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Diggs v. Arizona Cardiologists8/8/2000
cated an acute myocardial infarction and that proper interpretation of the EKG required a cardiologist. In his deposition, Dr. Valdez agreed that he confirmed Dr. Johnson's pericarditis diagnosis, that he recommended Mrs. Diggs be treated with Indocin, and that by ordering Mrs. Diggs to follow-up with him in ten days, he implied to Dr. Johnson that it was safe to discharge her.
Dr. Valdez admitted that his advice significantly affected Mrs. Diggs' treatment. When asked what Dr. Johnson did to rule out myocardial infarction as a diagnosis, Dr. Valdez answered: "He relied on the clinical history. He relied on my curbside consult, and he thought that the clinical history and all the findings most favored pericarditis." Dr. Valdez later conceded, however, that nothing about the EKG, the clinical history, or the physical examination ruled out myocardial infarction. We can reasonably infer from this testimony that the principal factor that led Dr. Johnson to rule out myocardial infarction was his reliance on Dr. Valdez's "curbside" opinion that Mrs. Diggs suffered from pericarditis.
Dr. Valdez further testified that if he had considered Mrs. Diggs as his own patient, he would have ordered a cardiac enzyme test to rule out myocardial infarction. Mrs. Diggs was discharged, however, without the benefit of that additional test. Dr. Valdez's advice and implicit opinion that it was safe to discharge Mrs. Diggs consequently increased the risk of harm to her.
Dr. Valdez argues that if we find that he had a duty to Mrs. Diggs under these circumstances, "informal" exchange of information between medical professionals will be chilled. We are not persuaded. We are not dealing with the informal exchange of medical information between two physicians, one of whom merely serves as a resource such as a treatise or textbook. In that case, where the treating physician exercises independent judgment in determining whether to accept or reject such advice, few policy considerations favor imposing a duty on the advising physician. See Gilinsky v. Indelicato, 894 F. Supp. 86 (E.D.N.Y. 1995).
Here, Dr. Johnson was not free to accept or reject Dr. Valdez's advice. Dr. Johnson was not a cardiologist; he needed the specialized knowledge of someone such as Dr. Valdez to read the echocardiogram and to confirm his interpretation of Mrs. Diggs' EKG. Furthermore, because Dr. Johnson did not have admitting privileges, only Dr. Valdez could admit Cynthia Diggs to St. Luke's Medical Center.
The record and all reasonable inferences indicate that Dr. Johnson did not exercise independent judgment as to Cynthia Diggs' diagnosis; rather he subordinated his professional judgment to that of the specialist in cardiology, Dr. Valdez. Paraphrasing the Restatement, section 324A, comment e, Dr. Johnson's reliance on Dr. Valdez induced him to forgo other remedies or precautions against such risk. We conclude from this record that when Dr. Valdez rendered his opinions, he effectively became a provider of medical treatment to Mrs. Diggs. This relationship between Dr. Valdez and Mrs. Diggs gave rise to a duty of reasonable care from Dr. Valdez to Mrs. Diggs.
CONCLUSION
We conclude that even without a contractual relationship, Dr. Valdez owed Mrs. Diggs a duty of due care in rendering medical advice regarding her diagnosis and treatment. We reverse the grant of summary judgment to the Valdez defendants and remand this case for further proceedings consistent with this decision.
PHILIP E. TOCI, Judge
CONCURRING: JEFFERSON L. LANKFORD, Presiding Judge E. G. NOYES, JR., Judge
Page 1 2 3 4 5 Arizona Personal Injury Attorneys
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