Physician found liable for malpractice for patient he never treated

The Minnesota Supreme Court ruled in favor of a patient in a malpractice case in which the physician never spoke to or treated the patient.

While this ruling will only impact physicians practicing in Minnesota, physician advocacy groups are vehemently opposed to the principles of the ruling, and the potential precedent it sets in regards to whether physicians who do not have a care relationship with a patient are liable of malpractice. The American Medical Association filed a brief in the case in support of the physician defendant.

In the case, Warren v. Dinter, the court ruled that the existence of a physician-patient relationship is not a prerequisite for a malpractice action.

"A physician-patient relationship is not a necessary element of a claim for professional negligence," the justices wrote in the decision. "A physician owes a duty of care to a third party when the physician acts in a professional capacity and it is reasonably foreseeable that the third party will rely on the physician's acts..."

The Minnesota Medical Association (MMA), which opposed the ruling, said in a news release that it could have "wide ranging implications" for physicians in the state.

“The overall expansive language in the court’s opinion does raise concerns,” said Mark Fogg, general counsel of COPIC, a malpractice insurer that works with the MMA. “We respectfully believe that it is important that a physician-patient relationship be established before any liability may occur for alleged medical malpractice.”

Here’s the details of the case: A patient named Susan Warren visited a health clinic complaining of abdominal pain, fever, and other symptoms. A nurse practitioner (NP) ran some tests, found an elevated white blood cell count, and tried to get the patient admitted to the hospital. A hospitalist, Richard Dinter, MD, took the NP’s call.

Dinter had a brief conversation with the NP, who had recommended hospitalization. Dinter did not recommend hospitalization, and also did not review the patient’s records. After the call, the NP did not further seek hospitalization. The patient later died from sepsis caused by an untreated staph infection. The patient’s family sued the NP and the physician for medical malpractice, and the case worked its way up to the state supreme court.

“The court’s decision to rely on a broader legal theory of ‘foreseeability’ represents a troubling change that puts Minnesota in the minority of states that do not require the existence of a physician-patient relationship for a malpractice action,” the MMA wrote in a news release. “This change may expose physicians and other health professionals to malpractice risk in a variety of actions that were previously protected, including unbilled consultations.”

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