On December 16, 2015, the Court of Appeals published its decision in Davis v. South Nassau Communities Hospital, holding that the hospital and its physicians could be held responsible under a theory of medical malpractice for a car accident allegedly caused by a patient who was discharged earlier in the day without warning that the pain medication administered to her may impair her ability to drive. The facts before the court involved a patient who had driven herself to the ER earlier in the day. Her treatment in the ER included IV opioid narcotic pain killer and benzodiazepine, both of which have labels warning of potential negative effects such as sedation and at least one label cautions against mental impairment when driving. While driving herself home from the hospital, the patient crossed a double yellow line and struck a bus driven by the plaintiff.
After the trial court dismissed the claims against the medical providers, the Appellate Court, Second Department upheld the decision. However, the Court of Appeals granted certiorari in response to plaintiff’s motion. The majority set forth its reluctance to expand duty of care against a medical provider beyond that owed to the patient. However, it was found that the hospital and its physicians owed plaintiff a duty of care to warn the patient that the medication administered to her either impaired or could impair her ability to safely operate the vehicle. While citing to several prior Court of Appeals decisions which refused to expand the duty of care beyond that owed to the patient, the Court noted that the door was left open to do so should the proper factual circumstanced present themselves. Here, it appears that the Court’s decision hinged on the fact that it was only the medical providers who could have warned the patient of the potential dangers of driving, and that as a result a duty of care was owed to those who were put into danger by the foreseeable happening of an automobile accident.
Despite that, the court took the opportunity to clarify how this apparent expanded duty of care can be met by medical providers:
Providers may comply with the expanded duty by “merely advising one to whom such medication is administered of the dangers of that medication.” The Court of Appeals specifically states that the ruling does not compel providers to prevent their patients from leaving the hospital, but does compel them to properly warn of the effects of the medications administered to them.
In fact, the court specifically warned that the decision in no way eroded the prevailing principle that lower courts should proceed cautiously when recognizing a duty of care. It was noted that despite temptation to provide a remedy for every wrong, the court cannot find that all mistakes result in liability.
Despite the Court of Appeals attempt to constrain this decision to a limited set of facts, it is inevitable that novel theories of liability will be asserted on the merits of this decision. In a lengthy, and spirited dissent, it was argued that the decision obliterates the precept that a physician only owes a duty of care to the patient, and not the community at large and that any exception to the rule (such as extending a duty to the parents of a minor) should be constrained by the specter of limitless liability. For the medical provider, clear written warnings citing all possible side effects and dangers of any drug administered should not be given and receipt acknowledged in writing by patients. However, as recognized by the consent, this overload of information may have the opposite desired effect, because by removing the physician’s role of curator of information may lead to the patient ignoring the pertinent warnings due to the sheer volume warning that may be irrelevant to that patient’s circumstances. For this reason, it may be advisable that the general warnings be accompanied by the discrete warnings pertinent to the specific situation.
Dylan C. Baverman, Esq