Res Ipsa Loquitur in Medical Malpractice Cases in New York

The doctrine of res ipsa loquitur is available in a narrow category of factually simple medical malpractice cases requiring no expert to enable the jury to reasonably conclude that the accident would not happen without negligence (Kambat v. St. Francis Hosp., 89 NY2d 489, 496, 678 NE2d 456, 655 NYS2d 844 [1997]). Res ipsa loquitur permits a fact finder to infer negligence from the circumstances of the occurrence (Kambat, 89 NY2d at 495). Application of the doctrine requires a plaintiff to satisfy the burden of proof with respect to three elements - first, that the injury-causing event be of a kind that ordinarily does not occur in the absence of negligence, second, that the injury was caused by agent or instrumentality within the exclusive control of the defendant and, third, that no act or negligence on the plaintiffs part contributed to the happening of the event. The second and third elements are easily established here. There is no question defendants were in exclusive control of the operating table and the remote control used to raise and lower it during the surgery and Leddy, as a result of being anesthetized at time of the occurrence, could not have contributed to the happening of the intraoperative event. Regarding the first element, that the injury-causing event be of a kind that ordinarily does not occur in the absence of negligence, the Court of Appeals has held that it is proper to allow the use of expert medical testimony to inform the jury's question on this element (States v. Lourdes Hosp., 100 NY2d 208, 210, 792 NE2d 151, 762 NYS2d 1 [2003]). Specifically, the Court of Appeals stated that "expert testimony may be properly used to help the jury 'bridge the gap' between its own common knowledge, which does not encompass the specialized knowledge and experience necessary to reach a conclusion that the occurrence would not normally take place in the absence of negligence, and the common knowledge of physicians, which does" (id. at 212). The Court of Appeals further noted that just as a fact finder should be allowed to hear from a plaintiff's expert in order to determine whether an injury would normally occur in the absence of negligence, a defendant must be given the opportunity to rebut the assertion with competent expert evidence to show, for example, that the injury is an inherent risk of the surgical procedure and not totally preventable in the exercise of ordinary care (id. at 214).