eNotes: Liability – January 2023 – Washington, DC

SIGNIFICANT CASE SUMMARIES

Washington, DC Case Summary

Doheny v. Med. Faculty Assocs.
District of Columbia Court of Appeals
Nos. 19-CV-479, 19-CV-562

Decided: November 3, 2022

A doctor who provides a mild amount of input on a recent patient’s care may still be subject to a physician-patient relationship and its attendant duties.

Background

In 2014, Plaintiff’s wife underwent a cardiac ablation procedure to treat atrial fibrillation. The procedure was performed by a doctor who worked as a provider with Defendant, Medical Faculty Associates. Twenty-three days after the procedure, the patient began to experience stroke-like symptoms, and went to a hospital in Virginia. A different doctor providing care to the patient called the prior physician to update him about the patient’s condition. They also discussed the care the prior physician had provided, with the current doctor requesting any possible guidance for treatment. The prior physician did not mention the possibility that the stroke-like symptoms the patient was experiencing could be the result of an atrio-esophageal fistula, a rare but extremely dangerous side effect of the cardiac ablation he had performed. Diagnosing that side effect requires a common computed tomography (“CT”) scan.

Instead of receiving a CT scan in a timely fashion, more than a week would pass before the patient was scanned, during which time the patient suffered multiple additional embolic strokes, leaving her in a persistent vegetative state. The treating doctor had never heard of the atrio-esophageal fistula side effect because it was rare and was not common knowledge for doctors who did not engage in procedures such as cardiac ablation.

Plaintiff sued the original physician, stating that he had negligently failed to advise the subsequent doctor of the risk of atrio-esophageal fistula, despite having recently performed a procedure in which that was a possible side effect. The Trial Court granted summary judgment to Defendant, finding that there was no legal duty owed by the physician to the patient, because at the time of the phone call between the two doctors, there was no physician-patient relationship upon which a duty could be premised.

Holding

The D.C. Court of Appeals reversed the Trial Court’s entry of summary judgment because the existence of a physician-patient relationship, and its attendant duties, were factual questions to be decided by a jury. Negligence in the medical malpractice context requires the existence of a duty owed to a plaintiff, which duty is premised on the existence of a physician-patient relationship. The Trial Court erroneously held that no physician-patient relationship existed between the parties at the time of the phone call between the two doctors.

The existence of a physician-patient relationship is a unique analysis in every case and requires that the specific facts be weighed by the jury. Many factors in this case may have pointed to the physician not having a relationship with the patient, such as the time since treatment, the method of input, and the nature of services rendered. However, the Trial Court’s analysis was inappropriate. While it was possible for a jury to come to the same conclusion as the Trial Court, the Appellate Court examined potential ways the facts of this case might be perceived differently, such that a question of fact remained present, making summary judgment inappropriate. The Court of Appeals remanded the case back to the Trial Court for further proceedings.

Questions about this case can be directed to Joseph Mooradian at (202) 318-1751 or jmooradian@tthlaw.com.