Lead Opinion
This is an appeal from a summary judgment. Earl and Mellie Gooden originally brought suit against Edith and Mearle Goodpasture, seeking damages for personal injuries sustained by Earl Gooden when he was struck by a car driven by Edith Good-pasture. During discovery proceedings, the Goodens learned that at the time of the collision, Edith was under the influence of the drug Quaalude, which had been prescribed for her by Dr. Tips. Thereafter the Goodens amended their petition to include Dr. Tips as a defendant, alleging that he was negligent in prescribing said drug for Edith and in failing to warn her not to drive an automobile while under the influence of said drug. Dr. Tips then filed a motion for summary judgment based solely upon the pleadings, alleging that since there was no doctor-patient relationship between himself and the plaintiff there was no duty on his part owed to the plaintiff. The trial court granted Dr. Tips’ motion for summary judgment, and thereafter granted the joint motion of the parties to sever the cause of action against Dr. Tips from the cause of action against the Goodpastures. The Goodens then perfected their appeal from the summary judgment in favor of Dr. Tips.
In their sole point of error, appellants contend the trial court erred in granting Dr. Tips’ motion for summary judgment because genuine issues of material fact exist which preclude summary judgment.
At the outset we observe that Dr. Tips’ motion for summary judgment was directed solely to appellants’ pleadings and was not supported by affidavits, depositions or other summary judgment proof. Therefore this court takes as true every allegation of the pleadings against which the motion is directed. Holmes v. Canlen Management Corp.,
Paragraph V of Plaintiff’s Fourth Amended Original Petition alleges:
For approximately twenty (20) years prior to this collision, Defendant, Edith Goodpasture, was under the care and treatment of Defendant, Eugene Tips, M.D. Dr. Tips treated Defendant, Edith Goodpasture, for various medical problems, including depression and an ensuing drug abuse. As a result of his observation and treatment, Defendant, Dr. Tips, knew that Defendant, Edith Goodpasture, had a long history of abusing drugs, and could not be expected to take the medicine prescribed for her in the manner intended. Defendant, Dr. Tips, furthermore, did not warn Defendant, Edith Goodpasture, not to drive an automobile, or operate machinery, while under the influence of such drugs, including Quaalude, that were prescribed for Defendant, Edith Goodpasture, by Defendant, Dr. Tips. In continuing to prescribe the various drugs for Defendant, Edith Goodpas-ture, and in failing to warn Defendant, Edith Goodpasture, not to drive an automobile while under the influence of the drugs, including Quaalude, Dr. Tips deviated from the usual and customary care of a psychiatrist and physician in Harris County, Texas, under the same or similar circumstances. Defendant, Dr. Tips, conduct was a proximate cause of the injuries sustained by the Plaintiff, Earl Goo-den. Plaintiffs learned of this conduct during discovery proceedings, on or about July 11, 1978.
The pertinent portions of Dr. Tips’ motion for summary judgment are set out below:
*366 I.
Defendant Tips is entitled to judgment as a matter of law because there is no doctor/patient relationship, and therefore no duty, between the Plaintiff, Earl Goo-den, and Defendant Tips. In order for any kind of negligence action to lie against a defendant there must first be a duty flowing from the defendant to the plaintiff. In a medical malpractice action, this duty arises only from the existence of a doctor/patient relationship. In this case the only doctor/patient relationship was between Defendant Dr. Tips and Defendant Edith Goodpasture. The Plaintiff was only a third party, wholly unknown to Defendant Tips.
II.
In support of this motion, Defendant Tips relies solely upon the pleadings and motions that have been filed in this case.1 The trial court granted Dr. Tips’ motion
for summary judgment. Thereafter the parties’ joint motion for severance was granted and an order entered to that effect, at which time the summary judgment became appealable. See Schieffer v. Patterson,
The question presented then, under the facts of this case, is this: When a physician prescribes a drug for his patient which the physician knows or should know has an intoxicating effect, does the physician have a duty to the public to warn that patient not to drive while under the influence of said drug? Or, stated another way, is the physician under a duty to take whatever steps are reasonable under the circumstances to reduce the likelihood of injury to third parties who may be injured by that patient because said patient is under the influence of an intoxicating drug prescribed by the physician? Stated thus, it would seem this is a question of first impression in Texas.
