Faya v. Almaraz
61 U.S.L.W. 2554, 620 A.2d 327, 329 Md. 435 (1993)
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Rule of Law:
An HIV-infected surgeon has a legal duty to inform patients of their condition before conducting an invasive procedure. A patient's fear of contracting AIDS from exposure to the infected surgeon constitutes a legally compensable injury, even if the patient tests HIV-negative, but damages are limited to the time between learning of the exposure and receiving information that makes the fear unreasonable (the 'window of anxiety').
Facts:
- Dr. Rudolf Almaraz, an oncological surgeon, knew he was HIV-positive since 1986.
- On October 7, 1988, and again in March 1989, Dr. Almaraz performed surgical procedures on Sonja Faya.
- On October 27, 1989, Dr. Almaraz was diagnosed with full-blown AIDS.
- On November 14, 1989, knowing he had AIDS, Dr. Almaraz performed surgery on Perry Mahoney Rossi.
- Dr. Almaraz never disclosed his HIV/AIDS status to either Faya or Rossi.
- Dr. Almaraz died of AIDS on November 16, 1990.
- On or about December 6, 1990, Faya and Rossi first learned of Dr. Almaraz's illness from a newspaper article.
- Faya and Rossi immediately underwent blood tests for HIV, and both results were negative.
Procedural Posture:
- Sonja Faya and Perry Mahoney Rossi (appellants) sued the estate of Dr. Almaraz and Johns Hopkins Hospital (appellees) in the Circuit Court for Baltimore City, a state trial court.
- The appellees filed motions to dismiss for failure to state a claim upon which relief could be granted.
- The trial court granted the motions and dismissed the appellants' complaints in their entirety, holding that fear of a harm that did not materialize was not a legally compensable injury.
- The appellants appealed the dismissal to the Court of Special Appeals of Maryland, the state's intermediate appellate court.
- The Court of Appeals of Maryland, the state's highest court, issued a writ of certiorari, agreeing to hear the case before it was decided by the intermediate appellate court.
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Issue:
Does a surgeon infected with HIV have a legal duty to inform patients of that condition before operating, and if so, does a patient's fear of contracting AIDS from that surgeon constitute a legally compensable injury even if the patient subsequently tests HIV-negative?
Opinions:
Majority - Murphy, C.J.
Yes. A surgeon has a legal duty to inform patients of their HIV-positive status before performing invasive surgery, and a patient's fear of contracting AIDS as a result of a surgeon's breach of this duty is a legally compensable injury. The court reasoned that the duty arises from the foreseeability of harm. Citing B.N. v. K.K., the court found that a person with a highly infectious disease can foresee the danger of communicating it. While the probability of HIV transmission during surgery is low, the seriousness of the potential harm (death) is exceptionally high, which establishes a duty to warn or refrain from the procedure. Regarding the injury, the court held that fear of acquiring AIDS is not unreasonable as a matter of law, even without proof of a specific channel of transmission. However, damages for emotional distress are limited to a 'reasonable window of anxiety'—the period between the patient learning of the potential exposure and receiving medically reliable information (such as a negative blood test) that makes continued fear unreasonable. The court found that the appellants' alleged injuries of headache, sleeplessness, and the costs of blood tests were sufficient objective manifestations of physical injury to support a claim for emotional distress, consistent with Maryland precedent in Vance v. Vance.
Analysis:
This decision significantly clarified the scope of a physician's duty of informed consent by extending it to their own health status when it poses a material risk to patients. It also established a path for 'fear of disease' claims in tort law, even in the absence of actual transmission. By creating the 'reasonable window of anxiety' framework, the court balanced the recognition of genuine emotional distress with the need to prevent potentially limitless liability for defendants. This case provides a foundational model for analyzing claims of emotional distress resulting from exposure to latent, deadly diseases, influencing how courts handle similar cases involving fear of future harm.
