January 2016: Third Parties and Medical Malpractice: What You Need to Know

Publication Quarter: 
Wiinter 2016 (January)

In December 2015, the New York Court of Appeals issued an unexpected decision in the case of Edwin Davis v. South Nassau Communities Hospital (Davis) that extends physician liability to third parties. In Davis, the Court of Appeals ruled that South Nassau Communities Hospital could be held liable for injuries sustained by Edwin Davis in an automobile accident, despite the fact that the hospital had not treated Mr. Davis and neither the hospital's employees nor its vehicles were involved in the accident.

The decision in Davis represents a significant development in the medicolegal field, with ramifications for providers statewide. This month's tip reviews the Davis case and offers strategies for physicians and hospitals to protect themselves from potential third-party claims.

Factual Background 

On March 4, 2009, Lorraine A. Walsh was treated in the emergency department at South Nassau Communities Hospital. During treatment, Ms. Walsh was intravenously administered Dilaudid—an opioid narcotic painkiller, and Ativan—a benzodiazepine. Allegedly, these drugs were administered without warnings that they could impair her ability to safely operate an automobile. Shortly thereafter, Ms. Walsh was discharged and drove away from the hospital, while allegedly impaired by the medications. Her automobile crossed a double yellow line and struck a bus driven by Mr. Davis.

Mr. Davis subsequently sued South Nassau Communities Hospital. The hospital asked the court to dismiss the lawsuit because the hospital had not treated Davis and had no physician-patient relationship with him. However, the court did not dismiss the case based on existing law; instead, the court expanded the scope of a doctor's duty and recognized that Mr. Davis had a claim under New York State law.

Discussion

In discussing the issues presented to the court for consideration, Judge Eugene M. Fahey, writing the majority opinion, stated:

[H]ere we are confronted with the question whether third party liability can attach when a hospital administered drugs to a patient and then released her, in an impaired state, without any warning that the drugs affected or could have affected her ability to safely operate a motor vehicle.

Stated differently, the main question is whether defendants owed a duty to plaintiff (Edwin Davis) ... to warn Walsh that the medication defendants gave to Walsh either impaired or could have impaired her ability to safely operate a motor vehicle following her departure from the Hospital.

The court went on to agree with Mr. Davis and found that the hospital (and the involved physicians) had a duty to Mr. Davis to inform Ms. Walsh of the potential risks and side effects of the medications administered to her. The court agreed that failure to warn Ms. Walsh could make the hospital liable to Mr. Davis. The court did, however, reinforce that it was "mindful that in addressing the modification of a legal duty, its reach must be limited by what is foreseeable."

The court went on to explain:

Any expansion of duty is a power to be exercised cautiously, but it is a power that must be used if the changing needs of society are to be met. The court reviewed the many fact patterns where it has declined to expand the duty of a medical provider, and discussed the few unique situations where it has.

In the above case the court justified its decision by declaring:

Here, put simply, to take the affirmative steps of administering the medication at issue without warning Walsh about the disorienting effect of those drugs was to create a peril affecting every motorist in Walsh's vicinity. Defendants are the only ones who could provide a proper warning of the effects of that medication. Consequently, on the facts alleged, we conclude that defendants had a duty to plaintiffs to warn Walsh that the drugs administered to her impaired her ability to safely operate an automobile.

Those interested in gaining a deeper understanding of the Court's actions in Davis are encouraged to read the full text of the decision, available here.

How the Davis Decision Affects Providers

The Court of Appeals did not rule on the allegation central to Mr. Davis's case-whether South Nassau Communities Hospital and its physicians failed to provide Ms. Walsh with an adequate warning about the "disorienting" effects of the medications it was administering. Rather, the Court of Appeals ruled on Mr. Davis's right to bring such a suit. It will be up to a jury to determine whether the hospital and its physicians adequately warned Ms. Walsh about the medications administered to her based on the medical records produced at trial and the testimony of the involved parties.

The Court of Appeals has opened the door for third parties to sue medical providers in cases when treatment rendered to a patient allegedly results in harm to the third party. Given the current legal landscape, FOJP recommends that providers do the following:

  • Inform patients—both verbally and in writing—about the risks, benefits, and alternatives of the medications being prescribed or administered.
  • Answer all questions related to the medications being prescribed or administered.
  • Document any and all conversations about medications in the relevant record (e.g., discharge summary, progress note, clinic record).

Virtually all physicians provide medication information to patients verbally. Thoroughly and accurately documenting all such conversations will help protect providers in case of a liability claim.

FOJP is mindful that future plaintiffs may try to extend the decision regarding third parties to areas beyond the narrow fact pattern in Davis. As always, we will be vigilant in protecting our clients from unnecessary liability.