Maltais v. PeaceHealth ( 2023 )


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  • 318                    June 14, 2023                No. 294
    IN THE COURT OF APPEALS OF THE
    STATE OF OREGON
    Valerie MALTAIS
    and David Richardson,
    Plaintiffs-Appellants,
    v.
    PEACEHEALTH,
    a Washington nonprofit corporation,
    dba PeaceHealth Sacred Heart Medical
    Center at RiverBend, and
    Sarah L. Coleman, MD,
    Defendants-Respondents.
    Lane County Circuit Court
    19CV27100; A174706
    R. Curtis Conover, Judge.
    Argued and submitted June 2, 2022.
    Gregory Kafoury argued the cause for appellants. Also
    on the briefs was Kafoury & McDougal.
    Ruth A. Casby argued the cause for respondent
    PeaceHealth Corp - Sacred Heart Medical Center. Also on
    the brief were Janet M. Schroer and Hart Wagner LLP.
    Hillary A. Taylor argued the cause and filed the brief for
    respondent Sarah L. Coleman, MD.
    Before Ortega, Presiding Judge, and Powers, Judge, and
    Hellman, Judge.
    ORTEGA, P. J.
    Reversed and remanded.
    Cite as 
    326 Or App 318
     (2023)   319
    320                                           Maltais v. PeaceHealth
    ORTEGA, P. J.
    Plaintiffs Valerie Maltais and David Richardson,
    her husband, appeal a judgment dismissing their claims
    for negligence against defendants PeaceHealth and Sarah
    L. Coleman, MD. Defendants were medical service provid-
    ers for Maltais’s adult son, N. H., who suffers from paranoid
    schizophrenia and severe intellectual disabilities. In her
    claims, Maltais alleges that she suffered a physical injury
    and noneconomic damages as a result of defendants’ negli-
    gent handling of N. H.’s deteriorating psychiatric condition,
    leading to a psychotic episode during which N. H. stabbed
    Maltais, puncturing her lung. Richardson alleges that he
    suffered noneconomic damages for loss of spousal consor-
    tium and emotional distress as a result of witnessing the
    attack.
    On appeal, plaintiffs contend that the trial court
    erred in granting judgment on the pleadings for failure to
    state a claim under former ORCP 21 A(8) (2018), renum-
    bered as ORCP 21 A(a)(h) (2022), on the basis that defen-
    dants owed no duty to the nonpatient plaintiffs. We conclude
    that, if proven, the facts alleged in the complaint support
    a reasonable inference that defendants owed a duty of care
    that extended to Maltais. As such, we do not reach plain-
    tiffs’ alternative argument that the court erred in failing to
    give plaintiffs leave to amend their complaint. Accordingly,
    we reverse the trial court’s dismissal of the complaint with
    prejudice and remand for further proceedings.1
    I. BACKGROUND
    In reviewing a judgment dismissing a complaint, we
    accept as true the facts alleged in the complaint and draw
    all reasonable inferences from those allegations in favor of
    plaintiffs. Tomlinson v. Metropolitan Pediatrics, LLC, 
    362 Or 431
    , 434, 412 P3d 133 (2018). Our task is to “determine
    whether upon the facts alleged * * * no reasonable factfinder
    could decide one or more elements of liability” in favor of
    plaintiffs. Fazzolari v. Portland School Dist. No. 1J, 
    303 Or 1
    , 17, 
    734 P2d 1326
     (1987). The alleged facts are as follows.
    1
    We do not address Richardson’s claims because the parties and the court
    treated those claims as derivative of Maltais’s claims.
    Cite as 
    326 Or App 318
     (2023)                             321
    Maltais is the biological mother of N. H., an adult
    who suffers from paranoid schizophrenia and severe intel-
    lectual disabilities. N. H. lived in the family home with
    Maltais and Richardson. He was “profoundly disabled” by
    his conditions and Maltais was his primary caregiver. She
    managed his medical care and accompanied him to his med-
    ical visits, including visits with his psychiatrist and other
