Jeff Segal, MD, JD, FACS
Utah’s highest court ruled that family members can sue a doctor if something goes wrong with their loved one’s care. Doctors, of course, owe a duty of care to their patients. But, if their care affects non-patients…well, that is mostly new territory.
Dr. Hugo Rodier, a primary care doctor, prescribed antidepressants (and other medications with potential psychiatric effects – such as steroids) to his patient, David Ragsdale.
Ragsdale’s wife, Kristy had requested a restraining order against him. Unfortunately, the restraining order was not effective – Ragsdale gunned down his wife. Ragsdale pled guilty to first degree felony murder and is serving a 20 years to life prison term. He supposedly took full responsibility for his actions. One caveat. He said he would not have murdered his wife had he not been on the medications.
Ragsdale’s children (via a conservator) filed a medical malpractice lawsuit. A lower court dismissed the suit noting the plaintiffs were not the doctor’s patients.
Utah’s Supreme Court overruled.
“Healthcare providers perform a societal function of undoubted social utility. But they are not entitled to an elevated status in tort law that would categorically immunize them from liability when their negligent prescriptions cause physical injury to nonpatients,” Justice Thomas Lee wrote in the high court’s unanimous opinion. “We uphold a duty of healthcare providers to nonpatients in the affirmative act of prescribing medication.”
So, there you have it. The list of potential plaintiffs is long.
Thats weird.I am not sure what medicine will make you murder someone.
Actually it’s not the first of its kind, at least that I know of: when sildenafil came out there were a lot of unintended side-effects. There were two suits that I had read about, one by a woman who complained that her paramour, now newly re-potent, had taken off since he would be able to appreciate and be appreciated by young women; the other by a woman who complained that it had totally disrupted the equilibrium that she and her husband had had for many years–he was eager and able and she didn’t like that.
What I don’t recall clearly is whether the suites were against the physicians, the pharmaceutical company, or both, but it seems to me that both were involved.
The instant case is weak on its merits: how would the murderer know what he alleges, namely that he wouldn’t have pulled the trigger if he hadn’t been on anti-depressants? That’s an opinion, and possibly a correct one, but I can’t see how easily that can be proven. It’s also necessary that the plaintiffs show that what the doc did was beyond the scope of standard of care. Sounds supremely frivolous to me. MJ might want to take a stand here to nip this in the bud.
An example of absurd abuse of power. If this case had been litigated in NY or NJ, I wouldn’t have been surprised. For example, it is well known that NJ’s Highest Court has over the past couple of decades been especially active in “creating” rights that previously did not exist. In matters of general constitutional law, their are at least two instances where the Court ruled that while the plaintiff’s actions were unconstitutional, a ruling in favor of the constitution would have created an untoward disruption and burden. Really. Therefore, I’m somewhat surprised to see such a preposterous ruling from Utah, generally considered a more conservative state without a history of activist jurisprudence. This case along with the one cited last week (A Lawsuit Proceeds: Patient Had no Physical Injury) demonstrates how the courts have usurped legislative authority in expanding tort law to the point of absurdity.
If someone is prescribing antidepressants and other medications that have side effects for a valid indication and something untoward happens – where do we draw the line as a society? Logically a boundry must exist because without one, the very question itself is absurd. To control this egregious overstepping of constitutional authority, state legislatures should pay more attention to issues of fundamental constitutional import because they, not the courts, codify the rules that ultimately define the society that we are a part of. Subscribing to this absurd jurisprudence is also irrational because virtually any situation wherein a human being commits a felony could be ascribed to any infinity number of interactions deflecting culpability. This is not the basis of Tort law here nor in any country that I am aware of. I do not want to live in a society where a court, while well intentioned as it may be, sees it as its responsibility to create ever expansive theories of negligence and responsibility where one did not previously exist. The separation of powers and the duty of the llegislature to direct behavior and interpreted by the Courts are principles that we, as Americans, hold dear and must uphold. It’s what makes America and its people unique in the civilized world. We should be proud of this and not make excuses for it. Judicial malfeasance is best dealth with by the process of impeaching the jurist or voteing said individual out of office for abuse of power.
