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Tenuto v. Lederle Laboratories, 1997 N.Y. Int. 170 (Oct. 23, 1997).





Plaintiff contracted polio from an oral polio vaccine given to his daughter and was subsequently rendered paraplegic.  Plaintiff and his wife brought action against both the doctor who vaccinated the child and the laboratory that manufactured the vaccine.  The doctor moved to dismiss the action against him on the ground that the claim was based entirely on a failure to obtain the statutory informed consent mandated by N.Y. Public Health Law § 2805-d, and did not constitute a cause of action because Plaintiffs were not the doctor's patients.  The Supreme Court granted the doctor's motion and the Appellate Division affirmed. Maintaining that their claim is founded on a common law cause of action, Plaintiffs appeal. 



Whether the duty of reasonable care that a doctor owes his infant-patient should be extended to include the infant-patient's parents.


Yes. A doctor has a duty to warn parents of any well-recognized danger to their immediate family resulting from treatment of infant-patient.


Cases Cited by the Court

Other Sources Cited by the Court

Related Sources


State of the Law Before Tenuto

In Eiseman v. State of New York, 70 N.Y.2d 175 (N.Y. 1987), the Court of Appeals recognized that common morality, logic, and social policy could permit limited extensions of the physician's duty of care to parties other than the immediate patient under treatment where the circumstances are appropriate.  The Eiseman decision held that the doctor in that case owed a duty of care to "persons he knew or reasonably should have known were relying on him for this service to his patient." Id. at 188.  Furthermore, the court in Purdy v. Public Adm'r of County of Westchester, 72 N.Y.2d 1 (N.Y. 1988), noted that an appropriate place to extend this duty is where a special relationship exists; i.e., between doctor and injured non-patient, or between patient and injured non-patient.  Thus, under certain circumstances, the court may find that a doctor owes a duty of care to non-patients where there is no doctor/patient relationship.

Effect of Tenuto on Current Law

Furthering its opinion in Purdy, the court clarifies the scope of expansion of a physician's duty of care to include the patient's immediate family.  The significance of the Plaintiffs' role as the primary caretakers of the infant-patient supports the imposition of this expanded duty. See Tenuto at para. 14.  Despite the absence of a direct doctor/patient relationship between the physician and the Plaintiffs, the pediatrician knew, or should have known, that his services to the patient necessarily involved the protection of the health of Plaintiffs. See Tenuto at para. 15.  By reason of their family ties to the infant patient, Plaintiffs were at a foreseeable risk and were relying on the physician's exercise of due care. See Tenuto at para. 15.

Unanswered Questions

While the court holds that the physician owed a duty of care to Plaintiffs, it declines to define the entire class of potential plaintiffs within the scope of this duty.  The court suggests that the physician owes a duty to immediate family members or primary caretakers.  Applying this rule might be difficult when, as is often the case, an uncle or a baby-sitter accompanies the child to the doctor's appointment.  It is unclear whether the physician has a duty to this accompanying adult.  Furthermore, if the doctor informs the accompanying adult, does he still have a duty to inform the parents or the primary caretaker?

Other jurisdictions have defined this expanded physician's duty to include warning of the infectious nature of the patient's disease.  Is the court's holding in Tenuto limited to situations where the patient's treatment is potentially dangerous to the primary caretakers, or is warning of infectious disease implied in the court's holding?

Finally, the court left open the question as to whether this type of duty would extend to situations where the patient is an adult.

Survey of the Law in Other Jurisdictions

Courts in many states, including California and Texas, extend a duty to warn to protect third parties to whom foreseeable harm may occur as a result of the risks involved with the medical treatment. Reisner v. Regents of Univ. of Cal., 31 Cal. App. 4th 1195 (Cal. 1995) (husband of AIDS patient sues doctor).  Garcia v. Santa Rosa Health Care Corporation, 925 S.W.2d 372 (Tex. App. 1996), writ granted, 40 Tex. Sup. Ct. J. 956 (Tex. 1997) (wife of a hemophiliac sued the hospital after her husband contracted AIDS through blood products supplied by the hospital). In Garcia, the court held that the hospital owed a duty to warn to the wife. In support of its decision, the court looked to Tarasoff v. Regents of Univ. of Cal., 17 Cal. 3d 425 (Cal. 1976) (holding that a therapist who believed his patient posed a threat of violence to a foreseeable and readily identifiable potential victim had a duty to warn the potential victim).

Other courts have required physicians to warn third parties of the infectious nature of a patient's disease if either the patient or the doctor had a special relationship with the third parties.  In Hofmann v. Blackmon, 241 So. 2d 752 (Fla. Dist. Ct. App. 1970), the physician had failed to diagnose tuberculosis in the patient, who subsequently passed the disease to his daughter.  The court held that "once a contagious disease is known to exist," the physician owes a duty to warn the patient-caretaker of the dangers of his disease to his children. Id. at 753.

The court in Britton v. Soltes, 563 N.E.2d 910 (Ill. App. Ct. 1990), did not find an expansive duty of care.  A physician was charged with negligence when he failed to diagnose a man with tuberculosis, and the man's ex-wife and children contracted the disease. Id. at 911.  The court stated that physicians had to warn the patient's family of risks of the disease only where negligence by the physician would "necessarily [result] in injury to the third party." Id. at 913.  Such danger did not exist in this case because the patient did not live with his family. Id.

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