Case 1: Salgo v Leland Stanford Etc. Bd. Trustees, 317 P.2d 170, 154 Cal. App.

2d 560, Ramil, Venzuela

Facts

• Dr. Gerbode, a licensed to practice medicine in California since 1937. He

specializes cardiothoracicsurgery, with a special interest in cardiovascular
surgery. He is recognized as an outstanding authority and is a professor of
surgery at Stanford Medical School.
• Plaintiff, Martin Salgo, was 55 years of age, with a history of eye condition
indicating premature aging. About two or three years prior; he had developed
cramping in his legs upon walking and for approximately a year had been treated
with drugs by a physician which referred him to Dr. Gerbode as a specialist in the
surgical treatment of arterial diseases.
• December 31, 1953, at Stanford Hospitals, Dr. Gerbode examined plaintiff.
Upon evaluation, Dr. Gerbode concluded that Mr. Salgo was suffering from
abdominal aorta occlusion and an advance arteriosclerosis.
• Dr. Gerbode told plaintiff of the seriousness of his condition and
recommended that plaintiff should enter the hospital for a thorough
evaluation of his conditio
• Dr. Gerbode reported to the referring physician and recommended the
performance of an aortography but did not explain all of the various possibilities to
plaintiff of the proposed procedures but did say that his circulatory situation was quite
serious.
• At Dr. Gerbode's suggestion plaintiff entered the hospital on January 6, 1954.
That afternoon Dr. Gerbode ordered, X-rays of the chest and abdomen after a
barium swallow. Dr. Gerbode also requested in writing that the aortography
be performed by the hospital's X-ray department with Dr. Ellis - — a surgeon at the
university hospital with five years practice in surgery and was in charge of all
special diagnostic procedures.
• A day later, on January 7 th, 1954, Dr. Ellis at the postponed the aortography due
to the presence of residual barium from his previous x-rays, which were taken after
his arrival at the hospital.
• After it was determined that there was not any more barium in plaintiff’s system,
the surgery was proceeded on the afternoon of January 8 th 1954 under the
supervision of Dr. Ellis (surgeon), Dr. Bengle (anesthesiologist), Dr. Andrews
(radiologist), and technicians.
• Before injecting the 70% sodium urokon into the back of the patient while face
down, a sensitivity test was performed with radiopaque material. The 70% sodium
urokon injection was repeated with 30 c.c.'s and then with 20 c.c.'s (without
changing the position of the needle), in an attempt to get a clear picture of the
blockage. The entire procedure seemed to proceed in a normal manner, and the
patient seemed that evening to have recovered from the anesthesia.
• At 5 o'clock Dr. Gerbode was informed by Dr. Ellis that the procedure had been
routine and gone well. The next morning when plaintiff awoke, he noticed
that his lower extremities were paralyzed. This condition is permanent.
Issues

• Whether or not the doctrine of “res ipsa loquitur” is applicable to this case.
• Whether or not the physician had been negligent in his duty as an attending
physician to the plaintiff.
• Whether or not the physician (Dr. Gerbode) is liable for the negligence of the
hospital team.

Ruling
• The doctrine of res ipsa loquitor to be applicable, at least three
prerequisites was be evident:
1) The incident was of a type that does not generally happen without
negligence
2) exclusive control by the defendant
3) absence of control by the plaintiff
• The situation and damages were caused by negligence. An act or omission
(failure to act) by a medical professional that deviates from the accepted medical
standard of care

• No. Dr. Gerbode himself was not held liable as there was no explicit agreement
that he would perform the surgery and under the presumption that it is common
practice for the attending physician to not be present for the procedure.
Furthermore, Gerbode did not perform the procedure, but rather the hospital staff.
The attending physician cannot be held liable for acts over which he had and
could have no control.

Lessons

• We, as future physicians, must always give informed consent and exercise good
judgement in fully disclosing procedural risk to our patients.

• Most medical procedures or treatments involve some risk. It is therefore our duty as
physicians to disclose all the necessary information including the benefits, risks and
success of any medical procedure that is to be done to a patient.