B.R. v. West
275 P.3d 228 (2012)
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Rule of Law:
A healthcare provider owes a duty of reasonable care to non-patients when engaging in the affirmative act of prescribing medication that creates a foreseeable risk of injury to third parties.
Facts:
- In 2007, Trina West, a nurse practitioner at Pioneer Comprehensive Medical Clinic, provided medical treatment to David Ragsdale.
- West prescribed Ragsdale at least six medications, including Concerta, Valium, Doxepin, and Paxil.
- In January 2008, while these drugs were in his system, David Ragsdale shot and killed his wife, Kristy Ragsdale.
- David Ragsdale subsequently pled guilty to aggravated murder.
- As a result of the killing, the Ragsdales' young children were left parentless.
Procedural Posture:
- The Ragsdales' children, through their conservator, filed a negligence lawsuit in a Utah district court (trial court) against Nurse West, Dr. Hugo Rodier, and the medical clinic.
- The defendants filed a motion to dismiss under Rule 12(b)(6), arguing they owed no duty of care to the plaintiffs, who were not their patients.
- The district court granted the defendants' motion to dismiss, agreeing that no duty existed without a patient-health care provider relationship.
- The plaintiffs (appellants) appealed the district court's dismissal to the Utah Supreme Court.
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Issue:
Does a healthcare provider owe a duty of care to non-patients for injuries allegedly caused by the provider's affirmative act of negligently prescribing medication to a patient?
Opinions:
Majority - Justice Lee
Yes. A healthcare provider owes a duty of care to non-patients when the provider's affirmative conduct, such as prescribing medication, creates a risk of harm to third parties. The court reasoned that tort law fundamentally distinguishes between misfeasance (affirmative acts) and nonfeasance (omissions). While a duty for nonfeasance generally requires a 'special relationship' between the parties, a duty of care is presumed for affirmative acts that create a risk of harm. Prescribing medication is an affirmative act (misfeasance), not an omission, so a special relationship with the injured non-patient is not required. The court distinguished prior cases requiring a special relationship because those involved nonfeasance, such as the failure to control a patient. The court further concluded that policy considerations—including foreseeability, the provider's superior position to prevent harm, and general public policy—do not justify creating a categorical exception to this duty for healthcare providers.
Analysis:
This decision significantly clarifies Utah's tort law on duty, establishing that a healthcare provider's liability for negligence can extend beyond the direct physician-patient relationship. By distinguishing between affirmative acts (misfeasance) and omissions (nonfeasance), the court limited the 'special relationship' requirement to cases involving a failure to act, such as failing to warn or control a patient. This precedent expands the scope of potential plaintiffs in medical negligence cases to include third parties foreseeably harmed by a provider's active treatment decisions, such as prescribing medication, thereby increasing the legal accountability of medical professionals for the broader consequences of their actions.
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