Division One of the Arizona Court of Appeals recently issued an opinion discussing the difference between medical battery and traditional battery and the importance of having proper jury instructions at trial. Carter v. Pain Ctr. of Arizona, P.C. 2016 WL 2647711, (Ariz. Ct. App. May 10, 2016). The opinion issued in May is a corrected version of the Court of Appeals opinion on the same case issued in February of this year and reported on in the March Case Law Update. The opinion issued in February is no longer citable authority.
Facts and Procedural History
Christina Carter met with Dr. David Towns of The Pain Center of Arizona after injuring herself from a fall. Dr. Towns recommended a sacrococcygeal ligament injection to treat the pain. A sacrococcygeal ligament injection is a steroidal anti-inflammatory injection given in the ligament around the tailbone to treat pain related to trauma to the area.
When Carter expressed anxiety about the injection, Towns offered to sedate her for the procedure. In the notes he made after the appointment, Towns confirmed that he would sedate her for the procedure. Carter returned for the injection almost two weeks later. Before undergoing the procedure, Carter signed a consent form consenting to a “Sacrococcygeal Ligament Injection under Fluoroscopy with IV Sedation.” Dr. Towns then administered the injection without sedating Carte.
Carter subsequently sued Dr. Towns and The Pain Center for the failure to sedate her prior to the injection, alleging battery and false imprisonment. Before trial, the parties submitted two different proposed jury instructions. Defendants proposed the traditional civil battery instruction found in the Revised Arizona Jury Instructions (“RAJI”). The defendants’ proposed instruction read as follows:
Christina Carter claims that The Pain Center of Arizona, PC and Dr. David K. Towns committed a battery against her. On this claim, Christina Carter must prove:
- The Pain Center of Arizona, P.C., and Dr. David K. Towns intended:
- To cause harm or offensive contact with Christina Carter.
- The Pain Center of Arizona, P.C., and Dr. David K. Towns caused harmful or offensive contact with Christina Carter.
- Christina Carter’s damages.
A contact is offensive if it would offend a reasonable person.
Carter objected to the defendants’ proposed instruction, arguing that her proposed instruction more accurately identified the elements of a medical battery. Carter requested the following jury instruction:
Christina Carter claims that Dr. David K. Towns committed a battery against her. On this claim, Christina Carter must prove:
- Christina Carter’s consent to the sacrococcygeal ligament injection was conditioned upon receipt of IV sedation; and
- David K. Towns performed the sacrococcygeal ligament injection in willful disregard of the conditional consent given by Christina Carter; and
- Christina Carter’s damages.
The court overruled Carter’s objection and gave the traditional civil battery instruction proposed by the defendants. After a five-day trial, the jury returned a defense verdict. Carter moved for a new trial, arguing the court erred by refusing to give her requested jury instruction. Her motion was denied, and she appealed.
Arguments on Appeal
On appeal, Carter argued the court erred by giving the traditional civil battery RAJI instruction because that instruction required the jury to find defendants intended to cause her harm or offensive contact. She argued intent to cause harm or offensive conduct was not the determinative issue. Rather, because it was a medical battery case, she argued the determinative issue was whether the defendants performed a procedure to which she did not consent.
The Defendants argued a traditional battery instruction is appropriate in a medical battery case where there was a complete lack of consent and Carter waived the issue of conditional consent by failing to make it clear to the superior court was what her claim was based on. The defendants also argued even if the trial court erred by giving the traditional battery instruction, reversal was not warranted because Carter could not show prejudice. Additionally, defendants argued that any potential error was cured by Carter’s counsel in closing argument, when he explained to the jury the instruction given might be construed to impose liability without intent to harm.
Holding and Reasoning
The Court reversed the defense judgment and remanded for a new trial, finding the traditional civil battery instruction did not correctly state the law. The Court agreed with Carter, noting traditional battery turns on whether the defendants intended to harm the plaintiff, whereas medical battery occurs when a physician performs a procedure without a patients consent or in willful disregard of a patient’s limited to conditional consent.
In this case, the instruction proposed by Carter would have required her to prove her consent to the injection was conditioned upon receiving sedation and Dr. Towns administered the injection “in willful disregard of the conditional consent.” Instead, the instruction given required Carter to prove the defendants intended to cause harm or offensive conduct, which need not be proved in a medical battery claim.
The Court rejected the defendants’ argument Carter’s counsel had cured any error in his closing argument, because the defendants’ counsel repeatedly argued the intent to harm element in closing, stating “[Battery] requires that Dr. Towns had an intent to harm. That is what your jury instruction says, and don’t let any argument from any attorney allow you to change what the jury instruction actually says. It’s intent to harm.” The court pointed out closing arguments generally carry less weight than jury instructions from the court, especially when the parties’ attorneys argue conflicting standards of law, and the instructions given allowed one party’s attorneys to argue incorrect law.
The court also rejected the defendants’ lack of prejudice argument, holding “[w]hen a party has requested a jury instruction that is supported by the facts and correctly states the law, but the court declines to give the instruction and instead gives an erroneous instruction, there is no requirement that the aggrieved party request special interrogatories to prove prejudice.”
In order to provide the best defense, it is important at the outset of a case to gain a complete understanding of what a plaintiff is claiming and what the proper legal standard is for that claim. Moreover, it is crucial to ensure during trial the jury is properly instructed on the applicable law, as failure to give proper jury instruction is a potential cause for reversal on appeal.
ABOUT THE AUTHOR: Lena Pond is a graduate of the Sandra Day O’Connor College of Law at Arizona State University. She specializes in insurance defense, insurance coverage disputes, insurance bad faith, professional liability, and general civil litigation. Contact her at 602-386-5654 or firstname.lastname@example.org.
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