Case Title: MARQUIS DYER V EDWARD P TRACHTMAN

Citation: 

Docket Number: 123590

State: michigan

Court: Michigan Supreme Court

Date: 2004-05-05T00:00:00Z

Document:
_______________________________ 
 
 
 
 
 
 
Michigan Supreme Court  
Lansing, Michigan 48909  
Chief Justice 
Justices 
Maura D. Corrigan 
Michael F. Cavanagh 
Elizabeth A. Weaver 
Marilyn Kelly 
Clifford W. Taylor 
Robert P. Young, Jr. 
Opinion 
Stephen J. Markman 
FILED MAY 5, 2004 
MARQUIS DYER, 
Plaintiff-Appellee, 
v 
No. 123590 
EDWARD P. TRACHTMAN, D.O., 
Defendant-Appellant. 
BEFORE THE ENTIRE BENCH 
KELLY, J.  
In this case, plaintiff alleges that the defendant 
physician negligently injured him while performing an 
independent medical examination. 
The issue is whether 
plaintiff has a cause of action in ordinary negligence or 
in medical malpractice. 
The Court of Appeals concluded that the cause is 
grounded in ordinary negligence. 
We disagree and conclude 
that it sounds in medical malpractice. 
Therefore, we 
reverse the decision of the Court of Appeals, reinstate 
 
 
 
 
 
 
                                                 
plaintiff's medical malpractice claim, and remand this case 
to the trial court for further proceedings. 
I. Facts 
Plaintiff alleged in an unrelated civil complaint that 
he injured his left knee and right shoulder during a 
physical altercation. 
Following the injury, he underwent 
surgery to repair a tear in the superior labrum of his 
right shoulder. During the course of discovery in the civil 
action, 
the 
opposing 
party 
engaged 
defendant 
Edward 
Trachtman, 
D.O., 
to 
perform 
an 
independent 
medical 
examination (IME) of plaintiff. 
Before the examination, plaintiff asserted, he told 
defendant that surgery had been performed recently on his 
shoulder.1
 He also informed defendant that plaintiff's 
surgeon 
had 
placed 
restrictions 
on 
the 
movement 
of 
plaintiff's 
right 
arm 
and 
shoulder. 
Among 
these 
restrictions was a caution to plaintiff to avoid lifting 
the arm above forty-five degrees. 
During the course of the examination, it is alleged, 
defendant nonetheless forcefully rotated plaintiff's right 
arm and shoulder ninety degrees, detaching the labrum from 
the right shoulder. 
This required plaintiff to undergo 
surgery to repair the new damage. 
1We assume the accuracy of plaintiff's assertions for
the purpose of this appeal. 
2 
 
 
 
 
 
 
  
 
Plaintiff's 
original 
complaint 
against 
defendant 
alleged medical malpractice, among other claims. Defendant 
moved for summary disposition and argued that the IME did 
not give rise to a physician-patient relationship between 
plaintiff and defendant. 
Defendant also argued that the 
complaint’s 
remaining 
counts 
were 
nothing 
more 
than 
restatements of the malpractice claim. 
Plaintiff moved to amend the complaint to raise 
additional claims, including ordinary negligence. The trial 
court agreed with defendant that no physician-patient 
relationship had been created and held that a claim of 
medical malpractice could not be brought. 
Accordingly, it 
granted defendant's motion. 
In addition, it denied 
plaintiff's motion to amend the complaint, concluding that 
amendment 
would 
be 
futile. 
Any 
count 
sounding 
in 
negligence against the physician, it reasoned, would be a 
claim 
of 
medical 
malpractice 
that 
would 
require 
a 
physician-patient relationship. 
On appeal, the Court of Appeals agreed with the trial 
court that the absence of a physician-patient relationship 
was fatal to plaintiff's malpractice claim. 
255 Mich App 
659, 662-663; 662 NW2d 60 (2003). 
However, the court then 
determined that, without a physician-patient relationship, 
plaintiff 
could 
still 
maintain 
a 
claim 
in 
ordinary 
negligence. Id., 663-664. 
It remanded the case to allow 
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plaintiff to amend his complaint. 
In so doing, the Court 
of 
Appeals 
recognized 
that 
a 
determination 
whether 
negligence had occurred might require testimony about what 
a reasonable physician might have done during a similar 
IME. Id., 666 n 6. 
We granted leave to appeal to consider the following 
questions: 
(1) whether a physician may be held liable for 
ordinary negligence in the performance of an IME; (2) if 
so, whether expert testimony may be used to establish the 
physician's duty in performing the IME; and (3) whether an 
IME physician might have some limited professional duty, 
short of the duty that would arise if a traditional 
physician-patient relationship existed, that could support 
a claim for medical malpractice. 468 Mich 943 (2003). 
II. Standard of Review 
Whether a defendant owes any duty to a plaintiff to 
avoid negligent conduct is a question of law for the court 
to resolve. Simko v Blake, 448 Mich 648, 655; 532 NW2d 842 
(1995). 
"In determining whether to impose a duty, this 
Court evaluates factors such as: the relationship of the 
parties, the foreseeability of the harm, the burden on the 
defendant, and the nature of the risk presented." 
Murdock 
v Higgins, 454 Mich 46, 53; 559 NW2d 639 (1997), citing 
Buczkowski v McKay, 441 Mich 96, 100; 490 NW2d 330 (1992). 
Thus, a duty arises out of the existence of a relationship
4 
 
