100 N.Y.2d 22 (2003)

Expert medical testimony is admissible to help a jury determine whether an injury would ordinarily occur in the absence of negligence, even when the matter is outside the common knowledge of laypersons, for the purpose of establishing the first element of res ipsa loquitur.

Summary

Kathleen States sued her anesthesiologist, alleging her arm was injured during surgery due to negligent positioning. Lacking direct evidence of negligence, States sought to invoke res ipsa loquitur, offering expert testimony that her injuries wouldn’t occur absent negligence. The New York Court of Appeals addressed whether expert testimony is admissible to establish the first element of res ipsa loquitur – that the injury ordinarily doesn’t occur without negligence – in cases outside the common knowledge of laypersons. The Court held that expert testimony is indeed admissible to help the jury bridge the gap between their common knowledge and the specialized knowledge needed to determine whether the injury typically results from negligence. This allows the jury to consider the res ipsa loquitur inference.

Facts

Kathleen States underwent surgery for ovarian cyst removal. During the surgery, while under anesthesia, she alleges that her right arm was negligently positioned, specifically hyperabducted beyond a 90-degree angle for an extended period. She complained of pain and burning when an IV was inserted into her right hand prior to surgery. Upon waking, she experienced increased pain in her right arm and shoulder. She was later diagnosed with right thoracic outlet syndrome and reflex sympathetic dystrophy. She claimed the injury was a result of the negligent positioning of her arm during the surgery.

Procedural History

The Supreme Court denied the defendant’s motion for summary judgment, finding that the jury could rely on expert medical opinion to support the conclusion that the injury would not have occurred in the absence of negligence. The Appellate Division reversed, holding that the inference was not permitted since the injury was not the sort as to which a jury could draw upon its common knowledge to conclude that it would not have occurred absent negligence. The plaintiff appealed to the New York Court of Appeals based on a two-Justice dissent.

Issue(s)

Whether expert medical testimony is admissible to establish the first element of res ipsa loquitur—that the injury ordinarily does not occur in the absence of negligence—when the determination of whether such an event would occur is outside the common knowledge of laypersons.

Holding

Yes, because expert testimony may be properly used to help the jury “bridge the gap” between its own common knowledge and the specialized knowledge necessary to determine whether the occurrence would normally take place in the absence of negligence.

Court’s Reasoning

The Court reasoned that the doctrine of res ipsa loquitur allows a jury to infer negligence from the mere occurrence of an event, provided that the event is of a kind that ordinarily does not occur in the absence of negligence, the injury was caused by an agent or instrumentality within the exclusive control of the defendant, and the plaintiff did not contribute to the event. The court addressed the specific issue of whether expert testimony is permissible to establish the first element of res ipsa loquitur. It acknowledged that while res ipsa loquitur traditionally relies on everyday experience, the increasing specialization of society necessitates allowing expert testimony to inform the jury’s understanding in cases involving complex matters. The court emphasized that expert opinion serves to educate the jury and enlarge its understanding, but the jury remains responsible for drawing the ultimate conclusion. The court quoted the Restatement (Second) of Torts § 328D, Comment d, stating that expert testimony is essential where “there is no fund of common knowledge which may permit laymen reasonably to draw the conclusion.” The Court cited Connors v University Assoc. in Obstetrics & Gynecology, Inc., 4 F.3d 123, 128 (2d Cir. 1993) noting that expert testimony can bridge the gap between the jury’s common knowledge and the common knowledge of physicians. The court emphasized that allowing expert testimony does not relieve the plaintiff of the burden of proof or negate the jury’s role as the finder of fact. It merely permits the jury to infer negligence based on evidence that the injury-causing event would not normally occur unless someone was negligent. The defendant retains the right to rebut this inference with evidence to the contrary. The Court concluded by stating that the jury should hear from the plaintiff’s experts to determine whether the injury would normally occur in the absence of negligence, and the defendant should have the opportunity to present evidence that the injury is an inherent risk of the procedure not entirely preventable with reasonable care. “In an increasingly sophisticated and specialized society such as ours, it is not at all surprising that matters entirely foreign to the general population are commonplace within a particular profession or specially trained segment of society.”