Petition — Hartke v. McKelway

Supreme Court brief1983

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SEP 23 1983

ALEXANOER L STiEVAS,

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SUPREME COURT OF THE UNITED STATES

OCTOBER TERM 1983

SANDRA H. HARTKE

Petitioner.

DR. WILLIAM MCKELWAY

Repondent.

PETITION FOR WRIT OF CERTIORARI TO THE

UNITED STATES COURT OF APPEALS

FOR THE DISTRICT OF COLUMBIA CIRCUIT

7637 Leesburg Pike

Falls Church, Virginia 22043

(703) 734-2810

i

QUESTIONS PRESENTED

1. Whether a woman's constitutional right

of privacy and right to prevent procreation is

infringed and interfered with, when, as a matter of

law, the woman is denied damages for child rearing

expenses in a case of failed sterilization with

resulting childbirth as a result of medical negligence

and malpractice.

2. Whether a woman's constitutional right

of privacy and right to prevent procreation is

infringed and interfered with, when, as a matter of

law, the woman is denied damages for child rearing

expenses because the mother failed to get an abortion

after a failed sterilization with resulting child

birth as a result of medical negligence and malpractice.

Page

Gpimioms Below ..ccceccecsececcvcee 2

Ne | a Te a i a a a a ee ee

Constitutional Provisions Involved ..... 2

Statement of the Case... 2 se eececsvee §

Reasons for Granting the Writ ........ 8

TUR irT. sos 6 6 «© 6 6 0 e are”

APPENDIX CONTENTS

Opinion of the United States Court of Appeals for the

District of Columbia Circuit ...... . AppA.p.l

Opinion of the United States District Court for the

District of Columbia Circuit ...... . App B.p.l

TABLE OF CITATIONS

Cases

Akron v. Akron Center for Reproductive Health, 43

CCH ha es Bull. Pp. 3336 (1983). . . . . 9, 23

Christensen v. Thornby, 192 Minn 123, 24 N.W. 620

(1934) . . . . . . . ° . -_ . . . . . - . 12

iv

Page

Cockrum v. Baumgartner, 447 N.E. 2d 385 (Ill. S.Ct.

1983) . . . . . - . . + . . . . . . . . 22

Eisenstadt v. Baird, 405 U.S. 438 (1972) ..... 20

Griswold v. Connecticut, 381 U.S. 479 (1965) . . . 11,20,21

Hartke v. McKelway, 526 F Supp97, 105 (D.C.D.C.

1981) . . . . . . . . . . . . 7 . . . . . 7

Roe v. Wade, 410 U.S. 113 (1973) . . 2. «© « « «© « « 8,9,11,21,2

Sherlock v. Stillwater Clinic, 260 N.W. 2d 169

(Minn 1977) . . . . . . . . . . . . . . . 12

ul tion: Who Pays for Br i ?

47 Fordham L.Rev. 481, 432-35 (1978). . . 14

STATUTES

28 7.8.6. §1257 (3) . . . . . . . . . . . . . . . 2

S. Constitution, Amendment IX .

S. Constitution,

S. Constitution,

S. Constitution,

S. Constitution,

S. Constitution,

Amendment VI

Amendment XIV

Amendment I

Amendment IV

Amendment V

SANDRA H. HARTKE

Petitioner.

DR. WILLIAM MCKELWAY

Repondent.

PETITION FOR WRIT OF CERTIORARI

The Petitioner, Sandra Hartke, respectfully

prays that a Writ of Certiorari be issued to review

the judgment of the United States Court of Appeals

for the District of Columbia Circuit.

-2-

OPINIONS BELOW

The opinion of the United States Court of

Appeals for the District of Columbia Circuit, appears

in Appendix A - page l.

The opinion of the United States District

Court for the District of Columbia appears in Appendix

B - page l.

JURISIDICTION

Juridiction is based on 28 U.S.C. Section

1257 (3). The order sought to be reviewed was

entered May and rehearing was denied on July 30,

1983.

CONSTITUTIONAL PROVISIONS

U. S. CONST., Amend. IX

The enumeration in the Constitution, of

certain rights, shall not be construed to deny

or disparage others retained by the people.

This Constitution, and the laws of the

United States, which shall be made in pursuance

thereof shall be the supreme law of the land,

and the judges in every State shall be bound

thereby, anything in the constitution or laws of

any State to the contrary notwithstanding...

U. S. CONST. Amend. XIV

No State shall make or enforce any law

which shall abridge the privileges or immunities

of citizens of the United States; nor shall any

State deprive any person of life, liberty or

property, without due process of law; nor deny

to any person within its jurisdiction the equal

protection of the laws.

U.S. CONST. Amend. I

Congress shall make no law respecting

an establishment of religion, or prohibitng the

free exercise thereof; or abridging the freedom

of speech, or of the press; or the right of the

people peaceably to assemble, and to petition

the Government for redress of grievances.

U. S. CONST., Amend. IV

The right of the people to be secure in

their persons, houses, papers, and effects,

against unreasonable searches and seizures,

shall not be violated, and no Warrants shall

issue, but upon probable cause, supported by

Oath or affirmation, and particularly describing

the place to be searched, and the persons or

things to be seized.

U.S. CONST., Amend V

No person shall be held to answer for a

capital, or otherwise infamous crime, unless on

a presentment or indictment of a Grand Jury,except

in cases arising on the land of naval forces, or

in the Militia, when in actual service in time

of War or public danger; nor shall any person be

subject for the same offence to be twice put in

jeopardy of life or limb; nor shall be compelled

in any criminal case to be a witness against

himself; nor be deprived of life, liberty, or

property, without due process of law; nor shall

private property be taken for public use,

without just compensation.

STATEMENT OF THE CASE

This is a case of the invasion of a woman's

right of privacy not to procreate arising out of a

failed sterilization malpractice case of Sandra

Hartke against Dr. McKelway. The jury found the

doctor negligent on two counts and awarded the

plaintiff damages for child rearing expenses in the

special verdict as follows:

"Anticipated costs of raising this child

until age 18 less any benefit she received or in

the future will receive by reason of the love,

joy, happiness etc. she experienced in raising a

healthy, happy child. $200,000."

-5-

The trial court disallowed the jury's award

for childrearing expenses holding that, although such

expenses may be a recoverable item of damages in a

failed sterilization case, childrearing expenses were

not recoverable as a matter of law based on the

court's weighing of the facts in the instant case,

The court based its ruling on his personal and

private notion and a reweighing of the evidence of

whether the sterilization was obtained solely for

therapeutic reasons that is, that the plaintiff

actually wanted a child because otherwise she would

have had an abortion.

The U. S. Court of Appeals affirmed the

decision disallowing the jury verdict of $200,000 for

ordinary child rearing expenses notwithstanding the

plaintiff's argument that the denial violated the

constitutional rights of the plaintiff not to procreate.

The Court of Appeals' opinion found that

"the jury could not rationally have found that the

birth of this child was an injury to this plaintiff

-6-

and, that having a child would, on balance, be a

positive experience." (Slip opinion p. 25) and that

her decision not to have an abortion was conclusive

that the sterilization was for therapeutic reasons

and therefor child rearing expenses should be disallowed.

The District Court and the Court of Appeals

gave their opinion in light of their personal and

private notions that the plaintiff's failure to

undergo an abortion was evidence that the plaintiff's

sterilization was solely for therapeutic reasons. The

Court of Appeals disregarded as unimportant that

plaintiff was 36 years old and had a 16 year old

daughter when the second child was born; that she

specifically told the defendant doctor she "did not

want to have any more children"; that her husband

offered to have a vasectomy; that plaintiff testified

that she had a strong objection to undergoing abortions;

that she followed her treating physician's advice at

all times; that she sought to avoid having another

child and child-rearing expenses; that she objected

to another abortion because her doctor advised her

«Jo

that the health risks of abortion were as dangerous

as that of childbirth. The courts claimed these

facts were circumstantial and disallowed the award of

childrearing expenses claiming the motive for sterilization

was solely therapeutic because plaintiff chose not to

have an abortion. (Slip opinion, page 24). Hartke v.

McKelway, 526 F Supp 97, 105 (D.C.D.C. 1981).

This petition follows in due course. The

constitutional issues involved in this petition were

raised at each step of the proceedings below.

REASONS FOR GRANTING THE WRIT

THE LOWER COURTS DECIDED A QUESTION OF

IMPORTANCE IN A WAY THAT CONFLICTS WITH APPLICABLE

DECISIONS OF THIS COURT HOLDING THAT A NEGLIGENT

DOCTOR IN A STERILIZATION CASE CANNOT BE HELD RESPONSIBLE

FOR THE CHILD REARING EXPENSE OF A CHILD THAT WOULD

NEVER HAVE BEEN BEGET OR BORN BUT FOR THE DOCTOR'S

NEGLIGENCE, THEREBY DENYING A WOMAN'S RIGHT TO DECIDE

NOT TO PROCREATE AND CONCEIVE A CHILD.

This case represents still another attempt

by lower courts to overrule, circumvent and nullify

the Supreme Court's doctrine as set forth in Roe v. Wade

(410 U.S. 113 (1978).

The consequences of the lower court's

decision are that the doctor's negligence forces the

woman to:

(1) exterminate, by abortion, the fetus at

any time before birth, or (2) pay the expenses of

rearing a child caused by the doctor's negligence.

The consequence is not only unconstitutional,

it is absurd and revolting.

In the instant case, the plaintiff's zone of

privacy was the decision to be sterilized; it was her

personal right to so decide. It was the act of a

responsible woman who through the tort of a doctor

-9-

faced the unwanted choice of aborting a child or

assuming $200,000 in child rearing costs — after

having undergone the operation to specifically avoid

that precise agonizing choice and expense.

The rationale of Roe v. Wade is succinctly

Stated by Justice Powell in Akron v. Akron Center

for Reproductive Health, 43 CCH S. Ct. Bull. p 3336

(1983):

"These cases come to us a decade

after we held in Roe v. Wade, 410 U.S. 113

(1973), that the right of privacy, grounded in

the concept of personal liberty guaranteed by

the Constitution, encompasses a woman's right to

decide whether to terminate her pregnancy....

And arguments continue to be made, in these

cases as well, that we erred in interpreting the

Constitution. Nonetheless, the doctrine of

Stare decisis, )shile perhaps never entirely

persuasive on a constitutional question, is a

doctrine that demands respect in a society

governed by the rule of law. We respect it

today, and reaffirm Roe v. Wade."

The holding and logic of Roe v. Wade rewsires

this conclusion:

A negligent doctor that denies a woman

the right to prevent conception is responsible

for the child rearing expenses of the child that

would not have existed but for his negligence.

-10-

The Appeals Court postulate that their

decision is not based on logic, but on practical

politics! Politics should not control legal principles,

nor should the private and personal notions of

judges.

Judge Oberdorfer, who belatedly revealed he

had been a back door neighbor and friend to the

defendant/doctor, suggested that the plaintiff file a

motion to recuse and then the judge denied plaintiff's

motion. He held that the petitioner should have had

an abortion to avoid the costs of raising a child.

He places the blame for the doctor's negligence on

the innocent victim —- the mother who sought to avoid

conception. He claimed she had no moral objection to

abortion because she had had a prior abortion,

campletely ignoring the uncontradicted medical

testimony of two doctors that advised that the prior

abortion was performed in order to save her life.

The Court of Appeals' decision refuses to

recognize the authority of the Supreme Court, although

-ll-

they acknowledge the Roe v. Wade, supra and Griswold v.

Connecticut, 381 U.S. 479 (1965) holdings as follows:

"But when a couple has chosen not to

have children, or not to have any more children,

the suggestion arises that for them, at least,

the birth of a child would not be a net benefit.

That is their choice and the courts are required to

respect it. (U.S. Court of Appeals citing Cf. Roe v.

Wade, 410 U.S. 113, 153 (1973) (woman's right to

abortion: "Maternity, or additional offspring,

may force upon the woman a distressful life and

future.") Griswold v. Connecticut, 381 U.S.

479, 485-86 (1965) (couple's right to use

contraceptives). (emphasis added)

At the heart of this case is the Constitutional

right of privacy as guaranteed by the First, Fourth,

Fifth, Sixth, Ninth, and Fourteenth Amendments to the

Constitution of the United States which sets forth

the public policy considerations involved in this

type of situation. Griswold v. Connecticut, 381

U. S. 479 (1965).

"Maternity, or additional offspring may

force upon the woman a distressful life and

future. Psychological harm may be imminent.

Mental and physical health may be taxed by child

care. There is also the distress, for all

concerned, associated with the unwanted child,

and there is the problem of bringing a child

into a family already unable psychologically and

otherwise, to care for the child.” Roe v. Wade,

410 U.S. 113 at 153 (reh denied 410 US 959)

1973.

-]2-

The guaranteed constitutional right of

privacy and decision not to have a child is not

determined by motive or state of mind. Regardless of

motivation, a couple has the right to determine

whether they will have a child. That right is

legally protectible and need not be justified or

explained. The allowance of rearing costs is a

recognition of the importance of the parent's fundamenta

right to control their productivity. The lower

courts have endorsed a view that effectively nullified

this right by providing that its violation results in

no injury.

