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Physician-Patient Relationship Required for Medical Malpractice Claim

Last week, the North Carolina Court of Appeals issued an opinion in the case Wheeless v. Maria Parham Medical Center, Inc. As part of the opinion, the court held that the plaintiff could not bring a medical malpractice claim against the defendant because a physician-patient relationship did not exist.

In Wheeless, the plaintiff was a doctor who held privileges at the defendant hospital. In 2005 and 2006, the defendant hospital conducted peer reviews of the plaintiff. Allegations were raised during these peer reviews that the plaintiff had violated the hospital’s “disruptive physician policy.” As a result of these allegations, the plaintiff’s privileges were changed from active privileges to consulting staff privileges pursuant to a settlement agreement. However, in 2006 and 2007, the plaintiff alleged that the hospital failed to honor these consulting privileges.

In 2009, the North Carolina Medical Board received an anonymous complaint from “W. Blower” which alleged inappropriate and disruptive behavior from the plaintiff. The complaint referenced incidents that were alleged in the peer reviews of 2005 and 2006. The Medical Board investigated the complaint and ultimately the allegations were dismissed.

The plaintiff filed a complaint against the defendant hospital alleging many claims, including those for unfair and deceptive trade practices, malicious prosecution, negligence and medical malpractice.

In examining the medical malpractice claim, the court noted that North Carolina statute G.S. 90-21.11(2) defines a medical malpractice claim as

a. A civil action for damages for personal injury or death arising out of the furnishing or failure to furnish professional services in the performance of medical, dental, or other health care by a health care provider.

b. A civil action against a hospital, a nursing home licensed under Chapter 131E of the General Statutes, or an adult care home licensed under Chapter 131D of the General Statutes for damages for personal injury or death, when the civil action (i) alleges a breach of administrative or corporate duties to the patient, including, but not limited to, allegations of negligent credentialing or negligent monitoring and supervision and (ii) arises from the same facts or circumstances as a claim under sub-subdivision a. of this subdivision.

The plaintiff argued that the medical malpractice claim satisfied the statutory requirements because the defendant was a health care provider, which is defined in G.S. 90-21.11(1) as

Without limitation, any of the following:

a.     A person who pursuant to the provisions of Chapter 90 of the General Statutes is licensed, or is otherwise registered or certified to engage in the practice of or otherwise performs duties associated with any of the following: medicine, surgery, dentistry, pharmacy, optometry, midwifery, osteopathy, podiatry, chiropractic, radiology, nursing, physiotherapy, pathology, anesthesiology, anesthesia, laboratory analysis, rendering assistance to a physician, dental hygiene, psychiatry, or psychology.

b.     A hospital, a nursing home licensed under Chapter 131E of the General Statutes, or an adult care home licensed under Chapter 131D of the General Statutes.

c.     Any other person who is legally responsible for the negligence of a person described by sub-subdivision a. of this subdivision, a hospital, a nursing home licensed under Chapter 131E of the General Statutes, or an adult care home licensed under Chapter 131D of the General Statutes.

d.     Any other person acting at the direction or under the supervision of a person described by sub-subdivision a. of this subdivision, a hospital, a nursing home licensed under Chapter 131E of the General Statutes, or an adult care home licensed under Chapter 131D of the General Statutes.

The plaintiff further argued that a health care provider-patient relationship is not required to bring a medical malpractice claim, citing the 2000 court of appeals’ case, Jones v. Asheville Radiological Group, P.A. In Jones, the plaintiff was a patient who sued her doctor and medical provider for disclosing her medical records without her authorization. The trial court dismissed the claim, reasoning that the disclosure of medical records without authorization did not give rise to a medical malpractice claim. The court of appeals disagreed with this reasoning and stated that "in the context of a health care provider's unauthorized disclosure of a patient's confidences, claims of medical malpractice, invasion of privacy, breach of implied contract and breach of fiduciary duty/confidentiality should all be treated as claims for medical malpractice."

However, the court distinguished Jones from the Wheeless case because “in Jones, the plaintiff was a patient of the defendants and, thus, a clear physician/medical provider to patient relationship existed between the plaintiff and the defendants.” In Wheeless, on the other hand, “plaintiff was not a patient of defendants, but rather a fellow medical professional and associate of” the defendant.

The court cited a case from the North Carolina Supreme Court (Easter v. Lexington Memorial Hospital, Inc. (1981)) as stating that “[i]t is well settled that the relationship of physician to patient must be established as a prerequisite to an actionable claim for medical malpractice.” In an earlier case, the court of appeals also cited Easter when it stated that “it is well settled that the relationship of health-care provider to patient must be established to maintain an actionable claim for medical malpractice.” (Massengill v. Duke University Medical Center 1999) The court in Massengill also reasoned that “[a]lthough the legislature failed to define the term ‘professional services’ as set forth in N.C. Gen.Stat. § 90-21.11” the North Carolina Supreme Court stated in Barger v. McCoy Hillard & Parks (1997) that "the term `professional services' refers to `those services where a professional relationship exists between plaintiff and defendant—such as a physician-patient or attorney-client relationship'."

Therefore, the court of appeals in Wheeless agreed with the trial court’s decision to dismiss the plaintiff’s claim for medical malpractice because there was no physician-patient relationship between the plaintiff and defendant.

If you have been injured by an act of medical malpractice, contact an attorney at Rosensteel Fleishman, PLLC (704) 714-1450, to discuss your options.

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