I can only assume that the members of the high court are all contortionist, or they could not have developed the convoluted legal reasoning required. The patient admitted his personal responsibility. The excuse “I wouldn”t have done it except for the meds.” is incredibly weak. Where was expert testimony? If the high court follows this line of reasoning, then the car dealer who sells a car to someone who subsequently drives it into a school bus is liable, as the act wouldn’t have been possible had he not sold the car. How can a physician possibly know who a patient will come into contact with and who may “tip him over the edge”? Do we just stop providing antidepressants? Narcotics? Quinolones? Or just stop prescibing altogether, pat the patient sympathetically on the hand and tell them “Gee, I wish I could help, but…”.
It would seem, at the least, that equal protection under the law is being bashed here.
I am not a believer in banning guns at all, but really, how are the drugs the only things that are culpable in this story? He would not have killed his wife if it weren’t for the drugs?! Really? What about the gun? Would that have made a difference? It seems that the gun is more an agent to cause the woman’s death than the antidepressants.
And what about the probable numerous obstacles to mental health care? Every time there is a sensationalized killing reported in the news, you find that on further investigation, there were signs of potential harmful outcome that those around the perpetrator chose to ignore or there was no reliable access to mental health. So many insurance plans have shoddy mental health and it always surprises me that we don’t have a national debate about that whenever there is a senseless killing reported.
In this person’s case, there was a restraining order in place. Are the law enforcement agents responsible for enforcing this order also guilty? where were they? When did he buy the gun? Before or after the restraining order? Either way, shouldn’t the gun have been taken away from him?
so many questions about accountability here waaaay before the doctor’s culpability. I wonder why the lawyers don’t go after the drugs itself rather than the doctor who prescribed it.
Much “deeper pockets” there….
My son recently started medical school. I attended the opening ceremony welcoming the incoming students. I was never more proud to be a physician as I listened to the fine, articulate, intelligent and selfless nature of the professors and Dean of the medical school as they spoke. At the conclusion, all of the physicians in the audience were asked to stand and renew the Hippocratic oath. A great moment. My son is now laboring and sacrificing nearly all of his time to learn how to care for others. This will take him at least 8 years if he only does 4 years of post-graduate training. Since the private practice of medicine is disappearing he will then probably work for some type of managed care organization such as an ACO or “non-profit” (what a lie!) company that will tell him how and in what maner they want him to treat their customers while he assumes total responsibility and liability for the outcomes. The customers will demand immediate care with perfect results and if this doesn’t happen they (and now their families) can use the Monday Morning Quarterback Society otherwise known as State Bar Association to attack my son. As I walked out of my his ceremony I couldn’t help by think that at the other end of the campus the first year law students were getting started. After only three years they will be given a hunting license to steal and destroy my son’s livelihood and reputation as newly minted quarterbacks creating nothing but cost burdens to health care. How would Justice Lee classify their “societal utility”?
As I read it the court ruled on the concept that a relative could sue a doctor, not on this particular case.
I can’t imagine the actual case will go far– a murderer blames his actions on a medication? Impossible to prove unless there are many cases that prove it can happen.
I would like to see if Lawyers have an accountability too. They should make it public how much money they make and what is there data on how they are suing doctors and what is the failure rate.
In a country in which there is more than 50% of chance of being sued after coming out of medical school,that country must be full of “real bad” doctors. Yet ,the whole world knows we have the best doctors and best healthcare delivery system.
As a lawyer, it seems that some readers may not be understanding this ruling in the way that a lawyer would. The UT State Supreme Court ruling did not decide the case “on its merits.” The lower court had denied the right of the children to even make the claim against the doctor. More than likely, this denial of right was done on a “pre trial” motion. All the UT Supreme Court did was to reverse the trial court’s dismissal of the children’s claim against the doctor.
In other words, it is most likely that there was no trial on the facts, just a ruling on UT law by the trial court. Consequently, the UT Supreme Court order would “remand,” or send back, the case to the trial court for its further disposition in light of their decision. So then, the children would have the burden of presenting their case in chief to the trial court with all of the required supporting facts and legal theories according to existing law. The UT Supreme Court did not find that the doctor was liable to the children, only that the children had the legal right to make a claim of damages in the first place.
