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Christensen v. Munsen2/10/1994
king from the main instruction on informed consent two paragraphs stating that defendant had a duty to advise plaintiff that her elevated eye pressures might require surgery and that the surgeries might result in inflammation and scarring.
The trial court apparently struck these paragraphs and gave the after-acquired knowledge instruction since both parties' experts testified that they had never before heard of steroids causing permanent glaucoma resulting in surgery. Plaintiff's assertions that such complications were foreseeable by the defendant are unsupported by citations to the record. We need not consider the issue further since it was made without assignment of error, without citations of relevant authority, and without references to the record. See Painting & Decorating Contractors of Am., Inc. v. Ellensburg Sch. Dist., 96 Wash. 2d 806, 815, 638 P.2d 1220 (1982); State v. Peerson, 62 Wash. App. 755, 777, 816 P.2d 43 (1991), review denied, 118 Wash. 2d 1012 (1992).
V
The final issues presented are whether the trial court erred in giving instructions 11 and 12, the "no guarantee/poor result" and "error in judgment" instructions. At trial, plaintiff excepted to these instructions on the basis that they were unwarranted and were a comment on the evidence. Instruction 11 provided as follows:
An ophthalmologist does not guarantee the results of his or her care and treatment. A poor medical result is not, in itself, evidence of negligence.
Clerk's Papers, at 204.
Instruction 11 is based on Washington Pattern Instruction (WPI) 105.07. The comment thereto states that the giving of a "no guarantee/poor result" instruction does not constitute error if it is used to supplement a proper standard of care instruction. 6 Wash. Prac., WPI, at 523 (1989) (citing Watson v. Hockett, 107 Wash. 2d 158, 166-67, 727 P.2d 669 (1986)). Whether or not to give this type of instruction is a matter within the trial court's discretion. 6 Wash. Prac., at 523; Seattle Western Indus., Inc. v. David A. Mowat Co., 110 Wash. 2d 1, 9, 750 P.2d 245 (1988). If the court determines that the "no guarantee/poor result" instruction is appropriate, Watson suggests that the following language be used:
A doctor does not guarantee a good medical result.
A poor medical result is not, in itself, evidence of any wrongdoing by the doctor.
Watson, at 164; 6 Wash. Prac., at 523.
It is undisputed that instruction 11 followed a proper standard of care instruction. See instruction 10; Clerk's Papers, at 203. Moreover, the evidence supported giving the instruction, since the main issue at trial was whether plaintiff's blindness was the result of defendant's treatment or her underlying eye disease. Plaintiff now contends that the instruction given was worded improperly, since it substituted "negligence" for the word "wrongdoing" suggested by Watson. Since plaintiff did not except to the wording of the instruction at trial, that claim will not be considered here. See Galvan, at 692; Scott, at 246.
Plaintiff also excepted to instruction 12, which stated as follows:
A physician is not liable for an error of judgment if, in arriving at that judgment, the physician exercised reasonable care and skill, within the standard of care the physician was obliged to follow.
Clerk's Papers, at 205.
Instruction 12 is based on WPI 105.08. The comment thereto cites Watson i
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