On April 29, 2015, Roxine Lachney filed a Louisiana medical malpractice claim against James L. Gates, M.D., alleging that he breached the standard of care in performing three surgeries on her: the hysterectomy, the right oophorectomy, and the left oophorectomy. The medical review panel issued its opinion on July 21, 2017, and said, in part, that “in light of the sworn affidavit testimony submitted by the claimant, Roxine Lachney, there is a material issue of fact, not requiring expert opinion, which the panel cannot resolve without making a credibility determination, bearing on liability for consideration by the court.”
Following the medical review panel proceeding, Ms. Lachney filed a petition for damages. After a two-day trial on the merits and post-trial briefing, the trial court found that Dr. Gates did not breach the standard of care in performing the three surgeries at issue on Ms. Lachney. Ms. Lachney appealed.
The State of Louisiana Court of Appeal, Third Circuit stated in its December 11, 2024 opinion that the first issue was whether the trial court applied a locality standard of care or a national standard of care (no party disputed that the locality rule was inapplicable in this case as Dr. Gates was a specialist in the field of obstetrics and gynecology).
National Standard Of Care Versus Locality Rule
Louisiana Revised Statutes 9:2794(A)(1) sets forth the standard of care a plaintiff must prove in a medical malpractice claim: “The degree of knowledge or skill possessed or the degree of care ordinarily exercised by physicians, dentists, optometrists, or chiropractic physicians licensed to practice in the state of Louisiana and actively practicing in a similar community or locale and under similar circumstances [known as the “locality rule”]; and where the defendant practices in a particular specialty and where the alleged acts of medical negligence raise issues peculiar to the particular medical specialty involved, then the plaintiff has the burden of proving the degree of care ordinarily practiced by physicians, dentists, optometrists, or chiropractic physicians within the involved medical specialty.”
The Louisiana appellate court held: “Although the trial judge’s written reasons admittedly contain inconsistencies
in reference to the standard of care, we find that, after considering the totality of his written reasons, he correctly applied a national standard of care. Furthermore, the evidence presented at trial is devoid of any suggestion or testimony that the locality rule applies. In fact, on cross examination, Dr. Gates agreed with Ms. Lachney’s counsel that the standard of care in this case is a national standard of care. Simply put, the controlling standard of care was not in dispute at trial.”
Informed Consent
The plaintiff in an informed consent case bears the burden of proof. They must show: (1) the existence of a material risk which the physician must disclose; (2) the failure of the physician to inform the patient of a material risk; (3) the realization of the material risk; and (4) a causal connection between the failure to inform the patient of the risk and realization of the risk.
Hysterectomy Informed Consent
The Louisiana appellate court held: “Our review of the record shows ample evidence to support the trial court’s findings that Dr. Gates properly obtained Ms. Lachney’s consent prior to the hysterectomy and was not required to perform additional testing prior to the hysterectomy. The medical records, coupled with the testimony from Dr. Gates, Dr. Morris, and Dr. Tynes, support the trial court’s findings. Therefore, it was not manifestly erroneous for the trial court to find that Dr. Gates did not breach the standard of care by performing the hysterectomy on Ms. Lachney.”
Right Ovary Removal Informed Consent
“At trial, Ms. Lachney testified that she did not know that Dr. Gates was going to remove her right ovary. She thought she was having scar tissue removal and a scope put in to look at her pelvic organs. She only found out about the ovary removal after surgery when Dr. Gates allegedly told her that it was “smothered with scar tissue and it was shriveled.” Just as with the hysterectomy consent form, she testified that Dr. Gates did not go over the consent form with her for this surgery and that a nurse presented the form to her to sign. Dr. Gates admitted that he was not planning on taking the ovary out, and only did so after opening her up and finding the ovary covered in scar tissue. Dr. Gates further admitted that the consent form was “suboptimal” and that he wished he had written “lysis of adhesions, cystectomy – ovarian cystectomy oophorectomy” on the form … Although the consent form did not specifically mention the right
oophorectomy, it did list the scope of consent as including “other indicated procedures.” That medical record, coupled with the medical record indicating that Dr. Gates verbally discussed the possibility of removing an ovary with Ms. Lachney, supports the trial court’s conclusion that Ms. Lachney did give informed consent to Dr. Gates for the surgery, including the removal of her right ovary. Under the manifest error of review, we find that the trial court was not clearly wrong in finding that Dr. Gates did not breach the standard of care in removing Ms. Lachney’s right ovary.”
Left Ovary Removal Informed Consent
“Ms. Lachney testified that Dr. Gates told her she had a cyst on her left ovary the size of a lemon, and that if she did not remove it, it could rupture and cause her to die. She testified that Dr. Gates did not discuss any alternative treatments other than surgery, nor did he discuss the implications of removal of the left ovary, which would be premature menopause. However, she does admit to signing the consent form, though she said the nurse presented it to her and told her where to sign. She testified that Dr. Gates did not tell her that her problem may be associated with something other than a gynecological problem … Although we sympathize with Ms. Lachney for the serious complications and health issues she endured following the left oophorectomy, we do not find that the trial court manifestly erred in finding no breach in the standard of the care. The undisputed evidence shows that Ms. Lachney consented to removal of the left ovary, and the fistula complication, though unfortunate, was a known risk and not an indication of a breach.”
Lachney v. Gates, M.D., 24-195.
If you or a loved one were injured (or worse) as a result of medical malpractice in Louisiana or in another U.S. state, you should promptly find a Louisiana medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
Visit our website or call us toll-free in the United States at 800-295-3959 to be connected with medical malpractice attorneys in Louisiana or in your U.S. state who may assist you.
Turn to us when you don’t know where to turn.
