CHARLESTON – The West Virginia Supreme Court of Appeals ruled that a physician did not have a duty to provide follow-up care to a woman after she left the hospital against medical advice.
Justice Evan Jenkins authored the majority opinion. Justice John Hutchison did not participate in the decision and Putnam Circuit Judge Joseph Reeder sat on a temporary assignment.
"Upon a review of the parties’ arguments and briefs, the appendix record and addendum thereto, and the pertinent authorities, we conclude that the Circuit Court did not err by granting summary judgment to Dr. Farid in this case," Jenkins wrote. "Accordingly, we affirm the April 24, 2018, order of the Raleigh County Circuit Court."
Misty Kruse had her gallbladder removed at Raleigh General Hospital in July 2009 and, after being discharged, she returned several days later and Dr. Touraj Farid performed an endoscopic retrograde cholangiopancreatography, inserting temporary stents into her common bile duct and pancreatic duct.
The following day, Kruse left the hospital against medical advice (AMA). She signed a form that stated she would assume the risk and accept the consequences of her departure from the hospital and released all health care providers from all liability and responsibility for the ill effects that resulted from her leaving the hospital, according to the opinion.
"Although Ms. Kruse signed the form indicating that she understood that she was leaving the hospital AMA, she now claims that she believed that she was being discharged and did not appreciate that she was leaving AMA," Jenkins wrote.
The stents that Farid inserted were intended to be removed within several weeks or a few months of their insertion, but when Farid went to speak with Kruse about scheduling a follow-up for their removal, she had already left the hospital. Kruse did not follow up with Farid regarding the removal of the stents on her own.
Kruse was admitted in December 2013 to Charleston Area Medical Center and it was discovered she had blockages in the two stents that had never been removed. She was diagnosed with an infection of the biliary tree, ascending cholangitis and sepsis and she required a stent removal, a ventilator and intensive antibiotic treatment to recover.
Kruse sent Farid a notice of intent to sue, arguing he failed to inform her the stents needed removed and failed to provide follow-up care, which he responded that when she left against medical advice, she terminated the doctor-patient relationship and she had released him from any liability for any "ill effects" resulting from her leaving against medical advice.
As the case proceeded, Farid moved for summary judgment, which the court granted. The court concluded that any duty Farid had to provide follow-up care for Kruse ended when she left the hospital against medical advice. Kruse then appealed.
"Upon the facts presently before us, we are left with the solitary conclusion that Ms. Kruse’s assignments of error in this regard must fail because, by virtue of her discontinuation of the physician-patient relationship she had with Dr. Farid when she left the hospital AMA, Ms. Kruse removed herself from the class of individuals sought to be protected by the MPLA, i.e., patients," Jenkins wrote.
West Virginia Supreme Court of Appeals case number 18-0464