The patient’s widow consulted with a plaintiff’s attorney and after a discussion and examination of the medical records, the widow decided to sue. To Dr. J’s shock and surprise, he was sued along with Ms. D, even though he had never seen the patient, nor reviewed the patient’s chart. The lawsuit caused a rift between the clinicians. Their working relationship turned hostile and fell apart. Dr. J was angry at being drawn into a lawsuit that he felt was none of his business. He hired a defense attorney who filed a motion to dismiss the case, based on the assertion that he owed no duty of care, which is a required element for a medical malpractice case, because he never saw or treated Ms. D’s patient.

The trial court, however, ruled that Dr. J did owe a duty of care to the patient, and refused to dismiss the case against him. Dr. J appealed to the state’s Court of Appeals. During the appeal, he argued that he had never even seen the patient’s file, that the patient was not his patient, and that the only one who owed a duty of care to the patient was Ms. D. The Court of Appeals disagreed and held that Dr. J did have a duty to the patient.

Legal Background

Dr. J argued that since he had no doctor-patient relationship with the patient, he owed no duty to that patient. He argued that the mere existence of a collaborative practice agreement did not create a physician-patient relationship. While the Court of Appeals agreed that a collaborative practice agreement doesn’t automatically create a doctor-patient relationship, it held that healthcare practitioners can still sometimes owe a duty to a third party to whom they have not provided care. In analyzing whether a duty existed, the Court of Appeals looked at 3 factors: 1) the relationship of the parties; 2) the reasonable foreseeability of harm to the person who was injured; and 3) public policy concerns.

While there was no direct relationship between Dr. J and the patient, the court held that when a physician voluntarily enters into a contract with a nurse practitioner pursuant to which he agrees to provide oversight of her prescriptive practices, the purpose is for the protection of the NP’s patients. The court found this to weigh in favor of a duty.

When looking at the second factor—foreseeable harm—the court noted that Dr. J admitted that his failure to adequately supervise and review Ms. D’s charts, as required by their collaborative practice agreement, could result in harm to her patients. This also pointed toward a duty by the physician, because he knew his action or inaction could affect Ms. D’s patients.