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Do health care providers have a duty to consider how treatment of a patient may affect that patient's family?
The Utah Supreme Court is contemplating that question after hearing arguments Wednesday connected to a case filed by the children of murdered woman Kristy Ragsdale, who was shot to death by her husband in a Lehi church parking lot nearly three years ago.
The two Ragsdale children were 4 and 19 months old when David Ragsdale approached his wife, Kristy, in their church parking lot during Sunday meeting Jan. 6, 2008. He gunned down Kristy, 30, who had requested a restraining order against him.
Following the woman's death and David Ragsdale's subsequent murder conviction, a conservator filed a lawsuit on behalf of the Ragsdale children. The suit, filed against several health care providers, claims that prescription medications given to David Ragsdale contributed to his actions the day he shot his wife.
The children, identified in court documents as B.R. and C.R., sued their father's doctor, Hugo Rodier, and nurse practitioner Trina West, for prescribing antidepressants and other medications that allegedly carried risks of psychiatric complications. Third District Judge Denise Lindberg dismissed the case in February, writing that the children could not pursue a medical malpractice lawsuit because they were not the patients.
But attorneys for the Ragsdale children and their conservator, William Jeffs, are appealing that decision.
The high court heard arguments at BYU's law school in Provo.
The lawsuit filed by the Ragsdale children claims that in the months before Kristy Ragsdale's murder, West prescribed David Ragsdale a cocktail of steroids, antidepressants and other medications. Other drugs were added to the combination one month before the shooting at an appointment where David Ragsdale discussed his marital problems and the restraining order, the suit alleged.
Ragsdale, who pleaded guilty to first-degree felony aggravated murder and is serving a 20 years to life prison term, said he took full responsibility for his wife's death. But he also claimed he would not have murdered his wife had he not been on medications.
The Ragsdale children's lawsuit seeks damages from West, Rodier and Pioneer Comprehensive Medical Clinic.
The clinic's attorney has argued Ragsdale's care was "exceptional and appropriate," and other qualified health care providers would have made similar decisions.
In a brief filed prior to Wednesday's arguments, attorney Tawni J. Anderson, who represents the Utah Medical Association and several other health care providers, said a potential decision by the Supreme Court to reverse Lindberg's ruling would have "far-reaching and gravely deleterious consequences for the provision and quality of healthcare" in Utah.
"The question presented by this appeal is whether his children were owed a duty of care by Mr. Ragsdale's health care providers even though the children were not patients of [Rodier, West and Pioneer Comprehensive Clinic]," Anderson's brief states.
"With very few exceptions, health care providers owe a duty only to their patients," Anderson wrote.
Anderson wrote that reversing Lindberg's ruling would increase medical costs by causing physicians to practice "defensive medicine," ordering tests or treatments that they otherwise might forego, but instead feel necessary because of concern over liability to third parties. Reversing the ruling would also dissuade health care providers from treating patients in the first place because of an uncertainty over how third parties connected to the patient could claim they are affected by a diagnosis.
Justice Thomas Lee, however, questioned that theory during Wednesday's arguments.
"Don't we want doctors to take into account the possibility of harm to third parties?"
Attorney Stephen Owens told Lee that health care providers can't focus on what might happen to people related to their patient, or else they may be reluctant to see patients in the first place.
"Do we want Trina West to say 'I'm not touching this guy?' " Owens said, referring to Ragsdale. "We want troubled patients to seek medical help."
Attorneys for the Ragsdale children — Allen Young and Tyler Young of Provo and Jonah Orlofsky of Illinois — argue that the Ragsdale children do have a right to damages from the medical team that treated their father.
Orlofsky argued Wednesday that health care providers must think about how their actions affect those who interact with a patient regularly.
Ragsdale's case, Orlofsky said, is a prime example of doctors overlooking how a disturbed patient could have reacted to family members around him while on prescription medication.
"We have too much violence in society to say 'This is something you don't need to consider,' " Orlofsky said.
The high court took the arguments under advisement and will issue an opinion at a later date.
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