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March 12, 2008

Psychiatrist May Be Liable For Faling To Rule Out Physical Condition

You go to a psychiatrist to be treated for an emotional or mental condition. Suppose in addition that  the psychiatrist regards complains of pain as psychosomatic. Can the psychiatrist be held liable if he fails to rule out an actual physical condition? Yes.

Take the example of a case decided by the Second Department last week - Swezey v Montague Rehab & Pain Mgt., P.C., 2008 NY Slip Op 01939. In that case, the plaintiff had been treated by various chiropractors and acupuncturists, and in the course of that treatment, but unbekownst to her, an acupuncture or electromyography needle penetrated the right ventricle of her heart. The plaintiff then came under the care of the defendant psychiatrist where she allegedly made repeated complaints of chest and other physical pain. She further alleged that the psychiatrist treated these complaints as psychosomatic, and that he did nothing to rule out an actual physical condition. After eventually discovering the true cause of her pain and having the acupuncture needle surgically removed, she commenced a medical malpractice action against the psychiatrist, along with others.

The psychiatrist denied that she ever agreed to diagnose, evaluate or treat the plaintiff for any physical malady or condition, and alleged that the plaintiff never complained to her of "chest pain, heart pain or palpitations.

However, the Second Department found that the psychiatrist's assertions that no such complaints were made merely raised issues of fact and thus, affirmed denial of the psychiatrist's motion for summary judgment. The Second Department did not address the psychiatrist's claim that she never agreed to diagnose, evaluate or treat the plaintiff for any physical malady or condition. This being the case is it now required for psychiatrists to rule out physical conditions any time a patient makes some complaint of pain?

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That's an unfortunate situation.

It is interesting that the psychiatrist denies any such claim that she ever agreed to diagnose, evaluate or treat. However, she is a qualified professional and should be held responsible for whatever part she played in the patients distress and resulting surgery.

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