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WASFI v. CHADDHA3/26/1991
for hearing loss, it was proper to recommend carbogen therapy prior to a CAT scan was a matter of professional opinion - in other words, within the normal range of professional discretion exercised by competent otolaryngologists.
Despite the unfortunate use of the term "schools of thought," we believe that the trial court did not instruct on "schools of thought," but instead, correctly stated the settled principle that "where the treatment or procedure is one of choice among competent physicians, a physician cannot be held guilty of malpractice in selecting the one which, according to his best judgment, is best suited to the patient's needs." Ball v. Mallinkrodt Chemical Works, 53 Tenn. App. 218, 224, 381 S.W.2d 563 (1964); O'Neill v. Kiledjian, 511 F.2d 511,
513 (6th Cir. 1975); 61 Am.Jur.2d, Physicians, Surgeons and Other Healers 216; see also Meier v. Ross General Hospital, 69 Cal.2d 420, 434, 445 P.2d 519, 71 Cal.Rptr. 903 (1968); Huffman v. Lindquist, 37 Cal.2d 465, 473-75, 234 P.2d 34 (1951).
Because the court included language appropriate to an instruction on the "schools of thought" doctrine, the charge may have been confusing to lawyers, to whom "schools of thought" is a term of art. There is no reason, however, to believe that the jury suffered from any such linguistic preconceptions. Taken as a whole, the charge adequately conveyed to lay persons the principle that physicians may choose between alternative acceptable methods without incurring liability solely because that choice may have led to an unfortunate result.
In the context of her attack on the charge as a "schools of thought" instruction, Wasfi contends that even the principle of acceptable alternatives requires, as a predicate, that the physician first make a "careful diagnosis." This contention assumes that there may be acceptable alternatives of treatment, but that only one correct method of diagnosis is possible. Thus, she argues that failure to order a CAT scan was a failure to diagnose and that carbogen therapy was an incorrect method of diagnosis, to which the schools of thought principle could not apply.
We can perceive no reasoned basis for recognizing a physician's latitude in selecting alternative acceptable methods of treatment, but denying him the same latitude in selecting alternative acceptable methods of diagnosis, or, in the words of the trial court, "diagnostic modalities." So long as a method is approved by the profession as a whole, or there is an unresolved conflict within the profession concerning the wisdom of the method, it matters not that the method is used for diagnosis rather than treatment.
The "diagnostic modality" used by Riccio was to try carbogen therapy before, not after, a CAT scan. Riccio elicited testimony from Wasfi's expert, Gale Ramsby, chief of cardiovascular radiology at the University of Connecticut Health Center, that it would not be unusual for a physician to rule out a viral or vascular cause for hearing loss before ordering a CAT scan, or to recommend therapy and weight its results before considering a CAT scan. Diran Mikaelian, an otolaryngologist, another of Wasfi's experts, admitted that he had testified at his deposition that whether Riccio's conduct breached the standard of care was "a matter of opinion," although he insisted at trial that the CAT scan should be performed before prescribing carbogen therapy. Clarence Sasaki, chief of the department of otolaryngology at the Yale University School of Medicine, testified that while a CAT scan was recommended
at some point, it might not be ordered at all if other preliminary therapy was successful. The testimony of these experts con
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