New York Law Review

Tag: Physician-Patient Relationship

  • Bazakos v. Lewis, 12 N.Y.3d 631 (2009): Statute of Limitations for Negligence During an Independent Medical Exam

    Bazakos v. Lewis, 12 N.Y.3d 631 (2009)

    A claim against a doctor for negligence during an Independent Medical Examination (IME) is a claim for medical malpractice, subject to CPLR 214-a’s two-year-and-six-month statute of limitations, even in the absence of a traditional doctor-patient relationship.

    Summary

    Lewis Bazakos sued Dr. Philip Lewis, alleging injury during an IME required for a previous lawsuit. Bazakos claimed Lewis negligently injured him by forcefully rotating his head. The suit was filed approximately 2 years and 11 months after the IME. The court addressed whether such a claim constitutes medical malpractice subject to a shorter statute of limitations, or ordinary negligence. The Court of Appeals held that the claim was for medical malpractice because the doctor’s actions involved medical skill, and the legislative intent behind the shorter statute of limitations for malpractice applied equally to IMEs. Therefore, the claim was time-barred.

    Facts

    Lewis Bazakos was involved in a prior lawsuit stemming from an automobile accident. As part of that lawsuit, Bazakos was required to undergo an Independent Medical Examination (IME) by a physician selected by the opposing party.

    The opposing party designated Dr. Philip Lewis to conduct the IME. Dr. Lewis examined Bazakos on November 27, 2001.

    Bazakos alleged that during the IME, Dr. Lewis injured him by “tak[ing] plaintiff’s head in his hands and forcefully rotated it while simultaneously pulling.”

    Procedural History

    Bazakos commenced an action against Lewis on October 15, 2004, approximately 2 years and 11 months after the IME.

    Lewis moved to dismiss, arguing the claim was barred by the statute of limitations. Supreme Court granted the motion, relying on Evangelista v. Zolan.

    The Appellate Division reversed, overruling Evangelista, holding the action was timely because no physician-patient relationship existed, thus the claim was not for medical malpractice. Two justices dissented.

    The Appellate Division granted Lewis leave to appeal, certifying the question of whether its order was properly made.

    Issue(s)

    Whether a claim against a doctor for alleged negligence during an Independent Medical Examination (IME) constitutes a claim for “medical malpractice” under CPLR 214-a, thus subject to the statute’s two-year-and-six-month statute of limitations.

    Holding

    No, because such actions involve medical treatment by a licensed physician, regardless of the absence of a traditional physician-patient relationship.

    Court’s Reasoning

    The Court reasoned that the essence of Bazakos’s claim, like any medical malpractice claim, is that a doctor failed to competently perform a procedure requiring specialized medical skill.

    The Court emphasized that the act underlying the lawsuit – Lewis’s manipulation of Bazakos’s body – constitutes “medical treatment by a licensed physician,” thus negligent performance constitutes medical malpractice, citing Weiner v. Lenox Hill Hosp., 88 N.Y.2d 784, 788 (1996).

    The Court noted the legislative intent behind CPLR 214-a, enacted to address a crisis in medical malpractice insurance, aimed to enable “health care providers to get malpractice insurance at reasonable rates” (quoting Bleiler, 65 NY2d at 68). The Court found it unlikely the Legislature intended to exclude doctors performing IMEs from this protection.

    The Court agreed with the dissenting Justices at the Appellate Division that a “limited physician-patient relationship” exists during an IME, referencing an AMA opinion on the ethical responsibilities of doctors performing IMEs.

    Quoting Dyer v. Trachtman, 470 Mich. 45, 49-50, 679 N.W.2d 311, 314-315 (2004), the Court stated that this limited relationship “imposes a duty on the IME physician to perform the examination in a manner not to cause physical harm to the examinee.”

    The dissenting opinion argued that medical malpractice requires medical treatment, which was absent in the IME context. The dissent emphasized that the purpose of CPLR 214-a was to protect health care providers offering treatment, not those providing litigation support services. The dissent asserted that context matters, and that what constitutes malpractice in a treatment setting may not in an IME setting, highlighting the limited scope of responsibility in an IME.

  • Aufrichtig v. Lowell, 85 N.Y.2d 540 (1995): Physician’s Duty to Provide Truthful Information

    Aufrichtig v. Lowell, 85 N.Y.2d 540 (1995)

    A treating physician owes a duty to their patient to provide truthful information regarding the patient’s medical condition, especially when providing sworn testimony or affidavits that the patient’s insurance company will rely on.

