Helling v Carey (1974)

1. Impact

1.1. Osborn v Irwin Memorial Blood Bank (April, 1992)

1.1.1. A young boy contracted HIV following surgery in which he received a blood transfusion. The parents sued the university where the surgery occurred on the basis of negligence, intentional and negligent misrepresentation and products liability.

1.1.1.1. Ultimately, the university was not held liable for the boy contracting HIV because the blood bank failed to a run a test that no other blood bank at the time was running - this finding does not following the Supreme Court of Washington's ruling on the Helling v Carey case

1.1.1.1.1. In June 1992, blood banks began testing the blood supply for HIV.

1.2. Chester v Deep Roots Alderwood, LLC (2016)

1.2.1. A patron, Chester, sued a tattoo parlor for a negative reaction after she was tattooed, alleging that the ink used in her tattoo had been contaminated during manufacture

1.2.1.1. The court found in favor of the defendants that they were not negligent in the ink used on the tattoo and that the parlor and artists did not breach any standards of care in not ensuring that the ink was sterile prior to use

1.2.1.1.1. This case also negatively finds against the ruling of the Helling v Carey case by the Supreme Court of Washington - the artists acted in accordance with the standard of care and were not responsible to provide care beyond that.

2. Rule of Law

2.1. Negligene: Due care, reasonable prudence

3. Application/Analysis

3.1. Plaintiff's Side: plaintiff believed that the defendants were negligent because they did not do the pressure test when she repeatedly complained of irritation. In addition, they did not do a field of vision test despite the fact that she had been coming in with complaints for years.

3.2. Defendant's Side: standard practice did not require the defendants to perform a pressure test on the plaintiff because she was 32 and pressure tests did not occur in patients below 40 years old. The defendants' training did not require them to perform a pressure test on a patient who was below the standard criteria. In addition, it could be argued that the plaintiff should have sought another opinion if she continued to have issues and was not receiving any treatment or improvements from the defendants.

3.3. Courts Consideration: the trial and appellate courts found in favor of the defendants because the expert testimony defended that the defendants followed standards of practice for the time. However, the Supreme Court of Washington found that the defendants did not act prudently to treat the plaintiff, and that they should follow a "standard of care higher than that actually practiced by the profession." The courts looked at the seriousness of blindness as a result of undiagnosed glaucoma in comparison to the cost and risk of a pressure test for a patient below the standard of care age.

4. Influence

4.1. Defensive Medicine: healthcare providers over-test and over-refer in order to protect themselves from being found negligent if they miss a diagnosis - this drives up medical costs and can result in an increase in false positives and unnecessary treatment

4.2. I would argue that the over-prescription of pharmaceuticals is a result of this ruling, in that doctors will prescribe antibiotics for viral colds and the overprescription of opioids and resultant growing dependence in our society - a desire to provide patients with what they want, rather than what they need

5. Facts

5.1. Plaintiff: Helling: suffers from primary open angle glaucoma, in which pressure gradually rising above normal levels causes damage to the optic nerve and its fibers and results in vision loss. The disease often has few symptoms and often undetectable until vision loss has occurred without a pressure test.

5.2. Defendants: Dr. Carey & Dr. Laughlin, partners in an opthalmology practice.

5.3. Helling consulted with the defendants first in 1959 for myopia and received contact lenses. In 1963, Helling returned complaining of irritation caused by the contact lenses, and returned one month later, in Feb 1967, Sept 1967, Oct 1967, May 1968, July 1968, Aug 1968, Sept 1968, and Oct 1968. Defendants believed issues were all related to contact lenses until the consultation in Oct 1968, when Dr. Carey tested the plaintiff's eye pressure and field of vision for the first time and found glaucoma. Helling, a 32 yr old woman, had lost peripheral vision and most central vision by this point. Helling consulted with other physicians in 1969 and filed a complaint against the defendants due to negligence.

5.4. Standards of the profession indicate that glaucoma testing does not occur before 40 years of age unless symptoms suggest such tests

5.5. The trial court found the defendants not liable, as did the appellate courts, however, the Supreme Court of Washington disagreed.

6. Issue

6.1. Negligence: Did the defendants act with due care?

7. Conclusion

7.1. The Supreme Court of Washington found that the defendants were negligent for not acting with "reasonable prudence" despite the fact that the trial court and appellate courts had favored the defendants

7.2. Following the ruling of the Supreme Court, the Washington legislature passed a statute to overturn the Helling ruling, believing that it was the courts overstepping their power in terms of medical decision making - stating that "the plaintiff in order to prevail shall be required to prove by a preponderance of the evidence that the defendant or defendants failed to exercise that degree of skill, care, and learning possessed at that time by other persona int he same profession, and that as a proximate result of such failure the plaintiff suffered damages"

7.3. The defendants were behaving in accordance with the standards of care at the time and therefore, should not be liable for the damages suffered by Helling

8. Importance

8.1. A healthcare provider would care about the finding of the Supreme Court in this case because it places the burden of on the provider to act above and beyond their standards of care and learning.

8.2. This ruling found against the expert testimony stating that the defendants followed standard of care, which is one of the cornerstones of malpractice suits. Physician's are measured against the knowledge and skill of the average physician in the same line of practice, not above and beyond that as was found in this case.