Can a hospitalist be held liable for advising against admitting a patient to a hospital when he has no doctor-patient relationship and no direct contact with the patient? In Warren v. Dinter, 926 N.W.2d 370 (Minn. 2019), Susan Warren arrived at a health clinic with symptoms of abdominal pain, fever, and chills. A nurse practitioner (Simon) ordered tests and concluded that the patient had an infection that required hospitalization. Simon then called a local hospital to seek admission for the patient, and her call was randomly assigned to Dr. Richard Dinter, a hospitalist on call. Although the facts were disputed as to the nature of the conversation between Simon and Dr. Dinter, the Warren court accepted the nurse's account that Dr. Dinter decided that the patient did not need to be admitted to the hospital.
Three days later, the patient died at home. Her son sued the doctor and the hospital, alleging negligence in caring for the patient, including advising the nurse that the patient did not require hospitalization. The lower courts ruled that there was no liability, concluding that the relationship between the nurse and the doctor was merely an informal conversation and did not create a doctor-patient relationship.
Although the case raised an issue of first impression, the Minnesota Supreme Court noted that physicians have sometimes been held liable in the absence of a doctor-patient relationship. In one prior case, a doctor incorrectly told a patient's parents that it was safe to visit her at the hospital and take her home because she was no longer contagious. The parents became ill, and the doctor was found to owe a duty of care to the parents.
The Warren court ruled that the hospitalist owed a duty to the patient based on foreseeability of harm. "[A] duty arises between a physician and an identified third party when the physician provides medical advice and it is foreseeable that the third party will rely on that advice." Id. at 376. The court explained that "it is reasonable to conclude that Dinter knew, or should have known, that his decision whether or not to admit a prospective patient, based on his own medical judgment, would be relied on by Simon and her patient. He also knew, or should have known, that a breach of the applicable standard of care could result in serious harm. Finally, there is sufficient evidence in the record—the opinion of appellant's medical expert that the applicable standard of care was, in fact, breached and caused Warren's death—to survive a summary-judgment motion." Id. at 378.