 
 
 
                                                 
 
“between the parties of such a character that social policy 
justifies" its imposition. Prosser & Keeton, Torts (5th 
ed), § 56, p 374. See also, Buczowski, supra, 100-101. 
III. Physician-Patient Relationship 
The Court of Appeals correctly recognized that this 
Court has not yet directly determined what, if any, 
relationship should be recognized between a physician 
performing an IME and an examinee.2
 Having reviewed 
persuasive authority from other courts, we conclude that an 
IME physician has a limited physician-patient relationship 
with the examinee that gives rise to limited duties to 
exercise professional care. 
We agree with the decisions of other courts and of our 
own Court of Appeals3 that the relationship is not the 
traditional one. 
It is a limited relationship. 
It does 
not involve the full panoply of the physician's typical 
responsibilities to diagnose and treat the examinee for 
medical conditions. 
The IME physician, acting at the 
behest of a third party, is not liable to the examinee for 
damages resulting from the conclusions the physician 
reaches or reports. 
The limited relationship that we 
2Our decision is limited to the relationship between an
examinee and a physician who provides an IME but does not
treat the examinee. 
3See Rogers v Horvath, 65 Mich App 644, 647; 237 NW2d
595 (1975). 
5 
 
 
 
 
 
 
recognize imposes a duty on the IME physician to perform 
the examination in a manner not to cause physical harm to 
the examinee. 
As correctly noted by the Court of Appeals, the duty 
of care in a medical malpractice action has its basis in 
the relationship between the physician and the patient. 
See Dorris v Detroit Osteopathic Hosp Corp, 460 Mich 26, 
45; 594 NW2d 455 (1999), citing Bronson v Sisters of Mercy 
Health Corp, 175 Mich App 647, 652; 438 NW2d 276 (1989). 
See also anno: 
Physician’s duties and liabilities to 
person examined pursuant to physician’s contract with such 
person’s prospective or actual employer or insurer, 10 
ALR3d 1071; Greenberg v Perkins, 845 P2d 530, 534 (Colo, 
1993). The Court of Appeals relied on its earlier case law 
and cases from other jurisdictions to hold: 
"In an IME 
context, there is no physician-patient relationship and 
there can be no liability for professional negligence or 
medical malpractice." 
255 Mich 662, citing Rogers v 
Horvath, 65 Mich App 644, 647; 237 NW2d 595 (1975). 
See 
also 255 Mich 622 n 3. 
A majority of courts recognizes that a traditional 
physician-patient relationship does not exist in the 
context of an IME setting. 
However, a growing number find 
that the relationship does exist in some form. 
Moreover, 
they conclude that it gives rise to particular professional
6 
 
 
 
 
 
