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Superior Court Clarifies Ruling Regarding Third-Party Beneficiaries of Physician-Patient Relationship

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In reviewing its ruling in Matharu v. Muir, 29 A.3d 375 (2011), the Pennsylvania Superior Court unanimously held that physicians owe a duty of care to their patients’ unborn children.  The en banc panel distinguished this finding from the 2012 Seebold v. Prison Health Services case in which it held that physicians do not have a third-party duty of care to warn corrections officers that the inmates they watch have communicable diseases.

The Supreme Court vacated the Superior Court’s 2011 ruling in Matharu last year and asked it to review its analysis in light of the fact it declined to extend a third-party duty to the physicians in Seebold.  In response, Judge Christine L. Donohue authored a lengthy opinion that delineated the relationships between defendant doctors and third-party non-patients in Seebold and between defendant physicians and readily foreseeable future children in Matharu.   

In the underlying case, a woman learned she had Rh-negative blood during her first pregnancy.  Her husband had Rh-positive blood, meaning a child they conceived could have Rh-positive blood as well. The fetus’ Rh-positive blood could enter the mother’s bloodstream, which could trigger a reaction known as isoimmunization in which the mother’s body rejects the fetus.  To prevent that from happening, her obstetricians injected her with RhoGAM.   

The plaintiff-mother came under the care of the defendant-physicians during her second pregnancy in 1998.  These physicians did not administer RhoGAM and she became isoimmunized during her third trimester.  While pregnant in 2005, the mother and infant encountered complications that required an emergency Cesarean section.  The child died two days after birth.  As a result, the parents sued the defendants for failing to administer RhoGAM during the second pregnancy, thus creating a danger for future children. 

The physicians argued that the parents could not establish that they owed the infant a duty of care.  The Superior Court held otherwise and stated that the defendants knew that administering RhoGAM protects future, unborn children.  Accordingly, the plaintiff-parents’ future children fell within a class whose life depended on the treatment rendered by the defendants.

In reaffirming the Superior Court’s 2011 ruling, Judge Donohue held that the harm occurred during the plaintiff-mother’s patient-physician relationship as a contrast to the relationship the defendant physicians had to corrections officers in Seebold.  Thus, Judge Donohue explained, the Superior Court did not create a new duty of care in Marathu but rather relied on the well-accepted standard articulated in the Restatement (Second) of Torts.  Section 324A provides that a person who renders care to another that is necessary for protecting a third person is subjected to liability to the third person for harm that arises from failing to exercise reasonable care.   In applying that rule to Marathu, the deceased infant fell into this category as a future third person harmed by the defendant-physicians’ failure to administer the medication needed to prevent harm to the plaintiff-mother’s future, unborn children.


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