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The doctrine was not initially welcome in medical malpractice cases. In ''Gray v. Wright'',<ref>{{citation|title=Gray v. Wright 142 W. Va. 490, 96 S.E. 2d 671 |year=1957}}</ref> a seven-inch [[hemostat]] was left in Mrs. Gray during gallbladder surgery in June 1947, and despite her chronic complaints about stomach pain over the years, the device was not found until an X-ray in March 1953, when it was removed. Her $12,000 award was reversed by the Supreme Court of West Virginia because she was outside the statute of limitations when she filed and could not prove that the doctor concealed knowledge of his error. This "guilty knowledge" requirement disappeared over the years, and the "discovery rule" by which statutes of limitation run from the date of discovery of the wrongdoing rather than the date of the occurrence has become the rule in most states.
Forty years later, leaving a medical device in a patient was medical malpractice, provable without expert testimony, in almost every jurisdiction.<ref>See ''Fieux v. Cardiovascular & Thoracic Clinic, P.C.,'' 159 Or. App. 637, 641, 978 P.2d 429, 433 (1999); ''Steinkamp v. Caremark,'' 3 S.W.3d 191, 198-99 (Tex. Civ. App. 1999); ''Baumgardner v. Yusuf'', 144 Cal. App. 4th 1381, 1392, 51 Cal. Rptr. 3d 1381, 1392 (2006); ''Fox v. Green'', 161 N.C. App. 460, 465, 588 S.E. 2d 899, 904 (2003).</ref> [[Virginia]] has limited the rule. The Virginia Supreme Court stated: "Almost 60 years ago, this Court, discussing res ipsa loquitur, said: 'In Virginia the doctrine, if not entirely abolished, has been limited and restricted to a very material extent.
A contention of ''res ipsa loquitur'' commonly is made in cases of commercial airplane accidents. It was part of the commentary in a train collision in [[California]] in 2008: "If two trains are in the same place at the same time, someone was negligent."<ref>{{cite web|last1=Bernard|first1=Kirk|title=California Metrolink Train Accident Caused By Engineer's Error|url=http://www.seattleinjuryblog.com/2008/09/california_metrolink_train_acc.html|website=Seattle Injury Blog|accessdate=19 February 2015}}</ref>
In some states, the doctrine of ''res ipsa loquitur'' is also used as a method of proving the [[intent (law)|intent]] or ''[[mens rea]]'' element of the [[inchoate crime]] of [[attempt]]. Under the [[Model Penal Code]], "the behavior in question is thought to corroborate the defendant's criminal purpose
{{quote|Possession of materials to be employed in the commission of the crime, which are specifically designed for such unlawful use or which serve no lawful purpose of the actor under the circumstances|Model Penal Code<ref name="MPC"/>}}
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