The lower courts rely on, with approval as

authority, upon the dicta of a Minnesota case which

has been specifically rejected by the Minnesota

Court. The Christensen v. Thornby, 192 Minn 123, 24

N.W. 620 (1934) case relied on by the lower courts

was totally rejected forty three years later by

Sherlock v. Stillwater Clinic, 260 N.W. 2d 169 (Minn

1977).

The law of Minnesota is the Sherlock case,

-]3-

not the Christensen case as the lower court leads one

to believe. The Minnesota court allowed the costs of

rearing a healthy child as damages resulting fram a

negligently performed sterilization operation.

"Ethical and religious considerations

aside, it must be recognized that such costs are

a direct financial injury to the parents no

different in immediate effect than the medical

expenses resulting fram the wrongful conception

and birth of the child. Although public sentiment

may recognize that to the vast majority of

parents the long-term and enduring benefits of

parenthood outweigh the econamic costs of

rearing a healthy child, it would seem myopic to

declare today that those benefits exceed the

Costs as a matter of law. The use of various

birth control methods by millions of Americans

demonstrates an acceptance of the family-planning

concept as a integral aspect of the modern

marital relationship, so that today it must be

acknowledged that the time-honored command to

"be fruitful and multiply” has not only lost

contemporary significance to a growing number of

potential parents but is contrary to public

policies embodied in the statutes encouraging

family planning. Recent decisions of the United

States Supreme Court, moreover, seem to suggest

that the right to limit procreation is a constitutional

dimension. See Roe v. Wade, 410 U.S. 113, 93

S.Ct. 705 34 L. Ed 2d 147 (1973) Griswold v. Connecticut,

381 U.S. 479, 85 S. Ct. 1678, 14 L. Ed 2d 510

(1965). Campensatory damages for the cost of

rearing the child to the age of majority would

also, in our opinion, serve the useful purpose

of an added deterrent to negligent performance

of sterilization operations."

-14-

Purther misleading by the District Court and

Court of Appeals is their reliance for authority for

their decisions Wrongful Conception: Who Pays for

Bringing Up Baby? 47 Fordham L.Rev. 481, 432-35

(1978). Nothing in the Fordham article supports the

lower court's decision. The Fordham article suggests

the courts apply the Restatement of Torts "benefits"

rule. Fordham L. Rev, supra at 431-2. This approach

was followed by the jury in determining child rearing

expenses in the instant case. The Fordham article

states that the jury, not the judge, determines the

damages and any benefit offset. Fordham L. Rev.,

supra, at 433. In the instant case, the jury found

after considering any benefit offset that the plaintiff

was damaged in the net amount of $200,000.

The decision of the lower court violates the

Equal Protection Clause of the Constitution by

Characterizing the doctor as an elite class and not

subject to the liability of paying for the costs of a

child that was caused by his negligence. It is a

-15-

disguise to offer preferential treatment to absolve

doctors from liability for a tortious act and a

disguise to cover up the prejudice against contraceptions.

It is evident in their unsubstantiated statement that

“child rearing is a positive experience." The cost of

raising an unplanned child, in all other cases is on

the wrongdoer, not on the victim.

For example,

1. Rapist. The rapist, whose act results

in the birth of child, does not have a prison term

cammuted because he "gave a woman a blessing” and a

"positive experience". Such a ludricous argument

would never be attempted. The present ruling of the

lower courts would make such a decision appropriate.

2. Father of the Child. Whether born

during a marriage, or out of wedlock, the courts

routinely have stated that the father is responsible

for support. The Census Bureau, covering up to 1981

found that 4 million absentee fathers are under court

orders to pay child support. The father cannot make

the argument that the mother loves the child and that

-16-

rearing the child will be a "positive experience” and

he should thus be exempt fram paying support for that

child.

3. Runaway Fether. Fathers are not outside

of the law because they no longer see their offspring.

They are still required to support the child. It is

no excuse to hold that they are allowing the mother

the "benefit of the joy of raising the child”.

4. Paternity Cases. Each paternity issue

has as its final nature: who will financially support

the child. The dollar issue is not resolved by

deciding who loves the child once it is born. The

dollar issue is resolved by deciding who caused the

"conception to occur".

5. Delinquents. It is common knowledge that

juvenile delinquency is major problem. These children,

even when loved by a mother, present econamic and

other costs which must be borne. No juvenile court

would recognize that raising a child is always a

“positive experience” and a "joy". There are no

“guarantees” of how child will develop.

-l]7-

In a civilize’ world, no waman should be

forced to became a mother against her will. The

reason or motive for the plaintiff's decision to be

sterilized is irrelevant. It is the negligence of

the doctor and not the motive not to procreate that

should allow the mother entitlement to damages for

the costs of raising an unwanted child.

This mother — who now has imposed on her

the sole burden for child raising expense - is the

mother who did not choose abortion. Yet these courts

deny her compensation on their personal and private

notion of why she chose to be sterilized.

This decision advocates abortion. It is an

inhumane decision.

There is nothing humane in denying a mother

the wherewithal to support a child caused by a

doctor's negligence. There is nothing humane in a

decision which effectively immunizes a doctor from

his own negligence and victimizes the mother who

sought to avoid having another child.

-18-

This decision places a mother in the position

of demonstrating in a malpractice case that she does

not love her own child. A great anomaly is apparent.

The love by the mother/plaintiff for an unwanted

child is used against the mother in violation of her

constitutional rights. The love of a mother for the

child should not be a reason for denying her financial

damages. Love does not pay for raising a child.

In this case the doctor has invaded the

privacy of the individual on whether to even conceive

a child. Once he is found in error, the mother is

made to suffer and pay for the doctor's invasion of

the mother's privacy. The effect of the lower

court's decisions would mean there could be no form

of birth control (not even abstinence) because a

woman must have sexual relations only for the purpose

of having a child. As a further result, no father

would pay child support because the mother would have

the "joy and blessing" of having the child and paying

the costs of child support herself. This fundamental

-]9-

error of the Appeals Court cannot be explained away

and the mischievous consequences in a negligent

sterilization case are obvious:

The negligent doctor invades the privacy of

the individual. Pregnancy occurs. Either the mother

is forced to have an abortion, which she does not

want, or: She is forced to support a child, she did

not want to conceive.

Judge Oberdorfer and the Appeals Court

Claimed the sterilization was for therapeutic purposes,

but there was never a statement that the sterilization

was for "therapeutic purposes". The direct evidence

is that the mother said she did not want to have any

more children. Transcipt p. 105, l. 7.

The court reweighed the evidence and came to

its own "personal and private" conclusion as to the

motive for the sterilizaton.

The decision is unsound under established

principles of law and is a clear violation of constitutional

and tort law.

-20-

The lower courts decision is based on their

personal and private notions of the motive the

petitioner sought a sterilization. The lower courts

are in direct conflict with Justice Harlan in Griswold v.

Connecticut, supra:

"In determining which rights are

fundamental, judges are not left at large to

decide cases in light of their personal and

private notions. ......The inquiry is whether a

right involved "is of such a character that it

cannot be denied without violating those “fundamental

principles of liherty and justice which lie at

the base of all ow civil and political institutions."

"The secular state is not an examiner

of consciences; it must operate in the realm of

behavior, of overt actions..."

The lower courts, also, directly contradict

Justice Brennan, writing on Griswold in his Eisenstadt v.

Baird, 405 U.S. 438 (1972) opinion:

"If the right of privacy means anything,

it is the right of the individual, married or

single, to be free fram unwarranted governmental

intrusion into matters so fundamentally affecting

a person as the decision whether to bear or

beget a child.".... (emphasis added)

and contradicts Justice White's concurrence in Baird

(joined by Justice Blackmum)

"so here to sanction, a medical restriction

upon distribution of a contraceptive not proved

hazardous to health would impair the exercise of

the constitutional right."

-2l-

To deny all reasonably foreseeable consequences

is a denial of due process of law which provides that

all damages naturally flowing fram a tortious act are

allowable.

Roe v. Wade, supra and Griswold v. Connecticut,

supra established that the right to limit procreation

is a constitutionally protected right. To deny

child-rearing expenses effectively nullifies that

right by severely impairing the remedy available to a

mother who after choosing not to have a child, found

that she has a child due to a negligently performed

sterilizaton. In allowing recovery for damages for

child rearing expenses, it would only be compensating

the mother for damages that naturally flow fram the

camission of the tortious act of the doctor.

This decision below carves out an exception

to the normal duty of a tortfeasor to assume liability

for all damages proximately caused. Public policy

cannot support an exception to tort liability when

the impact of that exception impairs the exercise of

constitutional rights.

=22=

CONCLUSION

The right of privacy and right of whether or

not to procreate is guaranteed by the Constitution.

The lower courts endorse a policy that infringes and

interferes with this right by denying damages resulting

fram the foreseeable consequences of childrrearing

caused by a negligently performed sterilization

operation. The right of privacy and whether or not

to procreate is not a conditional right dependent on

motivation nor is it one which would require the

victim to have an abortion. The denial of child

rearing expenses is a denial of the mother's constitutiona

right.

The importance of this issue is emphasized

by the large number of recent appeals throughout the

country raising the same question. A notable example

is the case of Cockrum v. Baumgartner, a petition for

writ of certiorari in that case having been recently

filed in the October 1983 term of the Supreme Court.

The courts are inconsistent and uncertain about the

=23-

application of the constitutional right of privacy in

light of Roe v. Wade, supra to such cases. The lower

courts, in effect, overrule Roe v. Wade and Akron,

the constitutional right to privacy in matters

relating to having a child. This decision of the

Court of Appeals of the District of Columbia Circuit

holds that the right to have an abortion is converted

to an obligation to have an abortion in order to

avoid child rearing expenses.

Respectfully submitted,

Chines [York

VANCE HARTKE

WAYNE HARTKE

PAUL HARTKE

Hartke and Hartke

7637 Leesburg Pike

Falls Church, Virginia 22043

Telephone: (703) 734-2810

Counsel for Petitioner

APPENDICES

ole

APPENDIX A

Notice: This opinion is subject to formal revision before publication

in the Federal Reporter or U.S.App.D.C. Reports. Users are requested

to notify the Clerk of any formal errors in order that corrections may be

made before the bound volumes go to press.

United States Court of Apneals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

No. 81-2192

SANDRA J. HARTKE

Vv.

Dr. WILLIAM MCKELWAY, APPELLANT

No. 81-2193

SANDRA J. HARTKE, APPELLANT

7

Dr. WILLIAM MCKELWAY

Appeals from the United States District Court

for the District of Columbia

(D.C. Civil No. 79-03447)

Argued September 29, 1982

Decided May 20, 1983

Vance Hartke for appellant in 81-2193 and cross-

appellee in 81-2192. Wayne Hartke also entered an ap-

pearance for appellant cross-appellee.

Bills of costs must be filed within 14 days after entry of judement. The

court looks with disfavor upon motions to file bills of costs out of time.

2

Patrick J. Attridge for appellee in 81-2193 and cross-

appellant in 81-2192.

Before MACKINNON and GINSBURG, Circuit Judges, and

McGowan, Senior Circuit Judge.

Opinion for the Court filed by Senior Circuit Judge

McGowan.

McGowan, Senior Circuit Judge: These cross-appeals

arise out of the failure of an operation to sterilize the

plaintiff, resulting in the birth of a healthy baby girl.

The primary issue for our consideration in this diversity

case is whether, under District of Columbia law, the

plaintiff would be allowed to recover from the defendant

doctor some portion of the expenses of raising the child to

majority. We are also called upon to decide whether, in

the light of certain language in our opinion in Henderson

v. Milobsky, 595 F.2d 654, 657-58 (D.C. Cir. 1978),

patients in informed-consent cases must testify that they

would not have undergone the procedure had they known

of all the materia] risks involved. Finally, we must de-

cide whether the risk of subsequent pregnancy in this case

could reasonably have been considered material to a de-

cision whether to undergo the treatment.

After a jury verdict for plaintiff on all claims, the

District Court disallowed the award of childrearing ex-

penses because it found the evidence clear that plaintiff

had sought to be sterilized for therapeutic, not economic,

reasons, and because she prized the child she bore. Hartke

v. McKelway, 526 F. Supp. 97, 105 (D.D.C. 1981). The

court also held that in haec verba testimony of causation

is not required to get the issue of informed consent to the

jury as long as there is otherwise sufficient evidence from

which the jury could infer that a patient would have de-

clined the procedure had he or she known of the risks.

Id. at 103. Finding such evidence, the court upheld the

jury’s award of damages for plaintiff's medical expenses,

pain, suffering, and mental anguish resulting from the

8

pregnancy and childbirth. Jd. The court also held that a

jury could have found that a reasonable person in plain-

tiffs’ somewhat unusual position would likely have at-

tached significance to the undisclosed risk of subsequent

pregnancy here (one to three out of one thousand). Jd.

at 102-03. We affirm.

