Van Horn v. Chambers

• Decision Date: 03 July 1998
• Docket Number: No. 97-0630,97-0630
• Citation: 970 S.W.2d 542
• Parties: 41 Tex. Sup. Ct. J. 1168 Gage VAN HORN, M.D., Petitioner, v. Wallace Lee CHAMBERS, Annie Mae Chambers, and Edward Johnson, Respondents.
• Court: Texas Supreme Court

Page 542

970 S.W.2d 542

41 Tex. Sup. Ct. J. 1168

Gage VAN HORN, M.D., Petitioner, v. Wallace Lee CHAMBERS, Annie Mae Chambers, and Edward Johnson, Respondents.

No. 97-0630.

Supreme Court of Texas.

Argued Jan. 8, 1998.

Decided July 3, 1998.

Rehearing Overruled July 3, 1998.

Terry O. Tottenham, Austin, Renee A. Forinash, San Antonio, Dean A. Schaffer, Austin, for Petitioner.

Gayle E. Oler, Dallas, Winfred H. Morgan, Michael Phillips, Evelyn T. Ailts, Ray L. Shackelford, Houston, for Respondents.

GONZALEZ, Justice, delivered the opinion of the Court, in which PHILLIPS, Chief Justice, HECHT, ENOCH, SPECTOR, OWEN, BAKER and HANKINSON, Justices, joined.

The motion for rehearing is overruled. Our opinion of May 8, 1998, is withdrawn and the following is substituted in its place.

The issue in this case is what duty a physician owes to third parties outside the physician-patient relationship. Two hospital employees were killed and a fellow employee injured while trying to subdue a violent patient. The episode occurred after an attending physician transferred the patient from the neurological critical care unit to a private room on an unsecured general floor. The injured employee and the parents of one of the deceased employees sued the physician for negligence and gross negligence in causing the bodily injuries and wrongful death. The trial court granted summary judgment for the physician. The court of appeals reversed. Chambers v. Hermann Hosp. Estate, 961 S.W.2d 177 (Tex.App.-Houston [1st Dist.]1996) . We reverse the court of appeals' judgment and render judgment that the plaintiffs take nothing.

I

In April 1991, Johnny Long, Jr., was taken to the Hermann Hospital emergency room and was admitted for treatment of seizures and alcohol withdrawal. Long was combative on arrival. Emergency room personnel sedated him, administered anti-seizure and other medications, and secured him with leather restraints. The next day, Long was transferred to the hospital's neurological critical care unit ("NCCU"), where neurologist Dr. Gage Van Horn was the attending physician. On Long's second day in the NCCU, Van Horn determined that Long no longer required critical care and transferred him to a private room. After Van Horn finished his duties in the NCCU on that day, he had no further contact with Long until after the incident that is the basis of this suit.

That incident occurred the day after Long was transferred to his private room, when Long decided that he wanted to leave the hospital. Hospital personnel confronted Long to prevent him from leaving. After Long fled into the hallway, hospital food service worker Edward Johnson, patient care technician Ronald Chambers, and medical student Richard Larramore tried to stop him. During a struggle, all four men crashed through a large louvered grill covering an open air shaft and fell twenty-four feet to a concrete floor. Chambers and Larramore died; Long and Johnson were injured.

Johnson and Chambers' parents, Wallace Lee and Annie Mae Chambers, sued Van Horn for Johnson's injuries and Chambers' wrongful death, alleging negligence and gross negligence. The claims against Van Horn from the plaintiffs' petition are that he:

1) failed to properly diagnose Long's condition;

2) failed to select, prescribe, and oversee the proper treatment for Long's condition;

3) ordered and/or failed to prevent Long's transfer to an unsecured floor, which had inadequate facilities to treat Long's violent and disruptive behavior;

4) failed to see that Long was transferred to a proper facility to handle his violent and disruptive behavior;

5) permitted Long to remain on an unsecured floor after he exhibited signs that he would erupt into violent and disruptive behavior; and

6) failed to order mandatory physical restraints to be placed on Long while on the unsecured floor.

Van Horn moved for summary judgment, asserting that he owed no duty to the plaintiffs, did not breach any duty if he did owe one, and did not proximately cause the plaintiffs' injuries. The trial court granted Van Horn's motion for summary judgment without specifying the grounds. The court of appeals reversed, holding that Van Horn owed a duty to non-patient third parties based on this Court's decision in Otis Engineering Corp. v. Clark, 668 S.W.2d 307 (Tex.1983). 961 S.W.2d at 188-89. The court of appeals determined that a fact issue existed concerning whether Van Horn had taken control over the patient and then failed to reasonably exercise that control. Id. at 189. Three justices dissented to the court of appeals' overruling of the motion for rehearing and motion for rehearing en banc. Id. at 193-97.

