Jandre v. Wisconsin Injured Patients and Families Compensation Fund

On June 13, 2003, Thomas Jandre (plaintiff) began experiencing slurred speech, drooping on one side of his face, dizziness, and weakness in his legs. At the emergency room, Jandre was evaluated by Dr. Therese Bullis (defendant). Bullis’s differential diagnosis included Bell’s palsy, ischemic stroke, and other ailments. Bullis listened to Jandre’s blood flow with a stethoscope to determine whether Jandre had suffered an ischemic ministroke caused by blockage in the carotid arteries. Later, Bullis admitted that this was a poor method of detecting ischemic stroke because listening could not detect an almost complete arterial blockage. Bullis did not order a carotid ultrasound, a reliable, noninvasive diagnostic technique. Jandre’s symptoms were typical of ischemic stroke. Because Jandre’s symptoms came on suddenly, they were not typical of Bell’s palsy. Bullis diagnosed Jandre with Bell’s palsy. Bullis did not tell Jandre that his symptoms were consistent with ischemic stroke, that she had used a poor method of detecting ischemic stroke, that she could have ordered a more reliable carotid ultrasound, or that a ministroke could be followed by a full-blown stroke. On June 24, 2003, Jandre suffered a full-blown ischemic stroke. An ultrasound showed that one of Jandre’s arteries was 95 percent blocked. Jandre’s cognitive and physical abilities were impaired. Jandre sued Bullis under Wisconsin’s malpractice law for negligent diagnosis and for failure to provide disclosures needed to satisfy Wisconsin’s informed-consent law, § 448.30. Section 448.30 described physicians’ duties to give patients information on alternate modes of treatment. At trial, after hearing conflicting expert testimony, the jury found that Bullis’s diagnosis of Bell’s palsy was not negligent but that Bullis was negligent in failing to satisfy the informed-consent law. The court of appeals affirmed. On appeal to the Wisconsin Supreme Court, Bullis argued that she had no duty to inform Jandre of options unrelated to her diagnosis and that the plain language of § 448.30 meant that it applied only to treatment, not diagnosis.