I

In the winter of 1978, Sandra J. Hartke, the plaintiff

in this action, discovered she was pregnant and elected

to have an abortion. For reasons that are crucial to the

disposition of this appeal, and that are discussed at length

below, she also sought to have herself sterilized. Her

usual doctor recommended a hysterectomy, the complete

removal of the uterus. Hartke, then 33, thought this a

rather drastic procedure, so she approached the defend-

ant, Dr. William McKelway, for a second opinion. Dr.

McKelway recommended a procedure known as laparo-

scopic tubal cauterization, which involves blocking the

Fallopian tubes by burning them with instruments in-

serted through one or two small incisions in the abdomen.

Hartke consented to the procedure and on March 14,

1978, an abortion and tubal cauterization were per-

formed on her. Dr. McKelway subsequently examined

Hartke and termed the operation successful.

There was testimony from which the jury could infer

that prior to the operation Dr. McKelway failed to dis-

close to Hartke that there was a risk of recanalization—

where a Fallopian tube spontaneously reopens—of one to

three out of one thousand. Hartke and her boyfriend,

with whom she had lived for four years and whom she

later married, also testified that the boyfriend offered to

undergo a vasectomy if there was any risk of subsequent

pregnancy, but that McKelway told them that the proce-

dure was “a 100 percent sure operation,” and that Hartke

would not have to worry about becoming pregnant again.

Record Excerpts (R.E.' at 35; accord id. at 34.

4

Despite the surgery, Hartke again became pregnant in

September 1979. After an examination confirmed that the

pregnancy was normal—she had had a tubal or ectopic

pregnancy in 1968—she elected to carry it to term and in

June 1980 gave birth by Caesarean section to a baby girl.

At the same time, Hartke had herself resterilized by a

tubal ligation, which involves actually cutting the Fal-

lopian tubes. The record suggests that this method of

sterilization involves about the same risk of subsequent

pregnancy as cauterization. Transcript of July 23, 1981,

at 145, 148 (testimony of Dr. Falk); see also id. at 148

(risk when ligation performed at time of delivery is

greater). At the time of trial, one year after the delivery,

she had not resumed sexual relations with her husband.

Transcript of July 24, 1981, at 304 (testimony of Weddle

(plaintiff’s husband) ); see id. at 296 (testimony of Mrs.

Hartke (plaintiff’s mother) ).

Invoking the District Court’s diversity jurisdiction,

Hartke brought suit against McKelway alleging negli-

gence in the performance of the cauterization procedure,

failure to obtain informed consent, and breach of war-

ranty. At the conclusion of the plaintiff’s evidence, the

District Court granted McKelway a directed verdict as to

the breach of warranty claim; Hartke does not now com-

plain of this ruling. The jury returned a special verdict,

finding that McKelway negligently failed to cauterize

Hartke’s Fallopian tubes and that he failed to inform

her of a materia] risk of the procedure. It awarded

Hartke $10,000 in medical expenses, $100,000 for pain,

suffering, and mental anguish, and $200,000 for the

“Talnticipated costs of raising this child until age 18

less any benefit [Hartke] received or in the future will

receive by reason of the love, joy, happiness, ete. she ex-

perienced in raising a healthy, happy child.” R.E. at

1-2; 526 F. Supp. at 106 (copy of special verdict form

used).

The District Court granted in part McKelway’s mo-

tions for judgment notwithstanding the verdict and for

5

a new trial. It held that there was no evidence of medi-

cal expenses greater than $6,000 and no evidence of fu-

ture medical expenses, and ordered a new trial on this

issue unless Hartke agreed to remit $4,000. Jd. at 104.

Hartke made such a remittitur.: The court also ruled

that a new trial of the negligence claim would be neces-

sary because one of Hartke’s experts should not have

been allowed to testify on the standard of care for la-

paroscopic cauterization. Jd. at 101.2 Finally, the court

disallowed the award of childrearing expenses because the

“weight of authority does not, and the District of Colum-

bia courts would not, allow recovery of the costs of rais-

ing a healthy child in circumstances such as these where

the plaintiff sougit sterilization solely for therapeutic

reasons, and prizes the child she bore.”’ 7d. at 105.° Both

parties appealed.‘

1 Hartke objects to this order of a new trial as unfair and

unjustified. A plaintiff may not, however, appeal from a

remittitur order that he or she has accepted. Donovan v.

Penn Shipping Co., 429 U.S. 648 (1977) (per curiam).

? The District Court noted that since it upheld the jury’s

separate verdict on the informed consent issue, a new trial on

negligence would actually only be necessary if its holding on

informed consent were overtrrned on appeal. 526 F. Supp. at

102. Since we uphold the court’s ruling on the informed con-

sent issue, we need not reach Hartke’s argument that the

jury’s verdict on negligence should have been allowed to stand,

nor McKelway’s argument that he should have been granted

not a new trial but judgment notwithstanding the verdict on

that issue.

’ The District Court also ruled that if its disallowance of

the award of childrearing expenses were reversed on appeal,

a new trial would be required on the amount of those damages

because the only evidence on the question was Hartke’s testi-

mony that it had cost her about $60,000 to raise her first

daughter to the age of 17. 7d. at 105. Hartke now argues

that the jury’s verdict was reasonable and should be rein-

stated. Since we disallow the award of any childrearing ex-

penses in this case, we need not reach this issue.

* Hartke’s notice of appeal was limited to ‘‘that part of the

Order . .. relating to the disallowance by the Judge of the

II

We deal first with the judgment that Dr. McKelway

failed to disclose material risks to Hartke.

A. Materiality of the Risk

McKelway first argues that he had no duty to disclose

the risks of pregnancy in this case since no “reasonable

person in what the physician [knew] or should [have

known] to be the patient’s position would be likely to

attach significance to the risks in deciding whether to

accept or forego the proposed treatment,” Crain v. Alli-

son, 443 A.2d 558, 562 (D.C. 1982). The risk of preg-

nancy after laparoscopic cauterization was testified to be

one to three out of one thousand.

For present purposes, the crucial language in the above

formulation is “what the physician [knew] or should

{have known] to be the patient’s position.” The “pa-

tient’s position’”’ must include the patient’s medical his-

tory and other factors that might make knowledge of

certain risks particularly important to a certain patient,

acting reasonably. Here, there were two factors that

would make even a smal] risk of pregnancy unusually

dangerous for a patient in Hartke’s position. First, Dr.

McKelway knew that Hartke had a history of gyneco

Jury’s Verdict awarding Two Hundred Thousand Dollars

($200,000.00) for child rearing expenses.” Appellee/Cross-

Appellant’s Appendix at 32. Since we do not reach the other

issues now raised by Hartke, see supra notes 1, 2, & 3, we do

not decide the effect of the limited notice of appeal. Compare

Fed. R. App. P. 3(c) (“An appeal shall not be dismissed for

informality of form or title of the notice of appeal.”) and

Advisory Committee Note to 1979 Amendment of Fed. R.

App. P. 3(c) (“[SJo long as the function of notice is met by

the filing of a paper indicating an intention to appeal, the

substance of the rule has been complied with.”) with Gannon

v. American Airlines, 251 F.2d 476, 482 (10th Cir. 1957)

(Under old Fed. R. Civ. P. 73(b), “the jurisdiction of this

court on appeal is limited to the review of the judgment or

portion thereof designated.”’).

7

logical and pregnancy-related problems. She had con-

tracted peritonitis after the birth by Caesarean section

of her first child in 1964, resulting in a lengthy and

traumatic hospital stay. She had had an ectopic preg-

nancy in 1968, apparently begun while using an IUD.

She had been hospitalized numerous times for minor

gynecological procedures. Hartke testified she informed

Dr. McKelway that other doctors had advised her she

“would not make it through [another] pregnancy.”

Transcript of July 21, 1981, at 8. Second, Dr. McKelway

had before him conclusive evidence of the psychological

effect of pregnancy on his patient. He testified that she

was “extremely upset” and “very agitated” about the

pregnancy. Transcript of July 24, 1981, at 311. She

testified that she told him she thought she was going to

die from the pregnancy. R.E. at 23.

In sum, the jury could conclude that a subsequent

pregnancy would be a very serious consequence for this

particular patient, which would result possibly in physical

and certainly in psychological trauma. This was under-

scored by the testimony that Hartke’s boyfriend told the

doctor he would undergo a vasectomy instead if the

sterilization was not sure to be successful.

Moreover, less risky paths than relying on the cauter-

ization were open to Hartke. Had she been able to com-

pare the relative risks of failure, she might reasonably

have changed her mind and decided to undergo a hysterec-

tomy if, as the evidence suggested,’ the latter procedure

would have reduced the risk. Perhaps more likely given

her ultimate course of conduct, even if Hartke had

5 Compare Transcript of July 23, 1981, at 237 (Dr. Marlow)

(“surprisingly ... there have been a number of pregnancies”’

after hysterectomies) (emphasis added) and id, at 151 (Dr.

Falk) (25 abdorninal pregnancies have been reported in the

literature) with ‘d. at 148 (Falk) (risk of pregnancy after

laparoscopic sterilization is one to three or four per thousand)

and id. at 236 (Marlow) (“I know of no series in the world

where there have not be[en] failures following laparoscopic

sterilization.”).

8

agreed to the cauterization, she might reasonably have

decided to have her boyfriend undergo a vasectomy, ab-

stained from intercourse, or taken other precautions that

would reduce the risk.

In Canterbury v. Spence, 464 F.2d 772 (D.C. Cir.),

cert. denied, 409 U.S. 1064 (1972), this court noted in

this connection, ‘“‘Whenever nondisclosure of particular

risk information is open to debate by reasonable-minded

men, the issue is for the finder of the facts.” Id. at 788

(footnote omitted). There we held that the jury could

have found a one percent risk of a very serious harm—

permanent urinary incontinence and paralysis of the

bowels—to be material to a decision whether to undergo

an operation for back pain. Jd. at 794. In Henderson v.

Milobsky, 595 F.2d 654, 659 (D.C. Cir. 1978), we held

that a .001% risk of permanent loss of sensation in a

small section of the face could not reasonably be deemed

material to a decision whether to have impacted wisdom

teeth removed. In this case, the undisclosed risk was a

1% to .8% chance of subsequent pregnancy. For most

people, this risk would be considered very small, but this

patient was in a particularly unusual position. In view

of the very serious expected consequences of pregnancy

for her—possibly including death—as well as the ready

availability of ways to reduce the risk, we agree with the

District Court that a jury could conclude that a reason-

able person in what Dr. McKelway knew to be plaintiff’s

position would be likely to attach significance to the

risk here.

B. Proximate Cause

In order for there to be liability in tort, there must be

both breach of duty—here, the failure to divulge a ma-

teria] risk—and proximate causation. McKelway argues

that the issue of whether the failure to disclose the risk

of subsequent pregnancy here proximately caused the

harm should not have gone to the jury because Hartke

had not testified that she would not have undergone the

9

treatment had she known of the risks. The source of

McKelway’s argument is certain language in our opin-

ion in Henderson v. Milobsky, 595 F.2d 654 (D.C. Cir.

1978). Discussing the earlier case of Haven v. Randolph,

494 F.2d 1069 (D.C. Cir. 1974), the Henderson court

wrote:

Haven did not, however, add anything really novei

to our jurisprudence on risk-disclosure. In result, it

merely reemphasized the claimant’s burden of show-

ing that the alleged breach of duty to disclose led to

the injury for which compensation is sought. In

Canterbury we had held that when damages are

sought for a condition attributed to a medical pro-

cedure, causation by breach of duty cannot be demon-

strated simply by the claimant’s unadorned hindsight-

statement that had he known of the risk he would not

have consented to the procedure. Haven merely

stands for the cognate proposition that when the

claimant has not even made such an assertion, the

issue of causation cannot possibly go to the jury.

595 F.2d at 657-58 (emphasis added, footnote deleted).

The District Court rejected McKelway’s argument,

finding that Henderson should not be read to require in

haec verba testimony from the plaintiff “as long as there

is sufficient evidence from which the jury could infer

that she would have refused.” 526 F. Supp. at 103. The

court held that to require such testimony in such a case

“would only set a trap for the unwary.” Z/d. Citing

Hartke’s husband’s offer to undergo a vasectomy, the

court found that there was evidence in this case “from

which the jury could find that plaintiff would have de-

clined the procedure had she been informed of the risks.”

Id.

In its ruling the District Court appears to have ap-

plied a standard of causation based on what Hartke her-

self would have done. This is inconsistent with the

standard of causation adopted by this court in Canter-

bury v. Spence, 464 F.2d at 790-91. In that case the court

held that the issue of causation should be resolved on an

10

objective basis, “in terms of what a prudent person in the

patient’s position would have decided if suitably informed

of all perils bearing significance.” Jd. at 791 (footnote

deleted). The rule was based on a distrust of the pa-

tient’s hindsight testimony that he or she would have

foregone the treatment. Jd. at 790 (The patient’s testi-

mony “hardly represents more than a guess, perhaps

tinged by the circumstance that the uncommunicated

hazard has in fact materialized.”) (footnote deleted).