 
 
duties owed by the examining physician. 
See e.g., 
Greenberg, 845 P2d 534-535; Stanley v McCarver, 204 Ariz 
339, 341-342; 63 P3d 1076 (2003); Reed v Bojarski, 166 NJ 
89, 95-99; 764 A2d 433 (2001); 10 ALR3d 1071. 
As aptly noted in Greenberg, the cases considering 
malpractice liability in an IME setting "are remarkable for 
the diversity of their analyses." 
Greenberg, 845 P2d 535. 
The majority of jurisdictions has recognized that there is 
no traditional physician-patient relationship in an IME 
setting that would create a duty to properly diagnose or 
treat abnormalities or conditions. 
See 10 ALR3d 1071; 
Hafner v Beck, 185 Ariz 389, 391; 916 P2d 1105 (Ariz App, 
1995); Felton v Schaeffer, 229 Cal App 3d 229, 238-239; 279 
Cal Rptr 713 (1991); LoDico v Caputi, 129 AD2d 361, 362­
364; 517 NYS2d 640 (1987); Ervin v American Guardian Life 
Assurance Co, 376 Pa Super 132, 135-136; 545 A2d 354 
(1988); Martinez v Lewis, 969 P2d 213, 219 (Colo, 1998). 
This seems appropriate. In the particularized setting 
of an IME, the physician's goal is to gather information 
for the examinee or a third party for use in employment or 
related financial decisions. 
It is not to provide a 
diagnosis or treatment of medical conditions. 
In addition, the IME physician often examines the 
patient under circumstances that are adversarial, such as 
in the instant case. 
Thus, if the duties that arise in a 
7  
 
 
 
 
 
 
 
 
   
 
                                                 
 
regular physician-patient relationship were imposed on the 
IME physician, an unacceptable risk would exist. 
The 
examinee, disagreeing with the diagnosis, could sue and 
recover 
from 
the 
IME 
physician. 
Some 
courts 
have 
explicitly recognized this risk. 
As stated in Hafner, 185 
Ariz 391-392:   
If 
an 
IME 
practitioner's 
evaluations,
opinions, and reports could lead not only to
vehement disagreement with and vigorous cross­
examination of the practitioner in the claims or
litigation process, but also to his or her 
potential liability for negligence, the resulting
chilling effect could be severe. To permit such
an action by expanding the concept of duty in
this type of case would be, at best, ill-advised.
At worst, the fears expressed in Davis v Tirrell,
110 Misc 2d 889, 895-96; 443 NYS2d 136, 140 (Sup
Ct., 1981) may be realized: 
“To permit such an action would make it
impossible to find any expert witness willing to
risk a lawsuit based on his testimony as to his
opinions and conclusions before any tribunal. 
And such cause of action if permitted would lead
to an endless stream of litigation wherein 
defeated litigants would seek to redeem loss of
the main action by suing to recover damages from
those witnesses whose adverse testimony might 
have brought about the adverse result.”[4] 
4Also 
"[t]he 
general 
rule 
is 
that 
the 
physician who is retained by a third party to
conduct an examination of another person and 
report the results to the third party does not
enter into a physician-patient relationship with
the examinee and is not liable to the examinee 
for any losses he suffers as a result of the
conclusions the physician reaches or reports."
[Ervin, 376 Pa Super 136 (citations omitted).] 
8 
 
 
 
 
 
 
 
Likewise, 
other 
courts, 
including 
our 
Court 
of 
Appeals, have apparently recognized that the general duty 
of diagnosis and treatment is inappropriate in the IME 
setting given the purpose of the examination. 
See Rogers, 
65 Mich App 646; Ervin, 376 Pa Super 139; Lee v New York, 
162 AD2d 34, 35-38; 560 NYS2d 700 (1990). 
As correctly noted by the Court of Appeals here, 
however, the lack of a traditional physician-patient 
relationship has not normally been used to absolve an IME 
physician of all responsibility. Many cases recognize a 
duty of the physician "to 'conduct the examination in a 
manner not to cause harm to the person being examined.'" 
Greenberg, supra 845 P2d 535, quoting Rand v Miller, 185 W 
Va 705, 707; 408 SE2d 655 (1991).  See also Mero v Sadoff, 
31 Cal App 4th 1466, 1478; 37 Cal Rptr 2d 769 (1995); 
Ramirez v Carreras, 10 SW3d 757, 760 (Tex App, 2000). 
We find persuasive the cases that recognize a limited 
physician-patient relationship. 
The limited relationship 
imposes fewer duties on the examining physician than does a 
traditional physician-patient relationship. 
But it still 
requires that the examiner conduct the examination in such 
a way as not to cause harm. 
The patient is not in a traditional professional 
relationship with the physician. 
Nonetheless, he places 
his physical person in the hands of another who holds that
9 
 
 
 
