## Facts

- Dr. George T. Pack treated Robert Batkin in the 1950s–1960s for severe colon disease and cancer, with records noting diffuse multiple polyposis and malignant degeneration.
- In 1956, Dr. Pack performed a total colectomy and related surgery for multiple polyposis with malignant degeneration.
- In 1961, Dr. Pack performed further resection; pathology reported ulcerative adenocarcinoma with metastases and adenomatous polyps.
- In late 1963, Batkin’s cancer metastasized; he died in 1964 at age 45, when his daughter Donna Safer was 10.
- In 1990, Donna Safer was diagnosed with colon cancer and underwent major surgery, losing most of her bowel and one ovary.
- After her diagnosis, Safer obtained her father’s medical records and alleged Dr. Pack knew or should have known Batkin’s condition posed a significant hereditary risk to Batkin’s children.
- Safer alleged Dr. Pack failed to warn Batkin, Safer’s mother, or Safer of the genetic risk and that timely warning would have allowed earlier screening or preventive measures.

## Issues

1. Whether a physician’s duty of care can extend beyond the patient to warn the patient’s immediate family members of a foreseeable, serious genetic risk.
2. Whether the pleadings and submitted materials stated a viable negligence claim sufficient to survive dismissal/summary judgment despite no physician–patient relationship with the child.

## Decision

- The Appellate Division reversed the dismissal of the complaint, holding that a physician’s duty may, in limited circumstances, extend to the patient’s immediate family regarding serious hereditary risks.
- The court affirmed the denial of plaintiffs’ motion for partial summary judgment on liability, finding factual development was needed on breach, medical knowledge at the time, and causation.
- The case was remanded for further proceedings.

## Legal Principles

- A physician’s duty to exercise reasonable care to prevent avoidable harm to a patient may, in certain limited circumstances, extend to readily identifiable members of the patient’s immediate family who face a foreseeable risk from a serious hereditary condition.
- The absence of a direct physician–patient relationship with the at-risk relative does not categorically bar recognition of a duty where harm to an identifiable third party is reasonably foreseeable.
- The duty is framed as taking “reasonable steps” to warn or protect at-risk relatives; the court did not require a single mandatory method (such as direct contact with family members) in all cases.
- Foreseeability and the physician’s ability to reduce risk support the duty analysis; the court treated clearly identified genetic risk as analogous, for duty purposes, to risks posed by communicable disease to third parties.

## Conclusion

The court held that, when a physician knows or should know a patient has a serious hereditary condition posing foreseeable danger to identifiable immediate family members, the physician may have a limited duty to take reasonable steps to ensure warnings are given, and the patient’s child may proceed with a negligence claim even without a direct treatment relationship.


Safer v. Estate of Pack, 677 A.2d 1188 (N.J. Super. Ct. App. Div. 1996)