Mead v. Legacy Health System
283 P.3d 904
Or.2012Background
- Emergency room doctor consulted on-call neurosurgeon for advice about plaintiff’s case; jury found no physician-patient relationship and no duty; Court of Appeals reversed directing verdict for plaintiff; Supreme Court granted review.
- On July 1, 2002 defendant, as on-call neurosurgeon for Legacy, received a call from a male ER resident seeking advice about whether plaintiff should be seen by a neurosurgeon; defendant advised admission to medical service for pain management and did not personally treat plaintiff.
- Plaintiff’s primary care physician admitted plaintiff; over the next days plaintiff deteriorated; defendant later examined plaintiff on July 5, diagnosed cauda equina syndrome, performed surgery, but nerve damage had already occurred.
- Plaintiff alleged an implied physician-patient relationship arose from defendant’s July 1 advice; covenants settled with Legacy and Leonard, leaving defendant as the sole defendant; trial court denied plaintiff’s directed verdict, and evidence and instructions were contested at trial.
- Court held there is evidence that could support a finding that no physician-patient relationship arose on July 1; expert testimony differed on whether defendant’s on-call status and advice created a duty; Court affirmed remand for a new trial due to improper instruction requiring intent, while rejecting peremptory instruction on remand.
- Court also acknowledged variance in on-call obligations and that the trial court’s instruction tracked trial evidence rather than a legal standard; case remanded for new trial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether there was sufficient evidence of an implied physician-patient relationship on July 1. | Mead argued on-call status plus advice implies diagnosis and duty. | Advice to a colleague does not automatically create a physician-patient relationship. | Evidence supported a possible no-relationship finding; jury could decide both ways. |
| Whether on-call status plus advice can, as a matter of law, create a duty. | On-call duties and advice should impose liability. | Obligations vary; such advice may not amount to a diagnosis or treatment. | Not a matter of law; is a factual question for the jury on remand. |
| Whether the trial court erred by instructions requiring an intent to diagnose. | Intent was required to imply consent to a physician-patient relationship. | Knowledge or reasonable belief of diagnosing suffices; intent not required. | Instruction error prejudicial; remand for new trial with correct standard. |
| Whether the Court should direct a new trial and how to frame the on-call standard on remand. | Remand for new trial; not a peremptory instruction on remand. |
Key Cases Cited
- Dowell v. Mossberg, 226 Or 173 (Or. 1961) (duty arises from contract and implied physician-patient relationship)
- Kelley v. Middle Tennessee Emergency Physicians, 133 S.W.3d 587 (Tenn. 2004) (implied relationship may arise when a physician undertakes to diagnose/treat or participates in such diagnosis/treatment)
- St. John v. Pope, 901 S.W.2d 420 (Tex. 1995) (on-call physicians may or may not have implied relationships depending on facts)
- Reynolds v. Decatur Memorial Hosp., 660 N.E.2d 235 (Ill. App. 1996) (informal town-to-colleague opinions do not create duty to patient)