Opinion ID: 2625980
Heading Depth: 1
Heading Rank: 5

Heading: necessity of physician-patient relationship

Text: ¶ 11 Medical malpractice involves matters of medical science and occurs when those engag[ed] in the practice of the healing arts, 76 O.S.2001, § 20.1, fail to exercise ordinary care in delivery of professional services when a duty is owed the plaintiff. Franklin v. Toal, 2000 OK 79, ¶ 14, 19 P.3d 834, 837. Plaintiffs' have alleged that Dr. Schlinke was negligent in rendering professional services and, in so doing, have brought a medical malpractice action against Dr. Schlinke. ¶ 12 The elements of a medical malpractice action, as with other negligence actions, are (1) a duty of care owed by the defendant to the plaintiff, (2) a breach of that duty, (3) an injury, and (4) causation. Franklin, 2000 OK 79 at ¶ 14, 19 P.3d at 837. In other words, the plaintiff must show that the defendant breached a duty owed the plaintiff which caused the plaintiff's injuries. The issue of the existence of duty is a question of law for the court. Lowery v. Echostar Satellite Corp., 2007 OK 38, ¶ 12, 160 P.3d 959, 964. This Court has not directly confronted the issue of whether a physician-patient relationship is essential for imposition of a duty in a medical malpractice action. ¶ 13 An action for malpractice is based on an employment contract. Funnell v. Jones, 1985 OK 73, ¶ 5, 737 P.2d 105, 107, cert. denied, 484 U.S. 853, 108 S.Ct. 158, 98 L.Ed.2d 113 (1987). To receive the professional services, the patient agrees to be treated, Scott v. Bradford, 1979 OK 165, ¶ 8-12, 606 P.2d 554, 556-557, and if the patient is unable to give consent, the consent may be implied. Rolater v. Strain, 1913 OK 634, 39 Okla. 572, 137 P. 96. Otherwise, a physician may be liable for assault and battery. Scott, 1979 OK 165 at ¶ 8-12, 606 P.2d at 556-557. Because in Oklahoma a physician is not under a general duty to provide professional services to others, see Jackson v. Mercy Health Ctr., Inc., 1993 OK 155, ¶ 5, 864 P.2d 839, 842, the physician must consent to provide the services. The agreement of the physician to treat and the patient to receive treatment is the basis of the employment contract. ¶ 14 Unless the contract expresses otherwise, the law will imply as a contractual term that the physician possesses that reasonable degree of learning, skill, and experience which is ordinarily possessed by others of [the] profession, that [the physician] will use reasonable and ordinary care and diligence in the treatment of the case which [the physician] undertakes, and that [the physician] will use his [or her] best judgment in all cases of doubt as to the proper course of treatment. Muckleroy v. McHenry, 1932 OK 671, ¶¶ 0, 14, 160 Okla. 139, 16 P.2d 123 (Syllabus by the Court). Thus, the law imposes a duty in the context of a relationship born of a contract [for which] a person injured by substandard performance of [the] duty may bring an action for medical malpractice and a claim for breach of contract. Great Plains Fed. Sav. and Loan Ass'n v. Dabney, 1993 OK 4, ¶ 2, 846 P.2d 1088, 1095 (Opala, J. concurring). Because the duty in a medical malpractice action is born out of a physician-patient contract, the relationship is essential to an action for a breach of the duty giving rise to the malpractice action. ¶ 15 Most courts addressing the issue have likewise required a physician-patient relationship as a prerequisite to medical malpractice liability. Oliver v. Brock, 342 So.2d 1, 3-4 (Ala.1977); Chatman v. Millis, 257 Ark. 451, 517 S.W.2d 504, 506 (1975) (but would not say that the relationship must be predicated upon a contractual agreement); Bradley Center, Inc. v. Wessner, 250 Ga. 199, 296 S.E.2d 693, 695 (1982); Flynn v. Bausch, M.D., 238 Neb. 61, 469 N.W.2d 125, 128 (1991); Easter v. Lexington Memorial Hospital, Inc., 303 N.C. 303, 278 S.E.2d 253, 255 (1981); Lownsbury v. Van Buren, 94 Ohio St.3d 231, 762 N.E.2d 354, 357-358 (2002); Roberts v. Hunter, 310 S.C. 364, 426 S.E.2d 797, 799 (1993); Kelley v. Middle Tenn. Emergency Physicians, P.C., 133 S.W.3d 587, 593-594 (Tenn.2004); St. John v. Pope, 901 S.W.2d 420, 423 (Tex.1995); Didato v. Strehler, M.D., 262 Va. 617, 554 S.E.2d 42, 47 (2001); Rand v. Miller, 185 W.Va. 705, 408 S.E.2d 655, 656 (1991); James L. Rigelhaupt, Jr., Annotation, What Constitutes Physician-Patient Relationship for Malpractice Purposes, 17 A.L.R.4th 132 (1982 & Supp. 2009), cases cited therein (hereinafter 17 A.L.R.4th). But see Stanley v. McCarver, 208 Ariz. 219, 92 P.3d 849 (2004) (imposing on physician, who was employed by business to conduct a pre-employment tuberculosis screening, a duty to make known other medical abnormalities based on it being foreseeable that the plaintiff would want to know). ¶ 16 While this issue is a matter of first impression in Oklahoma, our resolution is foreshadowed by our previous decisions addressing legal malpractice. We have continuously required that a plaintiff claiming legal malpractice prove an attorney-client relationship. Worsham v. Nix, 2006 OK 67, ¶ 31, 145 P.3d 1055, 1065 (citing Manley v. Brown, 1999 OK 79, 989 P.2d 448) (a plaintiff in a legal malpractice action must prove, among other things, an attorney-client relationship); Norton v. Hughes, 2000 OK 32, ¶ 11, 5 P.3d 588, 591 (A plaintiff claiming legal malpractice must prove the existence of an attorney-client relationship.); Haney v. State, 1993 OK 41, ¶ 4, 850 P.2d 1087, 1089 (One of the requisite elements of a legal malpractice claim is the existence of an attorney-client relationship.); Allred v. Rabon, 1977 OK 216, ¶ 11, 572 P.2d 979, 981 (A plaintiff claiming legal malpractice must prove the existence of the relationship of attorney and client between himself and the defendant.). ¶ 17 By finding the element of duty in a medical malpractice action requires a physician-patient relationship, we are not disallowing a cause of action for medical malpractice by a third-party beneficiary, such as a child, based on negligent prenatal care or a negligent delivery. Part of the purpose of a contract for medical care of a pregnant female is to insure the health of the child. In Nealis v. Baird, 1999 OK 98, 996 P.2d 438, we recognized that the parents of a prematurely-born child could bring a wrongful death action on the child's behalf against the mother's treating physicians. In Graham v. Keuchel, 1993 OK 6, 847 P.2d 342, we allowed that a wrongful death claim could be brought on behalf of an infant for a physician's failure to administer a drug after a previous delivery which would have prevented the mother's Rh-positive sensitization. In this regard, this Court allowed that the intended beneficiaries of a will could bring a legal malpractice claim or contract claim against the attorney drafting the will. Leak-Gilbert v. Fahle, 2002 OK 66, ¶ 27, 55 P.3d 1054, 1062.