Short answer: In B.R. ex rel. Jeffs v. West, the Utah Supreme Court held that health care providers owe a duty to people who are not their patients to use reasonable care when prescribing medication that poses a risk of injury to others. The case is also the Utah Supreme Court’s main framework for deciding when anyone owes a duty of care at all. A later statute raised the bar for many claims by nonpatients against health care providers, so both the case and the statute matter.
Most people assume only a patient can sue a doctor. But a patient’s treatment can hurt other people too, for example when a medication impairs a patient who then drives. This decision addresses whether the provider can be responsible to those people, and it explains the test Utah courts use to decide duty in every kind of negligence case.
What Happened
The case is B.R. ex rel. Jeffs v. West, 2012 UT 11, decided February 28, 2012. According to the complaint, a nurse practitioner at a Draper medical clinic prescribed a patient at least six medications, including Concerta, Valium, Doxepin and Paxil. In January 2008, with those drugs in his system, the patient shot and killed his wife. He later pled guilty to aggravated murder.
The couple’s young children sued the nurse practitioner, her consulting physician and the clinic, alleging negligent prescribing. The trial court dismissed the case, reasoning that the providers owed no duty to people who were not their patients. The Supreme Court reversed.
The Holding
The court held that providers owe nonpatients a duty of reasonable care in “the affirmative act of prescribing medication.” It rejected the argument that health care providers are owed a special exemption, saying they “are not entitled to an elevated status in tort law that would categorically immunize them from liability when their negligent prescriptions cause physical injury to nonpatients.”
The court decided only the question of duty. Whether the nurse practitioner was actually careless, and whether the medications actually caused the killing, were separate questions left for later.
The Five Duty Factors
The decision’s lasting importance is its framework. The court listed five factors for deciding whether a defendant owes a duty:
- whether the conduct was an affirmative act or merely an omission;
- the legal relationship between the parties;
- the foreseeability or likelihood of injury;
- public policy as to which party can best bear the loss; and
- other general policy considerations.
The first two work together. “As a general rule, we all have a duty to exercise care when engaging in affirmative conduct that creates a risk of physical harm to others.” A failure to act, by contrast, usually creates a duty only when there is a special relationship, such as a common carrier and its passenger or a landowner and an invited guest. The remaining factors are used to carve out exceptions to a duty that would otherwise exist.
Two more points from the opinion shape Utah cases today. First, duty is decided as a matter of law for a whole category of cases, not based on the specific facts of one case. Second, foreseeability at the duty stage is a broad question. Whether a specific harm was foreseeable in a specific case goes to breach and causation, which are usually for a jury. The court also explained that “best bear the loss” has “little or nothing to do with the depth of their pockets”; it asks who is in the best position to take precautions, and here that was the prescriber.
What Happened Next
The children later settled with the nurse practitioner. Their claim against the consulting physician went back to the Supreme Court in B.R. ex rel. Jeffs v. Rodier, 2015 UT 1, and it lost. The claim against him was that he failed to consult with the nurse practitioner, which is an omission, and the court found nothing in the statute the children relied on that required him to consult on each individual prescription. The same act-versus-omission line decided both cases.
In Mower v. Baird, 2018 UT 29, the court applied the same five factors to a therapist treating a child and held the therapist owed the child’s nonpatient parent a limited duty: not to recklessly cause false memories or false allegations of childhood sexual abuse by that parent.
The Legislature Raised the Bar
After B.R. v. West, the Legislature added a section to the Utah Health Care Malpractice Act on “nonpatient plaintiffs.” Under Utah Code 78B-3-426, a nonpatient bringing a malpractice action must show that the provider owed a duty, that the injury was foreseeable, that the provider’s act or omission proximately caused it, and that the conduct “manifests a knowing and reckless indifference toward, and a disregard of, the injury suffered by the nonpatient plaintiff.”
That is a much higher standard than ordinary carelessness. The section says it does not apply to actions brought or seeking recovery under several other statutes, including Utah’s wrongful death statute (78B-3-106) and its survival statute (78B-3-107). How those exceptions apply depends on the claim, and the Supreme Court in Mower expressly declined to interpret the statute.
What This Means for an Injury Claim
- A provider can owe a duty to someone who was never a patient. If a person was hurt because a provider’s affirmative act, such as a prescription, impaired someone else, the provider’s role deserves a look.
- Expect a higher standard. For many nonpatient claims, the statute now requires proof of knowing and reckless indifference, not just a mistake.
- Acts and omissions are treated differently. A claim built on what someone did stands on firmer ground than one built on what someone failed to do.
- Deadlines are shorter. A malpractice action against a health care provider generally must be filed within two years after the injury is discovered or should have been, and no later than four years after the act or omission (Utah Code 78B-3-404). That is shorter than the four-year limit for most injury claims.
If someone else shares fault, such as the impaired driver, Utah divides fault among everyone responsible; see how shared fault works in Utah. For a death, see wrongful death claims in Utah, and for how a claim moves from investigation to resolution, the steps in a Utah personal injury case.
Talk to a Utah Injury Attorney
Claims involving a health care provider and a person who was not the patient raise hard questions of duty, causation and timing. We can review what happened and which deadlines apply.
Hurt in Utah? Call (801) 921-5134 or send us your case for a free consultation. No attorney fees unless we win. Hablamos Español.