## Facts

- Stephen and Valerie Molien were members of a health plan operated by Kaiser Foundation Hospitals.
- Valerie received a routine examination and was told by a Kaiser physician, Dr. Kilbridge, that she had an infectious form of syphilis.
- The diagnosis was alleged to be erroneous; Valerie underwent treatment (including large doses of penicillin) and suffered physical injury and serious emotional shock.
- Valerie was instructed to inform Stephen and to have him tested; Stephen did so, and his tests were negative.
- The disclosure allegedly triggered marital discord, accusations of infidelity, and dissolution proceedings.
- Stephen alleged severe emotional distress from the misdiagnosis and its foreseeable marital consequences, and he alleged loss of consortium due to the impact on the marriage.

## Issues

1. Whether a plaintiff may recover for negligently inflicted serious emotional distress without accompanying physical injury when the plaintiff is a direct victim of the defendant’s negligence.
2. Whether a spouse may recover for loss of consortium when the other spouse’s primary injury is serious emotional or psychiatric harm rather than physical injury.
3. Whether an appeal may proceed where the judgment, though not explicit as to all causes of action, was intended to dispose of all claims after demurrers were sustained.

## Decision

- The California Supreme Court reversed the judgment of dismissal and remanded.
- The court held that a direct victim may state a claim for negligent infliction of serious emotional distress without alleging physical injury.
- The court held that a loss of consortium claim may be based on serious nonphysical injury to the spouse if it substantially impairs the marital relationship.
- The court treated the judgment as final as to both causes of action (and, if necessary, amendable on appeal) because the trial court’s intent to dispose of both claims was clear.

## Legal Principles

- Serious emotional distress is a cognizable injury in negligence; a categorical physical-injury or physical-manifestation requirement is not required for a direct-victim claim.
- “Direct victim” emotional-distress claims are governed by ordinary negligence principles (duty, breach, causation, and foreseeability), not by the special limiting guidelines developed for bystander emotional-distress cases.
- A duty of care may extend to a person foreseeably harmed by negligent medical communication and instructions that are intended to reach that person.
- Concerns about fraudulent or trivial emotional-distress claims are addressed through standard negligence limits and ordinary proof requirements, including causation and the factfinder’s evaluation of severity and genuineness.
- Loss of consortium protects marital interests (including companionship, affection, sexual relations, and support) and may be impaired by serious psychological injury as well as by physical injury.

## Conclusion

The court recognized that foreseeable, serious emotional harm to a direct victim can support negligence liability without physical injury and confirmed that loss of consortium may rest on disabling nonphysical injury to a spouse when it materially damages the marital relationship.


Molien v. Kaiser Found. Hosps., 27 Cal. 3d 916, 616 P.2d 813, 167 Cal. Rptr. 831 (Cal. 1980)