Lection v. Dyll
2001 WL 688131, 65 S.W.3d 696, 2001 Tex. App. LEXIS 4075 (2001)
Premium Feature
Subscribe to Lexplug to listen to the Case Podcast.
Rule of Law:
A physician-patient relationship is formed when an on-call physician, who has a contractual obligation with a hospital to provide emergency care, takes affirmative action to treat a patient by providing a diagnosis and recommending a course of treatment to an emergency room physician over the telephone.
Facts:
- On August 15, 1992, Sandra M. Lection was taken to the emergency room of The Medical Center of Mesquite with neurological symptoms, including slurred speech and severe headache.
- Dr. Nabeel Syed, the emergency room physician, examined Lection and then paged the neurologist on call, Dr. Louis Dyll.
- Dyll telephoned the emergency room and spoke with Syed, who relayed the results of his examination and tests.
- Dyll informed Syed that Lection likely had a "hemiplegic migraine," that "no further treatment needed to be done," and instructed Syed to have Lection visit his office the following Monday.
- Syed stated that his decision on whether to admit or discharge Lection was based on what Dyll told him.
- There is a factual dispute over whether Lection left the hospital before, during, or after Syed’s conversation with Dyll.
- The morning after being sent home, Lection suffered a disabling stroke.
Procedural Posture:
- Sandra M. Lection sued Dr. Louis Dyll for medical malpractice in a Texas trial court.
- Dyll filed a motion for summary judgment, arguing that no physician-patient relationship existed.
- The trial court initially denied Dyll's motion for summary judgment in April 1996.
- Dyll filed a motion for reconsideration of his summary judgment motion.
- In May 1998, the trial court reconsidered and granted Dyll's motion for summary judgment, entering a take-nothing judgment against Lection.
- Lection (appellant) appealed the trial court's summary judgment to the Texas Court of Appeals.
Premium Content
Subscribe to Lexplug to view the complete brief
You're viewing a preview with Rule of Law, Facts, and Procedural Posture
Issue:
Does a physician-patient relationship, and its corresponding duty of care, arise when an on-call specialist consults with an emergency room physician by telephone, provides a diagnosis, and determines a course of treatment for a patient whom the specialist has not physically examined?
Opinions:
Majority - Justice Fitzgerald
Yes. A physician-patient relationship can be created when an on-call specialist takes affirmative action to treat a patient. The court reasoned that a physician-patient relationship does not require the formalities of a contract or direct physical contact. Dyll took affirmative action by evaluating the information from Syed, making a medical diagnosis of a hemiplegic migraine, determining that no further immediate treatment or admission was necessary, and directing that the patient follow up at his office. This conduct went beyond a mere collegial discussion and constituted rendering medical services, especially since Dyll was contractually obligated by hospital by-laws to provide emergency consultations. The court distinguished this case from precedents like St. John v. Pope, where the on-call physician declined to accept the patient or offer a diagnosis, finding it more analogous to Wheeler, where making a medical decision over the phone was sufficient to establish a duty.
Analysis:
This decision clarifies that the 'affirmative action' required to establish a physician-patient relationship for an on-call specialist can be satisfied through a substantive telephonic consultation. It shifts the focus from physical presence to the act of participating in the diagnosis and treatment plan of a patient. This expands potential liability for on-call specialists, establishing that their contractual obligations to a hospital, combined with rendering a medical opinion that influences a patient's care, are sufficient to create a legal duty, even without direct patient contact.
