Tort law - no duty for physician to warn guards of inmate's communicable disease.

• Author: Sweeney, Douglas
• Position: Case note

Tort Law--No Duty for Physician To Warn Guards of Inmate's Communicable Disease--Seebold v. Prison Health Services, Inc., 57 A.3d 1232 (Pa. 2012)

One of the critical elements of any action in negligence is the existence of a duty that one party owes to another. (1) Generally a defendant has no duty to protect someone who is at risk due to occurrences that the defendant had no part in generating, but there are exceptions to this rule where courts have imposed such a duty. (2) In Seebold v. Prison Health Services, Inc., (3) the court considered whether to create an additional exception to the general rule and impose a common-law duty on a physician who treats prisoners to warn guards that a particular inmate has a communicable disease. (4) The court held that physicians do not have such a duty to warn at common law. (5)

Michelle Seebold worked as a corrections officer at the State Correctional Institution at Muncy, Pennsylvania where Prison Health Services, Inc. (PHS) provided medical services to prisoners. (6) During that time, PHS allegedly misdiagnosed cases of methicillin-resistant staphylococcus aureus (MRSA), a contagious bacterial infection, among twelve inmates as "spider bites." (7) In her role, Seebold was charged with strip searching female inmates prior to, and following, their meetings with visitors, and as a result of this physical contact was infected with MRSA. (8) Due to this infection, Seebold filed a negligence claim against PHS, alleging that its staff knew or should have known of the infections among the prisoners and owed a duty of reasonable care to prison staff and inmates. (9)

PHS asserted in preliminary objections that it owed no affirmative duty of care to Seebold as a third-party nonpatient. (10) The trial court sustained PHS's objections, held that it did not owe Seebold a duty of care, and listed several factors that can be used to prove a duty does exist. (11) Moreover, the trial court distinguished an earlier Pennsylvania case that imposed a duty of care to a nonpatient third party from the case at hand because it involved a failure by the physician to properly advise the patient about the risks of a communicable disease, rather than the physician's failure to notify the third party directly. (12) Seebold appealed to the Pennsylvania Superior Court, which vacated the lower court's ruling, holding that the physician's duty could be extended to Seebold in this case because she was in a narrowly defined group of foreseeable plaintiffs. (13) PHS then appealed to the Pennsylvania Supreme Court, which reversed the Superior Court, holding that the Superior Court erred in determining that Seebold had stated a cause of action under Pennsylvania law, and further declined to impose an affirmative duty on doctors to warn third-party nonpatients. (14)

The concept of duty as a vital ingredient of negligence was developing around the same time that negligence itself was emerging as an independent basis for liability in the English courts during the early to mid-nineteenth century, and was firmly in place towards the close of that century. (15) The essential inquiry behind whether a duty exists is whether there is some type of relationship between the parties that entitles one to the reasonable care of the other. (16) Determining whether a certain type of relationship implicates a duty of care to another is often difficult and rooted in nebulous public policy considerations, with a general split among courts that mirrors the differing views between the majority and dissent in the famed case of Palsgraf v. Long Island Railroad Co. (17) In Palsgraf, Justice Cardozo and the majority held that the foreseeability of the risks posed by an action defines the relationship that creates the duty, while Justice Andrews and the dissenters believed that the key to the relationship was the connection between the defendant and those who were in fact injured. (18) Cardozo's view, which followed the Restatement (First) of Torts, emerged as the dominant common-law view in America, while Andrews' conception of duty was relegated to the minority. (19) Foreseeability of harm, however, is not the sole factor in determining whether a duty exists, as that determination is also based on an accumulation of policy considerations that amount to the idea that protection is due to a plaintiff, and this idea changes over time along with the attitude of society. (20)

Both this concept of relationship and its connection to foreseeability have led to the general rule that there is no duty to protect a person who is in peril due to circumstances the defendant did not create. (21) There are, however, exceptions to this general rule that impose affirmative duties on actors, which typically arise out of special relationships between the parties, such as a doctor patient relationship. (22) One of the most prominent examples of an affirmative duty is the one created by the California Supreme Court in the landmark case of Tarasoff v. Regents of the University of California, (23) which imposed a duty upon mental health professionals to warn an ascertainable third party of a patient's threatened violence against him or her. (24) Similarly, duties to third parties have also been extended to physicians who undertake the treatment of a patient with a communicable disease, such as the duty to properly inform the patient about the risks of infecting others so they can prevent the illness from spreading. (25)

These duties emphasize the idea that physicians owe a duty of care not only to their patients but also to identifiable third parties who will be harmed if the doctor negligently treats his patient. (26) This type of duty has been imposed, in part, through public policy justifications that physicians are in the best position to protect the public in certain situations. (27) Still courts have been reluctant to break from the general rule and impose these affirmative duties on defendants unless the consequences of such an imposition are reasonably foreseeable. (28)

In Seebold v. Prison Health Services, Inc., the Pennsylvania Supreme Court held that there is no duty at common law for physicians who treat inmates with communicable diseases to warn guards that a particular inmate has such an illness. (29) The court concluded that the Superior Court erred in holding that DiMarco v. Lynch Homes-Chester County, Inc. (30) and Troxel v. A.I. Dupont Institute (31) controlled this case because the duty imposed on the doctors in those cases was to inform patients about the risks of spreading their diseases, not to seek out and warn third-party nonpatients. (32) The court stated that the only exception to the general rule in Pennsylvania is the narrowly defined holding in Emerich v. Philadelphia Center for Human Development, Inc., (33) and, because there was no threat of imminent violence in the instant case, Emerich was inapplicable and thus did not create a duty to warn. (34)

While discussing the plaintiff's public policy argument for imposing the new duty, the court also reasoned that foreseeability alone does not create a duty of care, and that it is instead, one of a number of factors to be considered. (35) In addition, the court...