Utah Court of Appeals
Can jury instructions on general consent mislead juries in informed consent cases? Harward v. Urology Clinic of Utah Valley Explained
Summary
Cecilia Harward developed permanent vestibular damage from gentamicin infusions and sued her urologist for failing to obtain informed consent. The jury found no breach of the standard of care. The Court of Appeals reversed, finding that jury instructions on general consent confused the jury about the distinct requirement of informed consent.
Practice Areas & Topics
Analysis
In medical malpractice cases involving informed consent claims, the distinction between general consent and informed consent can be outcome-determinative. The Utah Court of Appeals’ decision in Harward v. Urology Clinic of Utah Valley demonstrates how confusing jury instructions can undermine a plaintiff’s case and necessitate a new trial.
Background and Facts
Cecilia Harward developed permanent vestibular damage after receiving multiple daily gentamicin infusions prescribed by Dr. Brandon Reynolds for a urinary tract infection. Dr. Reynolds had his medical assistant call Ms. Harward to arrange the antibiotic treatment without discussing the specific drug, its risks, or alternatives. At the infusion center, Ms. Harward received a handout about gentamicin and signed an acknowledgment stating she understood the instructions. The handout listed side effects including loss of balance but did not specifically mention permanent vestibular damage. After ten infusions, Ms. Harward suffered confirmed permanent vestibular damage.
Key Legal Issues
The Harwards sued for medical malpractice based on failure to obtain informed consent. However, the trial court gave jury instructions on both informed consent and general consent, including instructions that consent is presumed when patients submit to healthcare and that consent need not be in writing. Defense counsel repeatedly characterized Ms. Harward’s acknowledgment as a “consent form” and elicited testimony that patients consent by “showing up” and submitting to treatment.
Court’s Analysis and Holding
The Court of Appeals found that the jury instructions on general consent were potentially misleading because consent and informed consent are distinct legal concepts. Drawing on Nielsen v. Pioneer Valley Hospital, the court explained that while lawyers and judges can distinguish between different legal theories, lay juries may not understand that instructions on general consent don’t negate informed consent requirements. The court emphasized that since the Harwards never claimed Ms. Harward didn’t consent to treatment—only that she lacked informed consent—there was no reason to instruct on general consent. The repeated characterization of the acknowledgment as a “consent form” and expert testimony approving the jury instructions further exacerbated the confusion.
Practice Implications
This decision provides crucial guidance for Utah practitioners handling informed consent cases. Courts should refuse jury instructions on general consent when only informed consent is at issue, as such instructions create substantial potential for confusion. The case also clarifies that expert witnesses cannot opine on specific percentage allocations of fault, as apportionment is exclusively the jury’s responsibility. Additionally, experts should not testify about their approval of jury instructions, as this improperly invades the court’s role in instructing on the law.
Case Details
Case Name
Harward v. Urology Clinic of Utah Valley
Citation
2023 UT App 63
Court
Utah Court of Appeals
Case Number
No. 20220027-CA
Date Decided
June 8, 2023
Outcome
Reversed
Holding
Jury instructions on general consent and written consent were potentially misleading when only informed consent was at issue, creating substantial potential for confusion that likely affected the verdict.
Standard of Review
Correctness for whether jury instructions correctly state the law; abuse of discretion for decisions to give or refuse jury instructions, grant or deny mistrial, admit or exclude evidence, and admissibility of expert testimony
Practice Tip
When only informed consent is at issue, avoid requesting jury instructions on general consent that could confuse the jury about the distinct legal requirements for each type of consent.
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