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Smith v. Cotter4/30/1991 as well as medical evidence regarding the risks of remaining untreated, the possible alternative treatments and the risks and expected benefits of alternative treatments. This evidence may also include testimony from witnesses who observed the patients at the time they elected to undergo the treatment. No single type of evidence is to be conclusive; rather, all the evidence must be considered by the fact-finder in determining whether, had the full extent of the risk been known, the plaintiff would have reasonably refused treatment. Credible evidence was presented at trial to support the trial court's conclusion that Mr. Cotter would not have undergone the thyroidectomy if he had known of the risk of permanent vocal cord paralysis. Cotter testified that if he had been told of the risk of permanent vocal cord paralysis he would not have elected to have the surgery. As noted, this evidence is not conclusive, but it can be considered by the fact-finder. Evidence was also presented at trial that Cotter's thyroid problem was only a minor irritant and that it only required medical attention every few months. Further, an abundance of expert testimony (although at times conflicting) was presented on the issue of the risks of a total thyroidectomy. Alternative treatments were addressed somewhat by Dr. Knoernschild who testified that a subtotal thyroidectomy would have created less of a risk of vocal cord paralysis. Also, there was some evidence regarding Cotter's prior treatment and certainly the continuance of that treatment could have been seen as an alternative by the lower court. We conclude that the trial court did not err in finding that the evidence supported the required element of proximate cause in this case.
We affirm the judgment of the district court.
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