This medical malpractice action was brought by the appellant, David Riggins (“Riggins”), against Dr. Charles A. Mau-riello, an osteopathic physician. Riggins appeals the Superior Court’s denial of his motion for a new trial. The jury was given a standard charge, without objection from Riggins, that a “mere error of judgment” by a physician was not actionable. A verdict was returned in favor of Dr. Mauriello-. In this motion for a new trial Riggins argued that the jury instruction on “mere error of judgment” was erroneous. The Superior Court concluded that in the absence of a timely exception, Riggins had waived his objections. Nonetheless, the trial judge recognized the infirmity in the *828charge, and called on us to suggest its abandonment. We agree on both accounts. Thus, we direct the Superior Court to abandon further use of. the charge as given here. In directing that the old charge be abolished, we must also recognize that its use in this case was plain error. Accordingly, we reverse the judgment of the Superior Court and remand the case for a new trial.
I.
The basic facts are not in dispute. On October 26, 1982, Riggins fell from a roof while at work and fractured his right ankle. He was taken to Riverside Hospital where an admitting diagnosis was made by the attending physician, Dr. Ellis. Dr. Ellis notified Dr. Mauriello within 45 minutes of Riggins’ admission. The latter arrived at the hospital three hours later. Due to swelling, Dr. Mauriello performed a closed reduction on the fracture, placing Riggins in a short-leg cast, and admitted him to the hospital.
Six days later Dr. Mauriello opened the leg and attempted to use the plate and screw method to repair the damage. However, due to excessive swelling, Dr. Mau-riello was unable to complete the procedure or close the wound, as planned. Thus, Dr. Mauriello performed a limited internal fixation and placed a cast around the entire fracture site, including the extruding metal pins and open wound.
Riggins was discharged from the hospital on November 11, 1982. Between that date and May, 1983, he was readmitted or seen in the hospital emergency room at least seven times. On May 13, 1983, Dr. Mauriello determined that Riggins had developed osteomyelitis, an infection of the bone.1 This was confirmed by another orthopedic surgeon, Dr. Hogan. Riggins was then transferred to the care of Dr. Esterhai of the University of Pennsylvania Hospital who attempted to control the infection, without success. On Novémber 9, 1983, Dr. Esterhai amputated Riggins’ leg below the knee.
Riggins filed this malpractice action against Dr. Mauriello on October 16, 1984. Trial began on January 28, 1991. The jury was charged, without objection from Rig-gins, and a verdict returned in favor of Dr. Mauriello. Riggins moved for a new trial. The parties disagree whether the papers submitted by Riggins in support of his motion actually challenged or objected to the jury instruction.2 Dr. Mauriello contends that they did not, while Riggins argues that they did. In any case, Riggins does concede that no objection was made at trial.
At oral argument on the motion for a new trial Riggins challenged3, though obliquely, the trial court’s medical malprac*829tice instruction.4 Riggins disputed two passages, both of which occurred near the end of the lengthy instruction. First, Rig-gins contested the statement that it is not enough to prove malpractice if the “approach utilized by the defendant is regarded by some practicing within his specialty and in good standing in the community as an acceptable approach.” Second, Riggins challenged the statement that “a physician cannot be liable for a mere error of judgment in deciding what to do or what not to do for the patient provided that he has done what he thinks is best in the exercise of reasonable care.” (Emphasis added). Riggins argued that, in hindsight, these portions of the charge were misleading and confusing to the jury in dealing with the complex issues of the case.
The Superior Court fully considered Rig-gins’ arguments. Although the trial judge expressed surprise at the verdict, he noted that there was competent expert testimony that Dr. Mauriello’s treatment was within the applicable standard of care. The jury apparently accepted the testimony of Dr. Mauriello’s experts over that of Riggins’. The trial judge further stated that the jury instruction given, including the portions complained of, had been used for years in the Superior Court. Thus, the court found that giving the instruction was not “obvious error”5 and denied Riggins’ motion for *830a new trial. In doing so, however, the trial judge urged us to rectify continued use of the charge.
II.
A party may not assign error to the giving of a jury instruction without an exception to the charge before the jury retires to consider its verdict, or within the time set by the trial court immediately thereafter. Super.Ct.Civ.R. 51. Only where the interests of justice so require may we review questions not properly presented to the trial court. Supr.Ct.R. 8.
