Court Opinion

ID: 9547876
Source: CourtListenerOpinion
Date Created: 2023-08-07 17:53:43.454142+00
Date Added: 2024-06-11T15:18:11.244422
License: Public Domain

ROONEY, Chief Justice,
dissenting.
I do not contest the general law set forth in the majority opinion, but I believe that the majority opinion does not adequately distinguish between the standard of care and the existence of the duty in this case as a necessary element of negligence. The resulting situation is one which will hamstring the administration of proper medical treatment to patients by physicians.
The standard of care is not the problem in this case. It is properly set forth in the majority opinion in its quote from the first case of Vassos v. Roussalis, Wyo., 625 P.2d 768, 772 (1981). Here the problem is: Who owes the duty to apply this standard of care in this instance? The essential nature of the existence of a duty is also recognized by the majority opinion:
“ * * * As in any other negligence action, the plaintiff in a malpractice action must prove that the defendant owed a duty to the plaintiff and that the failure to perform that duty proximately caused damage to plaintiff. * * * ” (Emphasis added.)
Also see first case of Vassos v. Roussalis, supra; ABC Builders, Inc. v. Phillips, Wyo., 632 P.2d 925 (1981).
The standard of care is a necessary complement of duty. It defines that of which the duty consists. But standing alone, without the obligation arising from the duty itself, it is without force in determining the existence of negligence.
*1292“ * * * In other words, ‘duty’ is a question of whether the defendant is under any obligation for the benefit of the particular plaintiff; and in negligence cases, the duty is always the same, to conform to the legal standard of reasonable conduct in light of the apparent risk. What the defendant must do, or must not do, is a question of the standard of conduct required to satisfy the duty. The distinction is one of convenience only, and it must be remembered that the two are correlative, and one cannot exist without the other.” Prosser on Torts (4th Ed. 1971), § 53, p. 324; and see § 37, p. 206.
The existence of a duty, and the standard of conduct is entirely a question of law for the court. First case of Vassos v. Roussalis, supra; Maxted v. Pacific Car and Foundary Company, Wyo., 527 P.2d 832 (1974). In this instance, it was entirely proper for the court to grant appellee’s motion for a directed verdict if he did not owe a duty to the deceased to make the decision relative to the treatment which caused the death. The trial court decided that appellee did not have such duty, and the evidence supports that decision.
The entire medical testimony, taken as a whole, reflects the duty and responsibility for the treatment of the deceased was that of Dr. Corbett. The trial court was acting reasonably and predictably when it determined the duty owed to the deceased which wás not performed and which proximately caused his death was that of Dr. Corbett and not that of appellee.
The majority opinion refers to testimony of Drs. Flick and Wahl from which it can be “inferred” that appellee was negligent and that “no confrontation occurred” between appellee and Dr. Corbett. There was no inference in Dr. Corbett’s testimony. He testified that he performed surgery on the deceased and controlled the post-operative treatment of him until the time of death. He testified in part:
“Q. Now, Doctor, once the surgery is completed into the postoperative time, who is responsible for the management of the care and treatment of the patient?
“A. Surgeon.
“Q. Will the surgeon continue to assess and evaluate post operatively?
“A. Yes, sir.
“Q. On his own?
“A. Yes, sir.
“Q. Will the surgeon rely upon some other entries made by say the referring physician?
“A. Yes, but rarely without checking them or discussing them. For instance the referring physician said something in the progress record that I disagreed with I would go and find out why his feeling was different than mine and we would resolve it.
“Q. So, I take it again because the decision of the surgeon, the surgeon would be taking care to make his own assessment and evaluation?
“A. Yes, sir.
“Q. Throughout the post operative care. “A. Yes, sir.
* Sic * * * *
“Q. And throughout this matter any decision made concerning the care and treatment of this patient was yours to make?
“A. Yes, sir.”
Appellee’s testimony was without inference. It was in part:
“Q. Did you treat him for anything else while he was in the hospital during that period of time?
“A. Followed him after he went to surgery, followed him with advisement, followed him with Dr. Corbett and helped Dr. Corbett throughout his care.
“Q. Did you provide treatment to Gus Vassos?
“A. I provided care for Gus.
“Q. Were you satisfied of that during the period of time that you were caring for Gus Vassos in the hospital?
“A. I was satisfied with Dr. Corbett’s management of it, correct.
⅜ sfc * sfc 4t *
*1293“Q. Okay. What do you understand the treatment to be to an intra abdominal infection such as you understood to exist in Gus?
“A. Treatments to be prescribed by the surgeon, I don’t handle them.
“Q. So, you don’t know what they are? “A. I do, but I don’t handle it, I would ask him to prescribe what the range of motion, or, treatment he would want, and we would follow that treatment.
