Court Opinion

ID: 9569352
Source: CourtListenerOpinion
Date Created: 2023-08-21 20:13:07.506707+00
Date Added: 2024-06-11T11:51:07.774376
License: Public Domain

BARNES, Judge,
concurring in part and dissenting in part.
While I agree that Georgia allows a cause of action for preconception torts, and concur fully and completely in Divisions 2, 3, and 4, I disagree that no genuine issue of material fact exists regarding whether Dr. Rippy committed malpractice by failing to prescribe and *231recommend that Clay take four micrograms of folic acid daily before conceiving again. Accordingly, I respectfully dissent to Division 1.
The majority argues that Rippy did not violate his duty of care because he did not know that Clay would fail to return for follow-up care, which is when he would have counseled her thoroughly regarding the need for folic acid. While Rippy said the May 6 visit was not the time to counsel Clay on future pregnancies because she was crying, upset, and faced with a difficult decision to terminate her pregnancy, it was arguably even more forseeable that a 19-year-old, apparently unsophisticated, and very upset woman might not return for a follow-up visit after her pregnancy ended. But when asked whether he would send a letter or make a phone call to Clay regarding the recommendation she take folic acid if he had not told her about it, he responded that he would not, that the obligation to seek further treatment was Clay’s alone. He admitted he did not know if Clay were seeing any other physicians, and although he expected her to see someone for an annual checkup, he never told her that because she never returned to him in 1999.
Dr. Rippy also admitted that the standard of care under these circumstances required that he “supply the information [regarding the link between folic acid and NTD] in an understandable way and be complete.” While he thought the standard of care did not require him to give her the information on May 4, 1999, the day he discussed Dr. Molina’s findings with Clay, he agreed that if he had a patient whom he actually knew did not understand his recommendations his job was to take further steps to make sure she understood them, “as best as possible.” Rippy’s office notes indicate that Clay called Rippy’s office on May 10, 1999, to report that she had made an appointment with Dr. Malloy, and again called or made some sort of contact on May 14, 1999, although Dr. Rippy could not tell from his notes the nature of this contact.
Maternal-fetal care consultant Dr. Molina testified that all obstetricians knew in 1999 that folic acid should be given to all women capable of becoming pregnant to help prevent neural tube defects and that he expected Dr. Rippy to communicate to Clay the link between folic acid and neural tube defects and recommend the supplement. Molina agreed he was “literally thinking about folic acid and future pregnancies” when he saw Clay on May 4, 1999, but did not arrange a follow-up visit to ensure Clay knew about the link because he “assumed that she would have gone back to her OB and gotten that information.”
Tia’s expert said in his affidavit that in his opinion Rippy failed to exercise the degree of care and skill ordinarily exercised by members of the medical profession generally under the same or similar circumstances, and that his affidavit did not set forth every *232criticism regarding Clay’s care. He also said that Rippy violated the standard of care by failing to recommend or prescribe folic acid to Clay following the termination of her 1999 pregnancy. While the majority interprets this statement to mean that Rippy’s obligation to inform Clay did not arise until after the termination, it could also mean that Rippy’s obligation was to tell Clay when she should take the supplement — after the termination — instead of when he should tell her about it. As the Supreme Court of Georgia recently observed in a slip-and-fall case, factual issues “in general, must be answered by juries as a matter of fact rather than by judges as a matter of law.” American Multi-Cinema v. Brown, 285 Ga. 442, 445 (679 SE2d 25) (2009). Whether Rippy fulfilled his duty of care to tell Clay about the link between folic acid and neural tube defects at her final visit or could put it off until later is a jury question.
Decided July 16, 2009.
Harris, Penn & Lowry, Jed D. Mantón, for appellants.
Huff, Powell & Bailey, Michael S. Bailey, Julye M. Johns, Owen, Gleaton, Egan, Jones & Sweeney, H. Andrew Owen, Jr., Shannon C. Shipley, Hall, Booth, Smith & Slover, Terrell W. Benton III, Kevin A. *233Leipow, Carlock, Copeland & Stair, Rebecca C. Wall, for appellees.
*232Given the circumstances of this case, where any future unborn child of Ms. Clay was very likely to be afflicted with a severe neural tube defect and it is well-known that taking a daily dose of folic acid would prevent the birth defect, Dr. Rippy had a duty to Ms. Clay, and any future children of hers, to ensure that she knew she must take folic acid as recommended or face the high probability of having another child with these birth defects. Yet Ms. Clay testified that Dr. Rippy never told her about this connection. On the other hand, Dr. Rippy alleges that he did.
Clearly, this case is not “plain qnd undisputed.” After reviewing the record, I think that a jury question exists as to whether Dr. Rippy should reasonably have known and it was reasonably foreseeable that a 19-year-old woman whose first pregnancy was afflicted by a preventable neural tube defect might become pregnant again and should be advised immediately about the connection between folic acid and birth defects. Although Dr. Rippy contends that he advised Ms. Clay of this connection, she denied that he did so. Thus, a jury should resolve the issue, and I dissent to Division 1 affirming the grant of summary judgment to Rippy and his practice.
I am authorized to state that Presiding Judge Blackburn and Judge Ellington join in this opinion.