Ronald W. Young v. Frederick C. Fishback

PRETTYMAN, Chief Judge

(dissenting).

It seems to me my brethren go too far in this opinion. The difficulty arises from the way in which they state the. proposition. They say “Everybody knows * * * that it is not approved surgical practice to leave in a patient’s, body a small bit of gauze * * * or any other foreign nonabsorbable substance, no matter how small.” Of course the fact that a foreign substance is left-in a wound is not approved by the medical profession. But the question is whether the surgeon’s procedure is approved regardless of whether or not it has an unfortunate incident. I would suppose that in many operations calculated risks must be taken. Failure does not necessarily reflect on the surgeon. Of course a procedure which would risk leaving scissors or clamps in a wound is. clearly unreasonable, but a procedure which risks leaving a single fiber from a thread does not seem to me to be so clearly unreasonable. The point is thajt. the question before the court is not whether the result, or a by-product, of' an operation is approved by the medical profession but is whether the surgeon followed approved procedure. For this reason the presence of a few threads of gauze is not of itself prima facie proof that the cause was a departure from that degree of skill and care approved by surgeons. I am unable to say how minutely a surgeon should examine a sponge before, during and after an operation, how carefully he should avoid cutting a few threads from the sponges, how thoroughly he should explore a wound before closing the incision. It may be that if he did; these things as surgeons think they should be done the foreign body would' not have been left. But perhaps the-exercise of all the care surgeons think is reasonable would not have prevented the-unfortunate occurrence. The jury needed expert testimony on this point. Without such testimony there was no prima facie proof of departure from approved surgical practice.