An Arizona radiologist had a legal duty to inform the woman whose X-ray he read of his adverse findings, even if no formal physician-patient relationship existed, the state Supreme Court ruled Wednesday.
By a 4-1 decision, the court established the physician had an implicit duty to the patient and found against the defending physician's motion to have the cased dismissed on summary judgment.
The court sent the case back to the trial court, where a jury could decide whether Tempe, Ariz., radiologist Robert McCarver Jr., M.D., breached his duty to Christine Stanley, a nurse.
Stanley died April 29, 2004, of a lung infection that was a complication of radiation treatments, according to her attorney, Karen Lugosi of Phoenix. Lung cancer was listed as a factor on her death certificate, Lugosi said.
Stanley is survived by an adult daughter and a grandson. It will be up to family members whether the suit will go forward and be amended to include Stanley's estate or allegations of wrongful death against McCarver, the attorney said.
McCarver's attorney, Richard Kent of Phoenix, could not be reached for comment.
According to Lugosi and court records, McCarver read a chest X-ray Stanley had taken in January 1998 as part of a pre-employment physical for a job at Mesa Christian Care, a Mesa, Ariz., nursing home. McCarver's report concluded the X-ray showed "a small nodule" and a "patchy consolidated parenchymal pattern," according to court records.
McCarver did not report his findings to Stanley, and there is no evidence he reported them to the X-ray company he worked for, only to the nursing home, which had contracted with the X-ray company for the service.
Neither the X-ray company nor the nursing home told Stanley of McCarver's findings, Lugosi said.
Stanley did not find out about adverse reading until 10 months later, after she became ill and her treating physician ordered a new X-ray and compared it with the one McCarver had read, said Lugosi.
No Arizona law addresses the issue in the case, according to a 27-page ruling written by Justice Rebecca White Berch, who noted that while previous decisions of standing have required a finding of a formal physician-patient relationship, "the requirement of a formalized relationship between the parties has been quietly eroding in several jurisdictions . . . in Arizona as well."
Berch wrote that by contracting to read Stanley's X-ray, McCarver "undertook a professional obligation with respect to Ms. Stanley's physical well being" and "should have anticipated that Ms. Stanley would want to know of the potentially life-threatening condition and that not knowing about it could cause her to forgo timely treatment, and he should have acted with reasonable care in light of that knowledge."
Mesa Christian Care went bankrupt and was not a party to Wednesday's decision, having settled earlier, Lugosi said.
The high court also upheld a lower court's decision to dismiss the X-ray company, Osborn, Nelson & Carr Portable X-Ray, from the suit.
"Dr. McCarver was in the unique position of understanding what he was looking at," Lugosi said, describing the X-ray company as "just a middleman."
"I'm just happy that they found a physician has a duty," she said. "Look at all these healthcare providers out there who have to go through these screenings. No news is good news, right? That's scary."
While the decision sets a precedent in Arizona, it will not have a huge impact on medical practice in the state, Lugosi said.
"I think the stomach test here is that anybody who has an X-ray, if there is a problem, they should be notified," she said. "It's a good decision for the public. How often is a good doctor not going to communicate bad findings? Not very often."
