Helling v. Carey, 519 P.2d 981 (1974)
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1. Facts
1.1. Parties
1.1.1. Petitioners
1.1.1.1. Barbara Helling, female under the age of 40 years
1.1.1.2. Morris P. Helling, Barbara's husband
1.1.2. Respondents
1.1.2.1. Dr. Thomas F. Carey and Dr. Robert C. Laughlin, partners in an ophthamology practice
1.2. What Happened
1.2.1. In 1959, Mrs. Helling consulted ophthamologists Dr. Thomas Carey and Dr. Robert Laughlin for nearsightedness in 1959
1.2.1.1. Mrs. Helling was fitted with contact lenses during this consultation
1.2.2. In September 1963, Mrs. Helling returned to Dr. Carey and Dr. Laughlin regarding irritation she was having due to the contact lenses
1.2.3. Additional consultations between Mrs. Helling and Dr. Carey and Dr. Laughlin were noted to occur on these dates: October 1963, February 1967, September 1967, October 1967, May 1968, July 1968, August 1968, September 1968, and October 1968.
1.2.3.1. In all consultations prior to the October 1968 consultation, Dr. Carey and Dr. Laughlin believed Mrs. Hellings visual problems were related solely to complications with her contact lenses.
1.2.4. During the October 1968 consultation, Dr. Carey tested Mrs. Helling's eye pressure and field of vision for the first time.
1.2.4.1. The eye pressure and field of vision test indicated that Mrs. Helling had glaucoma.
1.2.4.2. Mrs. Helling was 32 years old by that time
1.2.4.3. By this consultation, Mrs. Helling had lost the majority of her peripheral vision, and her central vision had been reduced to approximately 5 degrees vertical by 10 degrees horizontal.
1.2.5. In August 1969, after consultations with other physicians, Mrs. Helling filed a complaint against Dr. Carey and Dr. Laughlin for negligence.
1.3. Procedural History
1.3.1. August 1969: Mrs. Helling filed a complaint against the defendants, Dr. Thomas Carey and Dr. Robert Laughlin
1.3.1.1. Alleged that she sustained "severe and permanent" damage to her eyes as the proximate result of the defendants' negligence
1.3.2. Trial court ruled in favor of the defendants
1.3.3. Mrs. Helling made an appeal to the Court of Appeals following the trial court's decision
1.3.4. The Court of Appeals agreed with the trial court's ruling
1.3.5. Mrs. Heller petitioned the Supreme Court for review of the case following the Court of Appeals verdict
1.3.6. Supreme Court granted the petition and heard the case
1.3.7. Supreme Court reversed the decision of the trial court and Court of Appeals. It remanded the case for new trial to determine the amount of damages owed Mrs. Helling.
2. Issue
2.1. Whether the trial court and court of appeals were correct in not finding Dr. Carey and Dr. Laughlin negligent in failing to administer a glaucoma test to an individual under 40 years of age, resulting in the failure to diagnose Mrs. Helling's open angle glaucoma.
2.2. Whether the trial court and court of appeals were correct in determining that the defendants' compliance with the standard of the profession of ophthalmology shields them from being held liable for negligence in failing to give the pressure test for glaucoma in a timely manner, which resulted in Mrs. Helling's substantial loss of vision.
3. Rule of Law
3.1. Breach of Duty
3.1.1. Standard of Care
3.1.1.1. After the standard of care was established, did the defendants fail in their duty to abide by that standard?
3.2. Strict Liability
3.2.1. Imposes liability without the need to show negligence
3.2.2. "Placing the burden of inevitable losses on those best able to bear them"
3.3. Proximate Cause
3.3.1. But for...
3.3.2. Was the issue foreseeable?
4. Importance
4.1. A health care professional would be concerned about this decision due to the impact it would have regarding the provider's testing for various diseases. The standard practice for glaucoma testing was not to routinely test with patients under 40 years of age; however, Mrs. Helling did indeed have glaucoma, likely starting in her early twenties. For those issues or diseases that are unlikely to present or occur in individuals under a certain age, what is the responsibility of the provider to test for those now? What will the margin be for "harmless" testing? If a provider tests for everything, costs increase for the patient and hospital? Could individuals then start to sue for costs incurred due to unnecessary testing in which the provider was trying to cover all bases?
