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K.A.C. v. Benson
527 N.W.2d 553
Minn.
1995
Check Treatment

*1 Plaintiffs, al., K.A.C., et

T.M.W., Respondent, Plaintiffs, R.E.S., al., et al., BENSON, Philip D. et Petitioners, Appellants. C4-93-1328, C5-93-1306, C6-93-1203. Nos.

Supreme of Minnesota. Court

Feb. *2 Ellis, Wicka, Jeffrey M. Messerli C.

James Kramer, respondent. Minneapolis, for & Sieben, Emmings, Judy Carey, W. John Ltd., Gross, Holtum, McCoy Carey, & Von *3 K.A.C., Fairfax, et al. for Parmater, Randall, & K. Randall Robert R.E.S., Ltd., Minnetonka, plaintiffs et al. for

OPINION

STRINGER, Justice. T.M.W., Plaintiff-respondent, brought this against Philip Benson and the action Dr. damages alleg- she Palen Clinic emotional upon learning that Dr. edly suffered Benson gynecological two performed upon her had Dr. Benson was infected procedures while immunodeficiency virus the human with (HIV)1 open suffering and was from sores on reject plaintiffs We his hands forearms. allege and hold that a must claims in order establish actual to HIV damages resulting from for emotional a claim contracting a fear of AIDS. T.M.W., including patients, former

Over 50 asserting complaints against defendants filed claims. The district court filed various summary judg- resulting orders series of plaintiffs in favor of because ment defendants allege exposure or direct con- failed Dr. blood or Benson’s HIV-infected tact with opinion, the unpublished fluids. its appeals and re- affirmed court genuine part, holding that a issue versed Schulte, Dr. Hart, fact as Christopher M. J. of material existed J. William Bland, Zurek, placed patients in “zone of Meagher his A. Richard Barbara Benson, No. C6-93- Geer, danger.”2 Minneapolis, appellants. K.A.C. & Acquired geon Report Immune De- acquired im- General's that causes 1. HIV is retrovirus (AIDS). deficiency syndrome invades Syndrome ficiency mune cells, notably T-lympho- replicates in host and cytes, type cells that are essen- of white blood alleges whether the district it is unclear functioning of the human immune tial to the pursuant Minn. dismissed her claims court sys- damage system. The to the human immune 12 or 56. The court R.Civ.P. Minn.R.Civ.P. eventually in- leaves the affected individual tem appeals applied of review for sum the standard creasingly susceptible opportunistic to certain mary judgment the district court consid because fatal, presently no there is AIDS is diseases. beyond the materials and used resource ered See, Levy, e.g., Jay A. Human cure. Immunodefi- agree and pleadings. 56.03. We AIDS, Minn.R.Civ.P. Pathogenesis ciency Viruses and the summary judg apply the standard of review (1989) (explaining infects how HIV JAMA Service, cells); appeal. this Sur- ment on Health human U.S. Public 1203, C5-93-1306, C4-93-1328, September 1993 WL Dr. Benson an consulted 14, 1993). (Minn.App. dermatologist Dec. The court diagnosed other who the le appeals reversed the district court with sions as (Mycobacterium exudative dermatitis arinum) claims, respect permitting to all of T.M.W.’s m an and ordered HIV test. seropositive. T.M.W.’s claims for and intentional Dr. Benson tested HIV distress, battery, negli- infliction of dermatologist reported emotional Benson’s Dr. Ben nondisclosure, gent seropositive and consumer fraud. son’s HIV status the Minneso Health, appeals The court of Department also limited as a matter ta and in October plaintiffs’ of law emotional distress 1990 Dr. Benson met the Minnesota (Board) anxiety” to “a reasonable window of between Board regard of Medical Examiners they time, ing practice. the time learned of Dr. Benson’s illness his medical At that *4 they negative until received HIV guidelines regarding test results. Board had no formal appeal This seropositive followed. HIV providers.3 health-care The Board advised Dr. Benson to wear two pending While this matter was in this pairs gloves caring of patients court, all plaintiffs ultimately but one of the performing to refrain from surgery. He defendants; against only settled their claims complied requirements, with the Board’s Benson, plaintiff T.M.W. remains. K.A.C. v. voluntarily delivering ceased babies. C6-93-1203, C5-93-1306, C4-93-1328, No. (Minn. (order 14, 1994) Board, 1994 WL meeting Oct. After with the Dr. Benson claimants). dismissing remaining performed gynecological We re two exams on verse the of appeals, during decision the court of he time suffered from summary judgment 1990, and reinstate in of favor dermatitis: the first in late October defendants. early January By second in 1991. the end of 1990, Dr. Benson’s dermatitis condition had Philip family practition- Dr. Benson was a significantly healed. Heights er at the Palen Clinic and Palen Early Clinic from until in June 1991. After Dr. performed Benson the second 1989, began losing Dr. weight Benson gynecological while exam January on T.M.W. in following 1991, weight program. a control In Dr. again Benson met with the State developed March a he series of skin Board of Medical Examiners.4 result As a of face, hands, arms, conditions on his meeting and head. that Dr. Stip- Benson entered a into Initially, Board, Dr. Benson self-treated these condi- ulation restricting and Order with the early babies, In tions. Dr. Benson a delivering consulted him from performing from dermatologist diagnosed variety surgery, who of performing procedures invasive disorders, including vitiligo, alopecia skin using ar- in sharp patient’s body instrument eata, cavity. and folliculitis. developed

