Dupree v. Giugliano, 20 N.Y.3d 921 (2012)
A sexual relationship between a therapist and patient can constitute medical malpractice if it is substantially related to and interferes with the patient’s mental health treatment; however, punitive damages require a showing of malicious or evil conduct beyond a breach of professional duty.
Summary
Kristin Dupree sued her therapist, James Giugliano, for medical malpractice after they engaged in a sexual relationship during her treatment for depression and anxiety. The New York Court of Appeals held that the sexual relationship could be considered medical malpractice because it was substantially related to her treatment. However, the court vacated the punitive damages award because there was no evidence that the doctor willfully caused the plaintiff’s transference or harm. The court also upheld the jury’s finding of comparative fault, concluding that the plaintiff was partially responsible for the affair.
Facts
Kristin Dupree sought treatment from James Giugliano for depression and stress. Giugliano prescribed antidepressants and referred her to a therapist. Later, Dupree and Giugliano began an adulterous relationship, initiated at a gym where he was showing her exercises to relieve stress. The affair lasted nine months, ending by mutual decision. Dupree confessed the affair to her husband, leading to a contentious divorce.
Procedural History
Dupree sued Giugliano for medical malpractice. The trial court charged comparative fault, and the jury found Giugliano liable, assigning 25% fault to Dupree. The jury awarded damages for mental distress and lost income, as well as punitive damages. The Appellate Division affirmed the judgment. Both parties sought leave to appeal, which was granted. The Court of Appeals modified the Appellate Division’s order by vacating the award for punitive damages, and affirmed the remainder of the order.
Issue(s)
1. Whether a sexual relationship between a therapist and patient can constitute medical malpractice.
2. Whether the trial court properly charged comparative fault to the jury.
3. Whether the circumstances warranted an award of punitive damages.
Holding
1. Yes, because the sexual relationship was substantially related to and interfered with Dupree’s mental health treatment.
2. Yes, because the jury could reasonably conclude that Dupree was partly responsible for the affair, even considering the “transference” phenomenon.
3. No, because there was no evidence of evil or malicious conduct beyond a breach of professional duty.
Court’s Reasoning
The Court of Appeals reasoned that the standard for medical malpractice is whether the challenged conduct constitutes medical treatment or bears a substantial relationship to the physician’s treatment of the patient. Here, Giugliano was treating Dupree’s mental health problems, including prescribing medication and counseling. The court held that “a jury might reasonably conclude that the sexual relationship was substantially related to and, in fact, interfered with the treatment so as to constitute medical malpractice.”
Regarding comparative fault, the court found that the affair continued for nine months, and both parties sought out repeated sexual encounters. Thus, the jury could reasonably discount the expert’s testimony that Dupree was wholly without volition in the matter.
Finally, the court determined that punitive damages were improperly charged because the standard for such an award requires a defendant to manifest evil or malicious conduct beyond any breach of professional duty. The court quoted Prozeralik v Capital Cities Communications, 82 NY2d 466, 479 (1993) stating the test is whether there was “aggravation or outrage, such as spite or ‘malice,’ or a fraudulent or evil motive on the part of the defendant, or such a conscious and deliberate disregard of the interests of others that the conduct may be called wilful or wanton’.” There was no evidence that Giugliano willfully caused Dupree’s transference or harm.