Warren v. Dinter
| Decision Date | 16 January 2018 |
| Docket Number | A17-0555 |
| Parties | Justin Warren, Appellant, v. Richard Dinter, et al., Respondents. |
| Court | Minnesota Court of Appeals |
This opinion will be unpublished and may not be cited except as provided by Minn. Stat. § 480A.08, subd. 3 (2016).
Affirmed; motion denied
St. Louis County District Court
Sam Hanson, Robert J. King, Benjamin E. Gurstelle, Amarachi Ihejirika, Briggs and Morgan, P.A., Minneapolis, Minnesota (for appellant)
Paul C. Peterson, William L. Davidson, Eric J. Steinhoff, João C.J.G. de Medeiros, Lind, Jensen, Sullivan & Peterson, P.A., Minneapolis, Minnesota (for respondents)
Considered and decided by Larkin, Presiding Judge; Hooten, Judge; and Smith, Tracy M., Judge.
UNPUBLISHED OPINION
Appellant Justin Warren sued respondents Dr. Richard Dinter and Range Regional Health Services for medical malpractice following the death of appellant's mother, Susan Warren. The district court granted summary judgment to respondents on the ground that Dr. Dinter did not owe a duty of care to Ms. Warren. The district court rejected respondents' alternative argument for summary judgment based on causation, concluding that a genuine issue of material fact exists on that issue. On appeal, appellant argues that the district court erred in concluding that Dr. Dinter did not have a duty, while respondents argue, on conditional cross-appeal, that the district court erred in concluding that a factual issue exists regarding causation. Because we agree that Dr. Dinter did not owe a duty of care to Ms. Warren, we affirm.
On the morning of August 8, 2014, Ms. Warren went to Essentia Health Hibbing Clinic (Essentia), complaining of abdominal pain, fever, chills, and other symptoms. She was examined by Nurse Practitioner (N.P.) Sherry Simon, had her blood drawn for testing, and was sent home. Once the blood tests were completed, N.P. Simon called Ms. Warren and asked her to return to Essentia for additional testing that afternoon. Based on the results of that testing (as well as the prior tests, examination, and health history), N.P. Simon believed that Ms. Warren needed to be admitted to a hospital.
Respondent Range Regional Health Services does business as Fairview Range Medical Center (Fairview), which is a hospital in Hibbing. Fairview is a separate legal entity from Essentia and is not affiliated with the Essentia clinic. Dr. Dinter is a hospitalist at Fairview; a hospitalist is a physician who provides care for patients in a hospital setting.
As a nurse practitioner, N.P. Simon did not have admitting privileges at Fairview. Fairview and Essentia had no contract between them. However, typical practice, when an Essentia employee believed that a patient needed hospitalization, was for the employee tocall Fairview, ask to speak to a hospitalist there, and have the Fairview hospitalist make the admission determination. N.P. Simon followed this practice.
Based on her belief that Ms. Warren needed to be admitted, N.P. Simon called Fairview and was connected with Dr. Dinter, one the three hospitalists on duty at that time. N.P. Simon described Ms. Warren's symptoms to Dr. Dinter. Based on the information that N.P. Simon orally provided, Dr. Dinter told her that it sounded like Ms. Warren had "a diabetes that's out of control" and that she should "treat the diabetes and see [Ms. Warren] back in [a] follow-up [visit]." Dr. Dinter specifically told N.P. Simon that Ms. Warren "did not need to be hospitalized," and recommended that N.P. Simon follow up with Ms. Warren on Monday, three days later.1
After N.P. Simon concluded her phone conversation with Dr. Dinter, she remained concerned that Ms. Warren needed hospitalization, so she consulted her collaborating physician at Essentia, Dr. Jan Baldwin. As N.P. Simon's collaborating physician, Dr. Baldwin was responsible for addressing any concerns or questions from N.P. Simon about a case. According to Dr. Baldwin, although she had admitting privileges at Fairview, her normal procedure was to have the Fairview hospitalists do admissions of her adult patients. Although she occasionally admitted her adult obstetrics patients directly,Dr. Baldwin stated that, for all other patients, if a Fairview hospitalist declined to admit a patient she thought should be hospitalized, she would either send the patient to Fairview's emergency room or to a different hospital.
Dr. Baldwin reviewed the lab results and discussed Ms. Warren's case with N.P. Simon. She did not examine Ms. Warren. Dr. Baldwin concurred with Dr. Dinter that hospitalization was not needed and that treating Ms. Warren's diabetes would resolve her abnormal lab results.