In June Dr. May Benson nodu- In 1991 the State Board of Medical lar lesions on his In hands and forearms. Department Examiners and the Minnesota of Department designed govern 3. The United States of practice Health of HIV-infected Human Services Centers for Disease Control health-care workers. See Recommendations for (CDC) voluntary guide- issues health-care worker Preventing Transmission Human Immunodefi- designed prevent lines transmission ciency Hepatitis B Virus and Virus to Patients patients during between health-care workers and Procedures, During Exposure-Prone Invasive procedures. invasive medical or dental In RR-8, (CDC), Morbidity Mortality Rep. Wkly. & CDC recommended all health-care workers 1-9 dermatitis, regardless with exudative their status, refrain from direct contact. month, 4. In that same the Minnesota State See, e.g., Recommendations Prevention HIV Board of Medical Examiners first established a Settings, Transmission in Health-Care 36 Morbid- formulating policy Task Force to assist them (CDC) 2S, ity Mortality Wkly.Rep. & 6S respect physicians. to HIV-infected Contro- regard- The CDC also recommends that decisions versy proposed guidelines over the Minnesota ing on restrictions HIV-infected health-care ensued, and the Medical on an Minnesota Association workers occur individual Id. at basis. ratify position 16S. could not on the issue. See July Update Minnesota month Dr. Board Medical after Benson ceased Examiners medicine, practicing guidelines (Spring the CDC issued patients against actions Dr. on whom commenced individual Health contacted 336 pro- more performed one or invasive and the Benson Palen Clinic for various at a he gloved, while but time when cedures claims. None the 325 tested HIV The let- from exudative dermatitis. suffered seropositive.5

ter, by Dr. signed dated June 1991 and practice Dr. Benson his medical ceased Benson, in relevant as follows: stated compli- 1991. He June died of AIDS-related conditions would be Under most there September cations you [of no reason alert Dr. Benson’s T.M.W.’s Claims diagnosis] AIDS since current recommen- physicians suggest dations infected Negligent a. Infliction Emotional pose with the virus or no risk AIDS little Distress However, patients. May their between presented appeal The first issue 21,1991,1 1,1990 February had a skin allege must my fingers. rash on hands and I am send- fluids an individ of HIV-infected you very ing this letter because there is a damages. recover ual to emotional distress possibility you exposed minimal were a claim infliction of To establish through body to the virus fluids AIDS distress, plaintiff must she: emotional show during pro- this from rash certain medical *5 (1) danger within a of physical was zone of rash, I cedures. At the time that had this (2) reasonably impact; feared for her own may I not there have been did realize that (3) safety; and severe emotional suffered any you wearing I risk because was physical with manifesta distress attendant gloves. I aware with am now that even Cross, tions. Stadler v. gloves, extremely an ex- minimal risk still argues although T.M.W. that isted. prove exposure cannot to HIV she Based the most current information occurred, possible was a exposed it is she opinions many about AIDS and the of ex Thus, body fluid transfer. T.M.W. effect you perts, the that have been likelihood alleges proximity her to Dr. HIV- Benson’s with from this infected the AIDS virus put infected her within the “zone fluids How type extremely of is low. danger” physical impact. the of of She offers ever, your peace for of mind and absolute Kuvin, of Dr. affidavit Sanford who recommending safety, you I am be that gloves inadequate testify protection are antibody for to the virus. tested AIDS per against HIV transmission. We are not you This test will tell us whether or not hold, by a argument, this as suaded are infected with the AIDS virus. Because law, for reasons hereaf matter of stated generally people symptoms have no ter, beyond plaintiff “zone of was they first become infected with AIDS purposes a claim of danger” for

