Helling v. Carey, 519 P.d (1974)

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Helling v. Carey, 519 P.d (1974) by Mind Map: Helling v. Carey, 519 P.d (1974)

1. Importance

1.1. Why health care professionals would care?

1.1.1. This case will determine the standard of care and what actions constitute breach of duty

1.1.1.1. Strict liability or liability without fault

1.1.1.2. Physicians can be held liable for not going above and beyond the standard of care

2. Facts

2.1. Parties

2.1.1. Dr. Thomas F Carey, Respondent

2.1.2. Dr. Robert C. Laughlin, Respondent

2.1.3. Morrison P. Helling, Petitioner

2.1.4. Barbara Helling, Wife of Morrison Helling, Petitioner

2.2. What happened

2.2.1. 1959 Mrs. Helling consults with Dr. Carey and Dr. Laughlin for myopia, nearsightedness

2.2.2. Sept 1963 Mrs. Helling consults with Dr. Carey and Dr. Laughlin for irritation caused by contact lenses

2.2.3. Additional consultations occurred in October, 1963; February, 1967; September, 1967; October, 1967; May, 1968; July, 1968; August, 1968; September, 1968; and October, 1968

2.2.3.1. August 1968 Mrs. Helling complained of a visual field problem

2.2.4. October 1968 Dr. Carey tested Mrs. Helling's eye pressure and diagnosed glucoma

2.2.4.1. Mrs. Helling lost her peripheral vision and her central vision was reduced due to the the open angel glaucoma

2.3. Procedural history

2.3.1. August 1969, Mrs. Helling filed a complaint against Dr. Carey and Dr. Laughlin (Proximate result of negligence)

2.3.2. Heard expert testimony from medical experts

2.3.2.1. Standard of care does not require pressure tests for <40 patients

2.3.2.2. Standard of care pressure test required if patient complaints and symptoms reveal glaucoma suspicion

3. Issues before the court

3.1. Whether there was sufficient evidence to support negligence against Dr. Carey

3.2. Does meeting standard of care set by the profession equal the appropriate duty of care

4. Rules of Law

4.1. Malpractice/Negligence

4.1.1. Damages

4.1.2. Duty

4.1.2.1. Legal obligation the defendant owes the plaintiff ; standard of care

4.1.2.1.1. Reasonable prudence

4.1.3. Causation

4.1.3.1. Proximal Cause

4.1.4. Breach of duty

5. Analysis

5.1. Plaintiff's Argument

5.1.1. Mrs. Helling attests that she sustained sever and permanent damage to her eyes as a proximate result of the defendant's negligence

5.1.1.1. Persons <40 should be entitled to the same protection as afforded to persons over 40 with routine pressure testing for early detection of glaucoma

5.2. Defendant's Argument

5.2.1. The defendant asserts that similar circumstances does not require routine pressure tests for glaucoma for patients <40 years old

5.2.1.1. This standard is adequate to insulate him from liability for negligence

5.3. Court's analysis

5.3.1. The standards of the profession does not require pressure testing for persons <40 years of age

5.3.1.1. Trail court entered judgement for the defendants following a defense verdict

5.3.1.1.1. Courts did not feel the issue was whether the defendant met standard of care set by his profession, it was the issue whether the defendant's compliance with the standard should insulate them from liability

6. Conclusion

6.1. Courts ruled that the customary practice at the time was followed

6.1.1. Trial court and Court of Appeals decision reversed

6.1.1.1. Defendants found negligent which proximately resulted in blindness sustained by the plaintiff

6.1.1.1.1. Case is remanded for a new trial on the issue of damages only

7. Impact

7.1. Gates v. Jensen 92 Wn.2d 246 (1979)

7.1.1. Malpractice suit about physician duties of care and disclosure to a patient

7.1.1.1. Ophthalmologist, Dr. Hargiss did not inform Ms. Gates of the high pressure found in both eyes nor the other diagnostic test available to her

7.1.1.1.1. Ms. Gates was diagnosed with glaucoma 2 years later with vision loss

7.2. Hall v. Hilburn 466 So.2d 856 (1985)

7.2.1. Mrs. Hall was admitted for abdominal pain and Dr. Hilburn performed exploratory surgery. Mrs. Hall expires 14 hours after surgery of respiratory distress syndrome

7.2.1.1. Malpractice suit that physician did not inquire about his patient's post operative condition and failure to give appropriate post operative instructions to the hospital nursing staff

7.2.1.1.1. Court determined that the the physician should have provided care beyond what was the customary standard

8. Influence

8.1. As a result of threats to greater exposure to lawsuits, health plans are:

8.1.1. Forcing treating physicians to focus on the cost effectiveness of medical treatments

8.1.1.1. The focus would be on whether or not the physician properly assessed the cost effectiveness of the alternative procedures or treatments rather than on prevailing standard medical practices.

8.1.2. Dropping pre-authorization requirements

8.1.2.1. Reduce the threat of being held negligent for delaying care

8.2. State Legislatures pass statues that defined standard of care in their jurisdiction

9. Supporting Cases

9.1. Texas & Pac. Ry. v. Behymer, 189 U.S. 468, 470, 23 S.Ct. 622, 623, 47 L.Ed. 905 (1903)

9.1.1. What usually is done may be evidence of what ought to be done, but what ought to be done is fixed by a standard of reasonable prudence, whether it usually is complied with

9.2. Pederson v. Dumouchel, 72 Wash. 2d 73, 79, 431 P.2D 973 (1967)

9.2.1. Degree of care and skill which is expected of the average practitioner acting in the same or similar circumstances