delivered the opinion of the Court,
The motion for rehearing is overruled. Our opinion of May 8,1998, is withdrawn and the following is substituted in its place.
The issue in this ease is what duty a physician owes to third parties outside the physician-patient relationship. Two hospital employees were killed and a fellow employee injured while trying to subdue a violent patient. The episode occurred after an attending physician transferred the patient from the neurological critical care unit to a private room on an unsecured general floor. The injured employee and the parents of one of the deceased employees sued the physician for negligence and gross negligence in causing the bodily injuries and wrongful death. The trial court granted summary judgment for the physician. The court of appeals reversed.
Chambers v. Hermann Hosp. Estate,
I
In April 1991, Johnny Long, Jr., was taken to the Hermann Hospital emergency room and was admitted for treatment of seizures and alcohol withdrawal. Long was combative on arrival. Emergency room personnel sedated him, administered anti-seizure and other medications, and secured him with leather restraints. The next day, Long was transferred to the hospital’s neurological critical care unit (“NCCU”), where neurologist Dr. Gage Van Horn was the attending physician. On Long’s second day in the NCCU, Van Horn determined that Long no longer required critical care and transferred him to a private room. After Van Horn finished his duties in the NCCU on that day, he had no further contact with Long until after the incident that is the basis of this suit.
That incident occurred the day after Long was transferred to his private room, when Long decided that he wanted to leave the hospital. Hospital personnel confrontеd Long to prevent him from leaving. After Long fled into the hallway, hospital food service worker Edward Johnson, patient care technician Ronald Chambers, and medical student Richard Larramore tried to stop him. During a struggle, all four men *544 crashed through a large louvered grill covering an open air shaft and fell twenty-four feet to a concrete floor. Chambers and Larra-more died; Long and Johnson were injured.
Johnson and Chambers’ parents, Wallace Lee and Annie Mae Chambers, sued Van Horn for Johnson’s injuries and Chambers’ wrongful death, alleging negligence and gross negligence. The claims against Vаn Horn from the plaintiffs’ petition are that he:
1) failed to properly diagnose Long’s condition;
2) failed to select, prescribe, and oversee the proper treatment for Long’s condition;
3) ordered and/or failed to prevent Long’s transfer to an unsecured floor, which had inadequate facilities to treat Long’s violent and disruptive behavior;
4) failed to see that Long was transferred to a proper facility to handle his violent and disruptive behavior;
5) permitted Long to remain on an unsecured floor after he exhibited signs that he would erupt into violent and disruptive behavior; and
6) failed to order mandatory physical restraints to be placed on Long while on the unsecured floor.
Van Horn moved for summary judgment, asserting that he owed no duty to the plaintiffs, did not breach any duty if he did owe one, and did not proximately cause the plaintiffs’ injuries. The trial court granted Van Horn’s motion for summary judgment without specifying the grounds. The court of appеals reversed, holding that Van Horn owed a duty to non-patient third parties based on this Court’s decision in
Otis Engineering Corp. v. Clark,
II
A negligence cause of action has three elements: 1) a legal duty; 2) breach of that duty; and 3) damages proximately resulting from the breach.
Praesel v. Johnson,
This Court has dealt with analogous situations before. In
Bird,
we determined whether a mental health professional owes a duty to a patient’/parent not to misdiagnose negligently a condition of his child.
Bird,
In reaching that conclusion, we noted that the father in
Bird
did not have the requisite physician-patient relationship with the defendant or the defendant’s employer as a basis for imposing a duty. Id. We analyzed courts
*545
of appeals’ decisions that dealt with similar situations and also found no duty.
Id.
at 769-70 (discussing
Vineyard v. Kraft,
Since our decision in
Bird,
this Court has twicе dealt with a husband’s claim that his wife’s physician owed him a duty during prenatal care.