Such testimony was believed to be the primary, if not

only, evidence on the question of causation in the usual

case.

The District Court’s confusion in this case—it charged

the jury under a reasonable-person standard, Transcript

of July 29, 1981, at 431—is understandable, because in

both Henderson and Haven, issued after the Canterbury

decision, this court appears to have applied a causation-

in-fact rather than a reasonable-person standard. In

Henderson, the court held that the plaintiff’s testimony

that he would not have undergone the procedure had he

known of the risk of temporary paresthesia could not be

believed because he did in fact continue the treatment

once the paresthesia had appeared. 595 F.2d at 658: see

id. at 659 (“‘We can hypothesize no more telling evidence

of what he would have done... .”). In Haven, this

court affirmed the District Court’s grant of a directed

verdict for the defendant, “primarily” for the reasons

stated in the District Court’s opinion, 494 F.2d at 1070.

The trial court’s holding rested in part on its finding

that “there was no evidence that the parents would not

have given their consent” had they known of the risks in-

volved. Haven v. Randolph, 342 F. Supp. 538, 544

(D.D.C. 1972), aff'd, 494 F.2d 1069 (D.C. Cir. 1974).

Since the trial court’s ruling in this case, however,

the District of Columbia Court of Appeals has unequivo-

cally adopted, albeit in dictum, the objective, prudent-

person standard. Citing the Canterbury case, the court

in Crain v. Allison, 443 A.2d 558, 563 n.14 (D.C. 1982),

11

wrote, “[T]he test of causation is objective. The test

is what would a prudent person in the patient’s position

have decided if informed of all relevant factors... .”°

® Despite the clarity of this statement, we confess to some

doubt as to whether the District of Columbia courts will apply

this rule in every case. After this court adopted the objective

standard in Conterbury. it and the District Court were

evidently confronted with cases in which the question of

actual causation could be decided without reference to plain-

tiffs’ speculation about what they would have done had

they known of the risks. In Henderson. for example. the

patient’s own pretriel actions made it clear that he would have

consented to the removal of his wisdom teeth regardless of

whether he was informed of the risk of paresthesia. In the

present case, the District Court found that the jury could

have found that Hartke would have avoided the risks pre-

sented had she known of them even though she did not testify

about what she would have done. In such cases, the rationale

for the prudent-person standard—distrust of resting the issue

of causation on the credibility of the patient’s hindsight testi-

mony—falls away. and courts feel pressure to return to the

more accurate causation-in-fact standard. On the other hand,

the rule one might glean from this line of cases is not entirely

logical: the standard of causation by which injuries are

judged ends up depending on the fortuity of whether pa-

tients happen to have created an evidentiary trail before

trial demonstrating what they would have done had they

known of the risks. What may eventually emerge is a stand-

ard of causation that requires the plaintiff to prove both that

he or she would in fact have avoided the risk if informed of

it ond that a reasonable person would have done so.

In any case, if the District of Columbia courts would have

anplied a subjective standard of causation in this case, the

District Court would still have been correct that in hare ver ba

testimony is not required to get the question of causation to

the jury. The statement in Henderson that seems to impose

such a requirement is based on an overreading of Haven.

Hoven said only that there was “no evidence” that the parents

would have consented, not that there was “no testimony from

the parents” to that effect. Moreover, such a requirement

would elevate such testimony virtually to the dominant posi-

tion from which Canterbury and Crain sought to remove it.

Such testimony is of little trustworthiness, so it rationally

adds little to the plaintiff’s case. To hinge the issue on this

12

Under this standard, it is no longer possible to argue

that a patient’s testimony is necessary for the issue of

causation to get to the jury. The entire motivation for

jettisoning the subjective standard of causation was dis-

trust of precisely this testimony. As the Canterbury

court pointed out, under the objective standard “(t]he

plaintiff’s testimony is relevant . . . but it would not

threaten to dominate the findings.” 464 F.2d at 791;

accord Crain, 443 A.2d at 563 n.14 (“Although the pa-

tient’s testimony is relevant on the issue of causation,

the test of causation is objective.”); Sard v. Hardy, 281

Md. 432, 450, 379 A.2d 1014, 1025 (1977) (“Under this

rule, the patient’s hindsight testimony as to what he would

have hypothetically done, though relevant, is not determi-

native of the issue.”). While it might be helpful, the jury

certainly does not need the patient’s testimony to decide

what a reasonable person in that position would have

done.”

III

The District of Columbia courts have not offered the

same kind of guidance as to the other major issue raised

testimony is therefore illogical. We agree with the District

Court that this is undoubtedly a case in which there was suffi-

cient evidence of what Hartke would have done, even with-

out testimony from her directly addressing the question. Sec

generally supra part 11(A); Hartke v. McKelway, 526 F. Supp.

at 103.

*It should be noted that in any case there is some testi-

mony in this case that could be construed as in haec verba

testimony that Hartke would have taken steps to avoid the

risk had she known of it. Hartke testified as follows:

Q. If someone offered you a million dollars for this

baby, would vou take it?

A. Sir, if I had known that the operation was not

100 percent, you could not give me a million dollars for

that, and for a million dollars—I would not take a mil-

lion dollars for my baby. but I wouldn’t go through the

hell for a million dollars either.

Transcript of July 23, 1981, at 117 (emphasis added).

13

by this appeal: whether Hartke may recover some portion

of the costs of raising to majority the child born after the

failed sterilization. Moreover, as the District Court noted,

the case law from other jurisdictions is almost evenly

divided, some courts allowing some recovery under various

formulas, others allowing no recovery whatsoever. See

Hartke v. McKelway, 526 F. Supp. at 104 & nn. 2 & 3

(citing cases).

In large part, the differences appear to revolve around

whether the child can be considered a kind of damage to

the parents. A number of courts have ruled that as a

® Cases that do not fit into the categorization outlined in

text include those that recognize that the parents may suffer

damage from the birth of a child, but find that those damages

are too speculative for calculation. See, e.g., Coleman v. Gar-

rison, 349 A.2d 8, 12 (Del. 1975); Sorkin v. Lee, 78 A.D.2d

180, 181. 434 N.Y.S.2d 300, 301 (1980). While the calcula-

tion of damages in a case like this may be difficult, we see no

significant distinction between the task here and the analogous

task of fixing damages for wrongful death, see, ¢.9., Hord v.

National Homeopathic Hosp., 102 F. Supp. 792 (D.D.C. 1952)

(death of three-day-old infant), aff'd, 204 F.2d 397 (D.C.

Cir. 1953), for pain and suffering, or for extended loss of con-

sortium, see. e.g., Hitaffer v. Argonne Co., 183 F.2d 811, 815

(D.C. Cir.) (loss of consortium due to permanent injuries).

cert. denied. 340 U.S. 852 (1950). Accord Ochs v. Borrelli.

187 Conn. 253, 260, 445 A.2d 883, 886 (1982); Troppi v. Scarf.

31 Mich. App. 240, 261-62, 187 N.W.2d 511, 521, leave to ap-

peal denied, 385 Mich. 758 (1971); Mason v. Western Pa.

Hosp., 286 Pa. Super. 354, 366-67, 428 A.2d 1366, 1572

(1981) (en banc) (Brosky~&%, concurring), aff'd. —— Pa.

—., 458 A.2d 974 (1982). Another argument that does not

relate to whether the birth of a child can be damage to the

parents is that the children involved might be adversely af-

fected when they found out that their birth was attributable

to a doctor’s negligence rather than to their parents’ desires.

or that their parents once claimed they were not worth the

cost of raising them. See, e.g., Coleman, 349 A.2d at 14 (show-

ing concern that child might view case as “founded on rejec-

tion of him as a person”); Note, 13 Val. U.L. Rev. 127, 142

(1978). We are not convinced that the effect on the child will

be significantly detrimental in every case, or even in most

14

matter of law no healthy child can ever be considered an

injury to its parents, because, as one court put it, “it is

a matter of universally-shared emotion and sentiment that

the intangible but all-important, incalculable but invalu-

able ‘benefits’ of parenthood far outweigh any of the mere

monetary burdens involved.” Public Health Trust v.

Brown, 388 So. 2d 1084, 1085-86 (Fla. Dist. Ct. App.

1980) (footnote deleted), review denied, 399 So. 2d 1140

(Fla. 1981); accord, e.g., Cockrum v. Baumgartner, 51

U.S.L.W. 2534, 2534 (Ill. Feb. 18, 1983) (“In a proper

hierarchy of values, the benefit of life should not be out-

weighed by the expense of supporting it.”). Other courts

have found that there are some cases in which the addi-

tion of a child constitutes an injury to the family. One

court provided the following explanation:

To say that for reasons of public policy contraceptive

failure can result in no damage as a matter of law

ignores the fact that tens of millions of persons use

contraceptives daily to avoid the very result which

the defendant would have us say is always a benefit,

never a detriment. Those tens of millions of persons,

by their conduct, express the sense of the community.

Tropy v. Scarf, 31 Mich. App. 240, 253, 187 N.W.2d 5i1,

517, leave to appeal denied, 385 Mich. 753 (1971); see

also Terrell v. Garcia, 496 S.W.2d 124, 181 (Tex. Civ.

App. 1973) (Cadena, J., dissenting (“The birth of [an

“‘unwanted’”’] child may be a catastrophe not only for

the parents and the child itself, but also for previously

born siblings.” |, cert. denied, 415 U.S. 927 (1974).

Though we need not finally decide the question given

our ultimate result, we suspect that allowing the plaintiff

to prove that raising a child constitutes damage is the

course of greater justice, and the one the District of

cases; at least in the absence of that, we think the parents, not

the courts, are the ones who must weigh the risk. Accord

Sherlock v. Stillwater Clinic, 260 N.W.2d 169, 176-77 (Minn.

1977).

15

Columbia courts may well adopt. Usually, of course, it is

true that the birth of a healthy child confers so substan-

tial a benefit on its parents as to outweigh the physical,

emotional, and financial burdens of bearing and raising

it; “else, presumably, people would not choose to multiply

so freely,” Troppi, 31 Mich. App. at 254, 287 N.W.2d at

517. But when a couple has chosen not to have children,

or not to have any more children, the suggestion arises

that for them, at least, the birth of a child would not be

a net benefit. That is their choice and the courts are

required to respect it. Cf. Roe v. Wade, 410 U.S. 113,

153 (1973) (woman’s right to abortion: “Maternity, or

additional offspring, may force upon the woman a dis-

tressful life and future.”); Griswold v. Connecticut, 381

U.S. 479, 485-86 (1965) ‘couple’s right to use contra-

ceptives).

Nevertheless, courts have recognized that there is an

unusual difficulty in wrongful conception cases in setting

the amount of compensation, because the extent, if any,

to which the birth of a child is an injury to particular

parents is not obvious but will vary depending on their

circumstances and aspirations. See Troppi, 31 Mich. App.

at 256-57, 187 N.W.2d at 518-19 ‘consequences of birth

from failure of contraceptives will vary widely with pur-

poses and circumstances of parents, comparing unmarried

college student with honeymooning newlyweds). The

parents may in fact have ended up with a child that

they adore and that they privately consider to be, on bal-

ance, an overwhelming benefit to their lives.* This is be-

* It has been said that courts should not allow defendants in

wrongful conception cases to thrust upon the plaintiff an un-

wanted benefit, and that therefore a plaintiff’s recovery should

not be reduced by any benefits conferred by the defendant's

tort. For example, one commentator has written:

Certainly, the birth of the child may confer certain in-

tangible emotional benefits upon the parent, but these are

benefits the parent did not ask for and quite possibly

cannot afford. The defendant can be analogized to an

16

cause the parents may have sought to avoid conception

for any of a number of reasons. They may have done so

for socio-economic reasons, seeking to avoid disruption of

their careers or lifestyle, or to conserve family resources,

officious intermeddler, and when he argues that the dam-

ages assessed against him should be offset by the un-

solicited benefits of parenthood, the resemblance is quite

striking indeed.

Kashi, The Case of the Unwanted Blessing: Wrongful Life.

31 U. Miami L. Rev. 1409, 1416 (1977).

Nevertheless, the courts that allow any recovery of child-

rearing damages have, with apparently only two exceptions.

always required that the detriments of childrearing be offset

against the benefits. See, e.7.. Ochs v. Borrelli, 187 Conn. 253.

256 n.3, 445 A.2d 883, 884 n.3 (1982); Troppi. 32 Mich. App.

at 254-57, 187 N.W.2d at 517-19; Sherlock v. Stillwater Clinic,

260 N.W.2d 169, 176 (Minn. 1977); Betancourt v. Gaylor,.

136 N.J. Super. 69, 344 A.2d 336 (1975). But see Custodio v.

Bauer, 251 Cal. App. 2d 303, 324, 59 Cal. Rptr. 463, 477

(1967) (compensation is ‘‘to replenish the family exchequer so

that the new arrival will not deprive the other members of the

family of what was planned as their just share of the family

income”); Bowman v. Davis, 48 Ohio St. 2d 41. 356 N.E.2d

496 (1976).

