the instrumentality by a specific defendant could not be established.
Ybarra has been the subject of frequent comment for the appellate courts of this state, particularly in malpractice cases. It was distinguished in Wallstedt v. Swedish Hospital, 220 Minn. 274 (1945) on the grounds that the Ybarra plaintiff’s injury had no possible cause other than someone’s negligence, while the injury to the Wallstedt plaintiff could have been the result of one of several causes. This distinction was repeated in Miller v. Raaen, 273 Minn. 109 (1966). Ybarra was also cited in support of the application of res ipsa loquitur to medical malpractice cases in Jensen v. Linner, 260 Minn. 22 (1961) . . .
The next case to urge Minnesota’s adoption of Ybarra was not a medical case: the appellant in Hanzel v. Good Earth Inc., 371 N.W.2d 72 (Minn.Ct.App. 1985) was injured by biting into a walnut shell. This court responded to appellant’s arguing of the Ybarra rule by observing that: “No Minnesota case has yet adopted the California theory. Such a change in Minnesota law is more appropriately left to the supreme court.” Notwithstanding this observation, this court did adopt Ybarra in another medical malpractice case, Hoven v. Rice Memorial Hospital, 386 N.W.2d 752 (Minn. Ct. App. 1986). That opinion distinguished Hanzel on the facts, and concluded by saying, “In the present case, we must decide whether to follow the majority of jurisdictions which have adopted the Ybarra rule. Because we agree with the rationale of those cases, we hold that the trial court erred.” However, the supreme court explicitly rejected the Ybarra rule when it overturned this decision in Hoven v. Rice Memorial Hospital, 396 N.W.2d 569 (Minn. 1986), stating the court of appeals had based its decision “on the almost absolute liability of the modified res ipsa loquitur doctrine applied by the California Supreme Court. Adoption of that analysis would put the burden on defendants to show how plaintiff’s injury occurred and that the injury was caused by no negligence on the part of any team member — in most cases creating what would amount to absolute liability.”
Loizzo v. St. Francis Hospital, 121 Ill. App. 3d 172 (1984):
In Ybarra, the plaintiff was injured during a surgical procedure while unconscious. The California Supreme Court held that where a plaintiff received unusual injuries while unconscious and in the course of medical treatment, all those defendants who had any control over his body or the instrumentalities which might have caused the injuries may properly be called upon to meet the inference of negligence by giving an explanation of their conduct. Different from the situation in Ybarra, the plaintiff here has not named as defendants all of the entities who might have caused his injuries. This is fatal to his action since the plaintiff must eliminate the possibility that the accident was caused by someone other than any defendant. Too, the situation in Ybarra concerned a single surgical procedure at a known time and location. Because all of the multiple defendants were present during Ybarra’s surgery, they each had superior knowledge as to the cause of his injuries. Their shared, joint, and concurrent control was sufficient to raise the inference and require them to dispel the prima facie case of their negligence. Since the situation here differs from that in Ybarra, the California Supreme Court’s limitation in Ybarra becomes extremely significant: “We do not at this time undertake to state the extent to which the reasoning of this case may be applied to other situations in which the doctrine of res ipsa loquitur is invoked.”