493 P.3d 592
Utah2021Background
- Jacob M. Scott, then 17, was injured (shattered knee) after slipping while descending a rock formation during a group hike run by Wingate Wilderness Therapy (Wingate).
- Wingate operates a licensed "wilderness therapy"/outdoor youth program that employs licensed therapists who drafted treatment plans and field staff who implement wilderness activities.
- A Wingate marriage-and-family therapist prepared a treatment plan for Jacob that expressly included "hiking (exercise)", immersion in wilderness experiences, and outdoor survival skills.
- During a supervised hike (field staff present), youths were allowed to climb a large rock formation without climbing gear or physical assistance; Jacob fell and was severely injured.
- Jacob sued for negligence; the federal district court dismissed, holding the Utah Health Care Malpractice Act (the Act) applied and Jacob failed to meet the Act's prelitigation and statute-of-limitations requirements. The Tenth Circuit certified to the Utah Supreme Court whether the injury "relates to or arises out of" health care under the Act.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Scope of "health care": whether hiking/rock-climbing during wilderness therapy qualifies as "health care" under the Act | Scott: only traditional counseling by licensed providers is "health care"; wilderness activities by field staff are non-medical and outside the Act | Wingate: wilderness activities are part of the therapist's treatment plan and thus are "health care" when provided pursuant to that plan | Held: "Health care" includes acts or treatments performed for/on behalf of a patient during the patient's treatment; hiking/wilderness activities prescribed in a treatment plan can be "health care." |
| Meaning of "relat[e] to or aris[e] out of": whether the phrase requires proximate causation or merely more than a tangential connection | Scott: Act should not reach injuries only tangentially related to treatment; suggests narrow application | Wingate: argues a proximate-causation standard (health care need only be a proximate cause) | Held: "Relating to or arising out of" requires more than a mere tangential relationship but is broader than proximate-cause; context and whether the act occurred during prescribed treatment control. |
| Effect of who implements care (field staff vs licensed therapist) | Scott: field staff lacked medical licenses and thus their acts are not "health care" | Wingate: employees/agents carrying out a licensed therapist's treatment plan act as health care providers when acting in scope of employment | Held: employees/agents implementing a licensed provider's treatment plan can be "health care providers" under the Act when acting within course and scope of employment. |
| Application to Jacob's claims | Scott: injury resulted from negligent implementation/supervision by field staff and is not a malpractice claim | Wingate: the hike/climb was part of the therapeutic program and the injury arose from the prescribed/implemented treatment | Held: Jacob's injury "relates to or arises out of" the health care because the therapist prescribed wilderness experiences (including hiking) and the staff implemented that treatment when the injury occurred; the Act applies. |
Key Cases Cited
- Dowling v. Bullen, 94 P.3d 915 (Utah 2004) (limits Act to acts connected to a patient’s treatment; rejects blanket application to all provider conduct)
- Smith v. Four Corners Mental Health Ctr., Inc., 70 P.3d 904 (Utah 2003) (distinguishes mental-health services from non-health-care foster services; examines whether injuries "mostly" arise from health care)
- Platts v. Parents Helping Parents, 947 P.2d 658 (Utah 1997) (statutory list of providers includes others rendering similar care; statute "means what it says")
- Barneck v. Utah Dep’t of Transp., 353 P.3d 140 (Utah 2015) (interpreting "arises out of/in connection with" in UGIA; Court contrasts UGIA analysis with the Malpractice Act)
- Vega v. Jordan Valley Med. Ctr., LP, 449 P.3d 31 (Utah 2019) (addresses prelitigation certificate requirement under the Malpractice Act)