virus, you important it is for to be tested. **** infliction of emotional distress. Co., 1991) (Letter City Ry. In Purcell v. Paul St. from Dr. Benson June (1892), court receipt of Minn. this (emphasis original). Following N.W. letter, physical patients impact ruled that actual is Dr. Benson’s over former first (EIA)), notified, zyme immunoassay HIV test and a second the 336 325 obtained 5. Of tests, testing, confirmatory three seven could not be refused test a Western Blot. Used called located, and died of unrelated to one had causes percent than together, these are more 99.0 tests al., A Look- AIDS. See also Richard N. Danila et Ninety-five percent of HIV-infected accurate. Investigation Patients an Back positive of HIV-Infected will HIV within 6 individuals test (1991) Physician, Eng.J.Med. 1406 325 New of the viral transmission. After months date of (case study documenting giving rise to incidents HIV, may positive be individual there an tests litigation). this latency period years physical before a of several developed medically a reliable Scientists have develop. diagnosis symptoms An AIDS AIDS presence antibody produced for the of an test seropositive an tests made when individual have contracted HIV. Blood individuals who severely compromised and has immune extremely accurate. tests for detection of HIV are virus, or one system as a contracts result enzyme- antibody screening exist: a Two tests opportunistic diseases. or more (or (ELISA) assay en- test linked immunosorbent Stadler, necessary objective inquiry. to sustain a claim for emotional 295 N.W.2d at damages. There, plaintiff distress suffered after car miscarriage the cable on which she Thus, permitting recovery negli cases passenger narrowly was a avoided collision gent infliction of emotional distress are char Id. another cable car. The court by a anxiety arising acterized reasonable test, adopted danger” noting the “zone of plaintiff, physical with attendant manifes impending cable car collision “seemed so im tation, being in from a situation where it minent, was caused, nearly and was so that the abundantly plaintiff grave clear that was in attending

incident ringing confusion of personal peril passengers rushing specifically for some alarm-bells out of defined plaintiff period the car fright caused sudden of time. Fortune smiled and the im fear great reasonable death Here, immediate calamity minent did not occur. n n bodily injury *.” Id. The zone of dan quite situation is different. The facts as ger test has law in remained the Minnesota alleged by T.M.W. indicate that Dr. Benson’s years. for over 100 place actions did in “apparent, never peril” contracting imminent danger” We adhered to the because “zone test in Corp., actually exposed Okrina v. Midwestern she was not 282 Minn. to the AIDS 401, 165 (1969), Purcell, plain where virus. 48 Minn. at 50 N.W. at tiff dressing in a at a Penney was room J.C. 1035. Transmission of HIV from Dr. Benson store when “she heard what sounded like a was, fortunately, never more than collapse bomb and witnessed the of the wall.” very possibility. remote escaped Id. ultimately Plaintiff “without be That contracting T.M.W.’srisk of HIV was ing physically struck debris other than no possibility more than remote is acknowl- dust.” Id. This court held was edged by the numerous resource materials within zone of danger. *6 the The court of by referred to the district court and the appeals applied danger” the “zone of in test parties. through HIV is Quill Airlines, transmitted Inc., direct v. Trans World 361 blood, semen, fluid-to-fluid contact with the (Minn.App.1985), pet. N.W.2d 438 rev. for secretions, denied, (Minn., 18, 1985), vaginal Apr. or milk of an breast where the HIV- plaintiff aircraft on which was a infected passenger individual.6 While other fluids suddenly plunged may HIV, rolled and toward the contain -the apparently virus is not earth. pilot regained Id. at 440. The by control transmitted other fluids. only of the craft seconds it before would have Documented modes of HIV transmission Id.; ground. struck the also see Silberstein unprotected include: sexual intercourse Cordie, (Minn. 852-53 person; with an using HIV-infected con- App.1991) (family was within zone danger of needles; taminated contact with HIV-in- family adjacent member in murdered blood, components, fected blood or blood room). products parenteral by mucous membrane court This has limited the zone of skin; or nonintact transplants of HIV-in- analysis danger plaintiffs to encompass who tissues; organs fected and/or transfusions have been in some personal physical actual blood; of HIV-infected artificial insemina- danger by caused negligence. defendant’s semen; tion perinatal of HIV-infected and

