Safer v. Estate of Pack
677 A.2d 1188, 291 N.J. Super. 619 (1996)
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Rule of Law:
A physician's duty to a patient includes the duty to warn identifiable third parties, such as the patient's immediate family, who are at foreseeable risk of avoidable harm from a genetically transmissible disease.
Facts:
- From 1956 to 1964, Dr. George T. Pack treated Robert Batkin for multiple polyposis, a hereditary condition that leads to colorectal cancer.
- During his treatment, Mr. Batkin underwent multiple surgeries for the condition and its cancerous degeneration, including a total colectomy in 1956.
- The hereditary nature of multiple polyposis was allegedly known to the medical community during the time Dr. Pack was treating Mr. Batkin.
- Mr. Batkin died in 1964 from metastatic colon cancer, leaving behind his ten-year-old daughter, Donna Safer.
- Dr. Pack never warned Robert Batkin or his wife that the condition was hereditary and posed a significant health risk to their children.
- In 1990, at age 36, Donna Safer was diagnosed with multiple polyposis and advanced colon cancer, requiring extensive surgery and chemotherapy.
- Donna Safer and her husband only learned that her father had suffered from the same hereditary disease after obtaining his medical records in 1991.
Procedural Posture:
- Donna and Robert Safer (plaintiffs) filed a complaint alleging professional negligence against the Estate of Dr. George T. Pack (defendants) in the trial court.
- The defendants moved for summary judgment, arguing the physician owed no duty to his patient's child.
- The plaintiffs filed a cross-motion for partial summary judgment on the issue of liability.
- The trial court granted the defendants' motion to dismiss, holding that a physician has no legal duty to warn a patient's child of a genetic risk.
- The plaintiffs, Donna and Robert Safer, appealed the trial court's dismissal to the Superior Court of New Jersey, Appellate Division.
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Issue:
Does a physician have a legal duty to warn a patient's immediate family members of the foreseeable risks associated with a genetically transmissible disease diagnosed in the patient?
Opinions:
Majority - Kestin, J.A.D.
Yes, a physician has a legal duty to warn a patient's immediate family members of the foreseeable risks of a genetically transmissible disease. The court held that there is no essential difference between the foreseeable genetic threat at issue and the established duties to warn third parties about contagious diseases or other physical harm. The individual or group at risk—the immediate family—is easily identified, and substantial future harm may be averted or minimized by a timely and effective warning. The court reasoned that this duty extends beyond the patient to immediate family members who may be adversely affected by a breach, citing Schroeder v. Perkel. The court explicitly declined to hold that this duty is always satisfied by merely informing the patient, leaving open the possibility that a physician may need to take further steps to ensure the warning reaches those at risk, especially if there is a conflict with the patient's preference for confidentiality.
Analysis:
This decision significantly expands the scope of a physician's duty of care beyond the direct patient-physician relationship, establishing liability to foreseeable third parties for genetic torts. By analogizing genetic risks to contagious diseases, the court grounded the new duty in established principles of foreseeability and public policy. The ruling rejects a bright-line rule where warning the patient is always sufficient, suggesting a more flexible, fact-sensitive standard that balances the duty to warn with patient confidentiality. This case creates a precedent that requires physicians treating patients with hereditary conditions to consider the health implications for immediate family members and to take reasonable steps to ensure they are warned of avertible harm.
