Doctors can be sued for third-party injuries

After David Ragsdale shot his wife to death in a church parking lot, the woman’s family decided Ragsdale was not the only person responsible.

Relatives sued Ragsdale’s family physician, Hugo Rodier, MD, and a nurse, claiming that a toxic combination of prescriptions led to Ragsdale’s deadly actions. Dr. Rodier’s attorneys argued that Ragsdale’s children had no standing to sue because they had no patient relationship with the medical personnel.

The Supreme Court of Utah on Feb. 28 ruled in favor of the children, finding that Dr. Rodier and his staff can be held liable for their patient’s actions. The decision will impact how doctors practice medicine and force them to consider all third parties who might be affected by a prescription decision, said Mark Fotheringham, a spokesman for the Utah Medical Assn.

“Physicians are now expected to risk their livelihoods for the unforeseeable, rare case of one patient who reacts badly and harms others,” he said in an email. “If we establish a duty of care for anyone who might possibly be harmed by the one patient who reacts badly to a regimen that has worked well for others, we will likely lose that regimen for everyone.”

Ragsdale killed his estranged wife in 2008. A guardian for Ragsdale’s children sued nurse practitioner Trina West, Pioneer Comprehensive Medical Clinic and Dr. Rodier in 2010. West prescribed Ragsdale various psychotropic drugs, antidepressants and steroids without consulting Dr. Rodier or warning Ragsdale of the side effects, according to the lawsuit. Dr. Rodier failed to properly oversee Ragsdale’s medical visits or monitor West’s prescription decisions, the suit said. In general, nurses in Utah have prescribing rights under certain circumstances.

Attorneys for Dr. Rodier said the doctor never saw the patient nor was he asked to consult about the medications. In addition, Ragsdale pleaded guilty to his wife’s slaying, precluding the family from proving that he killed his wife due to his medication, they said. Dr. Rodier and West denied wrongdoing.

A lower court found in the defendants’ favor. The family appealed. The Supreme Court of Utah agreed to hear the case, bypassing an appellate review. The Litigation Center for the American Medical Association and the State Medical Societies, along with the Utah Medical Assn., filed a joint friend of the court brief, expressing concern about the case’s potential consequences.

In the high court’s opinion, justices said a special relationship, or physician-patient relationship, need not underlie a doctor’s duty to third-party plaintiffs.

“When potential risks might outweigh potential benefits for a given activity, tort duties incentivize professionals — whether physicians, mechanics or plumbers — to consider the potential harmful effects of their actions on both their clients/patients and third parties,” the court said. “Health care 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 physician injury to nonpatients.”

At this article’s deadline, an attorney for Dr. Rodier had not returned messages seeking comment. The ruling means the lawsuit will go back to a trial court.

Ruling impacts how doctors practice

The decision clarifies state law and brings Utah in line with other states that recognize that health professionals have a responsibility to third parties, said Tyler Young, an attorney for the plaintiffs.

“In Utah, prior to this, doctors didn’t owe an obligation to people who were not their patients,” he said. “We thought that rule was too broad. If the doctor created the dangerous situation, [now] they can be sued.”

Young said he hopes the case encourages doctors to interact more frequently with their nurses to monitor nurses’ treatment decisions. He does not believe the ruling will create more lawsuits against doctors, because most of them properly manage their patients’ medications.

The ruling probably will make physicians hesitant to prescribe medications, Fotheringham said.

“Prescribing medication is not an exact science, especially when it comes to mental health, and patients are not manufactured on an assembly line,” he said. “Until such time as science can assure us of how any one person will react differently from another, physicians have to play the odds. But this ruling just changed the odds. The losers will be the patients who would likely be helped by the antidepressants or other mental health medications, which their physicians or other providers will now think twice about prescribing.”