Lacy Dodd v. Dr. Randall Hines

Citations: 229 So. 3d 124; 2016 WL 4615034Docket: NO. 2015-CA-00334-COA

Court: Court of Appeals of Mississippi; September 6, 2016; Mississippi; State Appellate Court

Original Court Document: View Document

SummaryOriginalCytator Case TreatmentBackward CitatorAnalysis

EnglishEspañolSimplified EnglishEspañol Fácil

Appeal case No. 2015-CA-00334-COA involves Lacy Dodd and her husband Charles Dodd appealing against Dr. Randall Hines, Reproductive Medicine PLLC, and Dr. Paul Seago, following the Rankin County Circuit Court's summary judgment favoring the defendants. The court ruled that Lacy had consented to the removal of both ovaries based on a signed document for ovarian cyst removal and other necessary procedures deemed emergent by the medical staff.

The Dodds' complaint was filed on May 17, 2013, with the defendants moving for summary judgment before discovery was completed, supported by various documents including affidavits and medical records. Lacy, concerned about fertility, had authorized Hines to perform a procedure on March 25, 2011, which included the removal of ovarian cysts and possibly a fallopian tube. The consent form allowed for additional unforeseen procedures deemed necessary by her doctors.

During surgery, Hines found both ovaries to be abnormal and clinically cancerous, leading to a consultation with Seago. They concluded that the removal of both ovaries was medically necessary for Lacy's long-term health. Post-surgery biopsies indicated that the ovaries were non-cancerous, leading Lacy to express a desire to explore options for preserving her fertility.

After the surgery, Lacy began hormone replacement therapy but had to discontinue it due to blood clots, resulting in early menopause and the inability to conceive biologically. The appellate court reversed the trial court's summary judgment and remanded the case for further proceedings.

On May 17, 2013, Charles and Lacy filed a pro se complaint in Rankin County Circuit Court against Hines, RM, and Seago, alleging negligence related to the removal of Lacy's ovaries, including failure to obtain informed consent, perform a biopsy, and misdiagnosis. Hines and RM, later joined by Seago, filed a motion for summary judgment. After Charles and Lacy retained counsel, an agreed order was established on May 22, 2014, allowing the court to hear all motions except for the causation aspect of the summary judgment motion. On October 1, 2014, the court ordered that the summary judgment motion be held in abeyance except for the consent issue, directing the defendants to file a supplemental motion addressing that specific concern.

Consequently, Hines and RM, with Seago, submitted a supplemental motion that included arguments regarding consent and causation. Charles and Lacy were granted an extension to respond and addressed all issues raised. On February 6, 2015, the circuit court granted summary judgment in favor of the defendants, determining that the consent document Lacy signed permitted the doctors to perform any necessary procedures during surgery, which negated all claims raised by Charles and Lacy. They appealed the decision on February 23, 2015.

The review of the summary judgment is de novo, focusing on whether Lacy provided appropriate consent for her ovaries' removal. Two types of consent analyses are outlined: the battery-based consent analysis, which emphasizes the necessity of consent for medical procedures, and the informed-consent analysis based on medical negligence, which assesses whether a reasonably prudent patient would have consented to the treatment after being fully informed of the risks involved. Establishing the known risks requires expert testimony.

Mississippi law lacks clear guidance on when to apply battery-based versus medical-negligence-based analyses in medical consent cases. In Spaight v. Shah-Hosseini, the Rhode Island Superior Court indicated that most jurisdictions view failure to disclose risks as negligence, reserving battery law for unauthorized procedures. In the current case, expert testimony was necessary to establish the material risks of the procedure, but none was provided. The affidavits from Hines and Seago were considered lay opinions, not expert evidence, and did not clarify whether the removal of Lacy's ovaries was a known risk. The record confirms Lacy was not informed of this risk, and she did not give explicit consent for the removal of her ovaries. Consequently, the analysis of her lack of consent under battery law prevails, as the trial court correctly limited its review to consent issues, given that discovery had not commenced. Judge Carlton’s dissent, advocating for a medical-negligence analysis, was deemed premature, as was Judge Wilson's reliance on the doctors' affidavits to validate the consent form without expert testimony.

Waivers signed by patients, while useful, may not definitively indicate consent. In Barner v. Gorman, it was established that generic waiver forms are insufficient; they must address specific risks related to the patient's treatment. In the case at hand, the form permitted "necessary or emergent" procedures but did not specifically inform Lacy of the risk of ovary removal, leaving her consent for that procedure unclear. Lacy sought treatment to improve her fertility, consenting only to the removal of ovarian cysts and one fallopian tube. Instead, both ovaries were removed, which constituted a substantially different procedure that undermined her fertility goals. This misalignment indicates a lack of express consent for the ovary removal. The court determined that genuine issues of material fact existed, thus reversing the lower court's summary judgment and remanding the case for further proceedings. The costs of the appeal were assessed to the appellees.