The question of whether a legal duty exists under a given set of facts is a question of law for the court. Producers Grain Corp. v. Lindsay,
Appellee relies upon three Texas cases to support his contention that no duty of care arises on the part of a physician unless a physician-patient relationship exists between the defendant physician and the plaintiff claiming injury. In Johnston v. Sibley,
In Childs v. Weis,
Finally, in Lotspeich v. Chance Vought Aircraft,
As previously noted, it is our opinion^ these cases do not address the issue in the instant case. In each of the cases cited by appellee the plaintiff was the person the doctor examined (or failed to examine). In each instance the plaintiff sought — and failed — to establish a physician-patient relationship between himself or herself and the defendant doctor. In each, the plaintiff sought to hold the doctor liable for negligent treatment of him or her as a patient.
Our research indicates other jurisdictions have allowed a cause of action by a third party against a physician for negligence in treatment of a patient. The Supreme Court of Washington has found such a duty to exist under facts remarkably similar to those alleged by the plaintiffs below in Kaiser v. Suburban Transportation System,
Mrs. Kaiser brought suit against the bus company and the driver and, in the alternative, against the doctor and his employer, Group Health Cooperative. The doctor and Group Health denied negligence, and were dismissed at the conclusion of the evidence on the grounds that the evidence showed no standard of care to which the doctor was bound, and even if negligent in failing to warn, the driver’s negligence was an intervening cause. Thereafter the trial court directed a verdict against the bus company and its driver.
The Washington Supreme Court found that there was evidence in the record that the doctor failed to warn his patient of the dangerous side effects of drowsiness or lassitude that may be caused by taking this drug. The court held,
The negligence of the bus driver is a jury question, and should the jury find the bus driver to be negligent, the doctor would nevertheless be liable if the jury finds he failed to give warning of the side effects of the drug since the harm resulting to the plaintiff was in the general field of danger, which should reasonably have been foreseen by the doctor when he administered the drug.2 (Emphasis added.)
The factual similarities between Kaiser and the instant case are readily apparent. In both the doctor prescribed a drug for his patient which the doctor knew could have detrimental effects on the patient’s ability to drive a motor vehicle. In both the harm — injury to a third party occasioned by the impaired driving ability of the patient due to the drug prescribed — was reasonably foreseeable by the doctors when the drug was prescribed. In both the doctor failed to warn his patient not to drive a motor vehicle while under the influence of the drug. And in both the reasonably foreseeable harm did in fact result.
It occurs to us that the specifications of negligence asserted by plaintiffs in their respective petitions, adequately serve to charge defendant Dieckmann with negligence in failing to employ recognized procedures to determine the cause of Lem-mon’s first seizure, and that such allegation, coupled with the allegations that Dieckmann:
(a) negligently failed to advise defendant Norman Lemmon not to drive an automobile;
(b) negligently failed to warn defendant Norman Lemmon of the dangers involved in driving an automobile in view of all the facts and circumstances; and
(c) defendant Dieckmann negligently advised the defendant Norman F. Lem-mon that he could drive an automobile;
are so specific that it cannot be said that to a certainty it is made to appear plaintiffs have failed to state a claim on which any relief may be granted under any state of facts which could be proved in support of the claims asserted by them.
Freese, supra at 579-30.
The Supreme Court of Tennessee has also found such a duty to exist. In Wharton Transport Corp. v. Bridges,
At the conclusion of the evidence, the trial court directed a verdict for the physician on the grounds that Wharton failed to establish that a negligent examination by the doctor was a proximate cause of the accident and that no duty ran from the doctor to the Rains family and thus the doctor could not be required to indemnify Wharton for settlement expenses on their claims. In reversing the trial court’s action the Supreme Court said:
We think there is material evidence to support a finding that the injuries suffered by the Rains family were reasonably foreseeable to appellee in that he knew the purpose of the examination and its importance in highway safety and that failure to properly conduct the examination would increase the risk of harm to members of the motoring public. We are not attempting to make the physician an insurer of highway safety, but his duty to properly conduct the physical examination extends beyond his contractual responsibilities to the driver and the trucking company. (Emphasis added.)
