§47.33 Proof of Causation in Res Ipsa Cases

The Case: Seavers v. Methodist Medical Center of Oak Ridge , 9 S.W.3d 86 (Tenn. 1999).

The Basic Facts: Plaintiff brought a medical malpractice suit against Defendant hospital after sustaining nerve damage to her arm after being strapped down in her hospital bed.

The Bottom Line:

• "We granted this appeal to address whether the doctrine of res ipsa loquitur, as codified at Tennessee Code Annotated section 29-26-115(c), is applicable in medical malpractice cases where the plaintiffs must rely upon expert testimony to prove the elements of causation, standard of care, and that the injury does not ordinarily occur in the absence of negligence." 9 S.W.3d at 89.
• "Pertaining to the doctrine of res ipsa loquitur, the Act essentially codified the common law. Section -115(c) reads in pertinent part:

  In a malpractice action as described in subsection (a) of this section there shall be no presumption of negligence on the part of the defendant. Provided, however, there shall be a rebuttable presumption that the defendant was negligent where it is shown by the proof that the instrumentality causing injury was in the defendant's (or defendants') exclusive control and that the accident or injury was one which ordinarily doesn't occur in the absence of negligence.

  [Id. at § 29-26-115(c)]." Id. at 93.
• "Having carefully reviewed the above authority, we believe that the better rule is to allow expert testimony in medical malpractice cases, where otherwise admissible, to assist the parties both in establishing or rebutting the inference of negligence under a theory of res ipsa loquitur. While we agree that res ipsa loquitur is best suited for cases where the nature of the injury lies within the common knowledge of lay persons, we see no reason to continue to preclude the use of the res ipsa doctrine simply because a claimant's injury is more subtle or complex than the leaving of a sponge or a needle in the patient's body. As recognized by the [Restatement] and a majority of other jurisdictions, the likelihood of negligence necessary to support a charge under res ipsa loquitur may exist even when there is no fund of common knowledge concerning the nature and circumstances of an injury. See Connors v. University Assoc. in Obstetrics & Gynecology, Inc., 4 F.3d 123, 128 (2d Cir. 1993) (applying Vermont law); [RESTATEMENT (SECOND) OF TORTS § 328D cmt. d]." Id. at 95.
• "We conclude that expert testimony may be used to establish a prima facie case of negligence under res ipsa loquitur. While this decision requires us to overrule prior case law, we find that it is supported by Tennessee's medical malpractice statute. As previously stated, Tennessee Code Annotated section 29-26-115(b) sets forth the qualifications for experts in medical malpractice cases, requiring experts to be 'licensed to practice in the state or a contiguous bordering state a profession or specialty which would make his expert testimony relevant to the issues in the case and [has] practiced this profession or specialty in one of these states during the year preceding the date that the alleged injury or wrongful act occurred.' Section 29-26-115(c) next permits the res ipsa inference of negligence 'where it is shown by the proof that the instrumentality causing injury was in the defendant's exclusive control and that the accident or injury was one which ordinarily doesn't occur in the absence of negligence.'" Id. at 96.
• "Nothing in the Act suggests that the inference of negligence under section -115(c) is available only where expert testimony is unnecessary. To the contrary, because expert testimony is required in most medical malpractice cases, it is inconsistent with section -115(c) to completely prohibit the application of res ipsa loquitur in those cases." Id.
• "We do not at this time undertake to extend the reasoning of this decision to other cases where a litigant seeks to invoke res ipsa loquitur. We merely hold that the res ipsa doctrine is available in medical malpractice cases to raise an inference of negligence even if expert testimony is necessary to prove causation, the standard of care, and the fact that the injury does not ordinarily occur in the absence of negligence." Id. at 97.