Rizzo v. Schiller

Plaintiffs, Michael Sean Rizzo Sr. and Pamela Rizzo, filed this action against defendant physician Maurice Schiller, who they alleged breached the standard of care owed to them with his negligent and nonconsensual use of obstetrical forceps during Mrs. Rizzo’s delivery.

Pamela Rizzo was admitted to Fairfax Hospital on November 7th at 9:00am in active labor. Upon admission, Ms. Rizzo signed an “authorization of medical and surgical procedures” form that authorized Dr. Schiller to perform general medical procedures. At 10:15pm, after Ms. Rizzo was unsuccessful at pushing the baby out, Dr. Schiller told her that he was going to use forceps to deliver the baby. Ms. Rizzo stated that, “before I could even get my composure together, ask what they were for, why, [the forceps] were inside me. And my son’s head was out, just the head.” Rizzo v. Schiller, 445 S.E.2d 153, 154 (Va. 1994)

Michael Rizzo Jr. was born at 10:30pm and was diagnosed with a subdural hematoma which was the result of trauma to the head and would be permanently disabled as a result. Multiple medical expert witnesses testified that the injury was the result of the use of forceps and that a standard of care was breached in failing to allow Ms. Rizzo to participate in the decision to use forceps.

The question for the Court was whether the plaintiffs presented sufficient evidence to establish a prima facie case that Dr. Schiller failed to obtain Ms. Rizzo’s informed consent for the use of forceps. The Court held that there was sufficient evidence in the record to establish a failure to obtain informed consent.

The Court cited expert testimony that stated that the appropriate standard of care required that Dr. Schiller inform Ms. Rizzo about the use of the forceps and that she be given an opportunity to participate in the decision. The Court finds that the authorization form that Ms. Rizzo signed did not sufficiently inform her of any specific procedures or her associated risks. The Court held that the duty imposed upon a physician to obtain informed consent requires more than just the patient’s signature on a general form.

The Court also determined that the plaintiffs presented sufficient evidence of proximate causation as an element of their prima facie case. They reached the conclusion based on evidence that supported the inference that had Ms. Rizzo been informed of the consequences of the forceps, she would have made the decision to forego their use.

“If forceps are used in “non-emergent situations,” the patient should be informed about the use of the forceps and should be given the opportunity to participate in the decision regarding whether the forceps will be used.” Rizzo v. Schiller, 445 S.E.2d 153, 155 (Va. 1994)

“it is the duty of a physician in the exercise of ordinary care to warn a patient of the danger of possible bad consequences of using a remedy,” but that the physician's failure to warn “is not per se an act of negligence.” Rather, the physician owes a duty to make a reasonable disclosure to the patient of all significant facts under the circumstances.” Rizzo v. Schiller, 445 S.E.2d 153, 155 (Va. 1994)

“As Dr. Arner observed, the form is so general in nature that “you could also justify amputating her foot.” We hold that the duty imposed upon a physician to obtain a patient's informed consent requires more than simply securing the patient's signature on a generalized consent form, similar to the form present here. The law requires informed consent, not mere consent, and the failure to obtain informed consent is tantamount to no consent.” Rizzo v. Schiller, 445 S.E.2d 153, 155–56 (Va. 1994)