## Facts

- Elmer Johns was admitted to a Memphis hospital on July 19, 1986, with fever, chills, headaches, and muscle aches, under the care of Dr. Chalmers B. Daniel, Jr.
- Dr. Daniel saw Johns on July 22, 1986, ordered chloramphenicol, and Johns died on July 23, 1986.
- An autopsy and later CDC confirmation established Rocky Mountain Spotted Fever (RMSF) as the cause of Johns’s death.
- During Johns’s treatment, Dr. Daniel communicated with Johns’s wife, Genevieve, but did not advise her that RMSF was a possible cause of death or warn her about risk of exposure to the source of RMSF.
- On August 1, 1986, Genevieve presented at another hospital with symptoms consistent with RMSF, was treated for RMSF, and died on August 4, 1986.
- It was undisputed that Genevieve had no physician–patient relationship with Dr. Daniel.
- William Jerome Bradshaw, Genevieve’s son, sued Dr. Daniel for negligence, alleging that the failure to warn Genevieve of RMSF exposure risk proximately caused her death.
- Expert proof indicated RMSF risk can cluster environmentally due to tick vectors, increasing risk for household members sharing the same environment, and that warning close family was consistent with accepted medical practice in such circumstances.

## Issues

1. Whether a treating physician owes a legal duty to warn an identifiable non-patient of foreseeable risk of exposure to the source of the patient’s non-contagious disease.
2. Whether the absence of a physician–patient relationship between the physician and the non-patient precludes a duty to warn.
3. Whether summary judgment was appropriate on the ground that the risk to the non-patient was insufficient, as a matter of law, to create a duty.

## Decision

- The Tennessee Supreme Court reversed the Court of Appeals and held that Dr. Daniel owed a duty to warn Genevieve, an identifiable third party foreseeably at risk of exposure to the source of RMSF.
- The court affirmed the trial court’s denial of summary judgment on duty and remanded for further proceedings.
- The court held that factual questions concerning breach, causation, and damages remained for the trier of fact.

## Legal Principles

- Existence of duty is a question of law for the court; duty turns on whether harm is foreseeable and a probable result of the defendant’s conduct rather than a remote possibility.
- A physician–patient relationship can supply a “special relationship” that supports a duty extending to identifiable third persons the physician knows or reasonably should know are foreseeably at risk from the patient’s illness.
- A duty to warn is not categorically limited to traditionally contagious diseases; it may apply to non-contagious diseases when foreseeable risk to identifiable persons arises from shared exposure to the disease’s source (e.g., shared environment with tick vectors).
- The duty is limited in scope: it runs to identifiable, foreseeably exposed persons (particularly immediate family in the circumstances presented) and is satisfied by reasonable warning enabling prompt evaluation and treatment.

## Conclusion

The court held that a treating physician may owe a duty to warn identifiable non-patients, such as immediate family members, of foreseeable risk of exposure to the source of a patient’s disease, even when the disease is not transmitted person-to-person, and it returned the case for trial on breach and causation.


Bradshaw v. Daniel, 854 S.W.2d 865 (Tenn. 1993)