212 A.3d 962
N.J. Super. Ct. App. Div.2019Background
- In June 2014 B.M.D. struck and killed bicyclist Judith Schrope; B.M.D. was convicted only of careless driving. Police observed no obvious impairment at the scene and did not perform sobriety or blood tests.
- Discovery revealed B.M.D. was treated by psychiatrist Dr. Stefan Lerner and prescribed multiple psychotropic drugs (including stimulants Focalin and Concerta); Lerner mailed a Concerta prescription days before the crash and had last seen the patient two months earlier.
- Plaintiff (Schrope’s executrix) sued Lerner, alleging negligent prescribing/warning that proximately caused the fatal collision; plaintiff presented two experts who opined the medications could impair driving.
- Lerner moved for summary judgment arguing no duty to the deceased (no readily identifiable victim) and lack of proof that prescribed medication actually impaired B.M.D. at the time of the crash.
- The trial court granted summary judgment for Lerner; the Appellate Division affirmed, reasoning duty to patient exists but proximate cause failed because the record contained no direct or circumstantial evidence that B.M.D. was impaired by medication when she hit Schrope.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a prescribing physician owes a duty to third parties to warn of medication side effects that could impair driving | Extend duty: prescribers must warn patients of side effects for the protection of foreseeable third-party victims | No new duty beyond existing patient relationship duty (or duty only when victim is readily identifiable); imposing broad third-party duty is policy-problematic | Court declined to expand duty; but held physician already owes duty to patient — case turns on causation not duty |
| Whether Lerner had sufficient notice to owe a Tarasoff-type duty to Schrope (a non‑identifiable third party) | Lerner should have foreseen risk from medications and warned patient for public safety | Lerner did not know or foresee harm to any identifiable victim; McIntosh/Tarasoff principle inapplicable | Court rejected reliance on McIntosh for duty analysis here, noting no special-relationship duty to unidentified third parties; did not rest case on that theory |
| Whether plaintiff established proximate cause that Lerner’s prescribing caused B.M.D.’s impairment and the crash | Experts opined medications could cause impairment and that impairment caused the collision | No evidence (police observations, lack of sobriety signs, no Alcotest, only careless-driving conviction) supports that B.M.D. was impaired at the crash | Held plaintiff failed to produce competent evidence of causation; expert opinions were conclusory and unsupported by the factual record — summary judgment affirmed |
| Whether policy or comparative cases require different outcome (e.g., social-host, IV-administered drug cases) | Analogies to cases imposing duty to warn where impairment from medication was immediate or foreseeable | Distinguish: those cases involved immediate, observable impairment (e.g., IV administration or loss of consciousness) or visibly intoxicated patrons | Court distinguished and applied social-host/visibly-intoxicated analogy to require evidence of observable impairment; no liability where impairment is not shown |
Key Cases Cited
- Tarasoff v. Regents of Univ. of Cal., 551 P.2d 334 (Cal. 1976) (mental‐health professionals may owe a duty to warn identifiable victims of a patient’s violent threat)
- McIntosh v. Milano, 168 N.J. Super. 466 (Law Div. 1979) (New Jersey recognition of a therapist’s duty to protect a readily identifiable victim)
- Kelly v. Gwinnell, 96 N.J. 538 (1984) (social-host/tavern liability where server continued to serve visibly intoxicated guest)
- Townsend v. Pierre, 221 N.J. 36 (2015) (summary judgment appropriate when plaintiff’s causation proof is speculative or unsupported)
- Coombes v. Florio, 877 N.E.2d 567 (Mass. 2007) (physician owes duty to foreseeable third parties to warn of medication side effects under certain circumstances)
- Davis v. South Nassau Cmty. Hosp., 46 N.E.3d 614 (N.Y. 2015) (duty to warn where a hospital administered an IV drug that caused immediate impairment)
- McKenzie v. Hawai‘i Permanente Med. Grp., 47 P.3d 1209 (Haw. 2002) (physician’s duty to warn third parties of side effects when those side effects are a foreseeable risk)