It may be, as one court has said, that allowing the benefits

of childrearing to reduce the damages recoverable “is nothing

more nor less than the applic: ion of an offset to reduce the

magnitude of verdicts and lessen the monetary shock to the

medical tortfeasor and his insurer.”’ Kingsbury v. Smith, 122

N.H. 237, 248, 442 A.2d 1003. 1006 (1982): cf. Palsgraf v.

Long Island R.R., 248 N.Y. 339, 352, 162 N.E. 99, 103

(1928) (Andrews, J., dissenting) (similar suggestion as to

proximate cause) (quoted infra note 16). If this is so, it is

nonetheless true that this desire to reduce the verdict is widely

shared, and reflects deeply felt values. The desire may per-

haps be based on a sense that, “even in this day of sophisti-

cated contraception and family planning,”’ couples are com-

monly faced with unanticipated pregnancies, Sorkin v. Lee.

78 A.D.2d 180, 184, 484 N.Y.S.2d 300, 302-03 (1980). Thus,

the sense of wrong that may arise in cases where the defend-

ant usurps the plaintiffs’ right to use their property as they

please, see, e.g.. Read v. Webster, 95 Vt. 239, 113 A. 814

17

see, €.g., Troppi, 31 Mich. App. at 244, 187 N.W.2d at

512 (after seven children, parents decided to limit size

of family); Sheriock v. Stillwater Clinic, 260 N.W.2d

169, 171 (Minn. 1977) (same); Betancourt v. Gayjlor,

136 N.J. Super. 69, 74, 344 A.2d 336, 339 (1975) (par-

ents sought to avoid expense of additional child); for

eugenic reasons, seeking to avoid the birth of a handi-

capped child, see, ¢.g., Ochs v. Borrelli, 187 Conn. 253,

254-55, 445 A.2d 883, 883-84 (1982) ‘semble! (prior two

children born with orthopedic defects) : or for therapeutic

reasons, seeking to avoid the dangers to the mother’s

health of pregnancy and childbirth, see, e.g., Wilezynski

v. Goodman, 73 Ill. App. 3d 51, 58, 391 N.E.2d 479, 481

(1979) (therapeutic abortion) ; Christensen v. Thornby,

192 Minn. 123, 123, 255 N.W. 620, 621 (1934) (vasec-

tomy sought because wife had been told another birth

would be dangerous to her health) .*°

(1921) (flooded land), is tempered by the knowledge that the

ability to be free of unwanted pregnancy has never been all

that secure. The benefits that the parents of an unplanned

child derive from parenthood are nonetheless real. The feel-

ing in wrongful conception cases may be that, especially in

view of the parents’ concerted efforts to avoid pregnancy, they

should recover something in addition to medical expenses and

pain and suffering for the disruption of their planning and of

their lifestyles. But to refuse to recognize the benefits of

childrearing would be contrary to all the humanistic impulses

that the law should seek to reinforce, see Cockrum v. Baum-

gartner, 51 U.S.L.W. 2534, 2534 (Ill. Feb. 18, 1983), and

would give plaintiffs a windfall with which to deal with a

problem that many couples face without compensation. What-

ever the reason, the virtual unanimity of opinion on this

question convinces us that the District of Columbia courts

would share the sense of justice evinced by the cases, and

would adopt some form of the benefits rule.

%” The terminology used here comes from Speck v. Finegold,

268 Pa. Super. 342, 348 n.4, 408 A.2d 496, 499 n.4 (1979),

aff'd. 497 Pa. 77, 489 A.2d 110 (1981). Our enumeration of

these three reasons for seeking sterilization is not intended

to exhaust the possibilities.

18

When a couple chooses sterilization solely for thera-

peutic or eugenic reasons, it seems especially likely that

the birth of a healthy child, although unplanned, may be,

as it is for most parents, a great benefit to them. In

such cases, a court will tend to feel that it is unjust to

impose on the defendant doctor the often huge costs of

raising the child, and will fear that a jury that did so

was motivated by passion or anti-doctor prejudice. Thus,

in considering the question of whether childrearing ex-

penses may be recoverable, many courts and commentators

have placed great emphasis on the couple’s reasons for

undergoing sterilization. For example, the court in the

earliest wrongful conception case, Christensen v. Thornby,

made the point most clearly:

The purpose of the operation was to save the wife

from the hazards to her life which were incident to

childbirth. It was not the alleged purpose to save the

expense incident to pregnancy and delivery. The wife

has survived. Instead of losing his wife, the plaintiff

has been blessed with the fatherhood of another child

The expenses alleged are incident to the bearing of

a child, and their avoidance is remote from the

avowed purpose of the operation.

Id. at 126, 255 N.W. at 622 ‘alternative holding). Other

cases are to the same effect. See, e.g., Betancourt, 136

N.J. Super. at 72-75, 344 A.2d at 338-39 ‘distinguishing

denial of recovery in Gleitman v. Cosgrove, 49 N.J. 22,

227 A.2d 689 (1967), on basis of eugenic rather than

economic purpose there!; Speck v. Finegold, 268 Pa.

Super. 342, 358-59, 362, 408 A.2d 496, 505, 507 (1979)

(discussing Christensen, Betancourt, and Gleitman', aff'd,

497 Pa. 77, 4389 A.2d 110 (1981); id. at 374 n.6, 408

A.2d at 513 n.6 (Spaeth, J., concurring & dissenting!

(where birth was unwanted because of risk that in the

end did not materialize—such as danger to mother or

fear of deformity—“arguably the damages should not in-

clude the expenses of raising the child”); Terrell, 496

S.W.2d at 130 (Cadena, J., dissenting) (distinguishing

19

Hays v. Hall, 477 S.W. 2d 402 (Tex. Civ. App.), rev'd,

488 S.W.2d 412 (Tex. 1972), because of eugenic purpose

there) ; Bishop v. Byrne, 265 F. Supp. 460, 463 (S.D. W.

Va. 1967) (under West Virginia law, victim was injured

py failure of therapeutic sterilization “if the condition

which [the operation] sought to avoid subsequently oc-

curred”) ; see also Comment, Liability for Failure of Birth

Contro! Methods, 76 Colum. L. Rev. 1187, 1197 (1976)

(hereinafter cited as Columbia Note] (“If contraceptive

measures fail here [where they have been used for thera-

peutic or eugenic purposes], but a normal child is born,

damages might properly be denied on the theory that no

injury was suffered.”); Recent Case, 28 DePaul L. Rev.

249, 257 (1978) (proposing use of special negligence in-

struction that would consider the purpose of the steriliza-

tion and family circumstances in determining the actual

damage caused!; Note, Wrongful Conception: Who Pays

for Bringing up Baby?, 47 Fordham L. Rev. 418, 432

(1978) [hereinafter cited as Fordham Note] (“In

wrongful conception cases, the ‘value’ of parenthood will

vary according to the individual’s reasons for wanting

the sterilization operation.’”’); Note, Wrongful Birth: A

Child of Tort Comes of Age, 50 U. Cin. L. Rev. 65, 78

(1981) (“{I)f plaintiffs in a failed sterilization case

hope to gain maximum recovery, they will have to prove

that the purpose of sterilization was to prevent preg-

nancy and not possible injury to the woman because of

pregnancy.”’).

We tend to agree that great weight should be placed on

a couple’s reason for undergoing sterilization in deciding

whether the subsequent birth of a child, on balance, con-

stitutes damage to the parents. Their reason for depart-

ing from the usual! view that childrearing is a positive

experience is in effect a calculation of the way in which

they anticipate the costs of childbirth to outweigh the

benefits. That calculation, untainted by bitterness and

greed, or by a sense of duty to a child the parents have

brought into the world, is usually the best available evi-

20

dence of the extent to which the birth of the child has

in fact been an injury to them. Thus, for example, where

a couple sought sterilization solely for therapeutic or

eugenic reasons, there is a presumption raised that the

uneventful birth of a healthy child constitutes damage to

the parents only to the extent that they experienced ab-

normal fear of harm to the mother or of the birth of a

handicapped child. Courts and juries may assume that

the parents treasure the child and that the usual expenses

of raising it will be outweighed by the benefits derived.

The presumption raised by the evidence of the parents’

reason fox seeking sterilization is, however, rebuttable.

If it can be shown that the parents’ situation has some-

how significantly changed since the sterilization—by reli-

ance on presumed infertility in making an income-reduc-

ing career change, for example, or by a sudden increase

in wealth—it may be that the original calculation of

anticipated injury has changed for better or worse. See,

e.g., Columbia Note, supra, at 1197 (“the motive for hav-

ing a vasectomy or tubal ligation is relevant as evidence

of lack of injury but should not be dispositive”) ; Fordham

Note, supra, at 485 (‘where motives for sterilization are

economic, “sudden relief from financial hardship or a re-

duction in family size” after operation may make benefits

override burdens! ; Note, Wrongful Birth Damages: Man-

date and Mishandling by Judicial Fiat, 13 Val. U.L. Rev.

127, 185 & n.66 (1978) (parent may have taken early

vetirement!.’? Generally, however, the plaintiff’s recovery

11 We note that some courts appear to treat the reason for

undergoing sterilization not as the best evidence of whether

the birth of a child constitutes damage to the parents, but as

conclusive evidence of that fact. The theory is that plaintiffs

should recover only for those harms that they sought to avoid.

E.g.. Christensen, 192 Minn. at 126, 255 N.W. at 622; sce

Columbia Note, supra, at 1197 (criticizing this per se ap-

proach). We think such an approach conflicts with the stand-

ard tort damages rule that a defendant takes his plaintiff as

he finds him, and pays for all damages proximately caused.

See, e.g., Lockwood v. McCaskill, 262 N.C. 663, 138 S.E.2d 541

21

will most accurately ~eflect the amount of injury incurred

if it is limited to paying for those risks that the plaintiff

specifically sought to avoid and that came to pass."

In jury trials, of course, it is usually the task of a

properly instructed jury to find such facts as the plain-

tiff’s motive in seeking sterilization and other facts re-

flecting the degree to which childrearing ultimately con-

stitutes injury to the plaintiff. Nevertheless, there are

always cases in which a rational jury could find that the

evidence suggested only certain facts, and in those cases

such findings must be directed by the court, notwithstand-

ing the jury’s verdict. On the issue of whether childrear-

ing constituted injury to Hartke, the District Court, as

(1964) (once breach of duty is proved, defendant is liable for

all damages suffered by plaintiff notwithstanding plaintiff’s

peculiar predisposition to amnesia). Regardless of the rea-

son for which the parents sought sterilization, there may

be persuasive evidence that the birth of a child was, at

the time of birth, damage to them; the parents may have

guessed wrong in their initial calculation or they may have

changed their minds. In the absence of intervening cause, the

defendant must pay for that damage.

Since the approach outlined in the text is merely a guide-

line to be used in evaluating the evidence in the usual case.

and not a conclusive test. it avoids placing undue weight on

what the patient told the doctor. For any of a number of

reasons, the patient may not have given the doctor all the

reasons involved or even the right ones. Also, we would not

want to encourage doctors to take extra care with persons

who provide “expensive” reasons, or to refuse to treat them

altogether.

2 This approach will be primarily useful in cases in which

the evidence of the reason for undergoing sterilization is

unambiguors and overwhelming, as it is in this case. Where

there is a mixture of motivations. and the socio-economic

reasons are at least a but-for reason for undergoing the opera-

tion, the trier of fact will have to look to more direct. but

perhaps less reliable, evidence of whether the birth of a child

constitutes damage to the parents.

22

we read its opinion, found this to be such a case. We

agree.

The evidence here is overwhelming that Sandra Hartke

sought to be sterilized for therapeutic reasons: she des-

perately feared that serious complications or even death

would result from pregnancy and childbirth. The record

is filled with testimony to this effect. For example, Hartke

testified that she told Dr. McKelway “that I didn’t want

to be pregnant, and I was terrified of being pregnant,

and I was extremely concerned about doctors and hos-

pitals. That was my overriding concern.” Transcript at

July 238, 1981, at 85-86. She also said she told him

[t]hat I did not want to go through a pregnancy,

that I was terrified of going through a pregnancy,

and I felt I was going to die, and I had been advised

by doctors that I would not make it through a preg-

nancy. I told him that I had peritonitis, which was

gangrene, of the abdominal cavity in 1964 when I

had my first daughter.

... He said that he could perform an abortion in

the hospital, and I said I didn’t want to be put in

this position anymore. I couldn’t keep coping with

the idea that I was going to die. I wanted him to

help me find a way that I wouldn’t have to keep going

back into the hospital for all these kinds of problems.

He told me that he can sterilize me.

Transcript of July 21, 1981, at 8, 14. Other like testimony

is printed in the margin.*® The testimony of Dr. Mc-

13 The other testimony from Hartke about her reasons for

undergoing sterilization or her fear of pregnancy is as follows:

Q. Will you tell the Court and jury what you told

Dr. McKelway as to the reason that you were there?

