Opinion ID: 1161831
Heading Depth: 2
Heading Rank: 5

Heading: common law duty of clinical care

Text: The plaintiffs assert that the trial court erred in dismissing their claim that the municipal defendants violated the duty of clinical care owed to the plaintiff class. They contend that health care providers have a common law duty to exercise reasonable care and diligence in the treatment of their patients, and that such a health care provider may be found liable for abandoning patients who are still in need of care without providing adequate notice. See Bolles v. Kinton, 83 Colo. 147, 149, 263 P. 26, 27 (1928) (A physician cannot discharge a case and relieve himself of responsibility for it by simply staying away without notice to the patient.). Cf. Katsetos v. Nolan, 170 Conn. 637, 368 A.2d 172, 182 (1976) (a physician is under a duty to provide care as long as the patient needs it and should not leave his patient at a critical stage without notice, but plaintiff must prove that the failure to observe this duty was the proximate cause of injury); Meeks v. Coan, 165 Ga.App. 731, 302 S.E.2d 418, 420 (1983) (recognizing that a physician may be liable for abandoning a case without reasonable notice, but noting that no recovery is possible unless injury results from the abandonment). The plaintiffs argue that the existence of this common law duty of clinical care gains support from this court's adoption of Restatement Second of Torts งง 323 and 324(A). [22] See Jefferson County School Dist. R-1 v. Justus, 725 P.2d 767, 770 (Colo.1986); De Caire v. Public Service Co., 173 Colo. 402, 408, 479 P.2d 964, 967 (1971). The plaintiffs argue that the municipal defendants violated this duty by abruptly reducing the community support services available to the mentally ill on June 1, 1981, and by the manner in which DHH withdrew as a community mental health center on January 1, 1985. In both instances, patients received a maximum of thirty days notice, while some received no notice at all. The plaintiffs assert that the municipal defendants should be held accountable for their breach of this duty by being required to provide services that will compensate class members for the injuries they suffered when mental health services were reduced. In addition, the plaintiffs assert that they should be free to seek damages for this breach. The imposition of a duty raises serious policy implications, see Taco Bell, Inc. v. Lannon, 744 P.2d 43, 46 (Colo.1987); University of Denver v. Whitlock, 744 P.2d 54, 56-7 (Colo.1987); Jefferson County School Dist. R-1 v. Justus, 725 P.2d at 769. At present, however, we need not determine whether such a duty exists because we conclude that the plaintiffs' claims for both injunctive relief and damages are not appropriate for resolution in the context of this class action as presently structured. Furthermore, we conclude that the existence of such a duty is more appropriately to be considered in the context of the particular facts giving rise to the asserted duty. This case presents difficulties in assessing both liability and damages. [23] Each class member asserting injury resulting from the municipal defendants' violation of the common law duty of clinical care would have to establish individually the services he or she was receiving prior to June 1, 1981, or January 1, 1985, as well as the services received after the change in the delivery of mental health services. Once a claimant established that the mental health services provided to him or her were reduced or terminated without adequate notice, the claimant would still have to establish the harm suffered as a result of this reduction, and it would then be necessary to fashion appropriate monetary or injunctive relief. This case appears similar to Rice v. City of Philadelphia, 66 F.R.D. at 20, in which the court noted: In the present case, not only would the calculation of the amount of damages depend upon the individual facts of each claimant's case, but virtually all of the issues would have to be litigated individually in order to determine whether a particular alleged class member was entitled to any damages at all. Each claimant, in order to obtain the benefits of the class suit, would have to establish his membership in the class ( i.e., that his rights were violated). We do not foreclose the possibility, however, that the class action device may prove appropriate for resolving some of the issues relating to this claim. Pursuant to C.R.C.P. 23(c)(4), a court has the discretion to limit the issues in a class action to those parts of a lawsuit that lend themselves to convenient use of the class action motif. Williams v. Owens-Illinois, Inc., 665 F.2d 918, 929 (9th Cir.1982), cert. denied, 495 U.S. 971, 103 S.Ct. 302, 74 L.Ed.2d 283 (1982). Accord, e.g., Windham v. American Brands, Inc., 565 F.2d 59, 67-70 (4th Cir.1977), cert. denied, 435 U.S. 968, 98 S.Ct. 1605, 56 L.Ed.2d 58 (1978). On remand, the trial court should consider whether the class can be divided into smaller sub-classes that were similarly situated in 1981 or 1984, and that were similarly affected by the defendants' actions with respect to liability, damages, or both.