In a case that could have wide-reaching implications for
medical practice in Minnesota, the Minnesota Supreme Court issued a ruling on
April 17 in the case of Warren v. Dinter holding that the existence of a
physician-patient relationship is not a prerequisite for a medical malpractice
action. Rather, a person may sue a physician for malpractice – even if that
person was not a patient of the physician – if the harm suffered by the person
was a “reasonably foreseeable consequence” of the physician’s actions.
The MMA partnered with the AMA and the Minnesota Hospital
Association to participate in the case as amici curiae, forcefully arguing that
expanding physician liability outside of the physician-patient relationship
would damage physician collaboration and informal consultation and ultimately
harm patients. Despite this counsel, the Court issued a ruling that may hinder
a physicians’ ability to collaborate with care partners.
“The overall expansive language in the Court’s opinion does
raise concerns,” said Mark Fogg, COPIC’s General Counsel. Colorado-based COPIC
is the MMA’s endorsed medical professional liability insurance (MPLI) provider
for its members. “We respectfully believe that it is important that a
physician-patient relationship be established before any liability may occur
for alleged medical malpractice.”
The Warren v. Dinter case arises out of the care provided to
a woman (Susan Warren), who complained of abdominal pain, fever, chills, and
other symptoms to a nurse practitioner at Essentia Health Clinic in Hibbing.
After testing showed that Warren had an elevated white blood cell count, the
nurse practitioner suspected infection and sought hospitalization for her at
Fairview Range Medical Center. The nurse practitioner’s call was randomly assigned
to a hospitalist at Fairview to discuss admission.
After a brief conversation, during which the physician was
unable to view the patient’s medical record, the physician and the nurse
practitioner discussed hospitalization and whether the elevated white-cell
count and blood sugar could be the result of diabetes. The physician did not
recommend hospitalization during the conversation and the nurse practitioner
did not seek hospitalization for the patient following the conversation. The
patient subsequently died from sepsis caused by an untreated staph infection.
Warren’s family sued both the nurse practitioner and the physician for medical
malpractice.
Before its ruling April 17, Minnesota law has generally
required the existence of a physician-patient relationship to sustain a
malpractice action against a physician. 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. This change may expose
physicians and other health professionals to malpractice risk in a variety of
actions that were previously protected, including unbilled consultations.
Although the ruling puts Minnesota physicians in uncertain legal territory, it
does not change the underlying duty that physicians have to their patients and,
more generally, to maintain a professional and ethical medical practice.
The MMA is developing resources for physicians to better
understand their legal risks following the Warren v. Dinter decision and is
exploring policy options to ensure that physicians can continue to collaborate
with their peers and provide the best care possible to their patients.
https://www.mnmed.org/news-and-publications/News/MN-Supreme-Court-Rules-Physician-Patient-Relations?utm_source=Informz+Email&utm_medium=Informz&utm_campaign=Informz+Emails&_zs=7CPLX&_zl=kE8b1
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