Davis v. South Nassau Communities Hospital, 26 N.Y.3d 563

Background

On March 4, 2009 Lorraine Walsh presented to South Nassau Communities Hospital ER and was IV-administered Dilaudid and Ativan by Island Medical physicians/PA; she was discharged ~1½ hours later.
Walsh drove away and 19 minutes after discharge crossed a double yellow line and struck a bus driven by Edwin Davis; plaintiffs allege she was disoriented/medically impaired by the medicines.
Plaintiffs sued the treating clinicians and the hospital for malpractice/ negligence for failing to warn Walsh that the drugs could impair driving; defendants moved to dismiss for failure to plead a duty to nonpatients.
Supreme Court dismissed; the Appellate Division affirmed; the Court of Appeals granted leave and reinstated the complaint in part, holding that a duty to warn third parties exists in the circumstances alleged.
The majority held that when a medical provider administers medication that impairs or could impair driving, the provider owes third parties a duty to warn the patient of that danger; the duty can be satisfied by a simple warning.
A dissent argued the decision improperly expands physician duties to an indeterminate class, risks unlimited liability, harms the physician–patient relationship, and should be left to the legislature.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a treating medical provider owes a duty to injured nonpatients to warn a patient that medication administered may impair driving	Walsh’s treating clinicians had the best position to warn Walsh; failure to warn foreseeably caused harm to Davis	No physician–patient relationship with Davis; longstanding New York precedent limits duty to patient or identifiable third parties	Yes — where medication administered impairs or could impair driving, provider owes third parties a duty to warn the patient of that danger
Scope of the duty and how to comply	Duty should require reasonable precautions to prevent foreseeable harm to others	Imposing broader duties will create limitless liability and interfere with medical judgment	Narrow: duty limited to warning (not to restrain or prevent discharge); can be satisfied by advising the patient of driving-related risks
Whether plaintiffs could amend to plead ordinary negligence (rather than malpractice)	Plaintiffs sought leave to add a negligence claim based on “medical intoxication” causing the accident	Defendants argued the claim arises out of medical treatment and thus sounds in malpractice	Denied — the proposed claim sounds in medical malpractice, so amendment to plead ordinary negligence lacked merit
Policy balance: foreseeability vs. limitless liability	Foreseeability and the provider’s position to prevent harm favor recognizing duty	Expansion would expose physicians to indeterminate class and adverse social consequences	Court recognizes duty but emphasizes narrow scope to limit cost and avoid open-ended liability

Key Cases Cited

Leon v. Martinez, 84 N.Y.2d 83 (N.Y. 1994) (standard for reviewing CPLR 3211(a)(7) dismissal — accept pleaded facts and consider plaintiff affidavits)
Eiseman v. State of New York, 70 N.Y.2d 175 (N.Y. 1987) (physician’s duty runs to patient and identifiable parties relying on physician, not to the community at large)
Purdy v. Public Adm’r of County of Westchester, 72 N.Y.2d 1 (N.Y. 1988) (no duty to unidentified public to prevent or warn re: resident’s driving absent special relationship/control)
Tenuto v. Lederle Labs., 90 N.Y.2d 606 (N.Y. 1997) (duty extended to immediate family where physician’s treatment foreseeably risked harm to household members)
McNulty v. City of New York, 100 N.Y.2d 227 (N.Y. 2003) (refusal to extend physician duty to nonpatient absent the physician’s performance creating the risk and special relationship)
Hamilton v. Beretta U.S.A. Corp., 96 N.Y.2d 222 (N.Y. 2001) (duty questions are legal and require balancing foreseeability with social consequences)
Wolfgruber v. Upjohn Co., 52 N.Y.2d 768 (N.Y. 1980) (physician’s role as informed intermediary regarding prescription drug risks)