Legal Advisor: Reporting Patients to the Registry of Motor
Vehicles
Case Study
A primary care physician is caring for a 75-year-old patient
suffering from multiple debilitating conditions, including asbestosis,
emphysema, and lung cancer. The patient is taking eight different
medications, including painkillers, antidepressants, blood pressure
medicine, and steroids. These medications were prescribed by the
primary care physician in coordination with the patient’s
specialists. Side effects of those drugs include drowsiness,
dizziness and sedation, among others.
What duty, if any, does the physician have to the patient, and/or to
third parties the patient may encounter, with regard to the
patient’s operation of a motor vehicle?
[The Massachusetts Supreme Judicial Court addressed this scenario
in Coombs v. Florio, 450 Mass. 182 (2007). In this case, a patient
with the ailments and on the medications described above lost
consciousness while driving and struck and killed a 10-year-old child
who was standing on a sidewalk.
The child’s mother sued the primary care physician for
negligently prescribing the medications without warning to patient of
the potential cumulative side effects, or driving risks.
The court held that when a physician who has knowledge of a
danger that may be posed to others from a patient's decision to operate
a motor vehicle while under the influence of prescribed medication (a
danger of which the public has no way of knowing) does not warn the
patient of the foreseeable risks involved, the physician may be held
liable for injuries to others caused by the failure to warn.
Massachusetts physicians have long had a duty of reasonable care
to their patients. This duty requires warning patients of the
potentially dangerous side effects of medications, including side
effects that may impair the patient’s ability to drive. The
court’s decision in Coombs, however, is the first in Massachusetts
to impose such a broad duty of care on the treating physician to those
foreseeably put at risk by his or her treatment of patient.
The Coombs case clearly does not require reporting by physicians
to the Registry of Motor Vehicles of patients with disorders, or on
medications that may impair the patient’s ability to drive.
Moreover, absent statutory or regulatory authority – such
reporting to the RMV may be a breach of confidentiality. The Court
did not extend a duty to warn to potential third-party
victims.
Based on this decision, the physician should take care to warn
the patient of the potential impairing side-effects, and advise the
patient not to drive where appropriate. Prudence dictates clearly
documenting such warnings and advice in the patient’s medical
record.]
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