 
 
position solely because of his training and experience. The 
recognition 
of 
a 
limited 
relationship 
preserves 
the 
principle that the IME physician has undertaken limited 
duties but that he has done so in a situation where he is 
"expected to exercise reasonable care commensurate with his 
experience and training." Reed, 166 NJ 106. 
Moreover, the recognition that an IME physician does 
have a limited professional relationship with the examinee 
provides additional benefits to both the examiner and the 
examinee. 
It obviates the necessity of attempting to 
distinguish artificially between claims of malpractice by 
an independent medical examiner and claims against other 
physicians involving similar conduct. 
For example, here the Court of Appeals, correctly 
recognizing that defendant owed a duty to plaintiff absent 
the traditional physician-patient relationship, categorized 
the plaintiff's claim as one of ordinary negligence. 
It 
may have sought to do so because it recognized earlier 
courts' unwillingness to recognize a limited professional 
relationship in similar situations. 
However, the actions 
of defendant here more properly fit within the realm of 
medical malpractice than ordinary negligence. 
In general, where a professional relationship exists, 
the differentiation between a medical malpractice claim and 
an ordinary negligence claim depends on "whether the facts
10 
 
 
 
 
 
 
 
    
 
                                                 
 
allegedly raise issues that are within the common knowledge 
and experience of the jury or, alternatively, raise 
questions involving medical judgment." Dorris, 460 Mich 46 
(citations omitted). 
See also Id., 49 (Kelly, J., 
concurring in part and dissenting in part). 
In the case before us, defendant's examination of 
plaintiff called upon defendant's professional judgment. 
The facts plaintiff alleges indicate that defendant made 
the medical decision to fully rotate plaintiff's arm to 
examine its range of motion, despite the caution of 
plaintiff's treating physician. 
Such allegations "raise 
questions involving medical judgment." 
Dorris, supra, 460 
Mich 
46. 
They 
more 
properly 
fit 
within 
a 
medical 
malpractice cause of action.5 
IV. Conclusion 
In making our determination, we have considered the 
case law and the differentiation under Michigan law between 
ordinary negligence and medical malpractice. 
We have 
recognized a limited physician-patient relationship in the 
5This is not to say that an IME physician, like any
health professional, cannot be held liable for ordinary
negligence under other circumstances. For example, during
oral argument a question was raised regarding a scenario in
which an injury is caused when the IME physician overturns
a medicine cabinet onto the examinee. 
Here, however, the
injury 
and 
alleged 
negligence 
occurred 
during 
the 
examination itself and were directly related to defendant's
exercise of his professional services. 
Hence, the facts
cause plaintiff’s claim to sound in medical malpractice.
11 
 
 
 
 
 
 
IME setting. 
Our use of the word “limited” acknowledges 
the lack of a traditional physician-patient relationship in 
that setting. 
Also, it avoids creating an artificial 
distinction 
between 
the 
acts 
of 
independent 
medical 
examiners and other treating physicians. 
If the IME physician's alleged negligence sounds in 
malpractice, he will be able to avail himself of the 
evidentiary protections the Legislature has granted to 
physicians 
in 
other 
circumstances. 
See, 
e.g., 
MCL 
600.2912b; MCL 600.2912d. At the same time, the ability to 
forecast the type of action involved in the IME setting 
will avoid, for future plaintiffs, the confusion that 
occurred here. 
In this case, the Court of Appeals correctly noted the 
existence of a limited duty, notwithstanding the absence of 
a traditional physician-patient relationship. 
Where the 
Court of Appeals erred was in failing to recognize that the 
duty 
arises 
from 
the 
examining 
physician's 
limited 
professional relationship with the examinee. 
Contrary to 
the ruling of the Court of Appeals, this relationship may 
give rise to a claim for medical malpractice rather than 
for ordinary negligence, as this Court has recognized the 
distinction. 
The limited relationship encompasses a duty by the 
examiner to exercise care consistent with his professional
12 
 
 
 
 
 
training and expertise so as not to cause physical harm by 
negligently conducting the examination. 
Thus, we overrule 
Rogers and its progeny to the extent that they are 
inconsistent with this decision. 
The judgment of the Court of Appeals is reversed, 
plaintiff’s medical malpractice claim is reinstated, and 
the case is remanded to the trial court for further 
proceedings. 
Marilyn Kelly
Maura D. Corrigan
Michael F. Cavanagh
Elizabeth A. Weaver 
Clifford W. Taylor
Robert P. Young, Jr.
Stephen J. Markman 
13