THE WITNESS: I told him that J didn’t want to be

pregnant because I had a very traumatic time in 1964

23

having my daughter, and I thought I was going to die.

Okay.

Q. .... No more crying.

A. All right.

Transcript of July 21, 1y81, at 7.

Q. Did anybody else say anything there?

A. Danny [Hartke’s boyfriend] asked Dr. McKelway

rather than have me go through the surgery, since 1 was

so terrified of the hospital and surgical procedures, it

would be easier—it would be easier for him to have a

vasectomy.

Id. at 15.

Q. At that time did you—what did you do when you

went to the hospital, as you came into the hospital?

A. I was crying, and I get very upset when I have to

go to the hosptial.

... I have.a very difficult time controlling myself in

hospitats.

Id. at 20.

Q. Did you have any fear at that time [when making

the decision not to have an abortion] ?

A. Yes.

Q. What was your fear?

A. Iam terribly afraid that I am going to die when

I am pregnant, Every time—

Td. at 32.

“Question: What conversation did you have with him

at that time?

“Answer: I didn’t want to have a pregnancy, I didn’t

want to be ever in the position of just being pregnant

again and having operations.”

Transcript of July 23, 1981, at 89 (reading from deposition).

A. . . I did not ever want to be pregnant again.

That's w hy I went [to see Dr. McKelway].

Id. at 90.

“Answer: Well, then I said, ‘I don’t want this to

happen again. I am very, very upset and very nervous

about going in the hospital, and I don’t want to go back

and would do anything. What am I to do to keep from

24

Kelway and of Hartke’s husband was to the same effect."

That the danger of childbirth remained her sole con-

cern up to the time of her pregnancy is clear from her

reasons for deciding not to have an abortion. Once the

pregnancy was determined, by means of a sonogram, not

to be ectopic, Hartke was advised that the risks of carry-

ing the pregnancy to term were about the same as the

risks of abortion. She testified that she decided not to

have an abortion because, “[h]aving decided that the

risks were equal either way, that to resterilize me Dr.

coming back and having a pregnancy every time I turn

around?’

“Answer: I said that I didn’t want to have any more

children. What method was available besides the IUD?

And he said, ‘You could be sterilized.’ ”’

Id. at 104-05 (reading from deposition).

A. Sir, 1 love my daughter.

Q. (By Mr. Attridge) She gives you no comfort

and joy whatsoever?

A. She gives me joy, but I don’t know how she gives

me comfort, No, she doesn’t help me in the middle of the

night when I am having nightmares about being preg-

nant, if that’s what you’re asking. No, that’s no comfort.

Id. at 114.

1$ See Transcript of July 24, 1981, at 304 (testimony of

Weddle) (describing Hartke’s fear of pregnancy); id. at 311-

12 (testimony of McKelway) (same); id. at 348 (McKelway)

(reading from report about her “ ‘very apprehensive’”’ state

upon admission to hospital); Transcript of July 24, 1981,

afternoon session, at 4 (McKelway) (same).

The only evidence suggesting that plaintiff had other than

therapeutic motives is circumstantial: Hartke was 33 years

old and had a 13-year-old daughter when she first sought to be

sterilized, On the other hand, she had divorced her first hus-

band and was then living in an apparently stable relationship

with the man she would eventually marry.

25

Barter was going to open me back up, then I might as

well try to carry the pregnancy to term, that Dr. Barter

would help me through the pregnancy.” Transcript of

July 21, 1981, at 32. This is the only testimony regard-

ing her reasons for carrying the pregnancy to term. It

seems clear, then, that once the extraordinary dangers of

childbirth for her were passed, Hartke shared the general

view that having a child would, on balance, be a positive

experience.”

15 In view of the result we reach, we do not need to decide

the related question of whether Hartke’s failure to have an

abortion or place the child for adoption would preclude her

from recovering childrearing expenses. Compare Troppi v.

Scarf, 31 Mich. App. 240, 260, 187 N.W.2d 511, 520 (“While

the reasonableness of a plaintiff’s efforts to mitigate is ordi-

narily to be decided by the trier of fact, we are persuaded to

rule, as a matter of law, that no mother, wed or unwed, can

reasonably be required to abort ... or place her child for

adoption.”) (footnote omitted), leave to appeal denied, 385

Mich. 753 (1971), and Sherlock v. Stillwater Clinic, 260

N.W.2d 169, 176 (Minn. 1977) (same), with Sorkin v. Lee, 78

A.D.2d 180, 181, 484 N.Y.S.2d 300, 301 (1980) (plaintiffs’

failure to have abortion barred recovery of childrearing

expenses), Ziemba v. Sternberg, 45 A.D.2d 230, 234, 357

N.Y.S.2d 265, 270 (1974) (Cardamone, J., dissenting) (in

failed abortion case, plaintiff’s failure to have another abor-

tion after pregnancy was discovered in fourth month “should

operate to bar her present claim for damages’), Columbia

Note, supra, at 1203 n.91 (reasonableness of failure to abort

could be left to jury), and Note, Judicial Limitations on Dam-

ages Recoverable for the Wrongful Birth of a Healthy Infant,

68 Va. L. Rev. 1311, 1328 (1982) (question of reasonableness

of failure to have abortion or place child for adoption is one

of fact, not of law). Conceivably, a holding based on Hartke’s

failure to mitigate damages by having an abortion might re-

duce the damages for medical expenses and pain and suffering

that McKelway must pay under our present approach, see

infra note 16. McKelway has not pressed this claim here,

however, and has in any case provided no evidence as to what

Hartke’s medical expenses and suffering would have been had

she aborted the fetus, see G & R Corp. v. American Security

& Trust Co., 523 F.2d 1164, 1176 (D.C. Cir. 1975) (defendant

bears burden of proving mitigation).

26

In these circumstances, we agree that the jury could not

rationally have found that the birth of this child was an

injury to this plaintiff. Awarding childrearing expenses

would only give Hartke a windfall.’*

1 Conceivably, the benefits of childraising could be so

weighty as to outweigh even the pain and anguish associated

with the pregnancy and childbirth. Certainly, this is true in

the usual case, since parents are apparently not deterred

from having children by the usual prenatal pain and discom-

fort. Courts that have applied the rule of offsetting benefits

against detriments in wrongful conception cases have done so

in a variety of ways, however. See generally Note, Wrongful

Birth: A Child of Tort Comes of Age, 50 U. Cin. L. Rev. 65,

79-80 (1981) (reviewing various applications of the benefits

rule). Some have allowed the benefits of childrearing to be

offset against all damages, so that it might happen that a

plaintiff would not even recover for medical expenses or pain

and suffering. See Troppi v. Scarf, 31 Mich. App. 240, 255,

187 N.W.2d 511, 518, leave to appeal denied, 385 Mich. 753

(1971). Others limit the offset to reducing childrearing ex-

penses, so that medical expenses and the pain and suffering

of pregnancy would be separately recoverable. See Sherlock

v. Stillwater Clinic, 260 N.W.2d 169, 175-76 (Minn. 1977);

cf. Thompson v. Town of Ft. Branch, 204 Ind. 152, 164-65,

178 N.E. 440, 444-45 (1931) (in wrongful death case, cost of

maintenance of son should be offset only against value of his

services, not against funeral] expenses). The Restatement

(Second) of Torts offers the narrowest offset rule, requiring

that the benefits conferred by a tortfeasor be considered in

mitigation of damages only when the benefits are to the same

“interest” of the plaintiff that was harmed. Restatement

(Second) of Torts § 920 (1979). As applied in the comments,

this would require that the pecuniary expenses of childraising

be offset only by the monetary benefits that the child brings

in, and not by the psychological or emotional rewards derived.

Id. comment b (damages to husband for loss of consortium

are not diminished by savings derived from no longer having

to support wife); see Custodio v. Bauer, 251 Cal. App. 2d 303,

323, 59 Cal. Rptr. 463, 476 (1967) (if pregnancy benefited

wife’s health or emotiona] makeup, defendant should be able

to offset that against pain and damage to health); Recent

Case, 28 DePaul L. Rev. 249, 254-57 (1978) ‘criticizing courts

for misapplying Restatement rule); Note, 13 Val. U.L. Rev.

27

127, 159 (1978) (same); Note, 68 Va. L. Rev. 1311, 1326

(1982) (same). The overwhelming majority of courts that

have invoked the benefits rule in wrongful conception cases

have rejected the strict terms of the Restatement approach.

Few of these sources provide a clear rationale for the lines

they draw. Perhaps the most logical approach, in light of the

presumptions discussed in this opinion, would be to allow the

benefits of childrearing to be offset against the normal pain

and expenses of pregnancy and childbirth, but not against any

extraordinary expenses and pain associated with the condi-

tions that moved the parents to seek sterilization. Ser supra

p. 20. This suggestion may, however, attempt to put too

fine a point on an admittedly uncertain calculation. Once

again, see supra note 9, it may be that the courts’ motivations

are most accurately stated in terms of rough justice or public

policy, like the explanation once given of the concept that

damages are limited to those proximately caused by a tort:

What we... mean by the word “proximate’’ is that,

because of convenience, of public policy, of a rough sense

of justice, the law arbitrarily declines to trace a series of

events beyond a certain point. This is not logic. It is

practical politics.

Palsgraf v. Long Island R.R., 248 N.Y. 339, 352, 162 N.E. 99.

1038 (1928) (Andrews, J., dissenting) (quoted in Mason v.

Western Pa. Hosp., 286 Pa. Super. 354, 366, 428 A.2d 1365,

1372 (1981) (en banc) (Brosky, J., concurring), aff'd.

Pa. , 453 A.2d 974 (1982)).

The District Court in this case allowed the benefits of

childrearing to be offset against the expenses thereof, but not

against the expenses and pain associated with the pregnancy

itself. 526 F. Supp. at 106 (special verdict form). We think

this was a fair place to draw the line. The latter expenses

and pain are more clearly separable from the benefits of rais-

ing a child than are the expenses of raising it. See generally

Tropm., 31 Mich. App. at 255, 187 N.W.2d at 518 (positing

the severability criterion, but concluding that “pregnancy and

its attendant anxiety, incapacity, pain, and suffering are in-

extricably related to child bearing”); cf. generally Wilczynski

x. Goodman, 78 Ill. App. 3d 51, 63, 391 N.E.2d 479, 48§

(1979) (recovery of childrearing expenses disallowed on pul-

lic policy grounds but medical expenses deemed compensable

because they have little to do with a child’s right to life) ;

Thompson, 204 Ind. at 164, 178 N.E. at 444 (in wrongful

28

IV

The judgment of the District Court is affirmed.

It is so ordered.

death action, funeral expenses and medical expenses are a

“distinct item[] of damage[],” separate from the value of lost

services). More important, if the benefits of childrearing were

offset against all damages, it might happen that the defendant

would pay no damages whatsoever, which would not provide

any disincentive to negligence. See Wilczynski, 73 Ill. App. 3d

at 63, 391 N.E.2d at 488; Mason, 286 Pa. Super. at 381, 428

A.2d at 1380 (Hester, J., concurring & dissenting) (‘ ‘im-

munity tends to foster negligence while liability tends to in-

duce care and caution’”) (quoting Flagiello v. Pennsylvania

Hosp., 417 Pa. 486, 505, 208 A.2d 193, 202 (1965) (original

reads “neglect” not “negligence’”’)). Therefore, we agree that

Hartke may cover damages for her medical expenses and

pain and suffering during pregnancy and childbirth without

regard to the benefits of childraising.

Generally for the reasons stated in the District Court’s

opinion, 526 F. Supp. at 103, we will not disturb its ruling as

to the remaining issue raised by McKelway: that he was

entitled to a new trial because of the court’s failure to reopen

discovery in order to allow him to depose one of Hartke’s

witnesses. Hartke notified McKelway of the experts she

expected to have testify almost two weeks before the close of

discovery. McKelway did not notify Hartke of his experts’

names until three months later. Under these circumstances,

there was no abuse of discretion in allowing Hartke to depose

McKelway’s experts after the close of discovery, while refus-

ing to allow McKelway to depose Hartke’s at that time.

APPENDIX B

UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLUMBIA

SANDRA J. HARTKE

Plaintiff,

Vv. : Civil Action NO. 79-3447

This case is currently before the Court on

defendant's motions for judgment notwithstanding the

verdict and for a new trial. After considering the

submissions of the parties and reviewing the record

in this case, and in particular, the transcript of

the testimony of Dr. Suryabala Goswami, the Court

concludes tht the defendant's motions must be granted

in part and denied in part, as appears more fully

below.

-2-

This is what is sametimes known as a "wrongful

conception” case. The plaintiff, Sandra Hartke,

fearful of becoming pregnant due to previous problems

such as an ectopic pregnancy, went to Dr. McKelway,

the defendant, for a second opinion on the best

method of assuring that she would not become pregnant.

