According to the court's judgment in favor of the plaintiff, no further evidence as to the source of the muscle atrophy in his shoulder and arm, because "the thing itself speaks" when all three components of res ipsa loquitur are satisfied, as they were in the case of Ybarra vs. Spangard. The plaintiff's claim for negligence against his doctors was ultimately successful because (1) arm injuries do not ordinarily occur in an appendectomy operation absent negligent action by the physicians, surgeons, or nurses in attendance during the procedure, (2) the injuries were caused by an agency or instrumentality within the exclusive control of the defendant, as the plaintiff was rendered unconscious during the surgery's preparation period, and (3) the plaintiff never volunteered or submitted to the possibility of her arm being injured when they elected to undergo a surgery in their abdominal region. One of the most interesting aspects of Ybarra vs. Spangard from a legal perspective is reasoning used by the court in finding that "a patient injured while unconscious on an operating table in a hospital could hold all or any of the persons who had any connection with the operation even though he could not select the particular acts by the particular person which led to his disability" (Louisell & Williams, 1960). 2.) Are all the elements for a claim of negligence found in the case? Identify each of the four Ds.

The court ruled in favor of the plaintiff because the four requirements for negliegence under common law (Duty, Dereliction, Direct Cause, Damages) were ultimately deemed to be present in light of the evidence submitted. The concept of legal Duty was established when the plaintiff sought the medical advice of the hospital which diagnosed him with appendicitis, and referred him to Drs. R, S, and T. For the resulting appendectomy operation. Each of the medical professionals involved in treating the plaintiff bore an ethical and legal duty to provide a certain standard of care, and one component of that standard is the protection and preservation of a patient's health and well-being. Dereliction in the case of Ybarra vs. Spangard occurred when the doctors and anesthesiologists tasked with removing his appendix managed...

The fact that the plaintiff was rendered unconscious with his arms in perfect health, and only experienced suffering caused by injurious trauma after his appendectomy was performed, demonstrates Direct Cause, because Mr. Ybarra was unable to cause the injuries to himself while in state of immobility. Finally, with the plaintiff eventually experiencing paralysis due to the injuries caused to his arms and shoulders, the requirement of Damages is clearly satisfied, by virtue of the ceaseless and unending pain, suffering and inconvenience caused to Mr. Ybarra by the negligent actions of the medical professionals charged with the duty to preserve his health.