This section contains the nature of the case and procedural background.

P underwent a vaginal hysterectomy with entocele and rectocele repair. The procedure was performed by Pachtman (D), then a fourth-year resident in gynecology. Roberts (D), was the attending physician and was present for most of the surgery. Dr. Pachtman (D) performed the first two procedures, the hysterectomy and entocele repair, without complication, although the entocele repair took longer than expected. Dr. Roberts (D) left the room to attend another operation that had been previously scheduled. Upon Dr. Pachtman's (D) initial insertion into the levator ani muscle, the needle she was using broke. One-half to two-thirds of the needle, a length of about 1.5 cm, broke off and lodged somewhere within that muscle. She searched unsuccessfully for the broken portion of the needle for fifteen to twenty minutes. Dr. Roberts (D) returned and joined in searching for the needle fragment. Ds utilized a silver probe to x-ray the affected area, in an attempt to locate the broken portion of the needle. After ascertaining the approximate location of the fragment, they decided to close the old incision and continue their search through a new incision. After unsuccessfully searching for the needle for another forty-five minutes to one hour, they abandoned the search and closed the second incision. Ds felt it was in P's best interest to terminate the surgery at that point. Dr. Pachtman (D) informed P of the needle breakage and stated that the needle was entrenched in the muscle and therefore could remain there without causing her any problems. After experiencing considerable pain and discomfort, P consulted with another physician, Dr. Couch who advised removing the needle fragment, and, subsequently, she performed the surgical procedure, successfully locating and removing the broken portion of the needle. P sued Ds alleging negligence on various grounds, including the use of a needle that they knew or should have known was too small and failing to locate and remove the needle fragment. P's expert witness, Dr. Couch, was unable to identify any negligent conduct on the part of either Ds. Dr. Couch could not give an opinion regarding the adequacy of the needle size, because she had never viewed the needle intact. She explained that she could not identify the size of the needle without viewing the needle in its entirety. Dr. Couch stated that the standard of care did not relate to needle breakage at all, but rather to how one dealt with it, suggesting that needle breakage was simply one of the risks of surgery. She also noted that a surgeon's 'incorrect technique' often causes a needle to break. Dr. Couch described instances in which a surgeon fails to manipulate the needle correctly, such as by inserting it at the wrong angle or applying too much force. Dr. Couch also testified that she had previously had a needle break while performing surgery. Dr. Pachtman (D) told P's brother, ''I knew the needle was too small when I used it.'' P's husband testified that Dr. Pachtman (D) said, 'She told me that it was her fault, that she used the wrong needle, and she was sorry.' P testified to the same effect. Neither D acknowledged any negligent behavior in the choice of the needle, the needle breakage, or their subsequent search for the needle fragment. The trial court granted the Ds' motion for a directed verdict because P had failed to make a prima facie showing regarding the standard of care. The appeals court affirmed. P appealed.

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