Under res ipsa loquitur, the injury must be caused by something under exclusive control of whom?

• A. Patient
• B. Nurse anesthesiologist
• C. Hospital
• D. Surgeon

Answer: (B)

Res ipsa loquitur rests on the idea that the injury was caused by an instrumentality that was under exclusive control of the defendant at the time of the harm, and that such an injury would not normally occur without negligence. In an anesthesia-related injury, the instrumentality responsible—airway management, anesthesia drugs, and the anesthesia equipment—is controlled in the operating room by the nurse anesthesiologist. Because that professional has exclusive control over how the anesthesia is administered and how the airway is managed during the procedure, the defendant can be inferred to have been negligent even without direct proof of fault. The patient does not control the instrumentality, the hospital is a broad entity with multiple people involved, and while the surgeon oversees the surgical field, the anesthesia-related injury specifically hinges on the exclusive control of the anesthesia provider. This makes the nurse anesthesiologist the best fit for the exclusive-control requirement in this scenario.