    medical providers at PeaceHealth, for many years. She was
    responsible for communicating necessary medical infor-
    mation to providers and was authorized to receive medical
    information concerning N. H.
    N. H.’s psychiatric condition deteriorated in January
    2018. He began to exhibit severe and uncharacteristic symp-
    toms, including hearing voices. He feared that he was losing
    control of himself and that he would harm himself and his
    family; specifically, he felt driven to stab his family members
    with a knife. Concerned that N. H. had become dangerous,
    Maltais took him to PeaceHealth’s Emergency Department
    (ED) on January 28, 2018. Hospital staff interviewed N. H.
    and released him.
    The following day, January 29, Maltais took N. H. to
    his regular psychiatrist at PeaceHealth, Carolyn Hartman,
    MD. Maltais explained the symptoms that N. H. was expe-
    riencing, and told Hartman about their visit to the ED.
    Hartman evaluated N. H.’s condition and noted in his chart,
    “Due to active psychosis and recent threats, dangerousness
    is clear.”
    On January 30, Hartman communicated to Maltais
    that she would inform the ED that N. H. needed to be admit-
    ted because he was a danger to himself and others. Hartman
    then called an intake worker and a crisis worker at the ED
    and reported that N. H. was her patient, that he was coming
    to the ED, and that he should be admitted. Next, Hartman
    spoke to an ED doctor and explained that N. H. wanted to
    be admitted and that admission was appropriate because he
    was dangerous to himself and others. The ED staff mem-
    bers agreed that they would admit N. H. when he arrived.
    Later that day, Maltais again took N. H. to the ED.
    However, there had been a shift change since Hartman’s
    calls. The ED staff, including defendant Coleman, did not
    322                                     Maltais v. PeaceHealth
    admit N. H. and, that same day and in Richardson’s pres-
    ence, N. H. stabbed Maltais with a knife, puncturing her
    lung.
    Plaintiffs allege that defendants PeaceHealth and
    Coleman were negligent:
    “(a) In failing to restrain, admit, or secure [N. H.],
    when they knew or had reason to know that he was men-
    tally ill and a danger to himself or others;
    “(b) In failing to convey the decision to admit [N. H.] to
    a responsible medical staff at the change of shift;
    “(c) In failing to adequately document the decision to
    admit [N. H.];
    “(d) In failing to actively review available medical
    documentation, including * * * Hartman’s records, prior to
    declining to admit [N. H.];
    “(e) In failing to secure available information regard-
    ing [N. H.]’s mental status and risk from * * * Maltais when
    she was present and available to be interviewed;
    “(f) In failing to devise an adequate system for con-
    veying recently-received medical information from practi-
    tioners during one shift to practitioners in the next shift;
    “(g) In refusing to allow * * * Maltais to be present
    while her son was interviewed.”
    Defendants moved to dismiss the complaint, argu-
    ing that they did not cause Maltais’s injuries and that the
    lack of a physician-patient or other special relationship
    between the parties was fatal to plaintiffs’ claims. Plaintiffs
    maintained that the claims were cognizable under a theory
    that defendants’ conduct unreasonably created a foreseeable
    risk of physical harm to others and that they were therefore
    liable for the resulting injuries. Defendants responded that
    Tomlinson controls the analysis for third-party medical neg-
    ligence claims such that plaintiffs must have alleged inde-
    pendent interests that defendants were obligated to protect
    to allege that a duty runs from defendants to plaintiffs. The
    trial court granted defendants’ motion to dismiss the com-
