The doctrine of res ipsa loquitur (“the thing speaks for itself”)84 is an exception to the general rule that negligence is never presumed.85 The doctrine is codified as Delaware Rule of Evidence 304. When applicable, the doctrine permits, but does not require, the trier of fact to draw an inference of negligence from the happening of an accident.86 If the particular manner in which the plaintiff shows the injury to have occurred is so unaccountable that reasonable persons could conclude that the injury would not have happened in the absence of some negligence on the part of the defendant, then the doctrine of res ipsa loquitur is properly applicable to establish the negligence of the defendant.87 The rule is based on probability and the procedural policy of placing the burden on the party who possesses the superior knowledge or opportunity for explaining the causative circumstances.88
The applicability of the doctrine is dependent upon the peculiar facts and circumstances of each individual case. Furthermore, the application of the doctrine is considered to be in aid of the administration of justice and not to be applied in a manner that works injustice to a defendant. Thus, the doctrine is of limited and restricted scope, ordinarily to be applied sparingly and with caution, in peculiar and exceptional cases, and only where the facts and demands of justice make the application essential.89 As the doctrine is a rule of circumstantial evidence,90 it is inapplicable if there is direct evidence of the cause of the injury.91
Four elements must be present before the doctrine may be applied. First, the accident must be such as does not happen in the ordinary course of events if those who have management and control use proper care.92 Expert testimony may be required to show the applicable standard of care.93
Second, the facts must be such as to warrant an inference of negligence of such force as to call for an explanation or rebuttal from the defendant.94 There must be a causal connection between the defendant’s act or omission and the accident.95
Third, the thing or instrumentality that caused the injury must have been under the management or control of the defendant or an agent of the defendant at the time the negligence likely occurred.96 Exclusive control is no longer required, however.97 But if there is an intervening lapse of time between the act of the defendant and the happening of the injury, the plaintiff must demonstrate that no act of another could have intervened to cause the injury or that the instrumentality causing the injury was not tampered with after it left the defendant’s possession.98
Finally, where the injured party participated in the events leading up to the accident, the evidence must exclude the plaintiff’s own conduct as a responsible cause.99 The defendant has the burden of establishing the plaintiff’s negligent conduct.100
Although, as a general rule, the application of the doctrine should be determined at the close of the plaintiff’s case,101 courts have discretionary power to make such a determination at a pre-trial stage, considering the nature of the contentions, the sufficiency of the factual showing and the applicable standards of the doctrine.102 When the doctrine is found to be applicable, the defendant will not be entitled to a judgment as a matter, of law at the close of the plaintiff’s case, unless, at that point, the defendant has produced evidence destroying the inference of negligence on his or her own part or has so completely contradicted it that the jury could not accept it. The evidence necessary to achieve this will vary with the strength of the inference and the nature of the explanation. The defendant will not be entitled to a judgment as a matter of law merely by introducing evidence in explanation, even if such evidence has not been rebutted.103
Presumptions of negligence in a medical malpractice action are governed exclusively by statute. A rebuttable inference of negligence by a medical practitioner arises where (1) a foreign object was unintentionally left inside the body of a patient following surgery; (2) an explosion or fire originating in a substance used in treatment occurred in the course of treatment; or (3) a surgical procedure was performed on the wrong patient or the wrong organ, limb or part of the patient’s body. These statutory bases are exclusive, and there may be no other basis for presuming negligence on the part of a health care provider.104 Thus, the doctrine of res ipsa loquitur may not be used for any set of facts outside of those three areas described above in an action for medical malpractice.105
84. Biddle v. Haldas Bros., 190 A. 588, 595 (Del. Super. 1937); Edmanson v. Wilmington & Philadelphia Traction Co., 120 A. 923, 924 (Del. Super. 1923): Ayers v. Kent County Motor Sales Co., C.A. No. 88C-AU-26, slip op. at 4, Steele, J. (Del. Super. Dec. 16, 1991), aff’d mem., 601 A.2d 723 (Del. 1992).
