Juries in medical malpractice cases must be instructed on the law of contributory negligence whenever there is any evidence that the patient’s own role in the decision-making process was a proximate cause of her injuries, a divided panel of the 3rd U.S. Circuit Court of Appeals has ruled.

Overturning a judgment of nearly $900,000, the court ordered a new trial in Alexander v. University of Pittsburgh Medical Center in which three doctors were found liable for the death of a 17-year-old girl with a rare liver disorder, because the trial judge didn’t instruct the jury to consider the possible negligence of the girl and her parents in turning down available transplant livers on three occasions.