It was subsequently discovered that Ms. Hartke was

pregnant at the time she consulted Dr. McKelway. On

his advice, she agreed to undergo a surgical procedure

known as laproscopic cauterization, which essentially

involves the burning of the fallopian tubes. This

procedure has a failure rate of between 1 and 3 in

1,000. Nonetheless, there was considerable evidence

that defendant told plaintiff that she need not

concern herself with the possibility of becoming

pregnant in the future once she had this operation.

In March 1978, Dr. McKelway performed an abortion to

terminate plaintiff's existing »regnancy and performed

the laproscopic cauterization in an effort to prevent

her fram becoming pregnant in the future. Despite

-3-

the surgery, in September of 1979 plaintiff again

became pregnant. She elected to carry this child to

term, and in June 1980 gave birth, via Caesarian

section, to a normal baby girl.

Plaintiff presented three theories on which

to base recovery in this case: negligence in performing

the operation, failure to obtain the patient's

informed consent to the procedure performed, and

breach of a warranty that plaintiff would not became

pregnant. At the close of plaintiff's case, the

Court granted the defendant's motion for a directed

verdict on the warranty claim, holding that as a

matter of law plaintiff had failed to provide sufficient

proof that defendant had guaranteed favorable results

in view of the fact that plaintiff signed consent

forms which stated that no guarantee of favorable

results was given. See Sard v. Hardy, 379 A.2d 1014

(Ma 1977). The Court denied defendant's motions for

directed verdict on the negligence and informed

asain

consent counts. The case was submitted to the jury

with a special verdict form ( a copy of which is

attached). The jury found for plaintiff on both

remaining theories, and awarded her $310,000 in

damages, broken down as follows: $10,000 for medical

expenses; $100,000 for pain, suffering, and mental

anguish; and $200,000 for the future cost of raising

the child less the benefits of the child's comfort

and society. Defendant renews his motions for directed

verdict here, as well as moving for new trial on

several grounds. In addition, he asks for judgment

on the ground that plaintiff has not stated a claim

for relief, and maintains that damages are not

recoverable as a matter of law for the costs of

raising a healthy child. The Court will address these

contentions in turn.

I. Failure to State a Claim

Defendant urges that the Court should not

recognize a cause of action where an unplanned

conception results fram defendant's tortious conduct,

-5-

but should wait for the legislature to create such a

Claim. While the District of Columbia courts have

yet to confront the issue, the weight of authority in

other jurisdictions clearly supports the existence of

such a claim as a matter of cammon law. See cases

cited in Section IV, infra. The cases cited by

defendant as denying recovery altogether for wrongful

conception in fact deal only with whether certain

elements of damages are recoverable, such as the cost

of raising a child. See Coleman v. Garrison, 349

A.2d 8 (Del. 1975); Terrell v. Garcia, 496 S.W. 2d

124 (Tex.Civ. App. 1973), as clarified in

Garwood v. Locke, 552 S.W. 2d 892 (Tex. 1977). Since

all recent cases appear to contemplate same sort of

recovery in tort for negligent failure of a physician

to sterilize effectively, the Court concludes that

the District of Columbia courts would be likely to

follow the clear weight of authority and recognize

such a cause Of action. See Julander v. Ford Motor

Co., 488 F2d 839 (10th Cir. 1973) (upholding district

=-6-

court determination that Utah courts would follow the

weight of authority in adopting strict products

liability, despite the fact that they had not yet

done so). This is not a case like the collateral

estoppel issue in Gatewood v. Fiat, S.p.A., 617 F.2d,

820,826 n.11 (D.C. Cir. 1980) where the D.C. courts

had addressed the issue and had not yet adopted the

trend of the case law; rather, this issue is like the

jursidictional issue in that case, where there was no

D. C. case law and the court therefore looked to the

law of other jurisdictions. Id. at 824-25.

II. Negligence Claim

In support of his claim that he is entitled

to judgment as a matter of law on the negligence

Claim, defendant points to the general rule that

expert testimony is required to support a claim that

defendant's conduct did not meet the applicable

Standard of care. Robbins v. Footer, 553 F.2d 123

(D.C. Cir. 1977). He also points to the lack of

qualifications of plaintiff's only expert, Dr.

~

Goswami, wno is not, as the defendant is, Board

certified in obstetrics and gynecology, but rather is

a certified Family Practitioner. In response,

plaintiff cites the case of Baerman v. Reisinger, 363

F.2d 309 (D.C. Cir. 1966), which holds generally that

a physician is competent to testify even though not a

specialist in the field of which she speaks, and that

specialization goes to weight rather than admissability.

Dr. Goswami was invited by plaintiff and

admitted by her then doctor (not the defendant) to

witness the Caesarian delivery. During this procedure,

she literally observed with her eyes the fallopian

tubes which had been the object of the unsuccessful

sterilization attempt by defendant.

Dr. Goswami received her medical training in

India and Great Britain. She did not specialize in

obstetrics and gynecology, serving only one year in

residency in that field, while three years are

required for certification. Transcript of the Testimony

of Dr. Goswami at 116-17. While Dr. Goswami has

-8-

had considerable practice as a result of her Family

Practice in the United States from 1971 until present,

she has performed no surgical procedure since then.

Id. at 217. She has never performed the operation in

question, has never assisted in the performance of

such an operation, and has observed such operations

on only two occasions. The Court orginially granted

plaintiff's motion to qualify Dr. Goswami as an

expert.

This decision rested on her training and

experience in gynecology and obstetrics in India,

England and at the University of Maryland. Her

uncontradicted testimony that she performed several

hundred tubal ligations, id. at 49, coupled with her

experience and training in the United States qualified

her to testify as to the standard of care in respect

of conventional tubal ligations by surgery —actual

cutting of the tube. Any difference between her

opinion as to the correct standard and the opinion of

other physicians with better or more elegant qualifications

would be for the jury. But the evidence as it unfolded

-9-

indicated that her knowledge of the standard of care

in respect of tubal ligations by separation of the

fallopian tubes did not extend to knowledge of the

Standard of care for sterilization by the laproscopic

cauterization procedure. She had no training or

experience in that procedure. lLaproscopic cauterization

is relatively new, and the evidence revealed significant

differences between the two procedures. Her reading

of literature and conferring with other physicians on

the eve of trial did not qualify her to testify about

the standard of care-for laproscopic cauterization.

Specifically, she was not able to address with any

authority the question of whether the relevant

standard of care contemplated the sterilizing effct

of cauterizing and thereby congealing a fallopian

tube without actually severing it. In fact, she

testified that a major reason for her conclusion that

there was negligence was that the result was unfavorable.

Id at 155-56.

Upon reflection, the Court concludes that

-10-

although she was competent to testify about her

observations, Dr. Goswami was not a qualified expert

on the standard of care for laproscopic cauterization

procedures. While Baerman holds that a doctor need

not be a specialist to testify, it does not remove

the requirement that, in order to give an opinion on

whether the defendant complied with the applicable

standard of care, the witness must be familiar with

that standard. Robbins v. Footer, supra. The trial

court must weigh the qualifications of the witness

and determine whether or not she is qualified to

express an opinion on the subject. Sher v. DeHaven,

199 F. 24 777, 782 (D.C. Cir., 1952) cert. denied,

345 U.S. 936 (1953). Although her eyewitness account

of her observations in the delivery room were essential

and admissible, the Court not concludes that Dr.

Goswami was not campetent to express an opinion on

the defendant's due care of lack thereof, and should

not have been allowed to testify about the standard

of care for laproscopic cauterization.

-ll-

Moreover, the Court is convinced that its

failure to prevent Dr. Goswami fram testifying

concerning the standard of care was not harmless.

Except for the testimony of Dr. McKelway, who was

called by the plaintiff and testified that the

standard of care required cauterization of both left

and right fallopian tubes, Dr. Goswami was plaintiff's

Only expert. The Court cannot conclude that the jury

necessarily would have reached the same result on the

negligence issue without the benefit of her opinion.

In addition, much of Dr. Goswami's testimony was to

the effect that it violated the standard of care for

defendant to perform the laproscopic cauterization

technique on a patient with a history of peritonitis

and on a patient more than twelve weeks pregnant.

But the dangers of such violations of the standard of

care did not materialize in this case and are concededly

causally unrelated to the plaintiff's pregnancy. The

Court originally admitted this evidence on the ground

that the jury was entitled to know the context in

which the operation occurred. It now appears to

-12-

the Court that the prejudicial effect of this "negligence

in the air" testimony outweighed its rather minimal

probative value, and that it should have been excluded.

This is particularly so where its importance was

seemingly highlighted by what the Court has not

determined to be an unqualified witness. Accordingly,

the jury's verdict that defendant was negligent

cannot stand.

The Court concludes nonetheless that there

was sufficient evidence of negligence, even without

Dr. Goswami's opinion, to create an issue for the

jury so that defendant's motion for a judgment

notwithstanding the verdict must be denied. The

plaintiff called the defendant, Dr. McKelway, and he

testified that the standard of care requires same

cauterization of the tube so that failure to cauterize

one of the plaintiff's fallopian tubes would violate

the standard of care. In addition to Dr. McKelway's

Standard of care testimony which required submission

of the case to the jury, experts called by the

-13-

def« ise confirmed that the standard of care required

substantial cauterization of each tube. There was

evidence, albeit weak, fram which the jury could have

concluded that Dr. McKelway failed to cauterize the

right tube at all. Dr. Goswami testified that when

she observed the plaintiff during her delivery by Dr.

Barter in June 1980, plaintiff's right fallopian tube

was intact. Even though Dr. Goswami was incompetent

to testify concerning the standard of care, she was

campetent to testify concerning what she observed

during plaintiff's subsequent delivery, and that

testimony was sufficient to create a jury issue.

Defendant's witnesses did not succeed in rebutting

plaintiff's evidence of negligence to such an extent

that the Court could find that no reasonable jury

could have found Dr. McKelway negligent. Accordingly,

defendant's motion for judgment notwithstanding the

verdict for failure to prove standard of care must be

denied.

In view of the foregoing, if the only issue

decided by the jury were negligence, the setting

-14-

aside of the finding and verdict would obviously

require a new trial. In this case, however, the

Court obtained from the jury a special verdict which

found for the plaintiff on both the negligence and

the informed consent counts. Since the Court concludes

that the informed consent verdict is sound, and since

that verdict is sufficient to support the damages

awarded, a new trial on the negligence count is

unnecessary. Many courts have noted that where a

general verdict is returned, a new trial must be

ordered if either count must be set aside. This

danger was avoided here by use of a special verdict,

which, as stated by the Court in Mueller v. Hubbard

Milling Co., 573 F2d 1029, 1038 n. 12 (8th Cir.

1978), "will often obviate the necessity of deciding

difficult legal questions which are not essential to

an appropriate disposition of the controversy."

See also King v. Ford Motor Co., 597 ld 436, 439 &

n.2. (5th Cir. 1979); Brown, Federal Special

Verdicts: The Doubt Eliminator, 44 F.R.D. 245 (1967).

The two counts were clearly separated fram each

~ -15-

other in the instructions, which characterized the

informed consent count as "another issue" after the

negligence instructions.

As discussed below in Section III, expert

testimony is not necessary or even particularly

relevant on the issue of whether or not the physician

adequately disclosed the risks of the operation to

the patient. Canterbury v. Spence, 464 F.2d, 772,

791-92 (D.C. Cir. 1972). While expert testimony is

required to establish what the risks are — id.-

- Dr. McKelway himself provided that information.

The Court is satisfied that Dr. Goswami's testimony

did not prejudice the defendant on the informed

consent count, and that it is therefore unnecessary

to order a new trial on the negligence count. Should

the Court of Appeals reverse this Court's decision on

the informed consent count, however, then a retrial

on negligence would be in order. Accordingly,

defendant's motion for a new trial is denied. If the

Court of Appeals reverse this Court's judgment on the

informed consent count, defendant's motion is granted.

-16-

III. The Informed Consent Clain

Defendant makes essentially two attacks on

the finding of the jury that he did not adequately

inform her of the risks of pregnancy of this procedure,

estimated by various witnesses at between 1 and 3 in

1,000. First, defendant contends that in view of

plaintiff's strongly expressed desires to be sterilized

and the risks associated with various alternatives,

reasonable persons could only conclude that the risks

involved here were immaterial. Even though the risks

were small, however, the defendant was on notice that

plaintiff had a great anxiety about any possible

future pregnancy, and indeed could possibly have died

from a future pregnancy. In the District of Colimbia,

the relevant standard of materiality is expressed in

Canterbury v. Spence, supra, at 787: "a risk is

material when a reasonable person in what the physician

knows or should know to be the patient's position,

would be likely to attach significance to the risk or

cluster of risks in deciding whether or not to forego

-l7-

the proposed therapy." There is ample evidence fram

which a jury could conclude that a reasonable person

in plaintiff's position would have considered important

even a relatively small chance of pregnancy.

Defendant's second contention on this issue

is that no proximate causation has been shown as

there is no evidence that plaintiff would have

foregone the surgery had she been informed of the

risks. He points to a statement in Henderson v.