5. Analysis
5.1. Breach of Duty
5.1.1. Supreme Court found that what is customarily done is not always the legal equivalent of what ought to be done.
5.1.2. Plaintiff
5.1.2.1. Claimed that she sustained "severe and permanent" eye damage as the direct result of the defendants' negligence
5.1.3. Defendants
5.1.3.1. Presented that the incidence of glaucoma in individuals under 40 was around 1/25,000
5.1.3.1.1. Supreme Court singled out the "1" in 25,000, advocating that that "1" was entitled to the same protection that was afforded to individuals 40 and older. Mrs. Helling had the right to be diagnosed early in order to prevent the loss of her vision
5.2. Strict Liability
5.2.1. Supreme Court acknowledged that reasonable prudence would have required the defendants to give the pressure test in a timely manner. Numerous visits for eye irritation and various concerns would have compelled a reasonably prudent physician to have administered the test.
5.2.1.1. The Supreme Court made note to acknowledge that the defendant's didn't fail in abiding by the reasonable standard of care, but that liability was imposed because Mrs. Helling, an innocent plaintiff, should not have to bear the risk of loss. In the end, the defendants could have prevented the full effects of glaucoma by administering the simple pressure test.
5.2.2. The profession of ophthalmology has a duty to protect patients under 40 from the damaging results of glaucoma as well
5.2.2.1. Defendants were negligent as a "matter of law"
5.2.2.2. "Universal disregard cannot excuse the ommission"
5.3. The Supreme Court found that the standards of the practice of ophthalmology concerning glaucoma testing were inadequate.
5.3.1. A standard of care higher than that of the profession of ophthalmology would more likely than not have saved Mrs. Helling's vision or at the very least, given her a chance to stop the progression of the vision loss before it ended up as poor as it was.
5.3.2. If the defendants' had given the test, the evidence of the glaucoma would have been evident
5.3.3. Regardless of the standard of the practice, the Supreme Court believed that the standard of reasonable prudence should have compelled the defendants' to administer the glaucoma test. It is what ought to have been done, regardless of the professional standard.
5.4. Proximate cause
5.4.1. In failing to give Mrs. Helling the pressure test for glaucoma, the defendants were negligent and were the proximate cause of Mrs. Helling's blindness
5.4.1.1. But for the defendant's failure to administer the test, Mrs. Helling's glaucoma went undiagnosed, resulting in her loss of vision
5.4.1.2. If Mrs. Helling's glaucoma went undiagnosed, it is foreseeable that her vision would get progressively worse
6. Conclusion
6.1. Supreme court reversed the decision of the trial court and Court of Appeals, remanding the case to a new trial to determine the amount of damages owed to the petitioners.
6.2. Supreme court found that the rule of strict liability applied in the case, holding the respondents negligent in failing to administer the pressure test, which resulted in Mrs. Heller's glaucoma being undiagnosed.
7. Impact
7.1. Gates v. Jensen
7.1.1. Case in which an ophthalmologist, Dr. Hargiss, failed to administer two additional tests to plaintiff, Elisabeth Gates, for diagnosing glaucoma.
7.1.1.1. Both trial court and Court of Appeals found in favor of the defendants, however, the Supreme Court reversed the decision based on reasonable prudence - what ought to have been done.
7.1.1.1.1. Court found that the doctrine of Helling v. Carey, that reasonable prudence may require a higher standard of care applied
7.2. Harris v. Groth
7.2.1. Another case addressed by the Supreme Court regarding "whether the conduct of a health care provider is to be measured against the standard of care practiced by the profession or against a standard of reasonable prudence"
7.2.2. The plaintiff, Ms. Harris claimed that defendant, Dr. Groth, was negligent in failing to diagnose her glaucoma.