Smith v. Radecki

• Decision Date: 27 August 2010
• Docket Number: No. S-13171.,S-13171.
• Citation: 238 P.3d 111
• Parties: Terry L. SMITH, Appellant, v. Patrick L. RADECKI, M.D., Appellee.
• Court: Alaska Supreme Court

238 P.3d 111

Terry L. SMITH, Appellant,

v.Patrick L. RADECKI, M.D., Appellee.

No. S-13171.

Supreme Court of Alaska.

Aug. 27, 2010.

Terry L. Smith, pro se, Fairbanks, Appellant.

Howard A. Lazar and Kendra E. Bowman, Delaney Wiles, Inc., Anchorage, for Appellee.

Before: CARPENETI, Chief Justice, FABE, WINFREE, CHRISTEN, and STOWERS, Justices.

OPINION

CHRISTEN, Justice.

I. INTRODUCTION

Terry Smith injured his back while working for CSK Auto, Inc. (CSK) and brought a workers' compensation claim. CSK arranged for Dr. Patrick Radecki to perform an independent medical examination to assess Smith's condition. Dr. Radecki examined Smith and reported that he had no physical injury resulting from the incident. But Smith later underwent an MRI which revealed several spinal problems, including a Tarlov cyst. Smith filed suit against Dr. Radecki. His complaint included claims arising from Dr. Radecki's alleged failure to discover the existence of the cyst and Smith's earlier “failed” back surgery. In the alternative, Smith alleged that Dr. Radecki did discover his true back condition but failed to report it. The superior court granted Dr. Radecki's motion for summary judgment, ruling that Dr. Radecki and Smith did not have the requisite physician-patient relationship upon which to base a medical malpractice claim, and that Smith's claims were barred by the statute of limitations. Because we conclude that all of Smith's claims were dependent upon him having a physician-patient relationship with Dr. Radecki, and Smith did not have a physician-patient relationship with Dr. Radecki, we affirm the superior court's ruling. We do not reach the statute of limitations issue.

II. FACTS AND PROCEEDINGS

On March 29, 2001, Terry Smith injured his back while working as a delivery driver for CSK. Unloading cases of antifreeze from the bed of his truck, Smith “lifted and twisted” to remove two cases that were strapped together and immediately experienced “pain in his back and leg that took his breath away.” Smith sought medical attention the next day and was treated for “acute muscle strain.” He received temporary total disability benefits from March 30, 2001, through April 13, 2001.

When Smith's pain did not improve, additional assessments were performed which revealed abnormalities at L5 and possible degenerative disc disease at L4-5. He underwent a variety of treatments including medication, physical therapy, participation in a work hardening program, and epidural steroid injection. ¹ Smith was given some authorized time loss from work and then deemed partially disabled effective May 14, 2001. He returned to work in “a light duty capacity” from May 14 through July 8, 2001, but he continued to report symptoms including weakness, dizziness, disorientation, loss of consciousness, and pain. Smith began to miss work again and received additional temporary total disability benefits. But on August 14, 2001, Dr. Susan Klimow found Smith “medically stable.” ² Later that month Smith's treating doctors began to consider the possibility of psychological factors in his continuing complaints of pain, but physical interventions for his symptoms continued into 2003. ³

CSK arranged for Dr. Patrick Radecki to perform an independent medical examination (IME) of Smith on July 25, 2003. Dr. Radecki's report states that prior to conducting the examination he informed Smith (1) “that the purpose of the examination was to address specific injuries or conditions, as outlined by [CSK's insurance carrier],” (2) that the IME was “not a substitute for his/her personal physician(s) or health care,” and (3) that “[n]o physician/patient relationship exists or is sought.” Smith did not dispute that he received this statement describing the scope of Dr. Radecki's engagement.

The report Dr. Radecki prepared reflects his conclusion that Smith suffered from “[m]ild degenerative disc disease” in his “lumbar spine, including minimal disc bulge which [was] not ... symptomatic,” and exhibited “nonphysiologic pain behavior and multiple nonphysiologic responses to physical maneuvers ... that should not cause pain, typical of psychogenic pain disorder, severe in nature.” In his report Dr. Radecki stated that “there is no objective evidence of permanent partial impairment that can be said to have been caused by the March 29, 2001, incident,” advised against further physical or pharmacological interventions, and suggested psychological treatment and weight loss.

