What is the legal response to a medical negligence lawsuit after referring a patient for a flight physical examination due to lack of certification, followed by a myocardial infarction?

From the Guidelines

The correct answer is A, of no duty, as the physician did not establish a doctor-patient relationship and therefore did not have a legal duty of care to the airline pilot. In this case, the airline pilot came to the office for a flight physical examination, but the physician was not certified to provide this type of examination and appropriately referred him elsewhere 1. No doctor-patient relationship was established since the physician did not undertake to treat or examine the patient, and therefore no legal duty of care was created. Without a duty of care, one of the four essential elements of medical negligence (duty, breach, causation, and damages) is missing, making the negligence claim legally invalid. The physician's referral was appropriate given their lack of certification for flight physicals, and they cannot be held liable for a heart attack that occurred after the patient left, as there was no established duty to diagnose or treat any cardiac conditions in this individual who was not actually accepted as a patient.

The concept of duty of care is crucial in medical negligence cases, and it is essential to establish that a doctor-patient relationship existed before any liability can be determined 1. In this scenario, the physician's actions were reasonable, and they did not breach any duty of care, as no such duty was established. The heart attack that occurred after the patient left the office is not directly related to the physician's actions, and therefore, there is no proximate cause or nexus between the cause and effect.

Key points to consider in this case include:

• The absence of a doctor-patient relationship
• The lack of certification for flight physicals
• The appropriateness of the referral
• The absence of a duty of care
• The inability to establish proximate cause or nexus between the cause and effect. As stated in the study by 1, to establish negligence, the plaintiff must prove all of the following elements: the existence of the physician’s duty to the plaintiff, usually based on the existence of the physician–patient relationship; the applicable standard of care and its violation (ie, breach of the duty). In this case, the first element is missing, and therefore, the negligence claim is legally invalid.

From the Research

Legal Response to Medical Negligence Claim

The legal response to the patient's cause of action will be based on an assertion of:

• A. No duty: This is the most appropriate response, as the physician was not certified to provide a flight physical examination and referred the patient elsewhere 2. The physician did not owe a duty of care to the patient in this specific situation, as they were not qualified to perform the examination.

Elements of Medical Negligence

To establish a claim of medical negligence, the patient must prove:

• The existence of a duty of care
• A breach of that duty
• Causation (proximate cause)
• Damages In this case, the physician can argue that there was no duty of care, as they were not certified to perform the flight physical examination 2.

Proximate Cause and Nexus

While the patient may argue that the physician's failure to perform the examination was the proximate cause of their heart attack, the physician can argue that there was no nexus between the cause and effect 3, 4, 5. The patient's heart attack may have been caused by underlying medical conditions, and the physician's referral to another doctor does not necessarily establish a direct link between the two events.

Other Options

The other options are not supported by the evidence:

• B. No statute of limitations: This is not relevant to the case, as the patient's claim is based on medical negligence, not a statutory claim.
• C. No proximate cause: This is a possible argument, but it is not the strongest response, as the patient may be able to establish a link between the physician's actions and their injury.
• D. No nexus between cause and effect: This is similar to option C, and the physician may be able to argue that there was no direct link between their actions and the patient's injury.
• E. Good Samaritan Law: This is not relevant to the case, as the physician was not acting in a Good Samaritan capacity when they referred the patient to another doctor.