Perin V. Hayne Case Summary

Arden Clark
HAP 312
September 20, 2015
Discussion Paper: Negligence
In a 1973 case, Perin v. Hayne, the District Court System of Iowa addressed the question of whether a cervical fusion performed on a female patient resulted in a paralysis of a vocal chord. (Showalter 160.). In this particular case the plaintiff, Perin, began consulting Dr. Robert A. Hayne for a cervical fusion surgery. Perin underwent the cervical fusion surgery to eliminate the pain, weakness, and numbness in her back, neck, right arm, and hand, which was caused by two protruding cervical disks. Subsequently, Perin alleged she suffered paralysis of a vocal chord because of an injury to the right recurrent laryngeal nerve during the surgery. In a consultation in 1968, Dr. Hayne took on the cervical fusion surgery for the plaintiffs pain, weakness, and numbness in her back, neck, right arm, and hand. The results from this surgery had resolved the plaintiffs injuries. Soon after, the plaintiff admits that even though the surgery resolved her previous

problems it gave birth to a paralysis of the vocal chord which reduced her voice to a whisper. Not only this but, the plaintiff went on to file a complaint against Dr. Hayne alleging that she sustained damage to her right recurrent laryngeal nerve causing a paralysis to her vocal chord because of the negligence of the doctor. The court due to insufficient evidence on the plaintiffs behalf found the defendant not be negligent and did not hold the defendant liable for the damages suffered by the plaintiff. (Showhalter 163.) .

In the same case it is put forward, “The doctors agree that the technique employed by the defendant was proper. The sole basis for suggesting the expert testimony would support a finding of specific negligence is that the nerve was injured during retraction. Where an injury may occur despite due care, a finding of negligence cannot be predicted solely on the fact it did occur” (Showhalter 161.). The plaintiff should have taken the means to establish specific negligence into consideration before bringing forth an expert witness to testify. The court explained that the record of the plaintiff alleging that the laryngeal nerve was negligently injured be ruled out as there is no evidence that this occurred during the surgery and if an injury occurred despite due care, a finding of negligence cannot be foreseen on the basis that it did occur. Negligence by the physician is not valid either on the plaintiffs claim that there is a case of injury to a part of the body not involved in the treatment. However, this was not viewed as true as the surgery did include the body part the plaintiff said became injured after the procedure making the plaintiffs claims surrounding the issue of specific negligence inapplicable.The court correctly found the defendant not liable for correctly following the standards of a reasonable physician.

In addition to the issue of specific negligence, Res Ipsa Loquitur should be taken into account when determining an opinion towards the courts holding.

“In tort law, the doctrine which holds a defendant guilty of negligence without an actual showing that he or she was negligent. Its use is limited in theory to cases in which the cause of the plaintiff's injury was entirely under the control of the defendant, and the injury presumably could have been caused only by negligence”(Burt, M.A., & Skarin, G.D. (2011). In consideration of this, the defendant argues that the second foundation of this principle should be solely based on common knowledge of the situation. Although, there is a experts testimony tartar is no basis in this case , in the experts testimony or anything else, for indicating that the plaintiffs injury resulted from the negligence of the defendant. The court correctly found the defendant not liable under the Res ipsa

loquitur.

As well as this, in the same case, Illene Perin puts forward “She consented to fusion of two vertebrae (removal of only one protruded disc) thinking there would be a separate operation if additional vertebrae had to be fused. She asserts the fact four vertebrae were fused combined with defendant’s assurances and failure to warn her of specific hazards vitiated her consent and makes the paralyzed vocal chord the result of battery or trespass for which defendant is liable even without negligence”(Showalter 163). Illene Perin should have should have taken in the different aspects of the surgery into consideration when consenting to the surgery during her and the defendants first consultation. The defendant explains that there was no evidence by the plaintiff in trial court or at this court that the plaintiff would not have agreed to the surgery had she known the things she claims the doctor did not reveal to her before the surgery. Although this is brought forward by the plaintiff the defendant being fully aware of being a reasonable physician admits that the plaintiff was fully advised of the nature of her problem and the scope of the surgery thus clearing the defendant. In fact, “He acknowledges he did not advise her of the hazard of the vocal chord paralysis. He believed the possibility of such occurrence was negligible and outweighed by the danger of undue apprehension if warning of the risk was given” (Showalter 163). The court correctly found the defendant not guilty to claims of battery or trespass because the plaintiff consented to one type of treatment and the doctor performed that treatment but an undisclosed complication with a low probability occurred it was not intentional.
It is evident that the procedure of cervical fusion has a large scope that a patient should be well aware of before just undergoing the corrective surgery. The court determined that in this the doctor went about the surgery as any other doctor would have and followed the standards of a reasonable physician when treating the patient. The procedure when looking all aspects could have gone smoothly but the procedure does include a low risk of a complication and the physician would rather have taken the chance with the surgery knowing the risks and rewards than just not doing anything to help the plaintiff. Perin v. Hayne was an important case in determining what is defined as specific negligence, Res ipsa loquitur, and battery or trespass. As a result of a physicians’ decisions, a patient’s previous problems was resolved but as a result of a risk associated with the surgery suffered a paralyzed vocal chord. It is important to understand what consent can mean to the care performed and how negligence can be determined. The plaintiffs understanding of the surgery was a result of the injury suffered because of a misinterpretation on her part and the defendant was not found liable for Perin’s paralyzed vocal chord.

Citations
Burt, M., & Skarin, G. (2011, July 1). RES IPSA LOQUITUR IN CHILD PROTECTIVE PROCEEDINGS July 2011. Retrieved September 21, 2015, from https://www.nycourts.gov/ip/cwcip/Trainings/article10/resipsa.pdf
Showalter, J. Stuart. “Negligence.” The Law of Healthcare Administration. Seventh ed. 2014.