Tuesday, January 17, 2012
Court Rejects Claim by Mother of Child With Cystic Fibrosis
Justices Say Hospital Had No Duty to Inform Parent of Genetic Testing Results
By SHERRI M. OKAMOTO, Staff Writer
The mother of a child born with cystic fibrosis could not assert a negligence claim against the medical center which drew her blood specimen for genetic testing and accurately reported the results to her physician, the Fifth District Court of Appeal has ruled.
In a partially published decision Thursday, the appellate court ruled that the Sonora Regional Medical Center owed no duty to Amber Walker to inform her of the test results, or to invoke any policy or procedure to ensure she learned of the risk her child would suffer from the life-threatening chronic lung disorder.
Walker had selected Dr. Donavon Teel has her obstetrician for a pregnancy she failed to carry to term in 2004. She returned to Teel’s office for care of a new pregnancy in 2005, and he ordered a routine prenatal testing be conducted, including a cystic fibrosis screening.
Purpose of Test
The purpose of a cystic fibrosis screening test is to detect a person’s genetic predisposition to having a child with cystic fibrosis. If a person is found to test positive for the cystic fibrosis mutation, they are deemed a “carrier” and the chances of that person having a child with cystic fibrosis will be one-in-four if his or her reproductive partner is also a carrier.
Walker went to the Sonora hospital outpatient laboratory for her cystic fibrosis screening. A blood specimen was drawn there, but it was sent to a laboratory in Utah for processing.
The Utah laboratory determined that Walker was a carrier of cystic fibrosis and indicated this on the report returned to the hospital. On the same day the hospital received the report, it electronically transmitted the laboratory results to Teel.
In transmitting the laboratory results, the information was reformatted from the laboratory report, and included a note stating: “Heterozygous: One mutation was identified indicating this individual is at least a carrier of CF.”
Teel testified that he personally reviewed the results of the test on Feb. 3, 2005, and recognized immediately that his patient had tested positive as a carrier of cystic fibrosis. He said he had made notations to that effect on the report—including a notation to review the chart and a circle around the test results—so that he would be sure to inform Walker of the results at her next appointment.
Walker had again miscarried, but she had a follow-up appointment with Teel on Feb. 15, 2005. Teel allegedly failed to inform her of the cystic fibrosis test results at that time.
In June 2005, Walker returned to Teel’s office for care of another pregnancy. At an appointment that July, a nurse practitioner in Teel’s office filled out a new prenatal chart for Walker, on the first page of which was written that Walker had declined cystic fibrosis testing because “C.F. testing prev. neg.”
The nurse practitioner claimed she had offered the testing to Walker and Walker had declined, saying the prior screening had been negative. Walker denied this.
Walker returned to Teel’s office on a monthly basis until her daughter, Payton, was born in February 2006. The infant was officially diagnosed with cystic fibrosis by pediatric physicians the following year.
After Payton’s birth, Walker and her husband filed a complaint for damages against Teel and the hospital for medical negligence.
Walker alleged that she and her husband would not have conceived Payton if they had been advised of the risk their offspring would have cystic fibrosis. Among their contentions, Walker and her family claimed the defendants had breached their duty of care to notify and counsel Walker regarding the results of the cystic fibrosis screening test.
The hospital moved for summary judgment, asserting that it was not negligent because it did not have a duty to directly disclose the laboratory results to Walker. Tuolumne Superior Court Judge James A. Boscoe agreed.
Dismissals were subsequently entered against the remaining defendants as well.
Writing for the appellate court, Justice Stephen Kane explained that “under the circumstances of this case, [the hospital’s] duty to report the laboratory results was limited to promptly transmitting those results to Dr. Teel’s office, which it did.”
He noted that “there are legal limitations under both federal and state law that restrict the persons to whom a laboratory may release a patient’s test results,” which establish “a standard protocol that clinical laboratory reports are made to the physician who ordered the test, not to the patient for whom the test was ultimately performed.”
Additionally, since the hospital did not have a duty to directly disclose the results to Walker, Kane said, “it likewise did not have a duty to invoke unspecified policies to ensure such a disclosure apart from its prompt and accurate transmittal of the results to Amber’s physician.”
In the unpublished portions of the opinion, Kane also concluded that the manner in which the hospital transmitted the laboratory results to Teel adequately informed the doctor of the results and that the hospital could not be vicariously liable for Teel’s negligence since he was its not its ostensible agent
Presiding Justice Gene M. Gomes and Justice Betty L. Dawson joined Kane in his decision.
The case is Walker v. Sonora Regional Medical Center, 12 S.O.S. 197.
Copyright 2012, Metropolitan News Company