In Utah Nonpatients Can Sue for Medical Malpractice (Sometimes)

Salt Lake City, UTIn 2016, the Utah legislature amended existing medical malpractice law to permit people who are not patients to sue a medical practitioner for medical negligence – but only in some circumstances. The amended law appears to codify the Utah Supreme Court’s 2012 decision in B.R. v. West, a particularly gruesome murder case.

Utah joins a relatively small number of states where a medical practitioner’s duty of care can extend beyond the patient being treated. This is a significant expansion of the legal rights of people whose lives have been upended because someone else was the victim of medical malpractice. These new rights have limits, though, which must be explored with the assistance of experienced attorney.

A Terrible Story

David Ragsdale murdered his wife outside an LDS meeting in January 2008. She had previously obtained a restraining order against him because of his violent outbursts. He took full responsibility for his wife’s death, pleaded guilty to first-degree felony aggravated murder and was sentenced to 20 years to life in prison.

But this left their children. The children, known in the lawsuit as “B.R.” and “C.R.”, were 4 years old and 19 months old at the time of the murder. They were effectively left as orphans.

Ragsdale had been under the care of a nurse practitioner and supervising doctor. The nurse practitioner, who was his primary medical caregiver, had prescribed a complicated cocktail of antidepressants, steroids and other medications, including Concerta, Valium, Doxepin, Paxil, pregnenolone, and testosterone.

After the murder trial, a conservator filed a medical malpractice lawsuit on behalf of the Ragsdale children. The lawsuit alleged that prescription medications given to David Ragsdale contributed to his actions the day he shot his wife.

District Court Dismisses, Supreme Court Upholds -- Complications of Malpractice Law

In general, a medical malpractice case requires four things:

• The medical professional or organization must have had a duty to care for the plaintiff – this usually this means that there must have been a doctor/patient relationship;
• The provider performed that duty so badly that it did not meet the commonly accepted standard of care;
• The patient was injured; and
• The injury was caused by failure to meet those standards of care.

The problem, as far as the Ragsdale children were concerned, is the first element. They had no relationship with the nurse practitioner, the supervising doctor or the medical clinic. Because of this, the Third District Court dismissed the case, holding that none of the medical professionals had a duty of care toward the children. The conservator appealed to the Utah Supreme Court.

The Utah Supreme Court reversed the lower court’s decision, holding that:
“Healthcare providers perform a societal function of undoubted social utility. But they are not entitled to an elevated status in tort law that would categorically immunize them from liability when their negligent prescriptions cause physical injury to nonpatients. We uphold a duty of healthcare providers to nonpatients in the affirmative act of prescribing medication, and reverse the district court‘s conclusion to the contrary.”

The decision seems to focus on the wider responsibility that comes with a healthcare provider’s affirmative decision to prescribe powerful, potentially mood-altering, drugs. That, however, leaves a lot of undiscovered territory.

What about a doctor’s or healthcare facility’s medically plausible but incorrect diagnosis, a simple failure to take away car keys or the failure to lock a door? The Utah Supreme Court’s decision goes way down into the weeds about the difference between active decisions and passive failure to act and whether these decisions create a “special relationship” with people who are not patients.
In the day-to-day, this is not completely helpful to doctors or patients.

Utah Legislature Creates Some Clarity

Cogent analysis suggests that Utah law now allows nonpatients to file a malpractice claim against a healthcare provider if:

• they suffered an injury;
• the healthcare provider’s act or omission was the proximate cause of the injury suffered; and
• that the act or omission was “a knowing and reckless indifference toward, and a disregard of, the injury suffered by the nonpatient plaintiff.”

There are also some carve-outs. The new law does not affect existing law concerning:

• Lawsuits for loss of consortium (spousal care, company, etc.) due to the spouse’s personal injury;
• A lawsuit brought by an heir or personal representative of a deceased person; and
• The survival of a lawsuit for the injury or death to person, upon death of wrongdoer or injured person – Exception and restriction to out-of-pocket expenses.

This new law is also not intended to limit a therapist’s duty to warn. As defined by law and professional standards, a therapist has no duty to warn or take precautions to provide protection from any violent behavior of his client or patient, except when that client or patient communicated to the therapist an actual threat of physical violence against a clearly identified or reasonably identifiable victim.

Hard cases make bad law is a hoary legal maxim. Maybe this is not the case here though. The facts of the situation are certainly awful, and the outcome is not yet clear.

But maybe, perhaps … perhaps, medical malpractice law in Utah is moving towards providing greater protections for people who have been injured. It’s clearly an evolving situation.