Massachusetts SJC Limits Doctors' Liability to Non-Patients

Law and Ethics

Recent Case Affirms M.D.s Generally Not Liable to Non-Patient Third Parties

In 2007, the Massachusetts Supreme Judicial Court considered a case where a primary care physician had prescribed and coordinated a portion of a patient’s medications, including Oxycodone, Zarxolyn, Predinsone, Flomax, Potassium, Paxil, Oxazepam, and Furosemide.

The patient was driving, lost consciousness, and struck and killed a 9-year-old child. The court found that the physician failed to warn his patient that these drugs carried potential side effects, including drowsiness, fainting, and sedation, and that the patient should not drive a motor vehicle while taking these medications.

In a departure from previous Massachusetts law and in a deeply divided plurality opinion, the SJC held that a physician could be liable to a non-patient third party. The decision in Coombes v. Florio, therefore, expanded a physician’s liability to include third parties injured as a result of the physician’s negligent failure to warn a patient not to drive while on impairing medications.

In May 2013, the SJC again took up the issue of physician liability to non-patients in Medina v. Hochberg. In this case, a patient was being treated by a neurologist for an inoperable brain tumor. The tumor caused the patient to suffer seizures on several occasions, including a grand mal seizure which, under Massachusetts law, barred him from driving for six months. Following his physician’s instructions, the patient did not drive during this period. The patient resumed driving and, over a year after his previous grand mal seizure, suffered another grand mal seizure, causing him to lose control of his car and injure a man. In the suit against the physician, the injured man claimed that the physician was negligent in permitting his patient to drive given his numerous medical problems.

In contrast to the earlier decision in Coombes, the court ruled that the physician could not be liable to an injured non-patient for allegedly failing to warn a patient not to drive, or for otherwise failing to control the patient’s driving. The Court distinguished this case from Coombes, stating that the physician did nothing to create or increase the risk of harm to the general public.

Unlike the affirmative act of prescribing a medication with known side effects, simply treating a patient with an underlying medical condition cannot be a basis for imposing liability on the physician. The Court feared that to hold otherwise would place a duty on physicians to warn patients about the dangers associated with driving based on any number of pre-existing health conditions, none of which may stem from the physician’s affirmative treatment of the patient.

Although, physicians may still be liable to non-patient/third parties for harm resulting from a failure to warn a patient about possible side effects of a prescribed medication, this most recent case suggests that the Court views this as a very narrow exception to the general rule that a physician owes no duty to third parties who might be injured by a patient.

The “Law and Ethics” column is provided for educational purposes and should not be construed as legal advice. Readers with specific legal questions should consult with a private attorney.

—William Frank, ESQ
MMS Associate Counsel

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