Irving, P.J., Barnes, Ishee, and James, JJ. concur; Carlton, J. dissents with a separate opinion, as does Wilson, J., joined by Griffis, P.J. and Carlton, J. Lee, C.J. and Fair, J. do not participate. Carlton, J. argues for affirming the circuit court's summary judgment for Hines, RM, and Seago, stating Lacy did not raise a genuine issue of material fact necessary to prevent summary judgment. Lacy signed a consent document permitting Hines and other physicians to perform a laparoscopic ovarian cystectomy, including additional unforeseen procedures deemed necessary. 

The undisputed evidence indicated that during surgery, Hines found both of Lacy's ovaries enlarged and diseased, lacking normal tissue, raising suspicions of cancer. Hines consulted Seago, a specialist in gynecological cancers, who confirmed the findings. Given Lacy’s medical history and family background, they agreed that removing the ovaries was essential for her health. A biopsy was deemed risky and unnecessary, as it could spread cancer and would not conclusively rule it out.

Lacy did not provide expert testimony to counter the summary judgment evidence presented by Hines, RM, and Seago, failing to establish a genuine dispute regarding the necessity of the ovary removal or her consent to it. Citing legal precedent, Carlton, J. emphasizes that a party opposing summary judgment must provide evidence beyond mere allegations. The circuit court maintained that Lacy was required to respond to the informed consent issue during summary judgment proceedings.

Lacy's only counter-evidence against Hines, RM, and Seago was her affidavit, which the circuit court deemed insufficient to demonstrate a genuine issue of material fact. She did not present expert testimony regarding the necessity or urgency of additional surgeries related to her ovarian condition or the risks associated with the laparoscopic cystectomy. Under Mississippi law, informed consent requires that a patient be advised of material risks, a standard Lacy failed to meet. The dissenting opinion emphasizes that Lacy's claim is a "no-consent" rather than an informed-consent claim, as the removal of her ovaries was not a risk of the procedures she consented to. The surgery she underwent, a bilateral salpingo-oophorectomy, was deemed necessary due to the discovery of cancerous ovaries during the procedure. Lacy had consented to additional surgeries as deemed necessary by her medical team, which included the removal of her ovaries after a consult with Dr. Seago, who confirmed the cancerous condition. The undisputed facts establish that her consent covered the necessary procedure.

Dr. Seago determined that Lacy had virtually no chance of conceiving with her own eggs, leading him to recommend the removal of her ovaries, a decision supported by Dr. Hines. They believed that performing a biopsy would pose a risk of spreading cancer and that it would not definitively rule out cancer, thus posing an ongoing health risk. Both doctors maintained that their decision to proceed with the surgery was medically necessary and there was no evidence suggesting otherwise. Lacy had explicitly consented to any additional procedures deemed necessary by her doctors, and their affidavits confirmed their judgment regarding the necessity of the procedure. 

The majority's view that expert testimony was required to determine the necessity of the procedure contradicts the terms of Lacy's consent. The consent form indicated that Lacy agreed to additional procedures based on her doctors' judgment, establishing no genuine issue of material fact regarding her consent. The majority's reliance on the Barner v. Gorman case, which dealt with informed consent, is misplaced as this case concerns a no-consent claim. Lacy's signed consent is conclusive of her agreement to the actions taken by the doctors, and the circuit court's summary judgment in favor of the defendants was appropriate. The majority's refusal to uphold Lacy's consent implies a broader public policy issue regarding the validity of preoperative consent for necessary procedures as determined by a physician's judgment.

A common law rule of construction in New Jersey allows patient consent for one type of operation to extend, in the absence of contrary evidence, to additional procedures deemed necessary by the physician. The majority has improperly applied this rule as a mandatory limitation on medical consent forms in Mississippi, declaring any broader consent void against public policy. Lacy's consent allowed her doctor to perform necessary additional procedures based on his medical judgment, rather than solely on retrospective assessments by attorneys. The majority's disapproval of Lacy's broad consent does not justify invalidating it. Courts should enforce contracts as agreed upon unless a clear public policy prohibits the terms. The opinion raises concerns regarding the clarity of the Dodds’ claims, oscillating between categorizing it as a no-consent claim and suggesting the possibility of pursuing an informed-consent claim on remand. Additionally, the majority implies Lacy's consent is not conclusive evidence of her agreement to the procedures, leaving the matter as a genuine issue of fact for litigation. The majority also states Lacy did not expressly authorize a specific procedure, indicating she may be entitled to judgment as a matter of law on her no-consent claim. The dissenting opinion argues for affirming the circuit court’s summary judgment in favor of the defendants, emphasizing the need for clearer guidance on these legal interpretations for further proceedings.