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Res Ipsa merely helps establish the breach element of causation. Duty and Causation must both be discussed separately.
Byrne v Boadle might help you understand the concept a little. In the case a barrel of flour rolled out of the Ds shop and hit P. The P (without any evidence as to the true doings of the D) was allowed to have the jury infer that the barrel would not have fallen without some sort of negligence of the D. The case helped establish the prima facie elements for the inference 1) the accident does not normally happen without negligence 2) D was in exclusive control 3) P did not cause accident.
Remember Res Ipsa is just a tool for the P who has no way of proving breach in a negligence claim. In the medical context this MAY fall true, but there is a split of jurisdiction on whether or not to allow res ipsa. This is mainly because the patient is not usually under the EXCLUSIVE control of the D. There are usually nurses, anesthesiologists, surgeons, etc who all see the patient at some point.
It is also a rebuttable presumption, so if the D can show a reasonable alternative explanation the P may be out of luck.
A great hypo would be a car leaving highway and crashing into a stationary object. The P may not be able to prove affirmatively why the driver was negligent (i.e. speeding, etc) but a reasonable jury can infer that the driver was negligent because cars don't usually crash into stationary objects without negligence on part of the driver. The driver may be able to provide a rebuttal to this presumption, however, of a product defect, etc.
Hope this helps... happy studying
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Posted: Mon Apr 30, 2012 2:19 am 