    plaint with leave to replead facts that would demonstrate
    that defendant owed a duty to plaintiffs.
    Cite as 
    326 Or App 318
     (2023)                                                 323
    Plaintiffs filed a second amended complaint, add-
    ing a lengthy paragraph detailing the relationship between
    Maltais, N. H., and his medical providers.2 It describes
    her history of participating in his medical and psychiat-
    ric appointments at PeaceHealth and her role in commu-
    nicating medical information to providers about his care.
    Plaintiffs alleged that Maltais performed that role because
    N. H.’s disabilities made him dependent on her. Defendants
    then renewed their arguments that the complaint was
    legally insufficient because plaintiffs did not meet the stan-
    dard articulated in Tomlinson to state a third-party med-
    ical negligence claim, that is, that the complaint failed to
    allege facts showing that defendants had a duty that ran
    to plaintiffs. The trial court dismissed that complaint with
    prejudice.
    Plaintiffs appeal, assigning error to the trial court’s
    dismissal of their claims with prejudice, arguing once again
    that medical providers can be liable for foreseeable physical
    injuries to third parties resulting from the negligent treat-
    ment of their patients.
    II. ANALYSIS
    Under Oregon law, a person whose conduct unreason-
    ably creates a foreseeable risk of harm to others and causes
    an injury is generally liable for that injury, “unless the par-
    ties invoke a status, a relationship, or a particular standard
    of conduct that creates, defines, or limits the defendant’s
    duty.” Fazzolari, 
    303 Or at 17
    . Here, the negligent conduct
    alleged is defendants’ failure to diagnose N. H.’s psychiat-
    ric condition and dangerousness, and their failure to admit,
    secure, or restrain him. In defending against these claims,
    defendants invoke the doctor-patient relationship and the
    professional standard of conduct that structures their
    2
    Although this paragraph describes facts about the relationship between
    the parties that are relevant to all of plaintiffs’ claims, the second amended com-
    plaint locates it between plaintiffs’ first and second claims for relief with a sec-
    tion title stating that it is another second claim for relief, though no claim for
    damages is alleged in that section. For the purposes of this opinion, we treat this
    as an editing error and read it as a factual allegation that is relevant to the four
    claims alleged in the complaint. Defendants do not argue before this court that
    their substantial rights were affected by this defect in the pleading. ORCP 12;
    Hawkins v. City of La Grande, 
    315 Or 57
    , 63, 
    843 P2d 400
     (1992).
    324                                      Maltais v. PeaceHealth
    duties. They argue that plaintiffs’ claims are not cogniza-
    ble because their professional duty of care was owed only to
    their patient and not to third-party plaintiffs.
    The Supreme Court recently articulated the profes-
    sional standard of care for physicians in Tomlinson:
    “When a physician holds herself out as such and under-
    takes to provide medical services, the physician represents
    having a certain level of medical skill and competence * * *.
    In doing so, the physician invites a patient (or others acting
    to advance the patient’s interests) to rely on the physician
    to provide the patient with the level of care that a reason-
    ably prudent, careful, and skillful practitioner of the physi-
    cian’s discipline would have provided to the patient under
    the same or similar circumstances and within the same
    community. The law therefore imposes on a physician an
    obligation to meet that standard of care, which is defined
    by the scope of the physician’s undertaking.”
    
