Major Medical Malpractice Cases

Why This Matters

These landmark cases aren't just legal history—they're the foundation of every healthcare policy you'll encounter in practice. When you study medical malpractice law, you're really learning about the tension between patient autonomy, provider liability, institutional responsibility, and public safety. Each case on this list answered a fundamental question: Who decides what happens to a patient's body? Who bears responsibility when something goes wrong? What duties do healthcare providers owe to patients—and to society?

Don't just memorize case names and dates. For each ruling, know what legal principle it established, what problem it solved, and how it changed healthcare practice. Exam questions will ask you to apply these precedents to new scenarios, compare holdings across cases, and explain why courts reached specific conclusions. If you understand the underlying concepts—informed consent, duty to warn, institutional liability—you'll be able to tackle any question they throw at you.

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Informed Consent and Patient Autonomy

These cases established that patients have the fundamental right to control what happens to their own bodies. The legal principle is straightforward: medical treatment without consent constitutes battery, and consent isn't valid unless the patient understands the risks.

Schloendorff v. Society of New York Hospital (1914)

• Established bodily autonomy as a legal right—Judge Cardozo's famous opinion declared that "every human being of adult years and sound mind has a right to determine what shall be done with his own body"
• Created the foundation for informed consent doctrine—surgery performed without patient consent constitutes assault, regardless of medical benefit
• Predates modern malpractice law—this 1914 ruling laid groundwork that courts still cite over a century later when defining patient rights

Canterbury v. Spence (1972)

• Shifted informed consent standard to patient-centered disclosure—physicians must reveal what a reasonable patient would want to know, not just what other doctors typically disclose
• Required disclosure of material risks and alternatives—failure to inform patients of significant treatment risks creates liability even if the procedure itself was performed competently
• Distinguished between negligent treatment and negligent disclosure—a surgeon can be liable for malpractice without making any technical error during the procedure

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End-of-Life Decision-Making

These rulings address the most difficult questions in healthcare law: Who decides when treatment stops? What evidence is required? Courts have balanced individual liberty against state interests in preserving life, creating frameworks for advance directives and surrogate decision-making.

Cruzan v. Director, Missouri Department of Health (1990)

• Recognized a constitutional right to refuse treatment—the Supreme Court affirmed that competent adults can reject life-sustaining medical care under the Due Process Clause
• Established the "clear and convincing evidence" standard—states may require strong proof of an incompetent patient's wishes before withdrawing treatment
• Sparked the advance directive movement—this case directly led to the Patient Self-Determination Act of 1990, requiring healthcare facilities to inform patients about living wills

Gonzales v. Oregon (2006)

• Upheld state authority over physician-assisted death—the Supreme Court ruled that the federal Controlled Substances Act does not preempt Oregon's Death with Dignity Act
• Limited federal interference in medical practice—the Attorney General cannot use drug enforcement powers to override state-approved end-of-life options
• Distinguished between suicide assistance and palliative care—established that prescribing lethal medication under state protocols is a legitimate medical purpose

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Duty to Warn and Confidentiality Limits

This landmark case created an exception to patient confidentiality that continues to shape mental health practice. The principle: when a patient poses a serious threat to an identifiable third party, the duty to protect that person overrides the duty of confidentiality.

Tarasoff v. Regents of the University of California (1976)

• Created the "duty to warn" doctrine—mental health professionals must take reasonable steps to protect identifiable potential victims when patients make credible threats
• Established limits on therapeutic confidentiality—the privilege protecting patient communications ends where public peril begins
• Applies to "foreseeable" victims only—the duty extends to persons the therapist knows or should know are at risk, not the general public

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Institutional and Hospital Liability

These cases shifted liability beyond individual practitioners to the institutions that employ them. The legal theory: hospitals aren't just buildings where doctors work—they're corporate entities responsible for maintaining standards of care.

Darling v. Charleston Community Memorial Hospital (1965)

• Established corporate negligence doctrine for hospitals—healthcare facilities can be held directly liable for failing to maintain adequate standards, independent of individual physician negligence
• Required hospitals to monitor physician competence—institutions must review staff credentials, supervise care quality, and intervene when standards aren't met
• Changed hospital administration forever—this ruling created the modern framework for credentialing committees, peer review, and quality assurance programs

Wickline v. State of California (1986)

• Addressed third-party payer influence on medical decisions—examined whether insurance companies share liability when cost-containment measures harm patients
• Held physicians ultimately responsible for treatment decisions—doctors cannot blame insurers for inadequate care; they must advocate for patients and appeal denials
• Raised unresolved questions about managed care liability—while the physician was held responsible here, the court acknowledged insurers could be liable if they override medical judgment

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Standards of Care and Expert Testimony

These cases define how courts evaluate whether a healthcare provider met professional standards. The key question: what benchmark should courts use to judge medical decisions—customary practice or reasonable care?

Helling v. Carey (1974)

• Rejected customary practice as the sole standard of care—the Washington Supreme Court held that failing to perform a simple, inexpensive glaucoma test was negligent even though ophthalmologists routinely skipped it
• Applied a reasonableness standard over professional custom—courts can find negligence when common practice falls below what a reasonable provider should do
• Remains controversial and limited in application—most jurisdictions still defer to customary medical practice, making this case an important exception to discuss

Daubert v. Merrell Dow Pharmaceuticals, Inc. (1993)

• Replaced the Frye "general acceptance" test for expert testimony—federal courts now evaluate scientific validity, testability, peer review, and error rates
• Gave judges a gatekeeping role over expert evidence—trial courts must assess whether expert methodology is scientifically sound before admitting testimony
• Transformed medical malpractice litigation—both plaintiffs and defendants must ensure their experts can withstand rigorous methodological scrutiny

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Reproductive Rights and Healthcare Access

This landmark ruling extended constitutional privacy protections to reproductive healthcare decisions, fundamentally shaping the relationship between government regulation and medical practice.

Roe v. Wade (1973)

• Established constitutional protection for abortion access—the Supreme Court held that the right to privacy under the Due Process Clause encompasses a woman's decision to terminate pregnancy
• Created the trimester framework—state interests in maternal health and potential life increase as pregnancy progresses, allowing greater regulation in later stages
• Was substantially modified by later rulings—Planned Parenthood v. Casey (1992) replaced the trimester framework with the "undue burden" standard; Dobbs v. Jackson (2022) overturned Roe entirely

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Quick Reference Table

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Self-Check Questions

1. Both Schloendorff and Canterbury v. Spence address informed consent. What specific aspect of consent did each case establish, and how did Canterbury expand on the Schloendorff foundation?

2. A therapist learns that her patient plans to harm a specific coworker. Under Tarasoff, what duty does the therapist have, and what is the legal justification for overriding confidentiality?

3. Compare Cruzan and Gonzales v. Oregon: How do both cases address patient autonomy at end of life, and what distinguishes the constitutional issues in each?

4. If a hospital's credentialing committee fails to review a surgeon's qualifications and the surgeon injures a patient, which case establishes the hospital's direct liability? What legal doctrine does this case create?

5. An FRQ asks you to explain how courts determine whether a physician met the standard of care. Contrast the approaches in Helling v. Carey and the traditional rule, and explain how Daubert affects what evidence can be used to establish that standard.