An integral part of the mission for Physicians Insurance is preserving a level judicial playing field for health care professionals when their care is challenged in the court system.
by Gregory M. Miller and Justin P. Wade, Carney Badley and Spellman, P.S.
When issues arise in the appellate courts that could threaten a level playing field, Physicians Insurance joins entities like the Washington State Medical Association (WSMA) and the Washington State Hospital Association (WHSA) to educate the court about the impact of an appellate court decision on the delivery of care to patients.
Providing educational information to the appellate courts is done through a mechanism called an amicus brief (a brief from a friend of the court). We use these types of briefs to give voice to the perspective of the health care providers and the patients they serve. Recently, Physicians Insurance had the opportunity to support WSMA and WSHA in the filing of an amicus brief in Anya-Gomez v. Sauerwein, 331 P.3d 19 (Washington Supreme Court 2014). As a result, physicians and other health care professionals can now communicate effectively with their patients about pertinent results without the fear of an unjustified lawsuit. Following is a summary of the key facts and key rulings by the Supreme Court in the Anya-Gomez decision.
ANYA-GOMEZ V. SAUERWEIN, 331 P.3D 19 (WASHINGTON SUPREME COURT 2014)
In June, 2014, the Washington Supreme Court affirmed a defense verdict and pre-trial dismissal of an informed consent claim in a misdiagnosis case. The decision is a victory for physicians and other health care providers who, if sued for alleged negligent misdiagnosis, otherwise could have faced an additional claim based on informed consent if they did not tell the patient about every test result, including unconfirmed, preliminary results. If allowed, such “informed consent” claims for a failure to disclose test results could amount to strict liability. Fortunately, common sense prevailed on a majority of the Court, who affirmed the lower court rulings and the long-held distinction between medical negligence and informed consent claims.
An immunocompromised patient with type 2 diabetes mellitus presented to the local community hospital on the 20th complaining of urinary tract infection symptoms, samples were sent to a lab for analysis, and she went home the next day, the 21st. On the 23rd, she presented to the emergency room feeling ill, and, after having her bladder drained, felt better and went home. On the 24th, the lab preliminarily determined that the patient’s blood sample taken on the 20th tested positive for yeast. The lab reported those findings to the patient’s primary care clinic where the defendant family physician was covering for the patient’s usual physician. The family physician was concerned about the test results. He quickly consulted one of the treating physicians from the 20th to the 21st, an internal medicine specialist, who advised contacting the patient to find out if she was feeling ill and, if so, to bring her in for treatment. She was immediately contacted on the 24th and reported that she was feeling better and had no fever, so they determined it most likely was a false positive. The family physician did not tell the patient of the preliminary test result. On the 26th, six days after the initial hospital visit, the lab positively identified candida glabrata as the yeast strain in the blood sample but failed to report those results to the family physician, the patient’s clinic, or anyone else.
The patient’s condition deteriorated, and she was admitted to a hospital three days later on the 29th, where for the first time, her urine tested positive for yeast. Treatment for the candida glabrata infection came too late, and she died 10 weeks later.
The estate of the deceased patient sued the family physician for medical negligence for the misdiagnosis of the yeast infection in the blood. Three weeks before trial, the estate added an informed consent claim for failure to disclose the preliminary test result received on the 24th. The trial court declined to dismiss the belated informed consent claim until after the close of the plaintiff’s evidence and instructed only on the negligent misdiagnosis claim. The jury returned a defense verdict on the negligence claim, finding no breach of the standard of care.
The issue for appeal was whether the patient’s estate could bring an informed consent claim for an alleged failure to disclose preliminary test results based on the same facts giving rise to a medical negligence claim for misdiagnosis. The Washington Supreme Court held that the physician had no duty to disclose to the patient the preliminary lab test result of the patient’s blood, which the physician believed was a false positive result for yeast.