Helling v. Carey 519 P. 2d.

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Helling v. Carey 519 P. 2d. by Mind Map: Helling v. Carey 519 P. 2d.

1. March 14, 1974

2. Facts of the Case

2.1. Parties

2.1.1. Morrison P. Helling Barbara Helling

2.1.1.1. Plaintiff

2.1.2. Thomas F. Carey Robert C. Laughlin

2.1.2.1. Defendant

2.1.2.2. Ophthalmologists

2.1.3. Hunter, Associate Justice

2.1.3.1. gave summary opinion

2.2. What Happened?

2.2.1. 1959: Mrs. Helling first consulted the physicians for near sightedness

2.2.1.1. She was fitted with contacts

2.2.2. September 1963: consulted physicians complaining of irritation of the eyes

2.2.3. Several additional consultations: October 1963 February 1967 September 1967 October 1967 May 1968 July 1968 August 1968 September 1968

2.2.3.1. All visual problems associated with Mrs. Helling's contact lenses

2.2.4. October 1968: Dr. Care tested the plaintiff's eye pressure and field of vision

2.2.4.1. First time ever performing this test

2.2.4.1.1. Harmless, painless test with definitive results

2.2.4.2. Test showed the plaintiff had glaucoma

2.2.4.3. Patient was 32 years of age at time of test

2.2.4.4. Patient has lost her peripheral vision and central vision was reduced

2.2.5. August 1969: Mrs. Helling filed a complaint against the defendants after consulting other physicians

2.2.5.1. Alleged negligence

2.2.5.2. Testimony during trial established by medical experts that the "standards of the profession [ophthalmology]... do not require routine pressure tests for patients under 40 years of age

2.2.5.2.1. Reason: Glaucoma is rare in patients below the age of 40 years

2.2.5.3. Testimony also indicated if the patient's complaints and symptoms reveal glaucoma should be suspected, then pressure tests should be conducted

2.2.6. Judgement of Lower Courts

2.2.6.1. both Trial Court and Court of Appeals found in favor of the defendants

2.2.6.1.1. Plaintiff appeal to Supreme Court

3. Supreme Court of Washington, En Banc.

4. Issue Before the Court

4.1. Whether or not Dr. Carey and Dr. Laughlin were negligent in their late diagnosis of glaucoma in Mrs. Helling leading to the "severe and permanent damage to her eye".

4.2. Does following the professional standards satisfy the duty to care?

5. Rule of Law

5.1. Negligence

5.1.1. The unintentional failure to live up to accepted standards of behavior

5.1.2. 4 Parts: 1. duty to act 2. breach of that duty 3. damages occurred from that breach 4. direct cause of damages

5.1.3. Standard of Care of the Profession

5.1.3.1. Professionals who follow the standard in their specific line of work can still be held liable if their conduct is not reasonably prudent

5.2. Case References

5.2.1. Peck, Negligence and Liability Without Fault in Tort Law, 46 Wash.L.Rev. 225, 239 (1971)

5.2.2. Pederson v. Dumonuchel, 72 Wash. 2d 73, 79, 431, P.2d 973 (1967)

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

5.2.4. T. J. Hooper, 60 F.2d 737, on page 740 (2d Cir. 1932)

5.2.5. Wigmore, Responsibility for Tortious Acts: Its History, 7 Har.L.Rev. 315, 383, 441 (1894)

5.2.6. W. Prosser, The Law of Torts s 74 (3d ed. 1964)

6. Analysis

6.1. Mrs. Helling feels she should have been tested for glaucoma earlier which would have lead to early detection of the disease and could have been treated

6.1.1. Dr. Carey testified "I would think she probably had it ten years or longer"

6.2. Mrs. Helling did not complain of "vision changes" until the August 1968 consultation

6.2.1. Diagnosis made 30 days later

6.3. The question before the court is not whether Dr. Carey and Dr. Laughlin followed the standard of the profession for ophthalmology, but should the defendants compliance with the standard shield them from the liability under the facts of the case.

6.3.1. Though the standards were followed, the defendants are still liable for the damages caused to Mrs. Helling.

6.3.2. The standard of the profession was to not perform pressure testing on patients under 40 years of age due to the low risk of glaucoma

6.4. Changing the standard of care for the profession

6.4.1. Was the standard too low?

6.4.2. Reasonable prudence required the timely giving of the pressure test

6.4.3. The pressure test is a simple, harmless, inexpensive test to perform where the results are definitive.

6.4.3.1. The disease (glaucoma) can be successfully treated by early detection

6.5. Liability without fault

6.5.1. A careful person can be liable for an entirely reasonable mistake even when the standard was followed

6.5.2. When there is no blame on either side, it is asked "who can best bear the loss" and "hence to shift the loss by creating liability"

6.5.3. Strict Liability

6.5.3.1. When a person commits a wrong without intentionally doing so.

6.5.3.2. Serves as a compensatory function in situations where the defendant is the financially more responsible person.

7. Conclussion

7.1. Supreme Court of Washington REVERSED the decision of the lower courts and sent the case back to trial on the issue of damages only

7.1.1. By widening the law of the standard of the profession, it came to the conclusion that liability could be applied even if the person made a reasonable mistake

8. Impact

8.1. In the case of Gates v. Jensen, the court used the precedence set by the Helling decision despite a statute passed by the Washington Legislature

8.1.1. Cited the wording of the statute allowed the decision to be made

8.2. The court set Medical Malpractice Standards

8.3. Health Insurance companies started to change to no longer require treatment preauthorization forms as a way to save money

8.4. Cases referring to the Helling decision

8.4.1. Meeks v. Marx

8.4.2. Truman v. Thomas

8.4.3. Barton v. Owen

9. Importance

9.1. Because of this ruling, which was not like by the health profession, the state seemed to be able to set the "standard for the profession" instead of the physicians in that profession

9.2. The chance of a malpractice suit while following the standard of care at that time worried many physicians

9.2.1. Helling v. Carey allowed for a suit to be filed and hold the physician liable even if the physician made a "reasonable mistake"

10. Influence

10.1. Now, all eye exams include Tonometry Tests

10.1.1. The test done for glaucoma

10.1.2. However, it has a low Positive Predictive Value

10.1.2.1. The probability that a person with a positive result actually has the disease

10.1.2.2. Research conducted by the U.S. Preventive Services Task Force in 1989

10.2. The over-caution of physicians leads to the "over ordering" of medical tests driving up the cost of hospital visits.

10.2.1. Physicians "covering all basis"