Third Circuit Upholds Alexandria Doctor’s Actions As Within Standard of Care

Every year thousands of medical malpractice claims are filed. Why? The answer is simple. The practice of medicine is complex, and, as advanced as our medical sciences are, mistakes are made, false diagnosis are given, and new conditions emerge. Since there are so many complexities, the fact that a patient is misdiagnosed or suffers from a condition that the doctor missed does not necessarily guarantee a successful medical malpractice claim. As illustrated by Cheramie v. Norem, in order to succeed on such a claim, a plaintiff must establish that the doctor did something or failed to do something that fell below the appropriate standard of care which resulted in harm to the patient.

In most medical malpractice cases, including Cheramie v. Norem, the most contested issue regards the standard of care. Typically, healthcare providers are held to a reasonable care standard, requiring them to use diligence and their best judgment in applying their skills. General practitioners are held to local standards which are the standards that prevail in the area they live or a similar location. Specialists, on the other hand, are held to a single national standard that applies to the entirety of that particular specialty. Regardless of which locale’s standard applies, all standards are comprised of a number of elements which the failure to comply with can give rise to a medical malpractice claim.

Cheramie v. Norem provides a glimpse into one of these standard of care elements. In this case, a doctor provided post-operative treatment to a patient after repairing a hernia. After the hernia operation, a small hole opened in the patient’s small intestine, requiring permanent sutures. As time passed, the patient’s body began rejecting the sutures and the question arose as to whether or not the doctor should operate to remove them. After years of the doctor’s recommendation that the sutures should remain, the patient was forced by his insurance company to get a second opinion. This second doctor operated to remove the sutures, resulting in a full recovery by the patient. Afterwards, the patient filed suit against the original doctor for malpractice.
In this case, the standard of care element the court looked to was informed consent. Louisiana statutes provide that doctors are required to provide their patients with sufficient information to permit the patient to make an informed decision on whether or not to pursue a course of treatment (Hondrouis v. Schuhmacher, 553 So.2d 398, 411 (La. 1988)). This information includes the nature of the patient’s condition, the nature and risks involved with a proposed treatment, the likelihood of success of a particular treatment, and the risks of foregoing any treatment. When an issue of informed consent is raised regarding a general practitioner’s standard of care, local medical experts and doctors will often testify as to the defendant doctor’s actions. If these testifying doctors make statements indicating that certain medical practices or advice was reasonable and appropriate, then malpractice likely has not occurred.

At trial, a jury found that the doctor in Cheramie’s case acted within proper standards of providing informed consent. This informed consent included informing the patient of treatment options and the risks, in addition to alternative medical treatments. Dispute arose concerning whether or not the doctor conceded, in a timely matter, that a second opinion was needed. However, when there are conflicting opinions concerning compliance with a standard of care, a reviewing court gives deference to the trier of fact’s conclusion. Thus, since the jury found the doctor to be in compliance with the suitable standard of care, the appellate court upheld that decision.

Since the standard of care a general practitioner is required to adhere to correlates to where the doctor practices, rural areas may have a lower standard of care than those in urban settings. The reasons for this are varied, but may include limited access to equipment and technological resources. Therefore, a rural doctor would not be expected to have conducted tests that require an expensive piece of equipment only owned by large urban hospitals. Yet, this same rural doctor would likely be expected to have at least notified the patient of that opportunity, if the doctor knew of such a test. On the other hand, the doctor who practices in a technologically advanced hospital would be held to a higher standard of care because he would have more access to such equipment and specialists. For this reason, when an individual is deciding whether or not to file a medical malpractice claim, she must be aware of the standard of care a doctor is required to give in that location.

Medical malpractice claims are complex, incorporating several elements that may change the legal analysis based on things as simple as the doctor’s location. These matters are best left to a practicing attorney with knowledge and experience in this field. If you have any questions regarding a medical malpractice claim, please contact the Berniard Law Firm.