Morrison v. MacNamara

District of Columbia Court of Appeals, 1979.

407 A.2d 555.

Prosser, pp. 178-181


Facts: Morrison went in to a medical laboratory have a urethral smear test.  It was done with him standing up, and he fainted and seriously hurt himself.  At trial, the plaintiff presented expert testimony from out of town that suggested that having the test done standing up did not meet the national standard of care of having the patient seated or prone, as evinced by expert witnesses.  The defendant medical laboratory had its own expert witnesses who was local and who said that the local standard of care was to have the patient standing up.  The plaintiff’s expert testimony was disallowed in court.  The jury found for the defendant.  The plaintiff appealed.


Issue: Should the defendant be subject to the local standard of care or the national standard of care?


Rule: NEW RULE!  The defendant must exercise the “degree of reasonable care and skill expected of members of the medical profession under the same or similar circumstances”.  The locality rule says that doctors should only be measured against other doctors in their community.  This court abandons the locality rule for the first time in this jurisdiction.


Analysis: The locality rule came about because it was reasonable to expect that doctors in big cities would be able to provide a higher standard of care than rural doctors.


The court says that the locality rule is outdated because medical standards have been nationalized and there is no longer any reason to expect that health care in rural areas as a matter of course will be inferior to health care in big cities.


The court concludes that the defendant medical laboratory must be held to a national standard of care.


Conclusion: The court vacated the judgment for the defendants and ordered a new trial.


Notes and Questions


1.     So regional autonomy in deciding the standard of care ends up clashing with society’s interest in not making it too difficult to sue for malpractice.  In fact, I wonder if it wasn’t cases like this that opened the floodgates to the current boom of malpractice cases.

2.     It looks like there are two modern alternatives to the strict liability rule: there is the “similar community in similar circumstances” rule and there is the “national standard of care” rule.

3.     I bet it does.  This isn’t just injustice for health care providers, but also injustice for health care consumers who will have to pay more and more.


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