    362 Or at 444
     (citations omitted). The Tomlinson court
    explained further that this standard of care does not func-
    tion to limit a physician’s professional duty to just their
    patients. As in other professional settings, whether a phy-
    sician has a duty that runs to a nonpatient third party
    depends on “the existence of an undertaking, express or
    implied, between the [professional] and the third party.”
    
    Id. at 445
    . We therefore turn to the reasoning in Tomlinson
    to guide our analysis of plaintiffs’ claims.
    In that case, the plaintiffs were the parents of a
    child who began exhibiting developmental abnormalities.
    The defendants, the child’s medical providers, undertook to
    discover the cause of those abnormalities but failed to do so
    before the plaintiffs had another child. The older child was
    ultimately diagnosed with an inheritable genetic disorder
    with severe and potentially debilitating symptoms. The par-
    ents alleged that the defendants negligently failed to per-
    form appropriate diagnostic testing for the child’s symptoms
    and therefore failed to timely diagnose the genetic disorder.
    As a result, the defendants also failed to timely inform the
    parents of their own reproductive risks as carriers of the
    defective gene. The parents sought economic damages for,
    among other things, the cost of medical care for their second
    Cite as 
    326 Or App 318
     (2023)                                                   325
    child who was also born with the condition, as well as non-
    economic damages for emotional distress. 
    Id. at 435
    .
    Plaintiffs correctly point out that the injuries
    alleged in Tomlinson were economic and emotional and, on
    that basis, argue that the analysis does not apply in a case
    such as this one where a third-party plaintiff suffered a
    physical injury. They focus their arguments on lines of rea-
    soning that we do not find persuasive.3
    3
    Plaintiffs first argue that their claims may proceed under a common-law
    foreseeability analysis, whereby a physician may be liable to third parties when
    their negligent treatment of patients creates a foreseeable risk of physical injury
    to those third parties. See Horton v. OHSU, 
    277 Or App 821
    , 373 P3d 1158 (2016)
    (reversing dismissal of a mother’s claims for injuries resulting when she donated
    a portion of her liver to save her child as a foreseeable result of negligently per-
    formed liver surgery, holding that the mother’s claims were not foreclosed by the
    absence of a physician-patient relationship between herself and the defendant
    medical providers); Zavalas v. Dept. of Corrections, 
    124 Or App 166
    , 
    861 P2d 1026
    (1993), rev den, 
    319 Or 150
     (1994) (reversing an award of summary judgment to
    the defendant doctor and rejecting his arguments that a physician has no duty to
    third parties harmed as a foreseeable result of negligent treatment of a patient);
    Docken v. Ciba-Geigy, 
    86 Or App 277
    , 
    739 P2d 591
     (1987), rev den, 
    304 Or 405
    (1987) (reversing dismissal of claims brought by the estate of patient’s brother
    against prescribing physician, pharmacy, and drug manufacturer, holding that
    his claims for the fatal injury he suffered as a result of ingesting his brother’s
    medication were not foreclosed by the absence of physician-patient relationship
    between himself and the defendants). The difficulty with this line of reasoning
    is that, at common law, there is no duty to protect another from the conduct of a
    third party in the absence of a relationship creating such a duty. See generally
    Restatement (Third) of Torts: Phys. & Emot. Harm § 37 (2012). The cases cited by
    plaintiffs do not establish the existence of a general rule under Oregon law that
    a physician or medical provider is liable any time its actions create a foreseeable
    risk of injury to any third party.
    Relying on Cain v. Rijken, 
    300 Or 706
    , 
    717 P2d 140
     (1986), and ORS 426.232,
    plaintiffs also argue that defendants have a statutory duty to protect the public
    from persons with mental illness who are dangerous to others. The statutory duty
    in Cain was based on the defendants’ supervisory authority over Rijken who had
    been put under the jurisdiction of the Psychiatric Security Review Board (PSRB)
    and conditionally released under the supervision of Providence Medical Center.
    That “obligation to supervise Rijken’s conduct for the protection of the public”
    was “derived from the statutes defining the assignment Providence undertook for
    PSRB.” 
    Id. at 717
    ; ORS 161.336; ORS 161.390(3). The court opted to create a private
    right of action to enforce that duty even though the legislature neither expressly
    nor impliedly created such a right. Doyle v. City of Medford, 
    356 Or 336
    , 350, 337
    P3d 797 (2014). The statutory scheme laid out in ORS chapter 426 is not analo-
    gous insofar as it does not create an obligation for private practitioners to exercise
    that heightened level of supervision over a person. Furthermore, it specifically con-
    fers immunity from liability to practitioners exercising the powers granted under
    that chapter. See ORS 426.335(5) (“A licensed independent practitioner, hospital
    or judge may not be held criminally or civilly liable for actions pursuant to ORS
    426.228, 426.231, 426.232, 426.234 or 426.235 if the licensed independent practi-
    tioner, hospital or judge acts in good faith, on probable cause and without malice.”).
    326                                     Maltais v. PeaceHealth
    For purposes of this case, we use Tomlinson as a
    guide for our analysis of the duty owed to plaintiffs for two
    reasons. First, in Tomlinson, the Supreme Court applied
    its analysis in the context of an alleged failure to protect
    the parents from a risk of harm that the defendants did not
    themselves create. The injuries in that case were a result of
    reproductive risks associated with the parents’ preexisting
    genetic condition and the failure of the defendants to diag-
    nose that condition in their child. 
    Id. at 442-43
    . Similarly,
    Maltais suffered an injury that resulted from risks posed
    by N. H.’s preexisting psychiatric condition and defendants’
    alleged failure to appropriately assess that condition. See
    