“Q. You would ask the surgeon to do that?
“A. Right.
* * * * * *
“Q. Okay. So these are decisions for people who hold themselves out as surgeons to make?
“A. That is correct.
“Q. And you don’t make those decisions? “A. That is correct.
* * * * * *
“Q. I take it the care was under the surgeon?
“A. Certainly.
“Q. You assisted him in every way?
“A. Yes.”
The majority opinion properly reflects that Dr. Flick’s testimony was to the effect that:
“ * * * Dr. Corbett failed to meet that required standard in treating Gus Vassos’ infection and subsequent abdominal abscess, and that failure to so treat proximately caused Gus Vassos’ death. * * * ” (Emphasis added.)
There was no inference in this testimony. He testified in more than one instance that the post-operative care of patients is generally provided by the general surgeon.
Dr. Wahl also testified that the post-operative care of a patient is the responsibility of the surgeon:
“Q. Now, my question is you will agree with me, will you not, that it is within the realm of the surgeon to map out and plan the post operative care and treatment, isn’t that right?
“A. Yes.”
He was critical of appellee for ordering continuation of certain prescriptions during the post-operative period, for not disagreeing with Dr. Corbett, and for not recording a disagreement with the surgeon’s treatment. The majority opinion seems to attach liability from lack of “confrontation.”
The entire testimony of Dr. Wahl is to the effect that proper medical practice requires the placing of the duty to prescribe treatment in one person — the surgeon in this instance.
Dr. Wahl’s complaint against appellee concerning his failure to argue with Dr. Corbett about Dr. Corbett’s treatment infers a duty on the part of a physician to adversely criticize the action of another physician or be held liable for any improper action taken by the other physician. It is imperative that complete consultive dialogues be encouraged between physicians. The majority opinion hamstrings such dialogue. A physician will either completely avoid any involvement in the case of another physician or he will take a stand contrary to that of the other inquiring physician if he wants to avoid possible future litigation. Medicine is not an exact science. In most instances, there must be a single ultimate decision maker — other than the patient himself.
There cannot be two captains of the ship. There cannot be two steering wheels directing the course of an automobile. There cannot be two physicians responsible for the ultimate control of the treatment of a patient. A captain of a ship may ask for directional, depth, and other readings from his crew. The driver of an automobile may verify his road signs and map directions with his passengers. And a physician may consult with and consider the nature of treatment with associates. But the ultimate duty to bring the ship safely home is that of the captain. The ultimate duty to keep the automobile on the road is that of the driver. And the ultimate duty to pre*1294scribe the treatment for the patient is the physician in charge of the case.1
The majority opinion speaks repetitiously of appellee as the “treating physician” and of his participation in a “team effort.” All eleven men on a football team are participating in a “team effort” and they are all “treating athletes” in performing toward victory, but the only one responsible for the loss is the wide receiver who drops the easily caught pass in the end zone which would have resulted in a winning touchdown. It was his duty to catch the ball, and his teammates should not be held responsible for his failure to do so. For liability to attach there must be some causal connection between a responsibility for action or non-action and the bad result, but before such can be inquired into, there must first be the responsibility itself. Appellant had the burden of establishing such causation on the part of appellee. Not only was the burden not met, but there was no evidence whatsoever that appellee’s actions or inactions caused the death of the deceased. Stundon v. Stadnik, Wyo., 469 P.2d 16 (1970).
There is not a scintilla of evidence that Dr. Corbett would have followed suggestions or advice received from appellee, from any other physician, from the “treating” nurses or from anyone else. The evidence is to the contrary. He was running the show. He was satisfied with his prescribed treatment. If the death resulted therefrom, it was proximately caused only by his decision. The duty to make the decision was his alone.
Appellant has settled with Dr. Corbett. Dr. Corbett may not have acknowledged liability on his part through the settlement, but it reflects such liability to have been his if, in fact, anyone was liable. It reflects that he was captain of the ship. The trial court was correct in directing a verdict for appellee on the basis that he did not owe a duty to appellant with reference to the incident which proximately caused the death.
I would affirm.

. Of course, liability for violation of other duties may rest on others, e.g. failure by those responsible for properly carrying out the directions of the physician in charge may result in liability.