Wharton Transport, supra at 527.
Thus it is apparent that, under proper facts, a physician can owe a duty to use reasonable care to protect the driving public where the physician’s negligence in diagnosis or treatment of his patient contributes to plaintiff’s injuries. In the cases discussed above as in the instant case, the harm resulting to the plaintiffs was a reasonably foreseeable consequence of the physician’s failure to warn his patient not to drive. There, as here, the physicians knew,
We therefore hold that the plaintiffs’ petition was sufficient to state a cause of action against the defendant Tips. Summary judgment on the pleadings was thus inappropriate. This means no more than that there are fact issues to be presented to the jury as to whether, based on expert testimony, defendant Tips breached the appropriate standard of care in this case.
In light of appellee’s arguments, we point out that we do not hold that a duty arose on the part of Dr. Tips to control the conduct of his patient, as was imposed in cases such as Tarasoff v. Regents of University of California,
The holding in Kaiser v. Suburban Transportation System, supra, was limited in a like manner. In its directions to the trial court on remand, the court held that “in the event the jury finds that a warning of the side effects of the drug was given to the bus driver, then the verdict shall be against the bus company and the driver only.”
We also point out that the imposition of a duty upon a physician for the benefit of the public is not a new concept. Art. 4445, §§ 1 & 4, Tex.Rev.Civ.Stat.Ann. (Vernon 1976) requires a physician who diagnoses or treats a case of syphilis, gonorrhea or chan-croid to immediately report such case to the local health officer, who, upon receipt of such notice, “shall institute measures for
“Duty” is not a rigid formalism according to the standards of a simpler society, immune to the equally compelling needs of the present order; duty must of necessity adjust to the changing social relations and exigencies and man’s relation to his fellow; and accordingly the standard of conduct, his care, commensurate with the reasonably foreseeable danger, such as would be reasonable in the light of the recognizable risk, for negligence is essentially “a matter of risk * * * that is to say, of recognizable danger of injury.”
Or, as stated in Prosser, Handbook of The Law of Torts, § 53, at 325-327 (4th ed. 1971):
But it should be recognized that “duty” is not sacrosanct in itself, but only an expression of the sum total of those considerations of policy which lead the law to say that the particular plaintiff is entitled to protection.
... Within some such undefined general limits, it may be said that the courts have merely “reacted to the situation in the way in which the great mass of mankind customarily react,” and that as our ideas of human relations change the law as to duties has changed with them. Various factors undoubtedly have been given conscious or unconscious weight, including convenience of administration, capacity of the parties to bear the loss, a policy of preventing future injuries, the moral blame attached to the wrongdoer, and many others. Changing social conditions lead constantly to the recognition of new duties. No better general statement can be made, than that the courts will find a duty where, in general, reasonable men would recognize it and agree that it exists. (Footnotes omitted.)
Finally, we address appellees policy arguments against imposing such a duty on physicians. Dr. Tips argues that the Legislature, in enacting art. 4590i, Tex.Rev.Civ. Stat.Ann. (Vernon Supp.1982), intended to limit causes of action against physicians to “health care liability claims” involving injuries to patients. However, § 1.02(b)(7) of the Act states, in pertinent part:
(b) Because of the conditions stated in Subsection (a) of this section, it is the purpose of this Act to improve and modify the system by which health care liability claims are determined in order to:
* * * * * *
(7) make certain modifications to the liability laws as they relate to health care liability claims only and with an intention of the legislature to not extend or apply such modifications of liability laws to any other area of the Texas legal system or tort law. (Emphasis added.)
