Paetsch v. Spokane Dermatology Clinic, PS

Plaintiff Phyllis Paetsch was referred to Spokane Dermatology Clinic for Botox injections to smooth facial wrinkles. Paetsch had never heard of the clinic, had never been there before, and was not aware of the staff or medical reputation of the clinic. She made an appointment for treatment and was told that her appointment would be with Dan Rhoads. Spokane Dermatology Clinic is a professional services company owned solely by Dr. William Werschler. The clinic also employed another doctor as a dermatologist and three certified physician's assistants (PA-Cs), one of which was Dan Rhoads. Paetsch completed some medical history and patient profile forms, signed them, then was escorted to her appointment room. She was told "the doctor" would be in soon. Shortly thereafter, a man in scrubs entered and introduced himself as "Dan." Rhoads injected Paetsch with both Botox and Restylane. He injected Restylane into Paetsch's forehead, not knowing that the federal Food and Drug Administration did not approve the use of Restylane in the forehead as it increased the risk of necrosis. While initially pleased with the results, Paetsch later developed a headache, the symptoms of which worsened. Rhoads misdiagnosed her condition as an infection and prescribed antibiotics and anti-inflammatories to control it. These treatments were ineffective, and Paetsch's condition continued to deteriorate. Paetsch sought treatment from her primary care provider. The clinic properly diagnosed the condition as necrosis caused by the use of Restylane in the forehead; the Restylane had expanded throughout the forehead, cutting off the only flow of blood to the skin. This diagnosis was too late to treat the condition, and the provider could only scrape the dead tissue from Paetsch's face. The necrosis resulted in deep, permanent scarring to Paetsch's forehead. Paetsch filed suit against Spokane Dermatology Clinic and against Dr. Werschler personally for the failure to obtain her informed consent to treatment and for medical malpractice by Dr. Werschler and Dan Rhoads. At trial, Paetsch presented evidence that Dr. Werschler presented himself as her doctor through the use of consent forms, that he owed her a duty of care, and that he breached that duty. Paetsch also presented evidence that as a PA-C, Rhoads was an agent of the physician and that Dr. Werschler's failure to adequately supervise Rhoads breached the standard of care. After the close of evidence, the trial court granted Dr. Werschler's motion for judgment as a matter of law, dismissing Dr. Werschler from personal liability on the ground that no jury could find that he breached a duty to Paetsch under the evidence. Following this motion, Spokane Dermatology Clinic was the only remaining named defendant. Despite dismissing Dr. Werschler personally, the court instructed the jury that the clinic could be held liable for Dr. Werschler's medical negligence, as he was an employee of Spokane Dermatology Clinic. The jury was never told that Dr. Werschler was dismissed as a defendant, and the majority of the jury instructions remained unchanged. The jury returned a verdict in favor of defendants, and the Court of Appeals affirmed. The Supreme Court affirmed, finding that the jury instructions allowed Paetsch to argue her theory of the case and the jury found that the defendant was not negligent. View "Paetsch v. Spokane Dermatology Clinic, PS" on Justia Law