1. Facts:
1.1. Plaintiffs: Morrison and Barbara Helling; Defendants: Drs Thomas Carey and Robert Laughlin
1.2. 1st evaluation in 1959 for myopia and nearsightedness
1.2.1. Second visit Sep 1963 for irritation by contact lenses.
1.2.1.1. Additional visits for presumed contact lenses irritation: Feb, Sep, and October 1967, May, July, Aug, Sep, and October 1968.
1.2.1.2. In October 1968 visit the pressure was tested along with visual fields
1.2.1.2.1. Glaucoma was diagnosed and the patient was noted to have peripheral and some central visual loss.
1.2.1.2.2. The patient was 32 yo at this time
1.2.1.3. August 1969 a complaint was filed for negligence leading to visual loss as a proximate cause.
2. Issue:
2.1. Is following the standard of care enough to protect a physician against malpractice?
3. Rule:
3.1. The standard of care may not be enough to protect against liability if that standard is negligent (inadequate to offer reasonable protection) as a matter of law.
4. Application:
4.1. Defendants argue that following the standard of care is adequate to insulate against negligence because the risk is so low in this age group (1 in 25,000).
4.1.1. Court notes that even thought rare, that person (the 1 in 25,000) are entitled to the same protections as persons over the age of 40 that are routinely tested.
4.1.1.1. Texas & Pac. Ry. v. Behymer, 189 U.S. 468, 470, 23 S.Ct. 622, 623, 47 L.Ed. 905 (1903):
4.1.1.1.1. "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 or not."
4.1.1.2. T. J. Hooper, 60 F.2d 737,
4.1.1.2.1. "(I)n most cases reasonable prudence is in fact common prudence; but strictly it is never its measure... Courts must in the end say what is required; there are precautions so imperative that even their universal disregard will not excuse their omission."
4.1.1.3. Courts ruled that reasonable prudence would have been to give the test sooner despite the "inadequate standards" of the Opthalmology profession.
4.1.1.4. The judgement is compared to strict liability where negligence is not needed to find fault.
5. Conclusion:
5.1. They reversed the ruling of the lower court and remanded for new trial. Even though there was no fault, the standards of the profession fell below the legal standards of negligence.
6. Impact
6.1. Osborn v Irwin Memorial Blood Bank
6.1.1. Three week old Michael Osborn contracted AIDS from blood used during heart surgery at UCSF. His parents filed suit against the University and the blood bank.
6.1.1.1. Negligence issue boiled down to the issue of standard of care for blood banks.
6.1.1.2. The issues of custom and standard of care arose as no blood banks were doing what the plaintiffs experts testified should be done. Thus they had to look at a question of universal practice.
6.1.1.2.1. It was in this context that Helling v Carey was considered. The courts noted that there were a lot of criticisms of that case and very few affirmations. Ultimately, the court ruled that Irwin Blood Bank can not be held liable for not performing a test that no one was performing at that time.
6.2. Chester v Beep Roots Alderwood LLC.
6.2.1. Mrs. Chester decided to get a tatoo. Her tatoo got infected and she had complications of her infection including kidney failure and need for dialysis. It turns out that the ink used was not sterile and other minor injuries occurred to others who had the ink used on them as well.
6.2.1.1. Mrs. Chester tried to establish a duty of care arguing that the industry standard was substandard and that the benefit of using sterile ink outweighed the burden of ensuring that ink was sterile. For this argument she relied heavily on Helling v Carey.
6.2.1.1.1. The courts found Chester fell short on showing that sterile ink was available, the claims reliable, or that tattoo artists had the means to test for contaminated and sterilize ink if found to be contaminated.
6.2.1.1.2. In Helling v Carey it was clear that a cost effective, reliable, test existed and was not utilized.
7. Importance
7.1. A healthcare professional would care about the result because it notes that even if you follow the standard of care in good faith while treating patients you could still be liable for a bad outcome as a matter of law (very scary).
8. Influence
8.1. Defensive medicine
8.1.1. If a physician can practice the standard of care and still be liable for a poor outcome, then to protect themselves physicians must over test for curable diseases despite very low yields.