Clinic Not Liable for Denying Treatment When Man Late For Appointment

A man experienced confusion and swelling of his legs and calves. His daughter called a medical clinic to schedule an appointment. She was given an appointment with a doctor later that afternoon.


The man and his daughter arrived at the medical clinic approximately seven minutes late for his appointment. Because they were more than five minutes late, they were told that the doctor would not see him. The medical clinic advised the man and his daughter that he could reschedule with the doctor for another day, go to the emergency room, or go to a walk-in clinic at another location. The man and his daughter left the medical clinic to seek medical assistance elsewhere.


Outside the medical clinic the man fell and hit his head. The man’s daughter returned to the medical clinic and announced that the man had fallen and was injured. A registered nurse employed by the medical clinic assisted the man until he was taken by ambulance to a medical center where he was admitted for observation. While the man was hospitalized, he suffered two episodes of respiratory arrest and died nine days later.


The man’s estate and widow sued the medical clinic alleging breach of contract, negligence, and professional negligence. Specifically, the complaint alleged that the medical clinic breached its contract with the man, the medical clinic's acts and omissions were negligent and proximately caused the damages the man suffered, and the medical clinic committed professional negligence by failing to meet the generally accepted standards for medical care and treatment. The complaint argued that the medical clinic committed both professional and ordinary negligence because it breached the applicable standard of care by refusing treatment to the man for being late and, as a result, proximately caused his eventual injury and death.


The estate and widow offered the deposition testimony of a medical expert who opined that the medical clinic breached its duty to the man because a reasonable clinic would not have refused to see a patient who was only seven minutes late. The medical expert claimed a reasonable clinic would have performed a “common-sense assessment” to determine whether the man's condition warranted immediate treatment or hospitalization. The medical expert testified that had the man been seen by the doctor, he would not have fallen and suffered his injury, because he would have been evaluated to determine whether hospitalization was necessary and it was more probable than not that the man would have been hospitalized had he been seen by the doctor. The medical expert stated that the man’s fall was not caused by his medical condition but by his daughter’s failure to provide sufficient assistance to prevent the man’s fall because she was distracted by trying to schedule an appointment for the man at another medical care provider.


The medical clinic moved for summary judgment. The medical clinic argued that scheduling an appointment with a physician does not establish a legal duty to treat the patient, does not establish a physician-patient relationship necessary to maintain a medical malpractice claim, and does not constitute a contract.


The District Court, Burleigh County, South Central Judicial District granted summary judgment in favor of the medical clinic. The trial court specifically held the mere act of scheduling an appointment did not create a physician-patient relationship or a binding contract between the medical clinic and the man. Moreover, the trial court held that the man's injury and subsequent death were not proximately caused by the medical clinic's cancellation of his appointment.


The Supreme Court of North Dakota affirmed. The court held that the widow and estate failed to produce any medical evidence that proved the man’s untreated medical condition proximately caused his fall and subsequent death.


The widow and estate failed to produce any medical evidence that proved the man’s medical condition that was not treated by the clinic proximately caused his fall and subsequent death. Although professional negligence and ordinary negligence are separate claims requiring different elements, a plaintiff cannot maintain either claim without presenting a prima facie case that establishes a duty was owed to the plaintiff, the duty was breached, and the breach caused the plaintiff's injury. No medical testimony established the man’s untreated medical condition proximately caused his fall and subsequent death. Although a different sequence of events might have occurred had he been treated, that did not make the medical clinic liable for the remote result of its decision to deny him treatment. The testimony of the estate and widow’s own medical expert indicated that the man’s fall was likely caused by his daughter’s lack of attentiveness while walking with him. Without competent, admissible evidence that the man's fall and eventual death by respiratory failure was the natural and probable result of the medical clinic's refusal to treat him because he was late for his appointment, there was no evidence that the medical clinic's actions or inactions proximately caused the harm complained of.


The Supreme Court of North Dakota affirmed the trial court’s grant of the medical clinic’s motion for summary judgment. The widow and personal representative could not recover from the clinic.


See: Johnson v. Mid Dakota Clinic, P.C., 2015 WL 3407282, 2015 ND 135 (N.D., May 27, 2015) (not designated for publication).


See also Medical Law Perspectives, April 2015 Report: COPD Liability Risks: When Taking a Breath Is Not Easy


See the Medical Law Perspectives April 2, 2015, Blog: Use of Jury Instruction on Foreseeability in Medical Negligence Case