As stated in an earlier footnote to this opinion, the parties have conceded that, since the injury in this case was to one other than a patient, the case is not controlled by art. 4590i, supra. The above statement of legislative intent makes clear that cases such as this do not come under the provisions of this statute.
Appellee also argues that such a holding would force doctors to discontinue treating some of their patients, or to adopt ultraconservative treatment procedures, particularly in regard to prescribing drugs which can impair driving ability. We foresee no such “devastating” consequences. As the court pointed out in Wharton Transport v. Bridges, supra,
*372 The possibility (or perhaps what could be called a threat) that in some case or cases in the future some therapists may choose not to accept some potential patients for therapy in their private practice (with obvious ramifications, and potential new causes of action) should not forever preclude victims of torts or crimes referable to the breach of duty of such therapists from being without any remedy whatsoever.
The trial court rendered summary judgment in favor of Dr. Tips on the ground that Dr. Tips owed no duty to the Goodens. We have held that a limited duty does exist, under the facts alleged in the Gooden’s petition. The pleading, when liberally construed, is sufficient in law to state fact issues as to the appropriate standard of care to which Dr. Tips is to be held, whether he violated that standard of care in this instance, and whether such violation, if any be established, was a proximate cause of the Goodens’ injuries. The summary judgment was thus improperly granted. Holmes v. Canlen Management Corp., supra at 201; Gottleib v. Hofheinz, supra at 10. The judgment below must therefore be reversed and remanded for determination of these fact questions by the appropriate trier of fact.
Judgment of the trial court is reversed and remanded.
Notes
. Although Dr. Tips, both in the trial court and in his brief on appeal, characterizes this as a medical malpractice action, the parties conceded at oral argument that this action cannot be one for medical malpractice, since it is undisputed that no doctor-patient relationship existed between the Goodens and Dr. Tips. Tex. Rev.Civ.Stat.Ann. art. 4590i, § 1.03(a)(4) (Vernon Supp.1982) defines “Health care liability claim” as inter alia, “. .. a cause of action against ... a physician ... for ... claimed departure from accepted standards of medical care or health care or safety which proximately results in injury to ... the patient. ...” (Emphasis added.)
In a subsequent paragraph in their petition, plaintiffs alleged that notice had been sent to Dr. Tips “pursuant to Article 4590i.” The statute took effect after the accident upon which this suit is based occurred, and after the above-quoted pleading was filed, but before the hearing on the motion for summary judgment was held. It appears that said notice was given out of an abundance of caution, in case the provisions of the statute were held to apply to such an action. Since it is conceded that they do not, we treat this action as any other action for personal injuries based on negligence.
. This sentence is altered somewhat from the version in the original opinion. The modification was made in a per curiam order of the Washington Supreme Court in Kaiser v. Suburban Transportation System,
. The liability we here impose is liability for “misfeasance” as opposed to “nonfeasance.” Prosser, in Handbook of the Law of Torts, § 56, at 339-340 (4th ed. 1971) analyzes the distinction thus:
In theory the difference between the two is simple and obvious; but in practice it is not always easy to draw the line and say whether conduct is active or passive. It is clear that it is not always a matter of action or inaction as to the particular act or omission which has caused the plaintiffs damage.... The question appears to be essentially one of whether the defendant has gone so far in what he has actually done, and has got himself into such a relation with the plaintiff, that he has begun to affect the interests of the plaintiff adversely, as distinguished from merely failing to confer a benefit upon him. (Footnotes omitted.)
In the instant case the doctor had “gone so far” as to prescribe the drug for his patient, and in doing so had clearly “begun to affect the interests of the plaintiff adversely” as a member of the motoring public, by allowing his patient to leave without a warning of the possible adverse effects of the drug.
Concurrence Opinion
concurring.
I concur in the result reached, but for different reasons. I would reverse the summary judgment rendered below because, assuming the truth of appellants’ allegations set forth in their fourth amended original petition (quoted in the opinion), a cause of action was alleged against Dr. Tipps under existing common-law rules. I deem it unnecessary to adopt the so-called “limited duty to warn” rule created by the majority in this case.
