Module 3 - IRAC Case Analysis

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Module 3 - IRAC Case Analysis by Mind Map: Module 3 - IRAC Case Analysis

1. Helling v. Carey, 519 P.2d 981 (1974)

1.1. Facts

1.1.1. Parties

1.1.1.1. Morrison P. Helling and Barbara Helling, Petitioners

1.1.1.2. Thomas F. Carey and Robert C. Laughlin, Respondents

1.1.2. What happened

1.1.2.1. Mrs. Helling (Age 23) sought treatment from Dr. Carey for vision myopia and near-sightedness starting in 1959.

1.1.2.1.1. Mrs. Helling was fitted for contact lenses

1.1.2.2. In September of 1963, Mrs. Helling returned to Dr. Carey for treatment of irritation from the contact lenses.

1.1.2.3. Mrs. Helling then had 9 subsequent consultations for vision concerns

1.1.2.3.1. October 1963

1.1.2.3.2. February 1967

1.1.2.3.3. September 1967

1.1.2.3.4. October 1967

1.1.2.3.5. May 1968

1.1.2.3.6. July 1968

1.1.2.3.7. August 1968

1.1.2.3.8. September 1968

1.1.2.3.9. October 1968

1.1.2.4. In August of 1969, Mrs. Helling filed a complaint against the defendants after consulting with other physicians

1.1.3. Procedural History

1.1.3.1. The Trial Court ruled in favor of the defendants following a defense verdict

1.1.3.2. The Court of Appeals upheld the decision of the Trial Court

1.1.3.3. The judgement of the Trial Court and the Court of Appeals was reversed bu the Supreme Court of Washington and the case was sent for a new trial only on the issue of damages

1.2. Issue before the Court

1.2.1. Did the defendants commit medical malpractice by not testing the eye pressure of the plaintiff in accordance to the traditional standards of the ophthalmology profession?

1.3. Rule of Law

1.3.1. Malpractice

1.3.1.1. Negligence

1.3.1.1.1. Reasonable prudence

1.3.1.2. Strict Liability

1.3.1.2.1. The breach of duty took place in that Carey failed to perform a simple test that could have arrested the irreversible effects of Glaucoma

1.4. Analysis

1.4.1. The Defendants argument

1.4.1.1. The defendants liability should be removed because of the adherence to the standards of the profession

1.4.1.1.1. Standard of the profession does not require giving a routine eye pressure check for patients under the age of 40

1.4.2. The Plaintiffs argument

1.4.2.1. Claim that the irreversible damage imposed to Mrs. Helling could have been prevented if a simple pressure test was performed.

1.4.2.1.1. Having gone 9 years with Glaucoma like symptoms and not having a pressure test was the cause to the damage imposed on her

1.4.3. Court's analysis of substantive rights

1.4.3.1. Patients found outside of the traditional medical testing standards still have an equal right to protection

1.4.3.1.1. Following the standards of the profession resulted in proximate harm to Mrs. Helling

1.4.3.2. If the standard of reasonable care is inadequate to offer reasonable protection to the plaintiff, then liability is imposed without fault

1.4.3.2.1. When a simple, harmless, and well known test can be performed to arrest the development of an irreversible disease, liability exists

1.4.3.3. This court expanded the definition of strict liability for medical professionals when the standards of care do not provide the same protections for all patient demographics.

1.4.3.3.1. It was explicitly stated that if sufficient precision can be given to the application of strict liability as a compensatory measure, then the defendant, through insurance coverage, is considered the more financially responsible person

1.4.3.4. The more compelling facts of this case include the reasonable prudence of administering a low cost, well known, simple test in an effort to protect patients who develop rare diseases

1.5. Conclusion

1.5.1. Ruled in favor of the Petitioners, Mr. and Mrs. Helling

1.5.1.1. The courts applied the concept that a reasonably prudent professional should have performed the eye pressure test, given that Mrs. Hellings eyes were capable of the test and that Mrs. Helling (as a patient considered outside the standards of the profession) has just as much of a right to protection as patients within the traditional standard of the profession

1.5.2. The defendants were found liable for the approximate blindness sustained by Mrs. Helling

1.5.2.1. The court referenced the complexities of tort law in cases where maximizing the service of protection should not thereby create more issues than it fixes in cases with similar applications of liability

1.6. Impact

1.6.1. Gates v Jensen, 92 Wn.2d 246, 595 P.2d 919 (1979)

1.6.1.1. The citation of Helling v. Carey was in reference to the issue raised of the Ophthalmologist choosing not to dilate the patients eyes during the examination of the optic nerves when ruling out glaucoma. It was argued that reasonable prudence should have raised the standard of care in the instant case.

1.6.1.2. The courts referred to a house bill amended through the verdict of Helling v. Carey and upheld that the

1.6.2. Hood v. Phillips, 537 S.W.2d 291 (1976)

1.6.2.1. The instant case was a medical malpractice suit stemming from a surgical procedure carried out in treatment of emphysema. After reviewing the standards for treating the carotid issues for the patients, the courts determined that a physician is not guilty of malpractice where the method of treatment was used and supported by a respectable minority of physicians.

1.6.2.1.1. This decision removed the liability of the surgeon because a respectable minority would support the alternative treatment, while still upholding the standards of the profession

1.7. Importance

1.7.1. Each practicing health care professional should be familiar with the decisions made by the courts in Helling v. Carey. Health care providers understand that as advancements in the treatments of diseases evolve, and in consequence, so should the practices and standards for care. Physicians practicing in specialties like this one, typically meet with patients on referral situations, and thus, should be more prudent to their testing and ruling out of diseases. Both for patients in common and uncommon circumstances

1.7.1.1. Surgical procedures are very unique with their standards of care, because of the complications that may arise during the procedure. Surgeons may or may not hold strict liability when adherence to procedures can't always meet the warranty of their contracts and may result in approximate harm of the patient

1.8. Influence

1.8.1. Advancement in medicine often trigger updates to the well known clinical practice guidelines applied through the field of medicine. Physicians are constantly training and familiarizing themselves with the standards of care that, often times, are also regulated by third party compliance/accreditation bodies.

1.8.2. The policies/regulations on malpractice insurance are outfitted with new standards of care and contracts of liability with physicians. Companies moved to provide professional liability insurance for situations where physicians are compliant in upholding the standard of care, where injury still results.

2. What constitutes liability when neither party is considered at fault?