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Keywords

negligenceappealmalpractice
damagesnegligence

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Gomez v. Sauerwein, 180 Wash.2d 610, 331 P.3d 19

Facts

Christina Palma Anaya, suffering from uncontrolled diabetes, visited Toppenish Community Hospital with UTI symptoms. After lab tests indicated a positive result for yeast, Dr. Sauerwein, who was covering for her primary care provider, concluded it was likely a false positive based on her improving condition and did not inform her of the test result. Unfortunately, the lab later confirmed the presence of candida glabrata in her blood, which led to her death from complications related to the infection. Mr. Anaya, as the personal representative of her estate, brought a malpractice action against Dr. Sauerwein and the clinic, including a claim for failure to obtain informed consent.

Christina Palma Anaya (Mrs. Anaya) suffered from uncontrolled diabetes, leaving her immunocompromised and susceptible to serious infections. On August 20, 2006, Mrs. Anaya went to the Toppenish Community Hospital complaining of urinary tract infection (UTI) symptoms. Urine and blood samples were taken and sent to the laboratory at Yakima Regional Medical Center for analysis. She went home the next day. On August 23, Mrs. Anaya returned to the Toppenish emergency room still feeling ill from UTI symptoms and she could not empty her bladder.

Issue

1. Whether Mr. Anaya could bring an informed consent claim based on the same facts giving rise to a medical negligence claim for misdiagnosis. 2. Whether any reasonable finder of fact could conclude that Dr. Sauerwein's failure to obtain informed consent proximately caused Mrs. Anaya's death.

1. Whether Mr. Anaya could bring an informed consent claim based on the same facts giving rise to a medical negligence claim for misdiagnosis. 2. Whether any reasonable finder of fact could, on the facts in this case taken in a light most favorable to Mr. Anaya, conclude that Dr. Sauerwein's failure to obtain informed consent proximately caused Mrs. Anaya's death.

Rule

Informed consent and medical negligence are distinct claims. A health care provider who misdiagnoses a patient's condition may be liable for negligence but not for failure to secure informed consent if the provider believed the patient did not have the condition.

Informed consent and medical negligence are distinct claims that apply in different situations. While there is some overlap, they are two different theories of recovery with independent rationales.

Analysis

The court applied the Backlund rule, which states that a physician who misdiagnoses a condition cannot be held liable for failure to inform the patient about that condition. The court found that Dr. Sauerwein's conclusion that the test result was a false positive was reasonable based on the clinical picture presented by Mrs. Anaya. Since there was no duty to inform about a ruled-out diagnosis, the informed consent claim was dismissed.

The court applied the Backlund rule, which states that a physician who misdiagnoses the patient's condition, and is therefore unaware of an appropriate category of treatments or treatment alternatives, may properly be subject to a negligence action where such misdiagnosis breaches the standard of care, but may not be subject to an action based on failure to secure informed consent.

Conclusion

The Supreme Court affirmed the Court of Appeals' decision, concluding that the informed consent claim was properly dismissed as a matter of law because it was a misdiagnosis case and there was no evidence of proximate cause.

We hold that when a health care provider rules out a particular diagnosis based on the circumstances surrounding a patient's condition, including the patient's own reports, there is no duty to inform the patient on treatment options pertaining to a ruled out diagnosis.

Who won?

Dr. Sauerwein prevailed in the case because the court found that he did not breach any duty owed to Mrs. Anaya and that the informed consent claim was not applicable in this context.

The jury found that Dr. Sauerwein did not breach any duty owed to Mrs. Anaya. Finding that Dr. Sauerwein did not deviate from the standard of care, the jury did not reach the issues of proximate cause or damages.

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