One of the required elements of a medical malpractice case is duty. Physicians automatically have a duty towards their patients, but can they also have a duty to third-parties that might be injured by patients? This month’s case looks at this issue.

The physician, Dr. K, 64, was a primary care practitioner with an office in the suburbs of a large city. He was known among colleagues and patients alike as being compassionate and caring, and his bustling practice was a result of the positive word-of-mouth spread by his patients. Over the course of his long career, Dr. K had witnessed the cycle of life many times, yet it still affected him when he lost a patient, particularly when the circumstances of a patient’s death were part of a larger tragedy. Such was the case with Mr. P.

Mr. P was 72 years old when he began seeing Dr. K. The patient, a former construction worker who had smoked for over 40 years, was suffering from a variety of health conditions including chronic bronchitis, hypertension, emphysema, asbestosis, and lung cancer. Over the course of the next four years, Dr. K got to know the patient quite well. Mr. P came in at least every other month, often much more. During the time that Dr. K was treating him, Mr. Ps wife passed away, and Dr. K, himself a widower, empathized with his patient’s pain and distress.

A couple of years after he began seeing Dr. K, Mr. P began a course of chemotherapy for treatment of his lung cancer. Dr. K advised the patient not to drive while he was undergoing chemotherapy. During that one-year period, Mr. P grudgingly gave up driving. When he was finished with the treatment, he asked the physician if he could begin driving again, and Dr. K agreed that he could.

Another year passed. The patient, now in his mid-70’s, was on numerous medications, including metolazone, prednisone, potassium, furosemide, paroxetine, oxazepam, oxycodone, and tamsulosin. At most appointments, Dr. K would ask Mr. P about any side effects that he might be experiencing, but the patient reported no problems.

Things continued as usual, until one tragic morning when Mr. P got into his car to run some errands. At some point during the drive, he passed out and lost control of his vehicle. The car jumped the curb and ran onto the sidewalk, striking and killing a 9-year old child who was walking to school. Mr. P, who was unharmed in the accident, was rushed to the hospital, but checked himself out before the cause of his loss of consciousness could be determined. Over the next few weeks Mr. P went into a swift decline, both emotionally and physically. Within two months, Mr. P was dead.

The physician felt sorrow at the passing of his patient, and especially about the terrible circumstances that led up to it. However, it never occurred to him that he might be involved in any way. So, when Dr. K received papers notifying him that he was being sued by the family of the young boy who had been killed by Mr. P’s car, he was stunned.