501. Standard of Care for Health Care Professionals

A [insert type of medical practitioner] is negligent if [he/she] fails to use the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful [insert type of medical practitioners] would use in the same or similar circumstances. This level of skill, knowledge, and care is sometimes referred to as "the standard of care."

[You must determine the level of skill, knowledge, and care that other reasonably careful [insert type of medical practitioners] would use in the same or similar circumstances, based only on the testimony of the expert witnesses [including [name of defendant]] who have testified in this case.]

Directions for Use

This instruction is intended to apply to nonspecialist physicians, surgeons, and dentists. The standards of care for nurses, specialists, and hospitals are addressed in separate instructions.

The second paragraph should be used only in cases where the court determines that expert testimony is necessary to establish the standard of care.

In appropriate cases where the standard of care is set by statute or regulation, refer to instructions on negligence per se (CACI Nos. 418-421). (See Galvez v. Frields (2001) 88 Cal.App.4th 1410 [107 Cal.Rptr.2d 50].)

See CACI Nos. 219-221 on evaluating the credibility of expert witnesses.

Sources and Authority

"With unimportant variations in phrasing, we have consistently held that a physician is required to possess and exercise, in both diagnosis and treatment, that reasonable degree of knowledge and skill which is ordinarily possessed and exercised by other members of his profession in similar circumstances." (Landeros v. Flood (1976) 17 Cal.3d 399, 408 [131 Cal.Rptr. 69, 551 P.2d 389]; see also Brown v. Colm (1974) 11 Cal.3d 639, 642-643 [114 Cal.Rptr. 128, 552 P.2d 688].)

"The courts require only that physicians and surgeons exercise in diagnosis and treatment that reasonable degree of skill, knowledge, and care ordinarily possessed and exercised by members of the medical profession under similar circumstances." (Mann v. Cracchiolo (1985) 38 Cal.3d 18, 36 [210 Cal.Rptr. 762, 694 P.2d 1134].)

In Hinson v. Clairemont Community Hospital (1990) 218 Cal.App.3d 1110, 1119-1120 [267 Cal.Rptr. 503] (disapproved on other grounds in Alexander v. Superior Court (1993) 5 Cal.4th 1218, 1228 [23 Cal.Rptr.2d 397, 859 P.2d 96]), the court observed that failure to possess the requisite level of knowledge and skill is negligence, although a breach of this portion of the standard of care does not, by itself, establish actionable malpractice.

"The standard of care against which the acts of a medical practitioner are to be measured is a matter peculiarly within the knowledge of experts; it presents the basic issue in a malpractice action and can only be proved by their testimony, unless the conduct required by the particular circumstances is within the common knowledge of laymen." (Alef v. Alta Bates Hospital (1992) 5 Cal.App.4th 208, 215 [6 Cal.Rptr.2d 900].)

" 'Ordinarily, the standard of care required of a doctor, and whether he exercised such care, can be established only by the testimony of experts in the field.' 'But to that rule there is an exception that is as well settled as the rule itself, and that is where "negligence on the part of a doctor is demonstrated by facts which can be evaluated by resort to common knowledge, expert testimony is not required since scientific enlightenment is not essential for the determination of an obvious fact." ' " (Gannon v. Elliot (1993) 19 Cal.App.4th 1, 6 [23 Cal.Rptr.2d 86], internal citations omitted.)

"We have already held upon authority that the failure to remove a sponge from the abdomen of a patient is negligence of the ordinary type and that it does not involve knowledge of materia medica or surgery but that it belongs to that class of mental lapses which frequently occur in the usual routine of business and commerce, and in the multitude of commonplace affairs which come within the group of ordinary actionable negligence. The layman needs no scientific enlightenment to see at once that the omission can be accounted for on no other theory than that someone has committed actionable negligence." (Ales v. Ryan (1936) 8 Cal.2d 82, 93 [64 P.2d 409].)

The medical malpractice standard of care applies to veterinarians. (Williamson v. Prida (1999) 75 Cal.App.4th 1417, 1425 [89 Cal.Rptr.2d 868].)

Secondary Sources

6 Witkin, Summary of California Law (9th ed. 1988) Torts, §§ 774, 792, pp. 113, 137

3 Levy et al., California Torts, Ch. 30, General Principles of Liability of Professionals, § 30.12, Ch. 31, Liability of Physicians and Other Medical Practitioners, § 31.11 (Matthew Bender)

California Tort Guide (Cont.Ed.Bar 1996) § 9.1

17 California Forms of Pleading and Practice, Ch. 209, Dentists, § 209.42 (Matthew Bender)

25 California Forms of Pleading and Practice, Ch. 295, Hospitals, §§ 295.13, 295.43, 295.45 (Matthew Bender)

36 California Forms of Pleading and Practice, Ch. 414, Physicians and Other Medical Personnel (Matthew Bender)

17 California Points and Authorities, Ch. 175, Physicians and Surgeons (Matthew Bender)

(Revised December 2005)