Langeland v. Farmers State Bank Tri of transmission from mother child to around mont, (Minn.1982); N.W.2d 319 31 see birth.7 time of also v. Washington County, Leaon Ninety-nine percent reported of Whether AIDS cases plaintiff within danger intercourse, a zone of is an are transmitted sexual intra- Update: Berlin, 6. See Garry Universal Precautions Preven- G. Mathiason & Steven B. AIDS for tion Healthcare, Transmission Business, Human in the of of and Governmental Immunodeficien- Virus, Virus, cy Hepatitis B Other and Bloodborne (1994). Workplace, C902 ALI-ABA Pathogens Settings, Morbidity in Health Care (CDC) 377, Mortality Wkly.Rep. & 378-79 abuse, adopt today, perinatal requiring 554. The we drug venous or transmis- standard exposure allege sion.8 actual to HIV as objective predicate recovery, retains long recognized This court has component long this court has deemed neces- danger physi within the zone of sary stability predictability ensure reasonably impact cal fears for his or who disposition of emotional distress claims. safety during exposure, time of her own consequently suffers and who severe emo policy persuasive We also several find con- physical injury, tional with resultant distress siderations articulated the California may recover emotional distress Appeals Court of on remand Kerins v. impact Pur physical results. (Kerins II), Hartley Cal.App.4th cell, However, 48 Minn. 50 N.W. 1034. Cal.Rptr.2d 172 personal peril possibility remote is insuffi magnitude potential The class of place plaintiff cient to within a of dan zone (cid:127) plaintiffs seeking emotional distress dam- ger purposes negligent of a claim ages for negligent exposure to HIV or Consequent infliction of emotional distress. * * * AIDS cannot be overstated. “[t]he ly, allege we that a who hold fails devastating and the effects of AIDS wide- not, as a to HIV is matter of home, spread fear at of contamination law; danger in personal physical of contract work, school, healthcare facilities and HIV, else- ing within and thus not a zone of are, sadly, require known to danger where too well purposes establishing a claim point.” further negligent infliction of emotional distress. discussion at this Prolifer- ation of fear claims of AIDS absence exposure requirement adopt The actual we meaningful restrictions would run an today is with the court’s consistent historical equal availability risk compromising regarding caution emotional distress claims. medical, affordability dental and Concerns about unintended unreasonable insurance, malpractice medical dental prompted results this court to limit care, prod- drugs, and blood prescription per- infliction of emotional disti’ess claims to deliberating in ucts. fear of Juries AIDS physical experienced personal sons dan- who likely just lawsuits would be as reach ger negligence. as defendant’s a result of results, discouraging early inconsistent “zone-of-danger We determined the rule” of such resolution or settlement claims. to reasonable and re- lead consistent *7 least, coffers of Last but not defen- juries objective- can sults because courts and being dants and would risk ly plaintiffs their insurers determine whether were within Stadler, emptied suffering danger. pay 295 at to for the emotional zone of N.W.2d Bartlett, See, exposed e.g., Even if a 8. John G. HIV and is HIV-infected Infection 199, tissues, Surgeons, Surgery may 29 Current Problems HIV fluids or transmission of 1992). (April, 202 necessarily The theoretical risk of occur. date, To there are no known cases of HIV from an infected health-care transmission See, patient. physician procedures transmission from e.g., patient during worker to a invasive is Sacks, Surgeon, Jeffrey In a 313 J. AIDS Indeed, risk minute. "a modeled estimation (1985) (study Eng.J.Med. New 400 1017-18 of the CDC was transmission could occur in that AIDS); al., Armstrong patients surgeon with et of surgical 2.4 of 24 million one of million to one Symp Investigation Health Care Workerwith aof Knowledge procedures.” See The AIDS Base Immunodeficiency An tomatic Human Infection: (P.T. eds., 2d ed. 2.1-8 et al. Cohen Military Epidemiologic Approach, 152 Med. 414- 1991, the the theoretical of CDC estimated risk 1,804 (1987) military (study patients 18 of of a HIV-infected HIV transmission from an al., AIDS); surgeon D. Porter Man with John et following percuta- actual to a health-care worker by Surgeon agement Treated with HIV Patients of approxi exposure blood is neous to HIV-infected (1990) Infection, Lancet 113-14 Virus (study 335 The mately percent exposure. per See 0.3 Recom patients surgeon of a British with of 339 Preventing mendations Transmission Hu for al., AIDS); Surgeon et A with AIDS: Ban Mishu Immunodeficiency Hepatitis B Vi man Virus Patients, 264 Lack Evidence Transmission During Exposure-Prone rus to Patients Invasive 2,160 (1990) (study of of a JAMA467-70 Procedures, Mortality Wkly. Rep. Morbidity & 40 AIDS); Update: surgeon but Nashville with see RR-8, (CDC), (1991). 3 During an Invasive Transmission of Infection Florida, Morbidity 40 Dental & Mor Procedure — (CDC) 2, tality Wkly. Rep. No. 21-26 560 (2) plaintiffs many expo- outrageous; uninfected the conduct was intentional AIDS, (3) reckless; possibly leaving- distress;