“The failure to object at trial constitutes a waiver of the right to raise an issue on appeal unless the error is plain.” Culver v. Bennett, Del.Supr., 588 A.2d 1094, 1096 (1991) (citing Probst v. State, Del.Supr., 547 A.2d 114, 119 (1988)). ‘“Under the plain error standard of review, the error complained of must be so clearly prejudicial to substantial rights as to jeopardize the fairness and integrity of the trial process.’ ” Id. (citing Wainwright v. State, Del.Supr. 504 A.2d 1096, 1100 (1986). “While some inaccuracies and inaptness in statements are to be expected in any [jury] charge, this court will reverse if the alleged deficiency in the jury instructions undermined the jury’s ability to intelligently perform its duty in returning a verdict.” Id. (citing Probst, 547 A.2d at 119).
Turning to this record, it appears that the instruction was identical, in the parts complained of by Riggins, to the “MEDICAL MALPRACTICE” instruction submitted in Dr. Mauriello’s proposed jury instructions. A conference to consider the charge was held the night before the jury was instructed, yet Riggins did not object to the proposed instruction. Riggins also did not object to the instruction the next morning, either before or after the jury was charged. Neither did Riggins explicitly mention, although he claims otherwise, the instruction in the papers supporting his motion for a new trial. The instruction was challenged for the first time at oral argument on the motion for a new trial.
Clearly, Riggins did not timely object to the jury instruction. Super.Ct.Civ.R. 51. Thus, he must rely on principles of plain error. Culver, 588 A.2d at 1096.
The rather lengthy medical malpractice instruction, only a small portion of which is challenged, repeats longstanding Delaware law that a surgeon is bound to the same standards of care and competence as other surgeons in good standing ordinarily adhere to in the same or similar community. DiFilippo v. Preston, Del.Supr., 173 A.2d 333 (1961). The instruction also states the requirement, codified in 18 Del.C. § 6853, that the standard be established by expert witnesses.
We have never squarely addressed the issue of the propriety of the “mere error of judgment” language contained in the Superior Court’s standard instruction. Dr. Mauriello cites numerous cases in other states which have upheld similar “judgment” language in medical malpractice cases.6 Riggins also cites numerous cases which have struck down medical malpractice instructions containing passages similar to the “error of judgment” language.7 *831Our examination of these cases suggests that, on balance, the other jurisdictions are rather evenly split. Each case ultimately turns on peculiar variations in language and the context in which the “judgment” language is placed, as viewed by the reviewing court.
We have carefully reviewed the jury instruction which Riggins now challenges. In particular, we focus on the charge that “a physician cannot be liable for a mere error of judgment in deciding what to do or what not to do for the patient provided that he has done what he thinks is best in the exercise of reasonable care.” In our opinion the “mere error of judgment” charge is undesirable and should be abandoned. A proper instruction should state that, when a physician chooses between appropriate alternative medical treatments, harm which results from the physician’s good faith choice of one proper alternative over the other is not malpractice.
The “mere error of judgment” language thus permits too much. Under this standard, a jury could too readily conclude, incorrectly, that a physician is not liable for malpractice even if he or she is negligent in administering the treatment selected.
While Riggins now challenges Dr. Mauriello’s judgment in both his decision to perform a closed reduction on October 26th and his decision to attempt an open reduction six days later, the record discloses testimony and other evidence adduced at trial that Dr. Mauriello’s course of treatment in each situation was within the applicable standard of care under the circumstances. The defendant’s expert witnesses, Drs. Hogan, Marvel and Esterhai, so testified. Professional literature, supporting the procedures, also was placed in evidence. Thus, while Riggins’ expert opined to the contrary, there is sufficient evidence upon this record to support Dr. Mauriello’s defense that his choice of treatments in each circumstance was within the applicable standard of care.
In reviewing Riggins’ clear failure to timely object to the instruction, the plain error standard of review must be applied. In our opinion the “mere error of judgment” language was inappropriate as a matter of law. Although the defendant contends that there is sufficient evidence in the record to support the jury’s verdict, we must recognize that the jury’s decision was rendered upon the charge we now abandon. Under these circumstances, we find that use of the old charge was a “deficiency ... [which] undermined the jury’s ability to intelligently perform its duty in returning a verdict.” Culver, 588 A.2d at 1098. Accordingly, plain error is shown on this record.
The judgment of the Superior Court is REVERSED and the matter is REMANDED for a new trial.