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Cobbs v Grant

Law

Citation

8 Cal.3d 229, 104 Cal. Rptr. 505, 502 P.2d 1 (Cal. 1972)

Court

Supreme Court of California

Procedural History

The plaintiff, Cobbs, brought a medical malpractice lawsuit against Dr. Grant for negligence and failure to obtain informed consent before performing surgery. The trial court ruled in favor of Cobbs. However, the California Supreme Court reversed the judgment, ruling that the jury instructions did not properly distinguish between negligence and informed consent. The case was remanded for a new trial.

Facts of Cobbs v Grant

Cobbs was admitted to a hospital for the treatment of a duodenal ulcer. Two physicians, Dr. Sands and surgeon Dr. Grant, examined Cobbs and determined that surgery was necessary. Dr. Grant explained the nature of the procedure to Cobbs but did not inform him of the inherent risks associated with the operation.

During the surgery, unexpected complications arose. Cobbs suffered an internal hemorrhage, which led to the removal of his spleen. Following the surgery, Cobbs developed a gastric ulcer, requiring a subsequent operation. More complications ensued, leading Cobbs to file a malpractice lawsuit against Dr. Grant. Cobbs alleged that:

  1. Dr. Grant failed to obtain informed consent before surgery.
  2. Dr. Grant was negligent in performing the procedure.

The jury ruled in favor of Cobbs, holding Dr. Grant liable. However, on appeal, the California Supreme Court reversed the judgment and remanded the case for a new trial due to insufficient jury instructions on informed consent.

Legal Issue

The issues raised in Cobbs v Grant were:

  1. Did Dr. Grant’s failure to disclose the inherent risks of surgery constitute a breach of duty to obtain informed consent?
  2. Was there sufficient evidence of negligence to support the jury’s verdict?

Cobbs v Grant Judgment

The California Supreme Court in Cobbs v Grant ruled that:

  • The failure to disclose inherent risks falls under negligence, not battery.
  • There was insufficient evidence of negligence in performing the procedure.
  • Because it was unclear whether the jury based its decision on negligence or lack of informed consent, the court reversed the judgment and remanded the case for a new trial with proper jury instructions.

The court in Cobbs vs Grant analyzed two major components of medical malpractice: negligence in treatment and informed consent.

Negligence in Performing Surgery

  • The court determined there was no substantial evidence that Dr. Grant acted negligently during the operation.
  • Expert witnesses testified that Dr. Grant performed the procedure with due care.
  • The occurrence of complications alone does not imply negligence. Medical procedures inherently involve risks, and their mere occurrence does not constitute malpractice.
  • Therefore, the negligence claim did not stand.

Failure to Obtain Informed Consent

The court emphasized the doctrine of informed consent, recognizing it as a negligence issue rather than battery.

  • Traditional View (Battery Theory): Historically, failure to obtain consent was classified as battery, as it involved an unauthorized touching of the body. Under this theory, any unauthorized medical procedure was legally considered an assault.
  • Modern View (Negligence Theory): The court rejected the battery theory in favor of negligence. The rationale was that lack of informed consent is not an intentional wrongdoing but a failure to disclose risks. Thus, it should be addressed under medical negligence standards.
  • Legal Standard for Disclosure: The court ruled that a doctor’s duty to inform is not solely dictated by medical community standards, but also by a legal standard of reasonableness—what a reasonable patient would need to know before making an informed decision.

Key Points from the Court’s Reasoning

  1. Doctors must disclose all significant risks that a reasonable person would want to know.
  2. Informed consent is a negligence issue, not a battery issue.
  3. Jury instructions must clearly differentiate between negligence in performing surgery and negligence in failing to obtain informed consent.

Conclusion

Cobbs v Grant is a landmark case in the development of informed consent law. The ruling shifted the legal landscape by:

  • Classifying lack of informed consent as negligence rather than battery.
  • Establishing that the standard for disclosure is based on patient needs, not just medical norms.
  • Emphasizing the importance of proper jury instructions in medical malpractice cases.

Ultimately, this case reaffirmed the fundamental principle that patients have a right to be fully informed before making medical decisions. The court’s ruling set an important precedent, shaping medical ethics and legal obligations for physicians across the United States.