1. Issue
1.1. Does compliance with the standard duty, the standard of care insulate the defendant from negligence
1.2. Does the court need to set the standard ?
1.2.1. Consider the weight and circumstance of not diagnosing the disorder can cause blindness
2. Rule
2.1. Standard of Care
2.1.1. Reasonable and ordinary care
2.1.2. neighborhood rule
2.1.3. School Rule
2.2. Breach of Duty
2.2.1. Once the standard of care is established the court must determine if it was breached.
2.2.1.1. In this case the stand of care was clearly meet. The Question is raised as to weather that standard is prudent.
2.2.1.1.1. Note : T.J. Hooper and the Montrose tugboats
2.3. Causation
2.3.1. proximate cause
2.4. Injury/ Damages
3. Analysis
3.1. Mrs Helling argues that after complaints from 1963 to 1968 the Doctors should have tested her for glaucoma in a more timely fashion. The lack of timely testing being the proximate cause of vison loss.
3.1.1. Standard of Care
3.1.1.1. Mrs. Helling argues that after multiple complaints of vison loss it would have been prudent to test for glaucoma
3.1.1.1.1. In the Hooper v Montrose tugboats case it was ruled that new radio equipment would have allowed the defendant to receive early warning of a storm that caused the loss of the plaintiffs tug boats and coal, cargo.
3.1.2. Breach of Duty
3.1.2.1. Mrs. Helling claims the duty and standard of care was breached due to lack of reasonable prudence given her situation and the ease of testing.
3.1.3. Causation
3.1.3.1. Expert testimony established that early detection could lead to treatment that would reduce or reverse the progress of the disease.
3.1.4. Injury
3.1.4.1. Given early detection could stop the progression of the disease Mrs Helling argues injury as a proximate cause of the physicians lack of prudence in testing for the disorder.
3.2. The Drs. Argue that they provided the standard of care due Mrs Helling.
3.2.1. Defendants argue that the standard of care was meet and that causation could not be established with the locality Rule and school rule.
3.2.1.1. Standard of care given the neighborhood and school rule was that patients under 40 years of age did not receive testing for glaucoma.
3.2.1.1.1. Expert testimony for both side supports that the standard of care for the Glaucoma testing was to screen only patients 40 and over.
3.2.1.2. Defendants agrue that causation can not be established given that they acted with in the standard of care and that Mrs Helling's case does meet the standard test for negligence.
4. Conclusion
4.1. Under the facts of this case reasonable prudence required the timely giving of the pressure test to this plaintiff. The precaution of giving this test to detect the incidence of glaucoma to patients under 40 years of age is so imperative that irrespective of its disregard by the standards of the opthalmology profession, it is the duty of the courts to say what is required to protect patients under 40 from the damaging results of glaucoma Helling v. Carey, 83 Wash. 2d 514, 519, 519 P.2d 981, 983 (1974), disapproved of by Barton v. Owen, 71 Cal. App. 3d 484, 139 Cal. Rptr. 494 (Ct. App. 1977)
4.1.1. The court finds that given the severe nature of the consequences suffered by forgoing Glaucoma screening that it would have been prudent for the defendants to screen for the disease. Despite the established standard of care.
4.1.2. Given that it would have been prudent to screen for the disease in the case of Mrs. Helling a breach of the standard of care can be established and linked to causation and injury that leads to blindness.
5. Facts
5.1. Parties
5.1.1. Plaintiff Mrs. Barbara Helling
5.1.2. Defendant, Drs. Thomas Carey & Robert Laughlin (ophthalmologists)
5.2. What Happedned
5.2.1. Plaintiff, Mrs Helling suffers from vision loss due to Glaucoma. The plaintiff complained of vision problems during 9 office visits between 1959 and 1968, before pressure testing was used to screen for Glaucoma. Screening revealed that she had been suffering from Glaucoma, During testimony the Defendant states that she had been suffering for about 10 years in his opinion.
5.2.1.1. Mrs. Helling complained of nearsightedness to her Ophthalmologists and was prescribed contact lenses she complained for 5 years and was lastly screened for glaucoma. she sued for neglagence
5.2.1.2. The defendants argued that it was out side the standard of practice to screen for glaucoma for persons under 40 years of age. The plaintiff was 23 at the time of the initial visit in 1959.