II

A negligence cause of action has three elements: 1) a legal duty; 2) breach of that duty; and 3) damages proximately resulting from the breach. Praesel v. Johnson, 967 S.W.2d 391, 394 (Tex.1998). The existence of a duty is a threshold question of law. St. John v. Pope, 901 S.W.2d 420, 424 (Tex.1995); Bird v. W.C.W., 868 S.W.2d 767, 769 (Tex.1994). The nonexistence of a duty ends the inquiry into whether negligence liability may be imposed. See St. John, 901 S.W.2d at 424; Graff v. Beard, 858 S.W.2d 918, 919 (Tex.1993). The Chamberses and Johnson seek to impose a duty of reasonable care on Van Horn toward third parties stemming from his medical treatment of his patient, Long. It is undisputed that no physician-patient relationship existed between Van Horn and the injured parties in this suit.

This Court has dealt with analogous situations before. In Bird, we determined whether a mental health professional owes a duty to a patient's parent not to misdiagnose negligently a condition of his child. Bird, 868 S.W.2d at 769. The case involved a psychologist who determined that a child had been sexually abused by her father. The father sued the psychologist for negligence in diagnosing the child's condition. Id. at 768. In concluding that no duty was owed, we conducted the balancing test as set out in Greater Houston Transportation Co. v. Phillips, 801 S.W.2d 523, 525 (Tex.1990). Bird, 868 S.W.2d at 769-70. That test dictates that we consider the risk, foreseeability, and likelihood of injury weighed against the social utility of the actor's conduct, the magnitude of the burden of guarding against the injury, and the consequences of placing that burden on the actor. Greater Houston Transp. Co., 801 S.W.2d at 525. Our analysis of those factors led us to hold that a mental health professional owes no professional duty of care to a third party not to misdiagnose the condition of a patient. Bird, 868 S.W.2d at 770.

In reaching that conclusion, we noted that the father in Bird did not have the requisite physician-patient relationship with the defendant or the defendant's employer as a basis for imposing a duty. Id. We analyzed courts of appeals' decisions that dealt with similar situations and also found no duty. Id. at 769-70 (discussing Vineyard v. Kraft, 828 S.W.2d 248 (Tex.App.--Houston [14 th Dist.] 1992, writ denied), and Dominguez v. Kelly, 786 S.W.2d 749 (Tex.App.--El Paso 1990, writ denied)). In Vineyard, a psychiatrist and psychotherapist who had examined a child made a diagnosis implicating a parent in child abuse. Vineyard, 828 S.W.2d at 250-51. The parent sued, claiming negligent misdiagnosis and negligent infliction of emotional harm. The Vineyard court held, "Without some type of contractual physician-patient relationship, no duty is owed." Id. at 253 (citing Dominguez, 786 S.W.2d at 751).

Since our decision in Bird, this Court has twice dealt with a husband's claim that his wife's physician owed him a duty during prenatal care. See Edinburg Hosp. Auth. v. Trevino, 941 S.W.2d 76, 79-81 (Tex.1997); Krishnan v. Sepulveda, 916 S.W.2d 478, 482 (Tex.1995). In Krishnan, a husband alleged mental anguish damages suffered as a result of his wife's injury that was proximately caused by, among other things, her doctor's negligent diagnosis of her condition. Krishnan, 916 S.W.2d at 479. Citing Bird, the Court held that the doctor owed no duty to the husband, because such a duty arises out of the doctor-patient relationship. Id. at 482. In Trevino, Oscar Trevio claimed mental anguish damages after witnessing a physician's alleged negligent treatment of his wife. Trevino, 941 S.W.2d at 79. The Court relied on Krishnan and reiterated its holding: that the hospital owed no legal duty to a third party to provide competent medical care to the third party's wife or unborn child. Trevino, 941 S.W.2d at 79 (citing Krishnan, 916 S.W.2d at 482); see also Cathey v. Booth, 900 S.W.2d 339, 342 (Tex.1995) (per curiam).

The issue before us, as in Krishnan, is also squarely controlled by Bird. The basis of all the claims against Van Horn is his medical diagnosis of Long's condition, which dictated the treatment Long should receive. In the Plaintiffs' Response to Van Horn's Second Motion for Summary Judgment, the plaintiffs note that a different doctor in the emergency room diagnosed Long as having "Seizure Disorder," with a secondary diagnosis of "Alcohol Withdrawal." The plaintiffs' petition specifically alleged that once Van Horn became Long's attending physician, Van Horn failed to properly diagnose Long's condition, and in turn failed to select, prescribe, and oversee the proper treatment needed for the condition. All other claims are based on Van Horn's decision to transfer Long to an unsecured room and to discontinue physical restraints, which also directly resulted from the doctor's alleged misdiagnosis of Long's condition.

The gravamen of the plaintiffs' complaints is that Van Horn knew or should have known that Long posed a danger to others and should have treated him accordingly. However, Van Horn could only make the proper decisions based on Long's condition by utilizing his knowledge as a medical doctor, and applying that knowledge to Long's symptoms. If Van Horn's medical knowledge was adequate, and he properly applied it...