Matthies v. Mastromonaco – Case Brief
Matthies v. Mastromonaco, 160 N.J. 26, 733 A.2d 456 (N.J. 1999).
Facts: Ms. Matthies (P) fell in her apartment at a residence for senior citizens and broke her right hip. Mastromonaco (D), an orthopedic surgeon, prescribed bed rest rather than surgery. Mastromonaco reviewed the X-Rays and decided against pinning Matthies’ hip because she was elderly, frail, and in a weakened condition and the surgery would be risky. P also suffered from osteoporosis and her bones were too porous to hold the screws. D felt that bed rest, though controversial, could heal P’s fracture and restore the right leg to limited functionality.
P sued D for malpractice. P’s expert testified that bed rest was inappropriate and that it should only be done when the patient is terminally ill or in a vegetative state, due to the risk that the fracture could dislocate as in P’s case. P asserted that she would not have consented to bed rest if D had told her of the probable effect of the treatment on her life. The trial court entered judgment in favor of P and D appealed.
Issue: Must a doctor obtain a patient’s consent before implementing a nonsurgical course of treatment?
Holding and Rule: Under the doctrine of informed consent, a doctor must obtain a patient’s consent before implementing a nonsurgical course of treatment.
Historically, failure to obtain informed consent to an invasive procedure such as surgery was treated as a battery. Later courts saw the need for a patient’s consent to be derived from the right of self determination.
In a claim for negligence, the issue is the physician’s deviation from the standard of care. The court held that the issue was whether the physician adequately presented the material facts so that the patient could make an informed decision. Under this standard, a physician is obligated to disclose only that information which is material to a reasonable patient’s informed decision. The court held that D was under a duty to inform P of medically reasonable treatment alternatives and their probable risks and outcomes.