    Summary

    This case addresses whether a physician can be held liable for providing false information about a patient’s condition to the patient’s insurance company. The Aufrichtigs sued Dr. Lowell, alleging he provided a false affidavit to their insurance company, leading to a reduced settlement in their insurance coverage dispute. The New York Court of Appeals held that factual issues existed regarding whether Dr. Lowell breached his duty to provide truthful information, precluding summary judgment. The court emphasized the physician’s duty of trust and honesty to the patient, particularly when providing sworn statements.

    Facts

    Janette Aufrichtig, suffering from severe multiple sclerosis, required 24-hour skilled nursing care according to her primary care physician, Dr. Lowell. Hartford Insurance Company, initially providing reimbursement for this care, later reduced coverage based on a different neurologist’s assessment. The Aufrichtigs sued Hartford in federal court, alleging Mrs. Aufrichtig needed round-the-clock care. Dr. Lowell initially provided deposition testimony and an affidavit favorable to Hartford, stating Mrs. Aufrichtig only needed skilled nursing care at meal times. He later recanted, providing a new affidavit stating she needed constant care. Due to the conflicting statements, the federal judge encouraged settlement, resulting in a reduced benefits agreement.

    Procedural History

    The Aufrichtigs sued Dr. Lowell in state court for damages caused by his allegedly false affidavit. The Supreme Court granted Dr. Lowell’s motion to dismiss, and the Appellate Division affirmed. The Court of Appeals granted leave to appeal.

    Issue(s)

    Whether a treating physician can be held liable for breach of duty to a patient for providing false information to the patient’s insurance company regarding the patient’s medical condition when the information is used to reduce insurance benefits.

    Holding

    Yes, because a treating physician owes a duty of care to the patient to not impart false information in formal sworn submissions, especially when the litigation involves the patient’s medical condition and insurance benefits.

    Court’s Reasoning

    The Court of Appeals emphasized the fiduciary-like relationship between a physician and patient, stating that a physician has a duty to provide truthful information about a patient’s condition, especially when providing sworn testimony. The court distinguished this from a medical malpractice claim, focusing on the distinct duty of a physician to be truthful when providing information. The court noted that Dr. Lowell’s conflicting statements created a factual issue regarding whether he breached this duty. The court pointed out that doctors who provide false information may face professional misconduct charges under Section 6509 of the Education Law, highlighting the importance of truthful reporting. The court reasoned that Dr. Lowell was the key source of information about Mrs. Aufrichtig’s condition, and his false statements directly impacted the federal court case. The court stated, “[P]art of a physician’s duty to the patient, when authorized to supply otherwise confidential information to others…includes truthful utterances, particularly…when delivered under oath and with awareness that a false statement will be relied upon to the detriment of the patient.” Because Dr. Lowell admitted his initial statements were false and his testimony was crucial to the insurance coverage decision, summary judgment was inappropriate. The settlement, allegedly spurred by the trial judge’s assessment of the case based on Dr. Lowell’s contradictory statements, further supported the need for a trial on the merits.

  • Massie v. Crawford, 78 N.Y.2d 516 (1991): Application of the Continuous Treatment Doctrine in Medical Malpractice

    78 N.Y.2d 516 (1991)

    The continuous treatment doctrine tolls the statute of limitations for medical malpractice actions when the course of treatment, including wrongful acts or omissions, runs continuously and relates to the same original condition or complaint.

    Summary

    This case addresses the application of the continuous treatment doctrine to toll the statute of limitations in a medical malpractice action. The plaintiff, Massie, claimed the defendant, Crawford, committed malpractice by prescribing birth control pills despite her history of phlebitis. The defendant moved to dismiss based on the statute of limitations. The Court of Appeals held that the continuous treatment doctrine did not apply because the record did not establish a continuing patient/physician relationship related to the initial prescription. The Court emphasized that the policy behind the doctrine is to allow physicians to correct their own malpractice without interruption, a rationale inapplicable when continuous treatment is absent.

    Facts

    The plaintiff, Massie, alleged that the defendant, Crawford, committed medical malpractice by prescribing birth control pills, despite knowing her prior history of phlebitis while taking similar medication. The prescription was allegedly given nearly three years before the commencement of the lawsuit.

    Procedural History

    The defendant moved to dismiss the action as untimely under the statute of limitations. The plaintiff argued that the continuous treatment doctrine tolled the statute. The lower courts ruled against the plaintiff. The Court of Appeals affirmed the lower court’s decision, finding no basis in the record to support the application of the continuous treatment doctrine.

