2023 IL App (4th) 220238
Ill. App. Ct.2023Background
- July 26: Decedent presented to Graham Hospital ED with severe neck/trapezius pain; ED physician Dr. McMillin ordered labs (WBC, ESR) and considered infection but diagnosed torticollis as most likely and contemplated admission or close follow-up.
- McMillin did not have admitting privileges; he called on-call internist Dr. Kenneth Krock (employed by Coleman under a contract with the hospital) to discuss whether the patient should be admitted.
- During the ~8:57 p.m. call McMillin relayed history, exam findings, and test results; admission was discussed as a collaborative decision but, under hospital protocol, the ultimate authority to admit rested with Krock.
- Following the call, the patient was discharged with instructions to follow up with his PCP; infection remained on the differential. The patient returned July 29 in septic condition, was diagnosed with a spinal epidural abscess, and later died.
- Plaintiff amended to add a negligence claim against Krock and Coleman, alleging a physician-patient relationship and duty arising from the consultation; Krock moved for summary judgment arguing no physician-patient relationship/duty. The trial court granted summary judgment; plaintiff appealed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a telephone consultation between the ED physician and the on-call physician created a physician–patient relationship (and thus a duty) | Blagden: Krock was a contractually obligated, compensated on-call physician who was consulted about admission, received specific patient info, participated in the decision and had authority to admit — creating a special physician–patient relationship and duty | Krock/Coleman: the call was an informal confirmation or advisory conversation; Krock merely gave advice and did not perform services, treat, or accept the patient — no physician–patient relationship or duty | Reversed SJ: undisputed facts show Krock was contractually on-call, compensated, received case-specific information, participated in and had authority over admission decisions — a special relationship (physician–patient) existed and a duty may be owed; case remanded. |
Key Cases Cited
- Bovara v. St. Francis Hospital, 298 Ill. App. 3d 1025 (1998) (consulting/interventionist physicians who review tests, render opinions, and decide treatment can have a special relationship creating a duty)
- Lenahan v. University of Chicago, 348 Ill. App. 3d 155 (2004) (physician who reviews results and makes treatment/admission determinations may owe duty despite no in-person exam)
- Reynolds v. Decatur Memorial Hospital, 277 Ill. App. 3d 80 (1996) (an informal opinion given as a courtesy, without billing or specific services, does not create a physician–patient relationship)
- Weiss v. Rush North Shore Medical Center, 372 Ill. App. 3d 186 (2007) (on-call psychiatrist who only arranged follow-up care did not form a physician–patient relationship)
- Gillespie v. University of Chicago Hospitals, 387 Ill. App. 3d 540 (2008) (post-discharge test interpretation that did not inform contemporaneous treatment did not create a duty)
- Siwa v. Koch, 388 Ill. App. 3d 444 (2009) (special relationship arises where a physician takes affirmative action to participate in care, evaluation, diagnosis, or treatment of a specific patient)