Disturbing MA Court Decision against physicians

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In Coombes v. Floria, 877 N.E.2nd 567 (Mass.2007) the Supreme Judicial Court

of Massachusetts extended the duty to warn patients of side effects of

prescriptions to foreseeable third parties.

Coombes was killed in an accident when hit by Sacca, a patient of Dr.

Florio. Sacca was 75 and suffered from asbestosis, chronic bronchitis,

emphysema,

high blood pressure, and metastatic lung cancer. In the past Florio had warned

Sacca not to drive during cancer treatments, but when treatment ended, said

that it would be safe for him to drive again. Potential SEs of the prescribed

drugs were drowsiness, dizziness, lightheadedness, fainting, altered

consciousness, and sedation.

The Court found that Coombes' claim was NOT A MALPRACTICE CLAIM, BUT A COMMON

LAW NEGLIGENCE CLAIM (and thus would not be covered by malpractice

insurance).

It also found that a finding of negligence against Florio would not require a

direct physician-patient relationship. The Court found that the duty to warn

extended to Coombes because his injury was a foreseeable consequence of that

negligence.    The Court said that when side effects are likely to impair the

patient's mental capacity, the foreseeable risk of injury in a car accident is

not limited to the patient, and that it is irrelevant whether the defendant

did foresee, or should have foreseen THE PARTICULAR PLAINTIFF in the particular

circumstances even if there is an intermediary actor.

My comment: This effectively makes the physician the insuror of the

well-being of any driver on the highway with a patient who is taking drugs

prescribed

by a physician. The Court did not mention Florio's prior warning about

driving or whether or not Florio even knew that Sacca was still taking the drugs

at

the time of the accident. Can anyone think of ways this decision, if

followed by other courts, could affect paramedic practice? For example, what

if a

patient refuses care, but later is found to have been mentally impaired and

kills somebody? The patient expresses what a paramedic SHOULD HAVE KNOWN to be

suicidal/homicidal ideaology and kills someone. Could the paramedic be

liable to the 3rd party killed for failure to warn?

However, the Court sent the case back to the trial court to determine whether

or not Dr. Florio breached his " duty " to Coombes.

This case appears to go even further than Tarasoff v. Regents, in which the

California Court held that a psychiatrist owed a duty to a patient's intended

victim of harm. The MA case would seem to extend the duty to ANY person who

might come into contact with the patient.

GG.

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