Shinal v. Toms

Megan Shinal (plaintiff) had a nonmalignant brain tumor partially removed during surgery. The tumor regrew over the following years until it extended into Shinal’s vital brain structures and would have threatened her life if left untreated. Shinal met with Dr. Toms (defendant) to discuss surgical options, and Toms recommended an aggressive approach to remove the tumor entirely. Toms recalled discussing with Shinal the risk of damage to her carotid artery and optic nerve as a result of the aggressive approach. Shinal decided to undergo surgery but did not make a final choice about the method, i.e., aggressive or not. Shinal had a telephone conversation with Toms’s physician assistant about three weeks later to ask about possible scarring and the need for radiation. Shinal met with Toms’s physician assistant a month after that at the neurological center. Toms’s physician assistant provided information about the surgery and Shinal signed an informed-consent form for the aggressive approach. During the surgery, Toms perforated Shinal’s carotid artery and caused her hemorrhage, stroke, brain injury, and partial blindness. Shinal brought a medical-malpractice action against Toms in the trial court and claimed that Toms did not obtain her informed consent for the aggressive surgery as required by Pennsylvania statute. The trial court allowed the jury to consider information provided to Shinal by Toms’s physician assistant to assess whether Toms got Shinal’s informed consent to the surgery. The jury returned a verdict in favor of Toms. Shinal moved for posttrial relief and asserted that the trial court improperly instructed the jury to consider information communicated to Shinal by Toms’s physician assistant to determine whether Toms properly obtained Shinal’s informed consent. The trial court denied Shinal’s motion for posttrial relief. The appeals court affirmed the trial court’s decision. Shinal appealed.