85. See § 10:3.
86. D.R.E. 304(a)(l); Scott v. Diamond State Tel. Co., 239 A.2d 703, 705 (Del. 1968); General Motors Corp. v. Dillon, 367 A.2d 1020, 1023 (Del. 1976); Delaware Coach Co. v. Reynolds, 71 A.2d 69, 73 (Del. 1950); Moore v. Anesthesia Services, P.A., 966 A.2d 830, 841 (Del. Super. 2008); Hornbeck v. Homeopathic Hospital Asso., 197 A.2d 461, 463 (Del. Super. 1964); Vattilana v. George & Lynch, Inc., 154 A.2d 565, 567 (Del. Super. 1959); Williams v. General Baking Co., 98 A.2d 779, 780 (Del. Super. 1953); Biddle v. Haldas Bros., 190 A. 588, 595 (Del. Super. 1937); Ayers v. Kent County Motor Sales Co., C.A. No. 88C-AU-26, slip op. at 3, Steele, 3. (Del. Super. Dec. 16, 1991), aff’’d mem., 601 A.2d 723 (Del. 1992).
87. General Motors Corp. v. Dillon, 367 A.2d 1020, 1023 (Del. 1976); Slovin v. Gauger, 200 A.2d 565, 567 (Del. 1964); Skipper v. Royal Crown Bottling Co., 192 A.2d 910, 912 (Del. 1963); Dickens v. Horn & Hardart Baking Co., 209 A.2d 169, 171 (Del. Super. 1965); Phillips v. Delaware Power & Light Co., 202 A.2d 131, 132 (Del. Super. 1964); Biddle v. Haldas Bros., 190 A. 588, 595 (Del. Super. 1937); Thompson v. Cooles, 180 A. 522, 524 (Del. Super. 1935); Edmanson v. Wilmington & Philadelphia Traction Co., 120 A. 923, 924 (Del. Super. 1923); Wood v. Wilmington C. R. Co., 64 A. 246, 247 (Del. Super. 1905).
88. Vattilana v. George & Lynch, Inc., 154 A.2d 565, 567 (Del. Super. 1959); Ayers v. Kent County Motor Sales Co., C.A. No. 88C-AU-26, slip op. at 4, Steele, J. (Del. Super. Dec. 16, 1991), aff’d mem., 601 A.2d 723 (Del. 1992).
89. Slack v, Premier-Pabst Corp., 5 A.2d 516 (Del. Super. 1939); Thompson v. Cooles, 180 A. 522, 524 (Del. Super. 1935); Starr v. Starr, 170 A. 924, 925 (Del. Super. 1934).
90. D.R.E. 304(a)(l); Skipper v. Royal Crown Bottling Co., 192 A.2d 910, 912 (Del. 1963); Delaware Coach Co. v. Reynolds, 71 A.2d 69, 73 (Del. 1950); Hopkins v. Chesapeake Utilities Corp., 290 A.2d 4, 6 (Del. Super. 1972).
91. Slovin v. Gauger, 200 A.2d 565, 567 (Del. 1964); Mitchell v. Atkins, 178 A. 593, 594 (Del. Super. 1935). See also Wagner v. Olmedo, 365 A.2d 643, 645 (Del. 1976); Smigelski v. Smith, C.A. No. 86C-SE-148, slip op. at 4, Taylor, J. (Del. Super. July 17, 1990) (ORDER), reh’g denied, C.A. No. 86C-SE-148, Taylor, J. (Del. Super. Oct. 23, 1990, revised Nov. 30, 1990) (ORDER).