Smith again reported severe pain symptoms during subsequent vocational rehabilitation and underwent an MRI at Fairbanks Memorial Hospital on November 8, 2004. The MRI revealed disc desiccation at the L5-S1, L4-L5, and L3-L4 levels, displacement of the left S1 nerve root, L5 limbus vertebra, and a small sacral Tarlov cyst. ⁴

On December 17, 2004, Smith filed a workers' compensation claim for ongoing medical bills and temporary total disability during recovery from anticipated back surgery. The claim alleged that the anticipated surgery would address pain arising from Smith's 2001 work-related injury. CSK controverted the claim, relying principally upon Dr. Radecki's conclusions that: (1) Smith was medically stable as of July of 2003; (2) Smith had no permanent impairment resulting from the 2001 injury; and (3) Smith did not require further medical treatment.

Smith filed suit against Dr. Radecki in the superior court in October 2006. His complaint included 18 claims that we group into three categories: (1) claims arising from Dr. Radecki's alleged failure to discover and properly treat his back condition; ⁵ (2) claims associated with the alternative theory that Dr. Radecki did discover the nature of Smith's back condition but did not report these findings to Smith; ⁶ and (3) claims that are actually prayers for relief when read in context. ⁷

Dr. Radecki moved for summary judgment on the grounds that Smith's claims were: (1) barred by the statute of limitations; and (2) precluded by the lack of a physician-patient relationship and corresponding duty of care. Dr. Radecki asked the superior court to “construe each of plaintiff's allegations as sounding in medical malpractice” and argued that “for plaintiff to succeed on any of [his] claims, there must have been a physician/patient relationship.” Smith's opposition to the motion did not respond to the contention that Smith's claims should be treated as a malpractice allegation, but it did reiterate Smith's entire list of claims.

The superior court granted summary judgment, ruling that Dr. Radecki did not owe Smith a duty of care and that the statute of limitations barred his claims. The court's order did not distinguish between Smith's claims, impliedly treating them all as variously-stated claims for medical malpractice. Smith moved for reconsideration of the order granting summary judgment, but the superior court denied his motion and entered final judgment in favor of Dr. Radecki. Smith appeals.

III. STANDARD OF REVIEW

We review a grant of summary judgment “de novo, affirming if the record presents no genuine issue of material fact and if the movant is entitled to judgment as a matter of law. All reasonable inferences are drawn in favor of the nonmovant in this examination.” ⁸

We review questions of law using the de novo standard, “apply[ing] our independent judgment to questions of law, adopting ‘the rule of law most persuasive in light of precedent, reason, and policy.’ ” ⁹

IV. DISCUSSION

Dr. Radecki argues that he did not owe a duty of care to Smith because he did not have a physician-patient relationship with Smith. Dr. Radecki examined Smith only once, and only in the context of conducting an IME. His report reflects the fact that Smith was informed of the limited nature of their professional relationship.

Alaska Statute 09.55.540 defines the standard of care for malpractice actions based upon the negligent or willful misconduct of health care practitioners. We have previously held that the duty to meet this standard of care arises specifically from the existence of a physician-patient relationship. ¹⁰ We have not previously considered whether the performance of an IME creates a physician-patient relationship between a doctor and an examinee or whether such an examination otherwise gives rise to a duty of care owed to the examinee.

Alaska Statute 09.55.540 requires that a party alleging medical malpractice in Alaska must prove:

(1) the degree of knowledge or skill possessed or the degree of care ordinarily exercised under the circumstances, at the time of the act complained of, by health care providers in the field or specialty in which the defendant is practicing;

(2) that the defendant either lacked this degree of knowledge or skill or failed to exercise this degree of care; and(3) that as a proximate result of this lack of knowledge or skill or the failure to exercise this degree of care the plaintiff suffered injuries that would not otherwise have been incurred.

In M.A. v. United States, we held that the duty to meet the standard of care specified in AS 09.55.540 is dependent upon the existence of a physician-patient relationship. ¹¹ M.A. involved a minor's parents who alleged that their child's physician owed an independent duty of care to them. We held that the source of a physician's duty to provide reasonably competent medical care lies in the unique nature of the physician-patient relationship, and that a physician owes no comparable duty of care where no physician-patient relationship exists. ¹² Dr. Radecki relied on M.A. in his motion for summary judgment to support his argument that he did not owe a duty of care to Smith.

Decisions from the majority of other states support Dr. Radecki's assertion that Smith's medical malpractice claim should fail as a matter of law for lack of a duty of care. These jurisdictions have concluded that an IME performed at the behest of a third party does not give rise to a physician-patient...