Several months ago, the final ruling on the Warren vs Dinter malpractice case in Minnesota caused shockwaves throughout the medical com- munity, raising concerns about physician liability expanding outside of the physician–patient rela- tionship. Here is a summary of an interview with Dr. MedLaw from a recent PW Podcast episode:

Here are the Facts

As outlined by Dr. MedLaw, a patient named Susan Warren went to a nurse practitioner with complaints of abdominal pain, fever, and chills. Warren also had a high white blood count and elevated blood glucose. Based on the information and examination, the nurse practitioner suspect- ed an infection and wanted to admit the patient to the hospital.

This hospital, however, followed a protocol that required a physician to vet a potential admission. The nurse practitioner called the on-call hospi- talist, Richard Dinter, MD, and discussed the patient’s symptoms and test results. Based on the call alone and without access to Warren’s chart, Dr. Dinter decided her symptoms were due to diabetes, and that hospitalization was not required.

Warren subsequently died from sepsis due to an untreated staph infection, and her family sued for medical malpractice.

Sent to the Courts

In response to the lawsuit, Dr. Dinter sought summary judgment, asking to be released from the case because he never formed a relationship with the patient. The court agreed that the hos- pitalist was only providing his thoughts to the nurse practitioner as a professional courtesy.

After the plaintiff appealed the decision, the appellate court reversed the trial court and, in short, ruled that even without the express relationship between the doctor and the pa- tient, there can still be an implied relation- ship, which will then bear the duty of care to the patient—and a duty based on foresee- ability of harm. What about curbsides? What about consulta- tions? Breathless headlines in medical newsletters flooded inboxes following the ruling.