Cram v. Howell
| Decision Date | 30 May 1997 |
| Docket Number | No. 67S01-9609-CV-608,67S01-9609-CV-608 |
| Parties | Gregory J. CRAM, Appellant (Plaintiff), v. Ray HOWELL, M.D., Appellee (Defendant). |
| Court | Indiana Supreme Court |
Thomas A. Withrow, B. Keith Shake, Debra A. Mastrian, Henderson, Daily, Withrow & Pence Devoe, Indianapolis, for appellant.
John David Hoover, Ronald G. Sentman, Sally F. Zweig, Johnson Smith Pence Densborn Wright & Heath, Indianapolis, for appellee.
On Petition To Transfer
Finding that a physician owed no duty of care to an unknown person allegedly injured by the physician's treatment of a patient, the Court of Appeals affirmed the trial court's dismissal of a medical malpractice complaint under Indiana Trial Rule 12(B)(6). Cram v. Howell, 662 N.E.2d 678 (Ind.Ct.App.1996). We granted transfer and now reverse the dismissal.
In reviewing a dismissal under Trial Rule 12(B)(6), an appellate court must determine whether, in the light most favorable to the plaintiff and with every inference drawn in his favor, the complaint stated any set of allegations upon which the trial court could have granted relief. See Culver-Union Township Ambulance Serv. v. Steindler, 629 N.E.2d 1231, 1235 (Ind.1994); Couch v. Hamilton County, 609 N.E.2d 39, 41 (Ind.Ct.App.1993); Ivey v. Massachusetts Bay Ins. Co., 569 N.E.2d 692, 694 (Ind.Ct.App.1991); Lincoln Nat'l Bank v. Mundinger, 528 N.E.2d 829, 832 (Ind.Ct.App.1988).
Pursuant to Indiana Code Section 27-12-11-1 and Indiana Trial Rule 12(D), the plaintiff in this medical malpractice case filed his proposed complaint and a motion for a preliminary determination of law regarding "the existence of a duty of a health care provider to third-party non-patients under the facts [of the proposed complaint]." Record at 8. Summarized, the plaintiff's proposed complaint includes the following assertions. The defendant, Dr. Ray Howell ("Dr. Howell"), gave his patient, Rodney Weninger ("Weninger"), certain immunizations and/or vaccinations at his office. This treatment caused Weninger to experience episodes of loss of consciousness, two of which occurred in Dr. Howell's office. Despite Weninger's loss of consciousness at the doctor's office, Dr. Howell failed to monitor Weninger for a sufficient period of time thereafter and failed to warn Weninger of the dangers associated with operating a vehicle after receiving the immunizations and/or vaccinations. Weninger then drove from Dr. Howell's office, lost consciousness, and his out-of-control vehicle collided with George Cram, causing Cram's death. Record at 5-7. The trial court found, as a matter of law, that the plaintiff's complaint "under the facts set forth therein, does not state a cause of action upon which relief can be granted as no duty as alleged exists under Indiana law," Record at 276, and dismissed the complaint pursuant to Trial Rule 12(B)(6).
In his appeal from the trial court dismissal, the plaintiff asserts that his complaint is sufficient to establish that the physician had a duty of care to the plaintiff's decedent in accordance with Webb v. Jarvis, 575 N.E.2d 992 (Ind.1991), another case involving the evaluation of a physician's duty to a third party. The existence of duty in a negligence case is a question of law appropriate for appellate determination. Id. at 995. In Webb we affirmed a summary judgment for a defendant physician in a malpractice claim alleging that the physician had prescribed anabolic steroids to a patient who developed a toxic psychosis from the medication and later went into a rage, shooting the plaintiff. To determine whether the defendant physician owed a duty of care to the victim of his patient's subsequent violence, we considered three factors: (1) the relationship between the parties; (2) the reasonable foreseeability of harm to the person who was injured; and (3) public policy concerns. Id. at 995. These three factors are used in a balancing approach, not as three distinct and necessary elements. 1 Id.
The analysis in Webb principally found: (1) that there was no relationship between the physician and the nonpatient injured plaintiff; (2) that it was not reasonably foreseeable the doctor's prescription would cause his patient to use a weapon to harm another because there was no sufficient "causal connection between the use of steroids and violent behavior," id. at 997; and (3) that public policy considerations weighed against imposing a duty on physicians to consider unknown third persons in deciding whether to prescribe a course of drug therapy for a patient. Id. In its conclusion, Webb emphasized that its application of the balancing test was necessarily case specific.
Our analysis of the three factors which must be balanced in order to impose a duty leads us to conclude that generally physicians do not owe a duty to unknown nonpatients who may be injured by the physician's treatment of a patient. This conclusion should not be interpreted as inoculating physicians so as to give them complete immunity against third person claims. In a different factual case, the duty analysis undertaken here could lead to a different conclusion. Under the...
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