## Facts

- Cathy Lownsbury received prenatal care at Akron City Hospital from January 6–10, 1995; her child, Rebecca, was born on January 10, 1995 with severe brain damage.
- On January 6, 1995, Lownsbury underwent a nonstress test and amniotic fluid index test at the hospital’s perinatal testing center.
- Based on the test results, Dr. George VanBuren ordered Lownsbury transferred to labor and delivery for induction of labor.
- Obstetrics residents did not induce labor; instead they administered a contraction stress test and discharged Lownsbury the same day.
- The contraction stress test allegedly showed repetitive late decelerations suggesting fetal distress, but only a brief portion of the tracing was reviewed and interpreted as normal.
- Mary and Gerald Fabich (Rebecca’s adoptive parents) alleged that Dr. Thomas D. Stover, an obstetrician-gynecologist employed by a practice group contracted to provide obstetrical services and resident supervision at the hospital, had a duty to supervise the residents involved in Lownsbury’s care.
- The Fabichs alleged Dr. Stover’s failure to supervise was a proximate cause of Rebecca’s permanent brain injury.
- Dr. Stover asserted he owed no duty because he had no physician–patient relationship with Lownsbury or Rebecca and had no direct or indirect contact with them.

## Issues

1. Whether a physician–patient relationship, and corresponding duty of care, can be established between a physician who assumes resident-supervision responsibilities at a teaching hospital and a patient the physician neither examined nor consulted and with whom the physician had no direct or indirect contact.
2. Whether summary judgment was proper where the lower courts treated lack of patient contact as dispositive of duty.

## Decision

- The Supreme Court of Ohio reversed the judgment affirming summary judgment for Dr. Stover and remanded for further proceedings.
- The court held that a physician–patient relationship can be established when a physician contracts, agrees, undertakes, or otherwise assumes the obligation to provide resident supervision at a teaching hospital, even if the physician had no direct or indirect contact with the patient.
- Because the absence of contact was not determinative, the grant of summary judgment on the “no duty” theory was improper.

## Legal Principles

- Medical malpractice liability requires a duty of care, which generally depends on the existence of a physician–patient relationship.
- A physician–patient relationship may arise from a physician’s undertaking to provide professional services connected to a patient’s care; direct examination or consultation is not always required.
- In a teaching-hospital setting, a physician who assumes clinical resident-supervision obligations may form a physician–patient relationship with hospital patients treated by those residents, even without direct or indirect patient contact.
- A contractual or assumed obligation to provide resident supervision can be sufficient to support the existence of a physician–patient relationship and corresponding duty, depending on the scope of the undertaking.

## Conclusion

The Ohio Supreme Court held that a physician who assumes responsibility to supervise residents at a teaching hospital may have a physician–patient relationship with, and owe a duty to, a hospital patient despite no direct or indirect contact, requiring reversal of summary judgment entered solely on the absence of contact.


Lownsbury v. VanBuren, 762 N.E.2d 354 (Ohio 2002)