    id.
     at 460 n 15. Second, the test for whether the breach of a
    duty can give rise to liability for a physical injury suffered
    by a third party should be no more demanding than the test
    that applies to a third-party claim for economic and emo-
    tional harms as described in Tomlinson; put another way,
    the test for economic and emotional harms might well be
    more demanding than that for physical injuries, see 
    id. at 443
     (“without some justification for providing legal protec-
    tion, a person is not generally required to affirmatively pro-
    tect the economic and emotional interests of others”), but, in
    any event, the test would not be less demanding. Because we
    ultimately conclude that plaintiffs have met that test, it is
    an appropriate measure to use in this case.
    Tomlinson explains that the relationship between
    a professional and third parties who are not their clients
    may, in appropriate circumstances, support that third par-
    ty’s negligence claim:
    “[I]n carrying out a professional obligation to a client,
    the professional may be required to protect the interests
    of a third party as well. In such circumstances, the pro-
    fessional’s relationship with a client not only gives rise to
    an obligation to protect the interests of the client, but it
    also can give rise to an obligation to protect the interests
    of a third party. The facts of particular cases will deter-
    mine what interests and what third parties receive such
    protection.”
    
    362 Or at 445
    . Such a determination will be made “on a case-
    by-case basis” and the court identified three considerations
    Cite as 
    326 Or App 318
     (2023)                                                 327
    that may guide that determination: “whether the rela-
    tionship between the parties is a type of relationship that
    generally entails a mutual expectation of service and reli-
    ance,” “whether the potential plaintiffs were identifiable to
    the defendant or otherwise could be defined as a class that
    avoids indeterminate liability,” and “whether recognizing
    such a claim would interfere with or impair the loyalties
    that the professional owes to the client.” 
    Id. at 446
    .4
    With those considerations in mind, we turn to plain-
    tiffs’ factual allegations, mindful that “a complaint must
    allege facts, not legal theories.” Fazzolari, 
    303 Or at 15
    . To
    determine whether the facts alleged in plaintiffs’ complaint
    sufficiently stated a negligence claim against defendants,
    we assume the truth of all well-pleaded factual allegations
    in the complaint and draw all reasonable inferences from
    those allegations in favor of plaintiffs. Tomlinson, 
    362 Or at 434
    .
    As to the relationship between the parties, plain-
    tiffs allege that defendants undertook to assess and treat
    N. H.’s psychiatric condition, specifically, to assess whether
    his worsening symptoms posed a danger to himself or his
    family members. Plaintiffs allege that Maltais had a history
    of participating in the psychiatric and medical care that
    N. H. received at PeaceHealth for many years prior to the
    incident at issue. They allege that she managed his med-
    ical and psychiatric care because his own ability to do so
    was severely impacted by his psychiatric condition and his
    4
    Defendants argued before the trial court that Tomlinson requires plain-
    tiffs to allege that they had a separate legally protected interest, wholly inde-
    pendent of N. H.’s interest in receiving non-negligent medical care, in order to
    state a claim against defendants. Although Tomlinson does explain that the par-
    ents in that case had a legally protected interest in reproductive autonomy, the
    medical providers’ duty to protect that interest arose out of their undertaking to
    diagnose the child’s genetic condition and therefore was not wholly independent.
    
    Id. at 446-47
    . Identifying a protected interest, here, is simply a way to establish
    that plaintiff suffered some legally cognizable damage. As discussed below, all
    persons in Oregon have a legally cognizable interest in being free from physi-
    cal harm at the hands of others. The requirement that plaintiffs must identify
    and allege an independent legally protected interest is better understood in its
    original context, which is to serve as a limit on liability for economic harms and
    emotional distress damages. See, e.g., I. K. v. Banana Republic, LLC, 
    317 Or App 249
    , 505 P3d 1078 (2022); Rathgeber v. James Hemenway, Inc., 
    176 Or App 135
    , 30
    P3d 1200 (2001), aff’d, 
    335 Or 404
    , 69 P3d 710 (2003); see also Philibert v. Kluser,
    