See Edinburg Hosp. Auth. v. Trevino,
The issue before us, as in Krishnan, is also squarely controlled by Bird. The basis of all the claims against Van Horn is his medical diagnosis of Long’s condition, which dictated the treatment Long should receive. In the Plaintiffs’ Response to Van Horn’s Second Motion for Summary Judgment, the piaintiffs note that a different doctor in the emergency room diagnosed Long as having “Seizure Disorder,” with a secondary diagnosis of “Alcohol Withdrawal.” The plaintiffs’ petition specifically alleged that once Van Horn became Long’s attending physician, Van Horn failed to properly diagnose Long’s condition, and in turn failed to select, prescribе, and oversee the proper treatment needed for the condition. All other claims are based on Van Horn’s decision to transfer Long to an unsecured room and to discontinue physical restraints, which also directly resulted from the doctor’s alleged misdiagnosis of Long’s condition.
The gravamen of the plaintiffs’ complaints is that Van Horn knew or should have known that Long posed a danger to others and should have treated him accordingly. However, Van Horn could only make the proper decisions based on Long’s condition by utilizing his knowledge as a medical doctor, and applying thаt knowledge to Long’s symptoms. If Van Horn’s medical knowledge was adequate, and he properly applied it to Long’s situation through his diagnosis and corresponding treatment, the doctor may have had no basis for continuing physical restraint or critical care. On the other hand, if Van Horn acted on inadequate medical knowledge or improperly applied it to Long’s situation, the doctor may have had a basis for continuing physical restraint or critical care. A failure to do so could amount to medical negligence, but only against one to whom a duty is owed.
See Scott v. Uljanov,
In short, this is ultimately a ease of injured parties other than the patient claiming that a doctor negligently misdiagnosed, and in turn negligently treated, a patient’s condition. Any duty of reasonable care on Dr. Van Horn’s part to avoid such negligence originates solely through the relationship with, and flows only to, his patient.
Cf. Praesel,
*546 HI
Plaintiffs urge that this case is one of negligently exercised control over another, and thus we should follow
Otis Engineering Corp. v. Clark,
The court of appeals in
Kehler v. Eudaly,
The plaintiffs cite to the dissenting opinion in
Kerrville State Hospital v. Clark,
Kerrville State Hospital involved a court-ordered out-patient commitment. Id. A designated hospital social worker had the responsibility of overseeing the patient’s care, periodically examining the patient to monitor his compliance with court-ordered drug treatment, and informing the court if the patient failed to comply with the treatment. Id. These elements of the hospital’s court-ordered control led the dissenting Justices to conclude that KSH was in “charge” of the patient. Id. Even if the dissent were correct, the elements on which it rеlied are absent in this case. Therefore, plaintiffs’ reliance on the dissent in Kerrville State Hospital is misplaced.
Plaintiffs also assert that the Restatement (Second) of Torts sections 315 and 319 provide a basis for a duty to third parties on a physician’s part. Reliance on these is also misplaced. First, section 315 states:
There is no duty so to control the conduct of a third person as to prevent him from causing physical harm to another unless (a) a special relation exists between the actor and the third person which imposes a duty upon the actor to control the third person’s conduct, or (b) a special rеlation exists between the actor and the other which gives to the other a right to protection.
Restatement (Second) of Torts § 315 (1965). This Court has recognized in the past that the necessary special relationship for imposing a duty to control may exist between a parent and child, master аnd servant, or independent contractor and contrac-tee under special circumstances.
Triplex Communications, Inc. v. Riley,
Furthermore, by the language of section 315(a), the relationship itself must “impose[ ] a duty, upon the аctor to control the third
*547
person’s conduct.” Aside from the fact that a physician-patient relationship is not “special” so as to impose a duty to control, as we have discussed, there is nothing inherent in the relationship that gives a doctor the right to control his patient.
See Boulanger v. Pol,
As for section 315(b), a special relationship must exist between the actor (Van Horn) and another “which gives to the other a right to protection.” In this case, the “other” persons whom Dr. Van Horn allegеdly had a duty to protect were the hospital workers who tried to restrain Long. However, the record does not reflect that Van Horn ever had any contact whatsoever with these hospital workers, much less the necessary special relationship in order to impose upon the doctor a duty to protect these individuals. Accordingly, section 315(b) also does not apply.
Section 319 of the Restatement (Second) of Torts states:
One who takes charge of a third person whom he knows or should know to be likely to cause bodily harm to others if not controlled is under a duty to exercise reasonable care to control the third рerson to prevent him from doing such harm.
Restatement (Second) of Torts § 319 (1965). We have not adopted section 319 as the law in Texas.
See Crider,