92. D.R.E. 304(b)(l); Skipper v. Royal Crown Bottling Co., 192 A.2d 910, 912 (Del. 1963); Delaware Coach Co. v. Reynolds, 71 A.2d 69, 73 (Del. 1950); Dillon v. General Motors Corp., 315 A.2d 732, 737 (Del. Super. 1974), aff’d, 367 A.2d 1020 (Del. 1976); Hopkins v. Chesapeake Utilities Corp., 290 A.2d 4, 7 (Del. Super. 1972); National Fire Ins. Co. v. Pennsylvania R. Co., 220 A.2d 211, 220 (Del. Super. 1966); Phillips v. Delaware Power & Light Co., 202 A.2d 131, 133 (Del. Super. 1964); Hornbeck v. Homeopathic Hospital Asso., 197 A.2d 461, 463 (Del. Super. 1964); Vattilana v. George & Lynch, Inc., 154 A.2d 565, 567 (Del. Super. 1959).
93. Hornbeck v. Homeopathic Hospital Asso., 197 A.2d 461, 463 (Del. Super. 1964). See also 15:1.
94. D.R.E. 304(b)(2).
95. Dillon v. General Motors Corp., 315 A.2d 732, 737 (Del. Super. 1974), aff’d, 367 A.2d 1020 (Del. 1976); Scott v. Diamond State Tel. Co., 239 A.2d 703, 705 (Del. 1968); Vattilana v. George & Lynch, Inc., 154 A.2d 565, 567 (Del. Super. 1959).
96. D.R.E. 304(b); Slovin v. Gauger 200 A2d 565, 567 (Del. 1964); Skipper v. Royal Crown Bottling Co., 192 A.2d 910, 912 (Del. 1963); Vattilana v. George & Lynch, Inc., 154 A.2d 565, 567 (Del. Super. 1959).
97. Skipper v. Royal Crown Bottling Co., 192 A.2d 910, 912 (Del. 1963); Moore v. Anesthesia Services, P.A., 966 A.2d 830, 840 (Del. Super. 2008); Moore v. Douglas Aircraft Co., 282 A.2d 625, 628 (Del. Super. 1971); Phillips. v. Delaware Power & Light Co., 202 A.2d 131, 132 (Del. Super. 1964).
98. Skipper v. Royal Crown Bottling Co., 192 A.2d 910, 912 (Del. 1963).
99. D.R.E. 304(b)(4); Moore v. Douglas Aircraft Co., 282 A.2d 625, 628 (Del. Super. 1971).
100. Hopkins v. Chesapeake Utilities Corp., 290 A.2d 4, 7 (Del. Super. 1972).
101. D.R.E. 304(c)(l). See also National Fire Ins, Co. v. Pennsylvania R. Co., 220 A.2d 217, 219 (Del. Super. 1966); Delaware Coach Co. v. Reynolds, 71 A.2d 69, 75 (Del. 1950).
102. Lacy v. G.D. Searle & Co., 484 A.2d 527, 530 (Del. Super. 1984); Orsini v. K-Mart Corp., C.A. No. 95C-07-146-WTQ, slip op. at 5, Quillen, J. (Del. Super. Feb. 25, 1997); Bell v. Boscov’s Dept. Store, Inc., C.A. No. 89C-5E-l, slip op. at 5, Lee, J. (Del. Super. Feb. 28, 1992); Smigeiski v. Smith, C.A. No. 86C-SE-148, slip op. at 4, Taylor, J. (Del. Super. July 17, 1990) (ORDER), reh’g denied, C.A. No. 86C-SE-l48, Taylor, J. (Del. Super. Oct. 23, 1990, revised Nov. 30, 1990) (ORDER).
103. D.R.E. 304(c)(2). See also Moore v. Douglas Aircraft Co., 282 A.2d 625, 628 (Del. Super. 1971); Scott v. Diamond State Tel. Co., 239 A.2d 703, 705 (Del. 1968); Hornbeck v. Homeopathic Hospital Asso., 197 A.2d 461, 463 (Del. Super. 1964); Delaware Coach Co. v. Reynolds, 71 A.2d 69, 75 (Del. 1950).
104. 18 Del. C. § 6854.
105. Lacy v. G.D. Searle & Co., 484 A.2d 527, 530 (Del. Super. 1984).
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