Saturday, April 11, 2009

California Court finds doctor has no duty to third parties injured by patient

Here is a new case out of the Court of Appeals in California discussing an issue we have talked about in class and here on the blog. In this case, a teenager who was under the care of the defendant psychiatrist killed several of his neighbors. The decedent's surviving family members sued the doctor arguing he was negligent in prescribing a series of drugs knowing that they "have adverse side effects in teenagers, including homicidal and/or suicidal propensities," and that this negligent prescription of medication "increased the risk that . . . [the teenager] would exhibit violent behavior, and . . . proximately cause him to shoot and kill" other people. The teenager did shoot and kill his neighbors. The defendant moved for summary judgment, arguing he owed no duty of care to third party strangers to the psychotherapist-patient relationship. The lower court denied the defendant's motion for summary judgment holding he might owe a duty to the plaintiffs even though they were strangers to the doctor/patient relationship. The Court of Appeals reversed. The Court correctly points out that the issue in the case is whether the defendant "owed plaintiffs a duty of care when making medical decisions regarding the treatment of his patient." And the answer is NO. The Court explains that the concept of duty exists to "limit the otherwise potentially infinite liability which would follow from every negligent act" and that it is not good policy to extend the reach of possible liability to include the plaintiffs' claim. A psychiatrist acting in good faith should not owe a duty of care to third parties foreign to the psychotherapeutic relationship. The Court goes on to explain that to determine whether to impose a duty, Courts should balance many factors, among which are the extent to which the transaction was intended to affect the plaintiff, the foreseeability of harm to him, the degree of certainty that the plaintiff suffered injury, the closeness of the connection between the defendant's conduct and the injury suffered, the moral blame attached to the defendant's conduct, and the policy of preventing future harm. Analogizing the application of the factors to the analysis used in a similar case in the past, the Court found relevant that the transaction between the defendant and the patient had not been intended to affect or benefit the plaintiffs in any way, that the transaction was intended to benefit the patient by providing him with therapy for his mental problems and that it was not reasonably foreseeable that the patient would harm the victims. I think the Court reaches the correct result here, but it could have made it made its discussion of the concept of duty a bit more clear. The problem is that the Court initially states the issue is one of duty (and that it can be decided by imposing a clear-cut no duty rule), but eventually seems to suggest that the case should be decided using a proximate cause analysis based on the foreseeability of the injury. These two approaches to limiting the scope of possible liability are not the same and the court does not seem to make the distinction particularly clear. If the result is based on a "no-duty rule" then there would be no liability regardless of whether the conduct of the patient or the injury to the victims is foreseeable. I may be overstating what the Court says, but it appears to suggest that there could be a cause of action if the conduct had been foreseeable. Given what the Court says about the concept of duty at the beginning of the opinion, however, I don't think that is what it really wanted to say. The opinion is available here.

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