sure to HIV or or it caused emotional compensation inadequate plaintiffs (4) distress was severe. Hubbard v. actually whom the fatal AIDS was virus Int’l., Inc., 428, Press 330 United N.W.2d transmitted. (Minn.1983). actor 438-39 The must intend (citations proceed to cause severe emotional distress or II, Cal.Rptr.2d Kerins at 33 178-79 omitted). knowledge it substantially with the certain, probable, at highly least that se- Although our decision is based vere emotional distress will occur. Dornfeld law, upon existing Minnesota we case note Oberg, v. 119 majority it with is consistent Here, appeals the court of focused on the jurisdictions that have addressed the issue of outrageous conduct” “extreme element arising damages emotional from a distress dispute and concluded that a factual existed plaintiffs contracting fear of HIV. The ma regard to Dr. Benson’s conduct. jority of courts have decided fear of HIV exposure allege hold the cases must undisputed upon The show that facts exposure to HIV to emotional recover learning of damages.9 seropositive his HIV status Dr.

distress We concur with the ma sought jority jurisdictions reject plaintiffs guidance Benson from the Minnesota claim in case. In an Board of regarding this action for State Medical Examiners plaintiffs solely upon acquiring based practice. fear of his medical Dr. When Benson AIDS, allegation without of actual complied treated he with the restric HIV, legally cognizable no claim exists imposed by tions the Minnesota Board of Accordingly, under law. Minnesota we re pursuant Medical Examiners to the October appeals verse the court decision and rein meeting. 1990 no There is evidence Dr. summary judgment state favor of defen recklessly either Benson knew of or disre dants, Philip Palen and the Clin T.M.W., garded a known risk to nor in fact ic. any Dr. Benson actually pose did reasonable exposing risk of T.M.W. to the AIDS virus. b. Intentional Infliction of Emotional Consequently, we hold that T.M.W. failed to Distress establish that Dr. Benson’s conduct was ei purposes ther intentional or To a claim intentional reckless sustain distress, meeting Dornfeld, infliction of emotional must test. 503 Dornfeld (1) the establish: conduct was extreme and at 119. See, Inc., Products, e.g., Sage v. Burk 747 Md. 620 A.2d A few trial II, (E.D.Pa.1990); See, F.Supp. employed e.g., Kerins have courts also this test. 172; Olsen, Cal.Rptr.2d Ins., 1994 WL v. New Brzoska Castro York Misc.2d Life 2, 1994); (Del.Super.Ct. May Doe v. Sur (janitor (Sup.Ct.1991) pricked N.Y.S.2d *8 Joliet, Inc., 3-93-0765, gicare No. 1994 WL permitted pursue needle discarded to claim 461796, 25, 1994); Aug. (Ill.App.Ct. Ordway v. test); based on "reasonable fear” Marchica v. 269, County Suffolk, (E.D.N.Y. 154 Misc.2d N.Y.S.2d R.R., 583 F.Supp. Long Island 810 445 Doe, (Sup.Ct.1992); 1014 1015, Doe v. 136 Misc.2d 1993) (permitting claim emotional (Sup.Ct.1987); 519 N.Y.S.2d 595 Lubowitz (FELA), Employers' Liability Federal under Act Ctr., 468, Pa.Super. v. Med. 424 Albert Einstein (2d 51-60), aff’d, § 45 U.S.C. 31 F.3d 1197 Cir. (1993); 623 A.2d 3 Carroll v. St. Fran Sisters denied, - U.S. -, 1994), 727, cert. 115 S.Ct. Serv.,Inc., (Tenn. 585, cis Health 868 S.W.2d 594 However, (1995). pro L.Ed.2d 631 130 FELA 1993); By Gregory, Serv. v. Funeral Inc. Bluefield negligence a vides more relaxed standard that 424, Hosp., Community 186 S.E.2d W.Va. 413 79 actions, negligence law common and at least one (1991), Courtney grounds, on overruled other v. suggests "may court be an Castro aberration in 126, (1993); Courtney, W.Va. 436 190 437 S.E.2d general New York law” because the trend in Virginia Hosp., Johnson v. Univ. 186 W.Va. West Carroll, requires exposure. New York actual See 648, 889, (1991). 413 894 S.E.2d 15; 868 S.W.2d at 592 n. see also Kaehne v. Schmidt, (Ct. 524, Indeed, Maryland only jurisdiction 163 Wis.2d 472 N.W.2d 247 is permits recovery App.) (allowing damages expo highest which fear court when a of AIDS plaintiff virus, potential resulting alleges exposure from the AIDS sure unscreened blood transfusion test), proven exposure plaintiff negative absent either a channel of until received rev. Almaraz, denied, (1991). positive Faya or a 474 HIV test. See v. 329 N.W.2d 107