    Issue(s)

    Whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice action where the plaintiff alleges the defendant prescribed medication despite a known contraindication, and where the record does not establish a continuing physician-patient relationship related to that prescription.

    Holding

    No, because the record did not reflect that plaintiff contemplated, or had, a continuing patient/physician relationship with defendant concerning the original condition or complaint.

    Court’s Reasoning

    The Court of Appeals affirmed the order dismissing the case, holding that the continuous treatment doctrine did not apply. The court emphasized that the doctrine tolls the 2 ½-year limitations period when the course of treatment, including the wrongful acts, runs continuously and is related to the same original condition or complaint, citing CPLR 214-a; Nykorchuck v Henriques, 78 NY2d 255; and McDermott v Torre, 56 NY2d 399, 408. The court stated, “The premise underlying the doctrine is that a plaintiff should not have to interrupt ongoing treatment to bring a lawsuit, because the doctor not only is in a position to identify and correct the malpractice, but also is best placed to do so.”

    However, the court found that the plaintiff’s complaint and affidavits lacked support for her counsel’s assertions that the defendant supplied a six-month prescription, that she complained of leg pain, and that he advised her to continue the medication. Crucially, the court stated, “Indeed, the record does not reflect that plaintiff contemplated, or had, a continuing patient/physician relationship with defendant.” Therefore, the court did not reach the legal question of whether the conduct argued by counsel could constitute continuous treatment.

  • Shapira v. United Medical Service, Inc., 15 N.Y.2d 200 (1965): Establishing Physician-Patient Relationship for Payment

    15 N.Y.2d 200 (1965)

    A physician-patient relationship can be established even without explicit agreement on payment, especially when a specialist is called in for treatment, and the physician is entitled to a fee for services rendered when the patient is covered by a service contract that contemplates such payment.

    Summary

    Dr. Shapira, a surgical specialist, sued United Medical Service, Inc. to recover payment for services rendered to a patient covered by the defendant’s service contract. The Court of Appeals held that a physician-patient relationship was established when Dr. Shapira examined and operated on the patient, and the defendant was obligated to pay for the services under its contract. The dissent argued that the established practice and the terms of the service agreement implied an obligation to pay the physician’s fees, and the defendant’s refusal to pay constituted an unjust windfall.

    Facts

    Dr. Shapira, a surgical specialist, was called to examine Caleen Sinnette, a 10-year-old patient covered by United Medical Service, Inc.’s service contract.
    Dr. Shapira personally examined the patient and performed a successful surgical operation.
    United Medical Service, Inc. had a service contract with the patient’s family, obligating them to pay for medical services.
    Dr. Shapira sought payment for his services from United Medical Service, Inc., but they refused to pay.

    Procedural History

    Dr. Shapira sued United Medical Service, Inc. to recover payment for his services.
    The trial court found that Dr. Shapira had a special contractual relationship with United Medical Service, Inc.
    The Court of Appeals reviewed the case to determine whether the physician-patient relationship and obligation to pay were established.

    Issue(s)

    Whether a physician-patient relationship is established when a specialist examines and operates on a patient referred by another doctor.
    Whether United Medical Service, Inc. is obligated to pay Dr. Shapira for services rendered to a patient covered by their service contract.

    Holding

    Yes, because the act of examining and operating on the patient establishes a physician-patient relationship, especially when a specialist is called in.
    Yes, because the service contract contemplated payment for such services, and the defendant should not receive a windfall by avoiding its obligation.

    Court’s Reasoning

    The court reasoned that a physician-patient relationship arises from the examination and treatment of a patient, even without explicit agreement on payment. The dissent emphasized the practical construction of the agreement by the parties involved. It was undisputed that Dr. Shapira was a surgical specialist and that he performed the surgery.
    The dissent stated, “To hold that the relationship of physician and patient does not arise on these facts alone runs against established procedures in modern hospitals and in the practice of present-day medicine. In countless instances this is the way a surgeon or other specialist is called into a case to render treatment.”
    The dissent further argued that United Medical Service, Inc.’s long-standing practice of paying such fees implied an obligation to pay Dr. Shapira. The dissent noted that the defendant itself had previously paid fees earned in the same way Dr. Shapira’s fee was earned. The intent of relevant statutes was not to prohibit collection of fees chargeable to insurance coverage. The dissent concluded that allowing the defendant to escape liability would be unjust. It was irrelevant to the defendant’s obligation what Dr. Shapira did with the fees he was entitled to receive.