Milobsky, 595 F. 2d 654, 658 (D.C. Cir. 1978) to the

effect that where claimant has not asserted that had

she known of the risk she would not have undergone

the treatment, the issue of causation cannot go to

the jury. Defendant asserts that plaintiff never

stated in her testimony that she would have avoided

the operation had she known of the risks. This Court

does not interpret Henderson, supra, to require that

plaintiff make this assertion in haec verba, as long

as there is sufficient evidence fram which the jury

could infer that she would have refused. There is

-18-

ample evidence to that effect here. For example,

plaintiff's husband testified that had he known of

the risks of pregnancy, he would have undergone a

vasectomy. To require plaintiff herself to make this

assertion in a case such as this when her husband

testifies to this effect in her presence would only

set a trap for the unwary. The Court is satisfied

that there was evidence fram which the jury could

find that plaintiff would have declined the procedure

had she been informed of the risks. Defendant's

motion for judgment notwithst°nding the verdict on

the informed consent count is denied.

Defendant raises a number of contentions of

prejudice from plaintiff and her counsel's conduct

during the trial which are relevant to a motion for

new trial on both counts. These include allegations

that plaintiff's crying on the witness stand, questioning

about defects in hospital records, statements about

absent witnesses and various other allegedly inflammatory

remarks made by plaintiff's counsel prejudiced the

-]19-

jury against the defendant. The Court is satisfied

that any prejudice was cured by instructions to the

jury to disregard such statements. In addition,

defendant's counsel himself stated in closing argument

that plaintiff was blackmailing defendant and that

plaintiff and her family only wanted money, statements

with at least as much prejudicial potential as any

made by plaintiff. Defendant's motion for new trial

on these grounds is denied.

Finally defendant argues that he is entitled

to a new trial because he was not allowed to reopen

discovery to depose Dr. Goswami. The Court notes

that defendant was informed that Dr. Goswami was a

potentital witness some two weeks before discovery

ended and did not seek to depose her then. Despite

this fact, the Court allowed defendant an extensive

voir dire, in the nature of a deposition, before Dr.

Goswami testified. The Court is satisfied that no

prejudice to the defendant on the informed consent

issue resulted fram his inability to depose Dr.

-20-

Goswami, and since the Court has decided to set aside

the negligence verdict should the informed consent

judgment be reversed, it is unnecessary to decide

whether defendant was unduly prejudiced on the

negligence count.

Accordingly, defendant's motion for new

trial on this ground is also denied.

IV. Damages

The Court was aware before the trial of this

case began that there is a sharp division of authority

among various courts on the issue of what damages are

recoverable in wrongful conception case such as the

present ry Accordingly, the court submitted the

case to the jury with a special verdict form which

required the jury to separate the damages awarded

into medical expenses; pain, suffering, and mental

anguish; and the cost of raising te child less an

1

Although many of the case cited infra involved

wrongful failure to abort, the issues are essentially

the same.

-2)]-

offset for the benefits of the child's comfort and

society. In so doing, the Court intended to avoid a

possible retrial in its determination of what damages

were recoverable in a case such as this were later

reversed.

Defendant challenges the sufficiency of the

evidence with respect to all three elements of

damages. On the medical expense portion, defendant

points out that there is no evidence to support

expenses greater than $6,000, the amount claimed in

plaintiff's closing argument. Plaintiff claims that

the jury may have estimated future medical expenses

to arrive at the $10,000 figure. However, there is

no evidence to support a finding of future medical

expenses. Accordingly, the Court will grant defendant's

motion for new trial limited to the amount of plaintiff's

medical expenses, unless plaintiff agrees to remit

$4,000.

-22-

Defendant claims that the amount of $100,000

for pain, suffering, and mental anguish is excessive.

While the figure is high, the Court concludes that it

is not so excessive as to require the Court to set it

aside, in view of plaintiff's testimony concerning

her fear of pregnancy and the obvious effects which

her experience has had on her, which were corroborated

by several of plaintiff's witnesses. Defendant

himself admitted that plaintiff was very frightened

about the possibility of pregnancy when she came to

him for advice on how best to avoid it. The Court

will not disturb the jury's verdict on this issue.

Finally, defendant objects to the awarding

of costs of raising plaintiff's healthy child as an

element of damages. On the issue of whether such

damages are recoverable, the courts are almost evenly

divided. Approximately, one-half of the courts which

have reported such cases award such damages, reasoning

aZ%~

that plaintiff should be compensated for all damages

which result fran the defendant's tort and the burden

of any uncertainty in damages should fall on the

alae Others deny recovery, holding that

public policy dictates a finding that the costs of

raising a child are offset by the benefits of its

society and comfort, and that at any rate it is

unjust to place on the physician the entire cost of

raising the child while plaintiff retains all of the

benefits, particularly in view of the plaintiff's

2

See Cockrum v. Baumgartner, 50 U.S.L.W. 2040

(Ill App., July 2, 1981); Mason v. Western Pa. Hosp.,

428 A.2d 1366 (Pa. Super. 1981); Anonymous v. Hopsital,

398 A.2d 312 (Conn. Sup. 1979); Sherlock v. Stillwater

Clinic, 260 M.W. 2d 169 (Minn. 1977); Rivera v State,

404 N.Y.S. 2d 950 (Ct. Cl. 1978); Troppi v. Scarf,

187 N.W. 2d 511 (Mich. App. 1971); Custodio v. Bauer,

59 Cal. Rpt. 463 (Cal. App. 1967).

-24-

choice to keep the child rather than opt for abortion

or adoption. . Most which allow recovery of child-

rearing costs require an offset of the child's

society and PERT Oo

There does not appear to be any indication

in the case law of which view is likely to be adopted

by the District of Columbia courts. The question,

not yet decided in the District of Columbia or at

3

See Sorkin v. Lee, 434 N.Y.S.2d, 300 (App. Di.

2980), appeal dismissed, 53 N.Y. 2d 797 (1981);

Public Health Trust v. Brown, 388 So. 2d, Berman v.

Allan, 404 Ald 8 (N.J. 1979); Wilczynski v Goodman,

391 N.E. ld 479 (Ill. App. 1979); Jacobs v. Theimer,

519 S.W. 2d, 846 (Tex. 1975); Coleman v. Garrison.

349 A.2d.8 (Del. 1975); Reich v. Medical Protective

Co., 219 N.Y. 2d 242 (Wisc. 1974).

4

See Troppi v. Scarf, supra; Restatement (Second) of

Torts §920. See verdict form attached hereto.

=-25=

common law in Maryland, is closely balanced and

difficult. Om ome hand there is something inherently

distasteful about holding a child is not worth what

it costs to raise it, and samething seemingly unjust

about imposing the entire cost of raising the child

on the physician, creating in the words of one court

"a new category of surrogate deieoiiaec® On the other

hand, the admitted uncertainty of damages should not

work to the plaintiff's disadvantage, as the normal

rule is to place the burden of uncertainty on the

wrongdoer. See, e.g., Story Parchment Co.v. Paterson

Parchment Paper Co., 282 U.S. 555 (1931). And it

seems wrong to hold that a child is, as a matter of

law, worth the costs of raising her when the parents

have chosen differently in deciding against more

children.

However these factors would be balanced in

the more difficult case where the plaintiff originally

5

Reich v. Medical Protective Co, supra, at 244.

-26-

sought sterilization for economic reasons, that is

not this case. The evidence is clear that plaintiff

sought sterilization because she had previously

suffered an ectopic pregnancy, and feared for her

life should she become pregnant again. There is not

evidence to support the view that she sought to avoid

the expenses of raising another child. Plaintiff is,

of course, entitled to be compensated for the physical

and mental anguish she suffered as a result of

defendant's tort. To allow her to recover in addition

the costs of raising this child would be to give her

a windfall.

This conclusion is supported by the fact

that once she learned that this pregnancy was a

normal pregnancy rather than an ectopic one, plaintiff

chose not to have an abortion, though during her

previous pregnancy she had chosen to terminate the

pregnancy. This indicates that her decision to keep

-27-

the child was not the result of principled objections

to abortion. This, along with the plaintiff's testimony

that she now loves the child and that it is a source

of pride and joy to her and her family, convinces the

Court that defendant's wrong against plaintiff

consisted in imposing the pain, suffering, and mental

angush of @ ~“egnancy on her, not in imposing the

costs of a healthy child greatly cherished by its

mother. See Christensen v. Thornby, 255 N.W. 620

Min.. 1934), distinguished on this ground in Troppi

v. Scarf, 187 N.W. 2d 511, 514 (Mich. App. 1971);

Note: Wrongful Conception: Who Pays for Bringing Up

Baby? 47 Fordham L. Rev. 418, 432=35 (1978). Accordingly,

this Court concludes that weight of authority does

not, and the District of Columbia courts would not,

allow recovery of the costs of raising a healthy

child in circumstances such as these where the

plaintiff sought to be sterilization solely for

therapeutic reasons, and prized the child she bore.

=28-

The case where sterilization is sought for econamic

reasons is not before the Court.

Finally the Court must address the issue of

what action to take should the Court of Appeals

reverse this last determination. See Fed. R. Civ.

p. 50 (c). There is little, if any, support for the

$200,000 figure which the jury found to be the cost

of raising the child less the offest for benefits.

Plaintiff testified that the costs of raising her

previous child, born in 1964, was approximately

$60,000. In act, in her pretrial brief, plaintiff

estimated her cost of raising this child at $60,298.

Plaintiff now argues that the jury could have made a

rough adjustment for inflation and arrived at a

figure of $200,00 based on seventeen years inflation

(actually the relevant amount of time is sixteen

years: the child is already over one year old).

Plaintiff presented no econamist, as is the practice

in wrongful death case, nor was there evidence of

a

-29-

reasonableness of the claimed amounts. While defendant

could have cross-examined the plaintiff or presented

his own evidence on this issue, the Court is nonetheless

left with the conviction that the amount of the

verdict here is excessive. The interests of justice

would best be served, this Court concludes, by a new

trial on this issue so that both sides can present

evidence on the actual expected costs of raising a

child born in 1980, rather than by permitting the

existing verdict, which is necessarily found on

speculation, to stand.

Accordingly, in an accompanying order, the

court has vacated the $310,000 verdict rendered by

the jury in this case. A new trial has been ordered

on the issue of the amount of plaintiff's medical

expense, unless plaintiff agrees to remit the excess

$4,000. When the amount of the those expenses are

determined, judgment for that amount plus $100,000

for pain, suffering, and mental anguish will be

-30-

entered. Defendant's remaining motions for judgment

notwithstanding the verdict and for new trial are

denied, except that should the Court be reversed on

the informed consent count, then a new trial is

granted on the negligence count, and should the Court

of Appeals reverse this Court's determination that

the cost of raising plaintiff's child is not recoverable,

then a new trial is granted limited to the amount of

those damages.

/signed Lous F. Oberdorfer

UNITED STATES DISTRICT JUDGE

October 7, 1981

-3l-

UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLUMBIA

Civil Action NO. 79-3447

ORDER

For the reasons stated in the accompanying

Memorandum, it is this 7th day of October, 1981,

hereby:

ORDERED: That the judgment on the verdict

entered in the above captioned case is hereby VACATED,

and the motion by the defendant for a new trial is

granted, limited to the issue of the amount of

plaintiff's medical expenses, unless the plaintiff,

within twenty (20) days after service of this order

shall file a remittitur with the Clerk of this Court

remitting the sum of $4,000.00. Upon filing of said

remittitur, counsel for the defendant shall submit a

-32-

form of order granting judgment to the plaintiff in

the amount of $106,000.00. And it is further

ORDERED: That defendant's remaining motions

for judgment notwithstanding the verdict and for new

trial are hereby DENIED, except that, should this

Court's determiation tht the informed consent determination

of the jury is valid be reversed, then defendant's

motion for new trial on the issue of negligence is

GRANTED, and should this Court's determination that

damages for the cost of raising plaintiff's child are

not allowable be reversed, then defendant's motion

amount of such cost.

/signed Louis F. Oberdorfer

UNITED STATES DISTRICT JUDGE

for new trial is GRANTED, limited to the issue of the |

=-33-

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLUMBIA

SANDRA J. HARTKE

Plaintiff,

Civil Action NO. 79-3447

Has the plaintiff proved that the defendant

negligently failed to cauterize her fallopian tubes?

Yes | x |

yes Se

Has the plaintiff proved that pregnancy was

a material risk following the procedure she underwent,

that the defendant failed to inform her of this risk

and that had a reasonable person in her ciramatences

been informed, that person would not have consented

to the procedure.

Yes ee

—34-

If your answer to both questions is "No”

proceed no further and inform the Court you have

reached a verdict.

If your answer to either or both questions

is "Yes", proceed to the next question.

Enter the amount of damages you feel that

plaintiff proved she sustained for any or all of

the following:

Expenses $10,000.00

Pain, suffering and mental

anguish $100,000.00

Anticipated costs of raising this child

until age 18 less any benefit she received

or in the future will receive by reason of

the love, joy, happiness, etc., she experienced

in raising a healthy, happy child $200,000.00

Total damages $310,000.00

—S

lt eee

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