561 proce- of the Battery pect of the nature and character c. Consequently, plaintiffs performed. dure battery predicated is on claim for T.M.W.’s battery fail. claim must nondisclosure that Dr. Benson’s her assertion any initial vitiated consent of his HIV status Negligent d. Nondisclosure have care because she would not to medical appeals reversed the sum- The court of by Dr. Benson had to treatment consented negli- mary judgment T.M.W.’s claim of as to infected with HIV. known he was she nondisclosure, holding that had gent alleges she asked Dr. Benson about indeed stated a claim for relief. hands weight loss and the sores on his his arms, told her the and that negligent A claim for nondisclo a he received resulted from sunburn sores duty a to inform sure focuses on doctor’s weight vacation. The loss was due while on upon certain patients of the risks attendant weight program. control Tongen procedures. v. medical Cornfeldt (Minn. could I), 684, The district court held (Cornfeldt 262 N.W.2d 699 allega battery her claim absent not sustain prevail To on a claim for to HIV. The court tions of plaintiff must demonstrate nondisclosure reversed, adopting reasoning appeals person knowing of the risk a reasonable Appeals in Kerins treatment, Court of California would not have consented I, subsequently vacated and re which was actually risk material undisclosed Hartley, Kerins v. 17 versed on remand. Heupel, in harm. Kinikin v. 305 ized (1993), (Minn.1981). Cal.Rptr.2d 21 621 Cal.App.4th 589, 595 N.W.2d vacated, (Cal.), reh’g, rev’d on 868 P.2d 906 duty Doctors have a to disclose Cal.Rptr.2d 172 Cal.App.4th 33 bodily harm which of death or serious risks I, significant probability. are a Cornfeldt claims, malpractice In medical at 702. A doctor must also disclose substantially battery touching practitioner good of a consists of which a skilled risks reveal, community character from that to standing different nature and in the patient v. patient consented. Kohoutek is aware that a which the to the extent a doctor significance Hafner, particular 383 N.W.2d risks attaches Williams, Minn. enough to re example, generally For Mohr v. considered serious (1905), discussion, plaintiffs consent to too must be discussed. quire 104 N.W. these Kinikin, (citing not authorize surgery right on her ear did at 595 305 N.W.2d Cornfeldt II), A operate (Cornfeldt the left ear. Tongen doctor to on her (Minn.1980)). Indeed, battery peculiar lies when a doctor fails “[a] claim of also very aspect [plaintiffs] material fear of cancer to disclose unfounded procedure require to be might, anything, [defendant] and character of if nature discussing probability any supposed consent is its performed, because more time devote * * *." Kinikin, unpermitted touch 305 N.W.2d at and thus an her undermined Hosp., Bang T. Miller ing occurs. v. Charles How Minn. 88 N.W.2d 186 yet has not addressed This court ever, rendered void patient’s consent is not duty their physicians’ to disclose the issue of exactly touched

when the patients, and do not reach status to we Kohoutek, 383 N.W.2d way she consented. Dr. Ben today. or not that issue Whether *9 at 299. duty legal to disclose his son had legal patients, the breach of Dr. status to his allege T.M.W. does not damages recog compensable duty without procedure performed a different Purcell, 48 by law is not actionable. More nized which she consented. from that Here, 134, the undis N.W. 1034. over, not Minn. 50 Dr. conduct did because Benson’s closed, of HIV did minuscule “risk” risk that T.M.W. significantly increase the plaintiff HIV, in harm to because not materialize be said that it cannot would contract the HIV anti- negative for T.M.W. tested a material as- Dr. Benson failed to disclose 562 Therefore,

body. negli- T.M.W.’s claim for information determining gent nondisclosure fails. consent to treatment. In affirming the trial summary