    360 Or 698
    , 385 P3d 1038 (2016).
    328                                           Maltais v. PeaceHealth
    intellectual disabilities. They allege that she accompanied
    him on his three visits to PeaceHealth that are the factual
    basis for their claims, and that she alerted the psychiatrist
    there to the specific threat that N. H. posed to her, that is,
    that he was experiencing urges to stab his family members
    with knives.
    Based on the facts alleged, defendants’ professional
    undertaking could reasonably include Maltais in her role as
    N. H.’s primary caregiver and as a person endangered by his
    condition. A factfinder could reasonably infer from the facts
    alleged that the providers at PeaceHealth and N. H. relied
    on Maltais to ensure that N. H. received appropriate care
    in light of his disabilities, and that this role is reflected in
    his medical records. Those facts could also support the addi-
    tional inference that Maltais, in turn, relied on the provid-
    ers at PeaceHealth to come to a correct diagnosis of N. H.’s
    deteriorating condition and to provide him with appropriate
    treatment, which would mitigate both the risk he posed to
    himself and also the specific risk he posed to her physical
    safety while she acted as his caregiver. Those allegations are
    sufficient, if proved, to show that the relationship between
    the parties fell within the scope of a professional undertak-
    ing giving rise to legal protection.
    As to whether “the potential plaintiffs were iden-
    tifiable to the defendant,” id. at 446, plaintiffs allege that
    Maltais was present during the three encounters that are
    the subject of this litigation and that N. H. expressed a spe-
    cific concern that he was being driven to do physical harm to
    his family members. Plaintiffs further allege that Maltais
    was N. H.’s mother and current caregiver. The allegations
    of negligence support an inference that defendants should
    have been aware of her relationship to N. H. and the dan-
    ger he posed to her safety. On these facts, defendants could
    readily identify Maltais as a person who was at risk of phys-
    ical harm at the hands of their patient.5
    Finally, we turn to the issue of whether recognizing
    Maltais’s claim “will interfere with or impair the loyalties
    5
    As such, it is not necessary to determine whether plaintiffs “otherwise
    could be defined as a class that avoids indeterminate liability.” Id.
    Cite as 
    326 Or App 318
     (2023)                             329
    that the professional owes to the client.” 
    Id. at 446
    . The rea-
    soning in Tomlinson is instructive here. The court explained
    that, in undertaking to provide medical care to their patient,
    the defendants in that case were subject to a professional
    standard of care to “provide the patient with the level of
    care that a reasonably prudent, careful, and skillful prac-
    titioner of the physician’s discipline would have provided to
    the patient under the same or similar circumstances and
    within the same community.” 
    Id. at 444
    . That standard of
    care required that the defendants take reasonable steps
    to come to a diagnosis under the circumstances, including
    seeking testing for a genetic disorder, as well as communi-
    cating a diagnosis of a genetic disorder to the plaintiffs as
    the legal guardians and biological parents of the patient.
    The actions a reasonably prudent medical professional
    would be expected to take under such circumstances was
    also the source of the parents’ reasonable expectation that
    they would receive warnings about their own genetic risks.
    The court observed further that recognizing the physician’s
    duty to provide such information to the parents did not
    present a conflict with the physician’s duty to protect their
    patient’s interest in the privacy of their medical informa-
    tion. 
    Id. at 447-48
    .
    The relevant question here is whether recognizing
    that defendants have a duty to protect Maltais from being
    injured by their patient, N. H., would undermine the care
    that they have a duty to provide to N. H. Maltais, like all
    persons, has “a legally protected interest to be ‘free from
    physical harm at the hands of another.’ ” Scott v. Kesselring,
    