N.P. Simon discussed this determination with Ms. Warren, prescribed medication to begin controlling the diabetes, told her to call the clinic or go to an emergency department if her symptoms got worse, and scheduled an appointment for the following Monday. The next day, Ms. Warren died due to sepsis brought on by a staph infection.
In 2016, appellant, as next of kin, filed a medical malpractice claim against Dr. Dinter and Fairview. After the close of discovery, Dr. Dinter and Fairview moved for summary judgment on the bases that (1) Dr. Dinter did not owe a duty of care to Ms. Warren, (2) there was no genuine issue of material fact as to causation, and (3) subsequent decisions by N.P. Simon and Dr. Baldwin precluded any liability on the part of Dr. Dinter or Fairview. The district court granted summary judgment on the basis that there was no duty of care, noting that "there is a fact question regarding causation."
Appellant challenges the district court's conclusion regarding duty. Respondents challenge the district court's conclusions regarding causation.
Riverview Muir Doran, LLC v. JADT Dev. Grp., LLC, 790 N.W.2d 167, 170 (Minn. 2010) (citation omitted).
[T]here is no genuine issue of material fact for trial when the nonmoving party presents evidence which merely creates a metaphysical doubt as to a factual issue and which is not sufficiently probative with respect to an essential element of the nonmoving party's case to permit reasonable persons to draw different conclusions.
DLH, Inc. v. Russ, 566 N.W.2d 60, 71 (Minn. 1997).
Appellant argues that the district court erred in granting summary judgment for respondents based on the absence of any duty of care. "[D]uty is generally a legal question for the court to decide . . . ." Montemayor v. Sebright Prods., Inc., 898 N.W.2d 623, 629 (Minn. 2017). A physician-patient relationship creates a duty of care. Molloy v. Meier, 660 N.W.2d 444, 450 (Minn. App. 2003), aff'd, 679 N.W.2d 711 (Minn. 2004). Thus, "[t]he first question we must address in a medical malpractice action is whether a physician-patient relationship existed." Peterson v. St. Cloud Hosp., 460 N.W.2d 635, 638 (Minn. App. 1990).
We begin by identifying the allegedly negligent conduct. At various times appellant has identified the negligent conduct as Dr. Dinter's denial of N.P. Simon's request to admit Ms. Warren to the hospital. But at oral argument, appellant conceded that Dr. Dinter had no obligation to admit Ms. Warren, regardless of whether Ms. Warren had been correctlydiagnosed. Instead, appellant's claim is better understood as alleging that Dr. Dinter negligently made a determination and rendered advice that Ms. Warren did not require hospitalization. Such a determination and advice, however, are not actionable unless Dr. Dinter owed Ms. Warren a duty of care.
Appellant first argues that Dr. Dinter owed a duty of care to Ms. Warren because there was a physician-patient relationship between them. Dr. Dinter did not meet or examine Ms. Warren, and the record is clear that Ms. Warren never contracted directly with Dr. Dinter for medical services. Appellant argues, however, that Dr. Dinter entered into a physician-patient relationship with Ms. Warren indirectly through N.P. Simon at Essentia.
In Peterson, this court held that a physician-patient relationship may exist when the patient's physician contracts with a third-party physician to perform services. Id. at 638. In that case, the patient's physician contracted with a pathologist to examine tumor-cell samples. Id. at 637. The pathologist examined the samples and prepared a report, which the patient alleged negligently misdiagnosed the tumor. Id. This court held that the pathologist had a duty to the patient, even though the patient had not personally engaged the pathologist. Id. at 638. We quoted a case from the Indiana Court of Appeals, which reasoned that, in determining whether a consensual physician-patient relationship exists, "'[t]he important fact . . . is not who contracted for the service but whether it was contracted for with the express or implied consent of the patient or for his benefit.'" Id. (quoting Walters v Rinker, 520 N.E.2d 465, 472 (Ind. Ct. App. 1988)).
Unlike in Peterson, there is no contract here. Appellant conceded at oral argument that there was no contract between Essentia and Dr. Dinter or Fairview to provide services on Ms. Warren's behalf. Dr. Dinter did not create any reports or records for use by Ms. Warren's medical providers, nor did he bill Essentia or Ms. Warren for any services.
Appellant urges that, despite the absence of a contract, it is still possible to find a physician-patient relationship between Dr. Dinter and Ms. Warren because of the "working agreement" that existed between Essentia and Fairview. Appellant argues that, because Dr. Dinter had, in the past, taken calls from Essentia employees, evaluated symptoms during those calls, and admitted patients to Fairview as a result, Dr. Dinter had consented to be responsible...
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