Third parties can’t sue doctors when injured by patients, says state high court

The Connecticut decision conflicts with other state courts that have held physicians liable for harm to nonpatients.

By Alicia Gallegos — Posted Oct. 8, 2012

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Physician advocates are praising a Connecticut Supreme Court ruling they say protects doctors from being sued unfairly by third parties who are injured by patients.

In a Sept. 17 decision, judges said physicians owe no duty to nonpatients who are harmed because of a patient’s medical condition. The ruling contrasts with state Supreme Court opinions in similar cases.

The Connecticut ruling prevents doctors’ obligations from being expanded to third parties, said Layne Gakos, general counsel for the Connecticut State Medical Society. The society was not involved in the case.

“It’s a very important ruling,” Gakos said. “If this case had gone the other way, it would have had a detrimental effect on the physician-patient relationship. It essentially would have imposed [a] duty on physicians to constantly be on the lookout for third [parties]. It would have changed the way physicians practice medicine.”

The case stems from a June 2006 visit by Mary Ann Ambrogio to the Gastroenterology Center of Connecticut, PC, in Hamden. Ambrogio was diagnosed and treated by gastroenterologist Frank Troncale, MD, for liver and kidney ailments, including hepatic encephalopathy, according to court documents.

As she was leaving Dr. Troncale’s office, Ambrogio passed out in her vehicle and struck pedestrian John Jarmie. He sued Dr. Troncale for negligence. He claimed that Dr. Troncale had violated the standard of care by failing to warn Ambrogio of the latent driving risks associated with her condition. Ambrogio, who was not seriously injured, was not a party in the suit.

Dr. Troncale denied any wrongdoing. A trial court ruled in favor of the doctor, and Jarmie appealed to the Connecticut Supreme Court.

In their decision, judges said forcing doctors to be responsible to nonpatients would have negative consequences on health care delivery.

“A physician whose attention is diverted from the patient to the effects of his advice on unknown persons who could be harmed by the patient’s future conduct may, understandably, become less concerned about the particular requirements of any given patient, and more concerned with protecting himself or herself from lawsuits by the potentially vast number of person[s] who will interact with and may fall victim to that patient’s conduct outside of the treatment setting,” the court said. “In other words, a physician’s desire to avoid lawsuits may result in far more restrictive advice than necessary for the patient’s well-being.”

Ruling may impact other states

The Connecticut ruling diverges from a similar motor vehicle case in Massachusetts in which justices reached an opposite conclusion.

In that case, family members sued a physician after his patient lost consciousness while driving and struck a child, who died. The plaintiffs claimed that the crash was caused by effects from a medication the doctor prescribed.

In 2007, the Massachusetts Supreme Judicial Court ruled in favor of the plaintiff. The court said physicians owe a duty to people foreseeably put at risk by doctors’ failure to warn about the effects of a provided treatment.

Other courts have ruled similarly in third-party injury cases. For example, the Supreme Court of Utah ruled in February that a family physician could be sued for medication mismanagement after a patient shot and killed his wife. Relatives claimed that a toxic combination of prescription drugs led to the patient’s actions. The doctor in question denied wrongdoing.

In 2011, the Supreme Court of Georgia ruled that a psychiatrist could be sued for medication negligence after a patient fatally attacked his mother. The patient’s father said the doctor’s discontinuation of his son’s antipsychotic medications aggravated the patient’s violent tendencies.

Judges made the correct decision in the Connecticut case, said Eugene A. Cooney, Dr. Troncale’s attorney. The Jarmie case was unique because it did not relate to the administering of medication or a specific treatment, but rather the impact of a medical condition, he said.

“The big difference here is that this was an ongoing disease process,” he said. “This is a case involving a clinical assessment of the patient and when it’s appropriate to start giving warnings to the patient about driving risks. The doctor had not yet seen immediate evidence to suggest there was some type of immediate harm present.”

The court recognized that telling a patient about an eventual side effect of an ongoing disease is a medical judgment call that courts should not interfere with, he said.

Doctors are in the best positions to give guidance to patients about their medical conditions, which Dr. Troncale failed to do, said Steven Ecker, Jarmie’s attorney.

“Our position was that his duty to Mr. Jarmie, and anyone else who could’ve been injured, is coterminous with his duty to his patient,” he said. “If the doctor satisfies the standard of care as it relates to the patient, then the doctor cannot have any liability to us. We’re not claiming some extra duty or a different duty; we’re claiming an identical duty that he would have” had to the patient.

The Connecticut case probably will impact future state courts that face similar cases, Cooney said. It “calls into question the cases that have gone the other way,” he said. “I think the strength of this opinion is going to mean it gets cited an awful lot.”

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Case at a glance

Can physicians be held liable to third parties who are injured by patients?

The Connecticut Supreme Court said no. Physicians owe a duty to nonpatients only in narrow circumstances, the court said. Forcing doctors to be responsible to third parties would have negative consequences on health care delivery and harm the physician-patient relationship, judges said.

Impact: The ruling discourages third parties from suing physicians and protects the doctor-patient relationship.

John Jarmie v. Frank Troncale et al., Connecticut Supreme Court, Sept. 17 (link)

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External links

John Jarmie v. Frank Troncale et al., Connecticut Supreme Court, Sept. 17 (link)

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