5.3. Procedural History
5.3.1. In August of 1969 the plaintiff filled suit for malpractice on grounds that she sustained damages as the proximate cause of the Ophthalmologists negligence.
5.3.1.1. negligence claim
5.3.1.1.1. testing should have been done after multiple office visits despite the school and neighborhood established standards of care.
5.3.2. The lower court found in favor of the defendant
5.3.2.1. defendants claimed that negligence was not established based on the standard of care via expert testimony.
5.3.3. The Plaintiff appealed and the lower court found in favor of the appellee; defendant
5.3.4. Mrs. Helling appealed to the State Supreme Court of Washington
5.3.4.1. Case was accepted
5.3.4.1.1. The court allowed retrial for damages sustained by Mrs Helling.
6. Importance
6.1. Physicians must now consider that the standard of practice can no longer be considered an all inclusive insulator against malpractice.
6.1.1. Prudence vs Standard of Care
6.1.1.1. Prudence prevails
6.2. Glaucoma Testing is a standard practice with all patients now despite age.
7. Impact
7.1. DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Protection of Human Subjects; Compensating for Research Injuries; Request for Comments on Report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Tuesday, November 23, 1982 Protection of Human Subjects; Compensating for Research Injuries; Request for Comments on Report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 47 FR 52880-01
7.2. 193 Wash.App. 147 Court of Appeals of Washington, Division 1. Anna CHESTER, Appellant, v. DEEP ROOTS ALDERWOOD, LLC, a Washington Corporation; and Bonnie Gillson, Respondents. No. 73225–1–I. April 4, 2016. Chester v. Deep Roots Alderwood, LLC, 193 Wash. App. 147, 371 P.3d 113, review denied sub nom. Chester v. Deep Roots Tattoo & Body Modification, 186 Wash. 2d 1011, 380 P.3d 500 (2016)
7.2.1. The plaintiff brought suit on grounds of negligence due to an adverse reaction to tattoo ink.
7.2.1.1. There was a problem with that ink that occurred during the manufacturing process
7.2.1.2. Plaintiff cited Helling v Carey in attempt to establish Duty of the defendant.
7.2.1.3. Court ruled that the tattoo artist did not breach duty.
7.3. 92 Wash.2d 246 Supreme Court of Washington, En Banc. G. Walter GATES and Elisabeth Gates, husband and wife of the marital community composed thereof, Petitioners, v. Carl D. JENSEN, M.D., and his wife, James L. Hargiss, M.D., and his wife, Wood Lyda, M.D., and his wife, Walter C. Peterson, M.D., and his wife, Charles E. Boyland, M.D., and his wife, and Murray A. Johnstone, M.D., and his wife, and the marital communities composed thereof, and Eye Clinic of Seattle, Inc., P.S., a professional service corporation, Respondents. No. 45727. May 31, 1979. Gates v. Jensen, 92 Wash. 2d 246, 595 P.2d 919 (1979)
7.3.1. Malpractice suit brought on the grounds of lack of informed consent and the fiduciary duty between doctor and aptient
7.3.1.1. Petitioners in this suit for malpractice raise two important questions regarding a physician's duties of care and disclosure to a **921 patient, and the rules of law which apply when a physician allegedly breaches that duty. The first question is whether the doctrine of informed consent requires a physician to inform a patient of a bodily abnormality discovered during a routine examination and of diagnostic procedures which may be taken to determine the significance of that abnormality. Gates v. Jensen, 92 Wash. 2d 246, 247, 595 P.2d 919, 920–21 (1979)
7.3.1.2. The second question raised is whether the rule of Helling v. Carey, 83 Wash.2d 514, 519 P.2d 981 (1974), that reasonable prudence may require a standard of care higher than that exercised by the relevant professional group, prevails even after the enactment of RCW 4.24.290. We answer both these questions affirmatively, reverse the trial court, and remand for a new trial. Gates v. Jensen, 92 Wash. 2d 246, 247, 595 P.2d 919, 921 (1979)
7.3.1.3. Lower court judgement for the defendants
7.3.1.3.1. The Plaintiffs appealed