    370 Or 1
    , 17, 513 P3d 581 (2022) (quoting Philibert v. Kluser,
    
    360 Or 698
    , 703, 385 P3d 1038 (2016)). We follow Tomlinson’s
    approach and look to the professional standard of care for
    guidance. Because the physical injury that Maltais suffered
    allegedly resulted from N. H.’s psychiatric condition, the
    issue posed is whether defendants’ professional standard of
    care included a duty to guard against that harm, and what
    steps they were obligated to take to fulfill that duty. See
    Curtis v. MRI Imaging Services II, 
    327 Or 9
    , 15-16, 
    956 P2d 960
     (1998) (where the standard of care in a particular med-
    ical profession dictates that precautions should be taken to
    avoid or minimize a harm, a professional can be liable for
    330                                               Maltais v. PeaceHealth
    failing to meet that standard of care); Restatement (Third)
    of Torts: Phys. & Emot. Harm § 41 comment g (2012) (When
    a patient poses a risk of harm, a mental health professional
    has a duty of reasonable care under the circumstances and
    that “reasonable care may require providing appropriate
    treatment, warning others of the risks posed by the patient,
    seeking the patient’s agreement to a voluntary commitment,
    making efforts to commit the patient involuntarily, or tak-
    ing other steps to ameliorate the risk posed by the patient.”).
    As relevant here, the complaint alleges that because
    defendants negligently failed to diagnose N. H. as danger-
    ous to himself and others, they thereby failed to “restrain,
    admit, or secure” him. Plaintiffs also invoke the professional
    standard of care in alleging that their injuries resulted from
    defendants’ “conduct beneath the level of care that reason-
    ably prudent, careful, and skilled practitioners of the respec-
    tive disciplines would be expected to provide under the same
    or similar circumstances within this community.” Here, as
    in Tomlinson, the theory of recovery is that the standard
    of care that applies to a medical professional’s treatment of
    their patient generates a duty to protect the interests of a
    nonpatient. Plaintiffs pled facts that, if proved, would show
    that defendants undertook to treat N. H., a patient who
    posed physical risks to himself and others, that they neg-
    ligently failed to appropriately assess his psychiatric condi-
    tion, and thus to discover that his condition created a risk of
    physical harm to his family members. Plaintiffs sufficiently
    pleaded the theory that defendants’ professional duty of care
    under these circumstances would include a duty to restrain
    or admit patients to mitigate the risks of physical harm that
    they pose to others. A reasonable factfinder could also con-
    clude based on the facts alleged that defendants did not mit-
    igate that risk by restraining or admitting N. H., and that
    the harms suffered by plaintiffs resulted from defendants’
    failure to do so.6
    6
    In Curtis, the court inferred that “particular aspects of the relevant stan-
    dard of care were at issue,” based on the plaintiff’s allegations: a duty to warn of
    the MRI procedure’s possible claustrophobic effects, to monitor the patient appro-
    priately, and to terminate the procedure if the patient begins to experience phys-
    ical or psychological difficulties. 
    327 Or at 14
    . The court observed that “a medical
    professional may operate under a standard of care that includes a specific duty
    to be aware of and guard against particular adverse psychological reactions or
    Cite as 
    326 Or App 318
     (2023)                                                331
    Defendants point to the provider’s obligation to pro-
    tect N. H.’s liberty interest and posit that a duty to protect
    that interest would conflict with a duty to protect Maltais’s
    interest in her physical safety. They contend that recog-
    nizing a duty to protect Maltais’s physical safety would
    require defendants to commit or otherwise restrain N. H.
    against his will. Whatever the merits of that argument in
    the abstract, it does not track the factual allegations in this
    case: The complaint alleges defendants negligently failed to
    “restrain, admit, or secure” N. H., and also that he “wanted
    to be admitted.” Taking the latter factual allegation as true,
    this is not a case in which involuntary commitment is at
    issue.
    Reversed and remanded.
    consequences to medical procedures.” Id. at 14-15. It concluded that the complaint
    was sufficient to state a claim for malpractice because it adequately alleged that
    the medical professionals owed a duty to plaintiff to identify and guard against
    predictable psychological reactions to the MRI procedure. Id. at 16.
    Here, plaintiffs allege that defendants failed to admit or restrain N. H. under
    circumstances where he posed a danger to others. The remaining allegations
    relate to defendants’ failure to appropriately assess N. H.’s dangerousness. As
    in Curtis, those allegations support an inference that “particular aspects of the
    relevant standard of care” are at issue, that is, what a reasonable practitioner
    should do under conditions where their patient poses a danger. As in Curtis, that
    is sufficient to state a claim. The specific conduct that is required by that stan-
    dard of care is a fact-dependent issue, and common-law principles of reasonable
    care are relevant to that issue. See Piazza v. Kellim, 
    360 Or 58
    , 73 n 9, 377 P3d
    492 (2016) (“[I]f the special relationship (or status or standard of conduct) does
    not prescribe a particular scope of duty, then common law principles of reason-
    able care and foreseeability of harm are relevant.” (Internal quotation marks and
    brackets omitted.)).
    

Document Info

Docket Number: A174706

Filed Date: 6/14/2023

Precedential Status: Precedential

Modified Date: 11/18/2023