Opinion ID: 2080579
Heading Depth: 1
Heading Rank: 4

Heading: Implied Contract Count

Text: Prior to trial, the defendant moved under M.R.Civ.P. 12(b)(6) to dismiss Count I of the plaintiffs' complaint on the ground that the breach of contract allegation failed to state a claim upon which relief could be granted. The presiding Justice denied this motion, concluding that Maine law recognized a breach of implied contract as a theory of recovery for medical malpractice. Nevertheless, he ordered Count I stricken sua sponte on the ground that it was redundant in view of the negligence claim contained in Count III of the complaint. On appeal, the plaintiffs challenge the action of the presiding Justice, arguing that breach of implied contract is an independent theory of recovery in medical malpractice actions and that such a claim was not duplicative of the negligence count. In support of these contentions, the plaintiffs rely, as did the presiding Justice, on a frequently cited passage in Coombs v. King, 107 Me. 376, 78 A. 468 (1910), defining a physician's legal responsibility: He contracts with his patient that he has the ordinary skill of members of his profession in like situation, that he will exercise ordinary or reasonable care and diligence in his treatment of the case, and that he will use his best judgment in the application of his skill to the case. Id. at 378, 78 A. at 468. (Emphasis added). Although Coombs and other early cases framed a physician's duty in terms of an implied representation that he possessed and would exercise a reasonable level of professional competence, id. at 378, 78 A. at 469; e. g., Miller v. Toles, 183 Mich. 252, 256, 150 N.W. 118, 120 (1914); Leighton v. Sargent, 27 N.H. 460, 469-71 (1853), it is now clear that the implied contract theory merely imposes a duty that tort law would in any event require. See generally 1 Louisell & Williams, supra, at ¶ 8.03; Miller, The Contractual Liability of Physicians & Surgeons, 1953 Wash.U.L.Q. 413, 413-16. With the development of modern tort principles, the majority of courts, usually in the context of whether contract or tort limitation or venue statutes govern the action, have come to recognize that although the physician-patient relationship is typically consensual in nature the existence of this relationship imposes a duty of due care which arises in negligence rather than in contract. See, e. g., Harding v. Liberty Hospital Corp., 177 Cal. 520, 521-24, 171 P. 98, 99-100 (1918); Benson v. Mays, 245 Md. 632, 636, 227 A.2d 220, 223-24 (1967); Lakeman v. La France, 102 N.H. 300, 305, 156 A.2d 123, 127 (1959); Yeager v. Dunnavan, 26 Wash.2d 559, 562, 174 P.2d 755, 757 (1946). But see Zostautas v. St. Anthony De Padua Hospital, 23 Ill.2d 326, 327-31, 178 N.E.2d 303, 304-05 (1961) (malpractice is hybrid action sounding in contract or tort); Barrios v. Sara Mayo Hospital, 264 So.2d 792, 794 (La.App.1972) (liability in contract or tort). Illustrative of the modern view holding that malpractice actions are squarely grounded in principles of tort law is the leading case of Kozan v. Comstock, 270 F.2d 839 (5th Cir. 1959), in which the Fifth Circuit Court persuasively reasoned: It is the nature of the duty breached that should determine whether the action is in tort or in contract. To determine the duty one must examine the patient-physician relationship. It is true that usually a consensual relationship exists and the physician agrees impliedly to treat the patient in a proper manner. Thus, a malpractice suit is inextricably bound up with the idea of breach of implied contract. However, the patient-physician relationship, and the corresponding duty that is owed, is not one that is completely dependent upon a contract theory. There are instances in which the relationship exists though there is clearly no contractual relationship between the patient and the physician. Thus, the patient may be incapable of contracting or a third person may have contracted with the physician for the treatment of the patient. Even in these instances in which no contract is present the physician still owes a duty to the patient. The duty of due care is imposed by law and is something over and above any contractual duty. Certainly, a physician could not avoid liability for negligent conduct by having contracted not to be liable for negligence. The duty is owed in all cases, and a breach of this duty constitutes a tort. On principle then, we consider a malpractice action as tortious in nature whether the duty grows out of a contractual relation or has no origin in contract. Id. at 844-45. In addition to the inadequacy of implied contract as a comprehensive liability base in malpractice actions, we discern additional reasons for eschewing any reliance upon a theory that a physician has breached an implied contractual duty of due care. First, the reasonableness of a physician's conduct can be adequately determined under familiar tort principles without the necessity of importing into malpractice actions commercial concepts with traditionally distinct rules as to theory, proof, damages, limitation periods and venue. See Kozan v. Comstock, supra, 270 F.2d at 843-44 & n.16; 1 Louisell & Williams, supra, at ¶ 8.03. Second, and related to the foregoing, recognizing the continued vitality of implied contract as an independent cause of action would be fundamentally inconsistent with the modern view that malpractice actions should be predicated on a single basis of liability-deviation from the professional standard of care-with the application of common evidentiary and procedural rules. We are not here concerned with a breach of an express contract between a physician and his patient. A physician may be liable in contract for breach of an express agreement to effect a cure or to achieve a particular result. E. g., Depenbrok v. Kaiser Foundation Health Plan, Inc., 79 Cal.App.3d 167, 170, 144 Cal.Rptr. 724, 726 (1978); Robins v. Finestone, 308 N.Y. 543, 545-48, 127 N.E.2d 330, 331-32 (1955); cf. Miller v. Dore, 154 Me. 363, 365-66, 148 A.2d 692, 694 (1959) (express promises concerning treatment). See generally 1 Louisell & Williams, supra, at ¶ 8.10; Annot., 43 A.L.R.3d 1221 (1972). We hold only that where a plaintiff claims he has suffered personal injury as the result of a physician's faulty diagnosis or mistreatment his remedy lies in a complaint for negligence, not in an action based on an implied contract to exercise due care. Huysman v. Kirsch, 6 Cal.2d 302, 306, 57 P.2d 908, 910 (1936); Cooper v. Edinbergh, 97 Misc.2d 143, 145, 410 N.Y.S.2d 962, 964 (Sup.Ct.1978). In the instant case, the presiding Justice should have granted the defendant's motion to dismiss although his action in striking the count had the same effect.