Mr. White’s posting above seems to minimize the ruling of the Utah Supreme Court. While it is accurate to say that the Utah Supreme Court did not look at the merits of the claim, the court did open up a whole new world of liability for Utah physicians. The fact that the children did not receive a monetary damage award from the Utah Supreme Court seems to completely miss the point. A trial will now ensue where tens of thousands of dollars of expense will be incurred. This all seems a matter of perspective. From the children’s perspective all they have now is a legal right to go to court. From the physician’s perspective, they can now be sued by individuals that they have never met for actions of his/her patients.
It is unclear to me if the liability exposure will stop at the immediate family level in Utah, or expand to all persons. For example, what if a diabetic patient is treated by an endocrinologist in Provo, Utah? For a variety of reasons, the patient slips into unconsciousness. Unfortunately this period of unconsciousness comes as he is driving next to a school yard. His car goes off the road, through a fence and kills eight children. Does each of those eight families have cause of action against the endocrinologist for the patient passing out and killing their children? Traditionally these children’s families would not have a cause of action. Now, it seems they may. How do they know what kind of care the driver had received from his endocrinologist? Well, they will simply have to litigate the matter.
Imagine the cost that will be charged in insurance premiums to physicians now that they may be sued by any member of the public and not just their patients. This ruling expands the range of liability so far as to make the system unworkable. What psychiatrist is going to treat the pyromaniac who might burn down an apartment building? The liability is simply going to be too great to care for individuals who most need it. This is where I part ways with Mr. White and the Utah Supreme Court. By imposing unlimited and undefined liability upon physicians, the litigation flood gates have been opened.
Here you go. IN Hoover v. Hunter SC of Idaho 2011 it was found that lying to the family and cheating on all again all of the reports was medical malpractice not fraud to the family even though the lies happen to the husband only. My wife only lived for two weeks after this screw up and under abatement law you loose all claims. There is no malpractice to me.. She was not my doctor. Again duty of care.. . The only reason my wife had surgery was that it was safe. It is not safe when the doctors turn off all of the warning alarms of the life support monitors.. they said it was the hospital policy to turn off alarms during surgery because if the alarms would go off it might wake up the patient. I think my wife would have had rather been woken up by the alarms then to die from suffocation since the alarms did not go off when she went into breathing arrest. I am a retired fire fighter and we use these monitors for heart rate, breathing etc and yes we do not turn off the alarms since we can not just watch each light as we do our EMS. The lies from the doctor and hospital happen 6 months later to the family and again for the next two years but the court said that each time the doctor or hospital lied to the family it was one time. Being also a CPA for over 20 years and you lie on the F/S of the client you will be held to that third party you know about and that is right.. But like the law guys above said there is no duty to the family and just like me selling a car and telling the purchaser who asked about the breaks are they good? You buy the car and then you hit the breaks and they do not work and you kill someone. Tort has always been yes you have a wrongful death action against me and my defense would have been i was lied too. and I would have a breach of contract or fraud action against the seller of the car but now the courts are screwing with claims and now no one knows which claim of action you should file. another perfect example is i see this Rolex watch for sale. the guy sell me the watch for 500 and says it worth 1,000.00 I get it appraised and then told it is a fake rolex is only worth 100.00.. I can either sue for breach of implied contract or fraud depending upon which damages is better.. Again the courts are messing with tort , and contract law and making it impossible for anyone to gain a remedy. Now also since you can lie about the reports you would be only held to the two year statute of limitation since it is not fraud which allows the party to use upon the knowledge of the lie. Now it works for the doctor to lie wait two years since it is not fraud but malpractice when you like to the family and the reports. Yes the lies were in the affirmative when asked by the family why they did not do this or that when it was discover the patient was suffocating. ? Also why the alarms did not go off when asked and then two years later during a investigation by the medical board did it come out that they lied t o the family and the reports that they had turn off the alarms.. Hoov