court’s negli dismissal of T.M.W.’s gent claims, battery e. Fraud Consumer nondisclosure and I be misapplied lieve the court has the laws of presented appeal The final issue on is negligent battery nondisclosure ig properly alleged whether T.M.W. a claim un- patient’s rights. nored the In ignoring the Act, der the Consumer Fraud Minn.Stat. patient’s rights, the court excludes from “the 325F.69, (1994). § subd. 1 T.M.W. asserts decision-making process the most critical prevaricated regarding Dr. Benson his participant patient.” Estate Beh —the status, rely with the intent that she Princeton, ringer v. Medical Center at 249 upon explanation his and continue under his (Ct. N.J.Super. 592 A.2d 1278 Law asserts, ap- care. T.M.W. and the court of Div.1991). peals 325F.69, § held that subd. 1 of the by physician “[A] failure to disclose a Consumer Fraud Act does not limit the dam- may risk that in arise ages course of medical “pecuniary available to claimant to loss- procedure or negli- treatment constitutes es.” gence.” Hafner, Kohoutek v. 383 N.W.2d provides per The Consumer Fraud Act in 295, 299 When recog- we first act, use, tinent employment by “[t]he claim, negligent nized the nondisclosure any person fraud, any pretense, false false Tongen, v. 262 N.W.2d Cornfeldt (Minn.1977) promise, misrepresentation, misleading state I), (Cornfeldt we declined to deceptive practice, ment or with the intent provide a scope definite standard for the rely that others thereon in connection with * * n subject Instead, risks to disclosure. we ad- any enjoina- the sale of merchandise n * * subject vanced two rules that were to later 325F.69, § ble .” Minn.Stat. subd. physicians refinement: duty had a to disclose (1994). The sale of merchandise includes the (1) risks of bodily death or serious harm and services, private sale of citizen is enti (2) by risks that would be disclosed a skilled bring tled to a civil action for practitioner good standing under similar injuries caused violation of the Act. circumstances. (quoting Id. at 702 Cobbs v. 325F.68, (1994); § Minn.Stat. subd. Minn. Grant, 505, 515, 8 Cal.3d Cal.Rptr. 8.31, (1994); § Stat. subd. 1 Minn.Stat. (1972)). time, P.2d At the we felt (1994). 8.31, § subd. 3a adequately those rules insured enough would receive “injury,” Unable to establish an information to allow them recovery right has no to exercise basis for under the their to self-determi- Act, 325F.69, nation placing § Consumer Fraud without Minn.Stat. unreasonable disclo- requirements sure holding physicians. subd. 1 In so we Id. at find it 701- unnecessary question to reach the of whether allegation an pecuniary required loss is The rules were years refined three later Act, under the Consumer Fraud Minn.Stat. when again was before the court. Cornfeldt 325F.69, § subd. 1 Tongen, Cornfeldt (Minn.1980) II), (Cornfeldt we broadened foregoing For the reasons we reverse the physicians defined the risks which have a appeals decision of the court of and reinstate duty patients: to disclose to their summary judgment defendants, in favor of Philip Benson and the Palen Clinic. make out a [To claim for nondis closure, duty show a must] n * n COYNE, J., part. took no disclose the risk evidence estab lishing that a reasonable in what PAGE, (dissenting). Justice physician knows or should have known respectfully I high- dissent. This case patient’s position to be the likely * * n lights the conflict between a significance doctor’s self- attach to that risk ability interest his practice to continue the formulating his decision to consent *10 patient’s right medicine and the to full treatment. text, patient’s safety following explanation the the fear for her need Id. We footnoted only subjectively of this rule: have been reasonable. Thus, fears, patient’s “peculiar” the when the opinion prior the extent that our To them, physician know of knows or should physician’s duty suggests that a to disclose duty physician create a on the disclosure risks, i.e., only significant death extends to Kinikin, regarding those fears. harm, hereby it is modified. or serious heightened places at 595. The burden this Further consideration of the standard of physicians patient the on insures that re- disclosure has led us to the conclusion enough meaningfully ceives information to objective the above-stated standard accom- right in exercise the to self-determination professional competence pa- modates See, e.g., matters of medical treatment. Es- tient self-determination. Behringer at tate v. Medical Center added). (emphasis clearly Id. at n. We Princeton, N.J.Super. A.2d require phy- intended to broaden the rule to (Ct.Law Div.1991). only or sicians to disclose not risks of death harm, risk, bodily any regardless serious but Here, it is evident that there is an issue of it, opinion profession’s of the medical jury fact for the as to whether Benson should patient plaintiffs position a reasonable the particular sig- have known T.M.W. attached significant. would find nificance to the risk of disease transmission open weeping from his wounds. It is later, year Heupel, One Kiniken v. equally jury evident that the should decide (Minn.1981), we indicated person, position, a in her reasonable subject mandatory that the risks to disclo- (1) have shared her fear. would sure include risks of death or serious bodily significant probabil- harm are of which however, prevail, To a must also (2) practitioner ity, risks which a skilled “first, prove proximate a cause: had community good standing the would re- person reasonable known of the risk he (3): veal, and treatment; not have consented a can [T]o the extent doctor is or be aware second, that the undisclosed risk materialized patient particular' signifi- attaches that his Kinikin, in harm.” 305 N.W.2d at 595. generally not cance to risks considered Both the trial court and this court conclude profession enough serious the medical that T.M.W. is unable to meet the second patient, require discussion with the these proximate cause. element brought determining too be out. must element, regard there is With first particular importance whether risks of an issue of fact as to whether reasonable physi- existed and whether his person have consent- aware of the risk would im- cian should have been aware of their gynecological Even ed to the examinations. portance, jury must look to what a rea- knowledge among if it was common medical physician in what sonable professionals risk of HIV transmis- that the knows or should have known to be presented here sion under the circumstances signifi- plaintiffs position would consider low, probably it not common knowl- was was contemplating procedure]. [the cant Further, public. edge among general notes, peculiar itself “[a] As the court n * n fact that there was a low risk of transmission [plaintiffs] part unfounded fear no risk. De- does not mean that there was require might, anything, if [defendant] risk, consequences of spite the low the severe discussing probability time its devote more might a reasonable transmittal have caused * * *." (quoting Op. her at 561 Kini phy- from another person to seek treatment kin, reasoning The 305 N.W.2d at Thus, jury could conclude that sician. only rule behind this is obvious: the risk of person, reasonable informed of right to information about actual have the transmission, would not have consented health, they to their but and substantial risks to the treatment. right to information about risks also have the prox- regard element of personally important to their With to the second they consider jury ques- cause,, imate T.M.W. has raised In the nondisclosure con- health. *11 tion as to by whether the misrepresentations risk of undisclosed Benson’s concern- transmission materialized in harm. ing It has his health. been the law in Minnesota since at least 1981 today, holding The court’s without discuss- physician that a must disclose risks of treat- issue, ing apparently plain- the forecloses a ment which he knows or should know are battery tiffs claim where the con- significant by patient, considered the even if touching sents the due to a defendant’s physician

