What is considered "wilful misconduct" in the context of medical malpractice cases?

'Wilful misconduct means intentional wrongful conduct, done either with knowledge that serious injury to (another) probably will result or with a wanton and reckless disregard of the possible results; the (defendant's) entire course of conduct, * * * is to be considered; and the existence of wilful misconduct is essentially a question of fact. (Citation.) "(A)n intent to injure anyone is not a necessary ingredient of wilful misconduct * * *." (Citation.)' (Reuther v. Viall, 62 Cal.2d 470, 475, 42 Cal.Rptr. 456, 459, 398 P.2d 792, 795.)