'Dead People Don't Move,' a Witness Says; More

Wayne J. Guglielmo, MA

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June 18, 2019

In This Article

Doctor-Patient Relationship Not Necessary for Malpractice Action, Court Rules

In a decision that has rattled the state's medical and legal communities, the Minnesota Supreme Court ruled last month that doctors can be sued for medical malpractice even when no standard physician-patient relationship exists, as a story in the Star Tribune and other news sources reports.[4]

The high court ruling is based on a case originating in the state's Iron Range, a region rich in iron ore deposits. In August 2014, Susan Warren went to Essentia Health Clinic, in Hibbing, complaining of abdominal pain, fever, chills, and other symptoms. After obtaining Warren's test results, a nurse practitioner (NP) phoned Fairview Range Medical Center, a local hospital, with which Essentia had a working agreement regarding admissions.

The NP spoke to Richard Dinter, a hospitalist at Fairview, who, after a 10-minute conversation, refused the admission. (Among the details in dispute in the case is whether a formal request for admission was ever made.) Sent home, Warren died 3 days later. An autopsy revealed that she died of sepsis, brought on by an untreated staph infection.

In 2015, Warren's son sued Essentia, which settled for an undisclosed amount. The following year, he also sued Fairview and Dinter. Both the district court and appeals court dismissed the suit, on the grounds that Dinter wasn't directly treating the patient and thus didn't have a standard doctor-patient relationship. The state Supreme Court reversed the lower court rulings, however, noting that there were legal precedents for its decision that went back 100 years. "We have never held that...[the doctor-patient] relationship is necessary to maintain a malpractice action under Minnesota law," Justice David Lillehaug wrote for the 5-2 majority.

Although the court's ruling may have been based on precedent, it nevertheless alarmed the state's physician community. "It seems to be changing the conventional wisdom around when liability exists," said Janet Silversmith, CEO of the Minnesota Medical Association.

The high court's decision sought to allay these fears: "Our decision today should not be misinterpreted as being about informal advice from one medical professional to another. This case is about a formal medical decision."

As for the suit against Fairview and Dinter, it's likely to hinge on the legal concept of "foreseeability of harm." In other words, when Dinter denied Warren admission to Fairview, could he reasonably foresee injury to her if his refusal proved wrong or negligent?

That's the question, experts say, the trial court will need to decide.

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