the professionals and other medical misrepresentations. Kinikin, insignificant. consider the risk by N.W.2d at 595. The harm avoided such

disclosure is emotional distress on the patient physician the because the ex- —either plains away worry, the cause of or because the does not consent to the treat- Here, ment. precisely emotional distress is the harm T.M.W. claims she suffered because Thus, re

of Benson’s PETITION FOR nondisclosure. I believe it REINSTATE- MENT was error to the Practice grant to affirm the trial of Law of court’s summary judgment dismissing Frederick D. KRAEMER. neg- T.M.W.’s ligent nondisclosure claim. No. C0-84-1996. battery claim of against physi “[A] lies Supreme Court of Minnesota. performs cian who procedure medical aon patient without his or her consent.” Kohou Feb. (Minn. Hafner, tek v. physician Even where appar the has consent, “[ujnder ently gained however, some ORDER * * * patient’s circumstances the consent WHEREAS, petitioner the Frederick D. can be vitiated.” Id. at Page 299. See W. Kraemer, applied has for reinstatement Keeton, al., et Prosser and Keeton on Torts law; practice the (5th 1984) § at 114 (noting ed. consent WHEREAS, 18(e), Lawyers Rule Rules on void, can be example, where there is Responsibility, Professional requires petition- coercion, mistake, fraud). incapacity, or successfully er complete professional One such circumstance is when the consent responsibility portion of the written examina- through misrepresentation obtained required by tion applicants for admission to (Second) fraud. Restatement of Torts practice by of law the State Board of 892B(2) (1977) § provides: reinstatement; prior Law Examiners If the consenting to the conduct WHEREAS, panel Lawyers by of another is induced to consent a sub- Responsibility Professional assigned Board concerning stantial mistake the nature of petition consideration of the for reinstate- the invasion of his interests or the extent ment recommends that this court dismiss the harm expected to be from it and the petition ground on the petitioner has not mistake is known to the other or is induced requirement successfully satisfied the com- misrepresentation, the other’s the con- pleting examination, the written which has sent is not unexpected effective for the been offered on three filing occasions since invasion or harm. petition reinstatement; his When gynecologi- T.M.W. consented to the examinations, cal clearly she did not antici- IT HEREBY peti- IS ORDERED that the pate any risk of HIV dismissed, transmission. Nor did tion of Frederick D. Kraemer is anticipate suffering she prejudice emotional dis- without being subsequently re- filed; however, tress caused her contracting provided, concern for petitioner HIV from jury the examinations. It is a completion must show successful of the State question as to whether T.M.W.’s consent to Board of Law Examiners’ written examina- gynecological examinations was required applicants induced tion for admission to

Case Details

Case Name: K.A.C. v. Benson
Court Name: Supreme Court of Minnesota
Date Published: Feb 10, 1995
Citation: 527 N.W.2d 553
Docket Number: C4-93-1328, C5-93-1306, C6-93-1203
Court Abbreviation: Minn.
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