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MN Supreme Court: Warren v. Dinter

Wednesday, June 26, 2019   (0 Comments)
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As many of you know, on April 19, 2019, the Minnesota Supreme Court issued a ruling that changed the way courts view consultations by physicians. The case, Warren v. Dinter, eliminated the prior requirement of a physician/patient relationship for liability to attach to one where the question revolves around foreseeability.

Background:

  • The patient, Susan Warren, presented at an Essentia Health clinic in Hibbing complaining of abdominal pain, fever, chills and elevated white blood cell count.
  • The Essentia Nurse Practitioner treating her called the on-call Hospitalist at the Fairview Hibbing hospital, Dr. Richard Dinter.
  • The N.P. and Dr. Dinter discussed the case; Dr. Dinter believed the elevated white blood count could be caused by diabetes.
  • There’s a fact dispute about whether the nurse practitioner consulted Dr. Dinter specifically about admitting Ms. Warren to the Fairview Hospital (Dr. Dinter says there was no request for admission).
  • The N.P then consulted with her supervising physician at the clinic who agreed that the elevated white blood count could be caused by diabetes.
  • Ms. Warren was sent home by the N.P.
  • Three days later, Ms. Warren is found deceased at home from sepsis.

Court Decision:

  • There is no requirement in Minnesota that in order for a provider’s duty to a patient to attach, there needs to be a direct physician/patient relationship.
  • The question centered around foreseeability: Was it foreseeable to conclude that Dr. Dinter knew, or should have known, that his decision whether or not to admit the patient would be relied on by the N.P. and her patient.
  • The court stated that its opinion “should not be misinterpreted as being about informal advice from one medical professional to another.” The court specifically declined to address “curbside consults” or “professional courtesy” conversations.
  • The court seemed most concerned about the “gatekeeping” function of the Hospitalist involved in the case.

This is a major precedent-setting MN Supreme Court decision that is sending ripples through the MN physician community. Both the Minnesota Medical Association (MMA) and Minnesota Hospital Association (MHA) have taskforces addressing this issue and the impact on medical practice in the state.


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