(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the
convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the
interests of brevity, portions of any opinion may not have been summarized).
Argued November 29, 1999 -- Decided July 25, 2000
COLEMAN, J., writing for a majority of the Court.
This appeal addresses the question of whether a doctor who was hired as an employee of a company to treat
its workers' compensable injuries pursuant to the Workers' Compensation Act can be sued in the Superior Court of
New Jersey, Law Division, for malpractice arising from negligent medical treatment, or whether the immunity
afforded co-employees by the Act extends to the doctor, requiring the injured employee to seek relief through the
Division of Workers' Compensation (“Division”).
Plaintiff was a pressman for the New York Times Company (“Times”). He incurred injuries to his left
elbow, left knee and left leg when he fell from a ladder while performing his duties. The Times maintained its own
medical facility, and plaintiff was treated for his injuries by defendant Dr. DePietro in the facility for approximately
one year. Because plaintiff experienced persistent pain in his left thigh, an x-ray and MRI were performed
approximately ten months after the accident. The medical tests revealed a lesion. Plaintiff was referred to an
orthopedic oncologist who performed a biopsy of the mass and diagnosed cancer.
Plaintiff filed a petition with the Division for the injuries incurred when he fell from the ladder. That claim
was still pending in the Division when plaintiff filed this malpractice action against Dr. DePietro and other medical
professionals. The trial court granted Dr. DePietro's motion for summary judgment, holding that the defendant was
a fellow employee and therefore immune from a tort action pursuant to the Workers' Compensation Act.
Thereafter, plaintiff's workers' compensation claim for the injuries resulting from his fall was resolved by entry of an
order approving a settlement in which plaintiff was awarded 10" of his left leg for residuals of a hamstring pull.
The order also reflected the parties' stipulation that the cancer was not causally related to plaintiff's employment or
his ladder accident.
After entry of the order approving settlement of the ladder-injury claim, plaintiff filed a motion to vacate the
order granting summary judgment to Dr. DePietro in this malpractice action. The motion was denied by the trial
court. After the claims against all other defendants were resolved and the order granting summary judgment to Dr.
DePietro became final, plaintiff appealed the order denying the motion to vacate. The Appellate Division affirmed
the trial court's order in a published opinion,
319 N.J. Super. 89 (1999), holding that plaintiff could not maintain a
tort action against Dr. DePietro for failing to diagnose the cancer during his treatment of plaintiff's compensable
injuries. The court adopted the position of the majority of courts in the United States that an injured employee may
not maintain a malpractice action against a co-employee physician for the negligent aggravation of his or her existing
injury.
Plaintiff filed a Petition for Certification and shortly thereafter an application in the Division for review or
modification of his disability award. The Court granted the Petition and addressed both the malpractice claim and
the status of plaintiff's settled workers' compensation claim.
HELD: A worker may not maintain a tort action against a medical practitioner who is also an employee of the
injured worker's employer-owned-and-operated health care facility for harm caused during the treatment of the
employee's work-related injury. The injured worker's exclusive remedy for the alleged malpractice is to pursue the
claim in the Division.
1. Where a worker is claiming that his compensable injury was aggravated by the professional negligence of a
co-employee medical practitioner, the claim is to be treated as an accident that arose out of and in the course of
employment within the meaning of N.J.S.A. 34:15-7, which does not require proof of negligence. However, to
establish compensability for plaintiff's claim that the defendant failed to diagnose cancer in a leg he was treating for
muscle strain, plaintiff must prove negligence before a Judge of Compensation in the Division. (Pp. 6-11)
2. The Court rejects plaintiff's claim that a company doctor in a medical facility owned by an injured worker's
employer acts in the dual capacity of co-employee and physician and therefore owes the injured worker an
independent duty of care, breach of which would permit a tort action. A contrary holding would burden the
employer indirectly with common-law damages superimposed upon its workers' compensation liability by reason of
either a legal, moral or practical obligation to indemnify the sued doctor, or with the expense of carrying insurance to
cover the personal liability of the doctor. N.J.S.A. 34:15-8, which extended immunity under the Act to co
employees, was intended to eliminate such concerns. (Pp. 11-12)
3. Since plaintiff's employer concedes and the Court concludes that the alleged malpractice constitutes an
accident under N.J.S.A. 34:15-7, that portion of the order approving settlement of plaintiff's workers' compensation
claim that stipulated the cancer was not causally related to plaintiff's employment or his ladder accident, entered
pursuant to N.J.S.A. 34:15-20, is vacated so that plaintiff can pursue his claim against Dr. DePietro in the Division.
(Pp. 12-14)
The judgment of the Appellate Division dismissing the tort action is AFFIRMED, and the matter is
REMANDED to the Division for further proceedings in accordance with this opinion.
JUSTICE STEIN, dissenting, contends that the Court should deny co-employee immunity, pursuant to
N.J.S.A. 34:15-8, to company doctors for their negligent treatment of employee-patients, and that workers should be
permitted to pursue their tort claims against company doctors in the Law Division.
CHIEF JUSTICE PORITZ and JUSTICES O'HERN, GARIBALDI, and VERNIERO join in JUSTICE
COLEMAN'S opinion. JUSTICE STEIN filed a separate dissenting opinion in which JUSTICE LONG joins.
SUPREME COURT OF NEW JERSEY
A-
104 September Term 1998
DONALD HAWKSBY and JOANNA HAWKSBY,
his wife,
Plaintiffs-Appellants,
v.
JOSEPH A. DEPIETRO, M.D.,
Defendant-Respondent,
and
WALTER URS, M.D., MATTHEW
GARFINKEL, M.D., WILLIAM H. ROSS,
D.O., METUCHEN ORTHOPAEDIC GROUP,
JOHN DOE, M.D. 1-50, JANE DOE,
M.D. 1-50, JOHN DOE, R.N. 1-50,
JANE DOE, R.N. 1-50, JOHN DOE
1-50, JANE DOE 1-50 and JOHN DOE
CORP. 1-50, (Fictitious Names),
Defendants.
Argued November 29, 1999-- Decided July 25, 2000
On certification to the Superior Court,
Appellate Division, whose opinion is reported
at
319 N.J. Super. 89 (1999).
E. Drew Britcher argued the cause for
appellants (Leonard & Butler, attorneys).
Francis E. Borowsky, Jr., argued the cause
for respondent (Monte, Sachs & Borowsky,
attorneys; Mr. Borowsky and Michelle A.
Monte, on the brief).
Anthony C. Famulari submitted a brief on
behalf of amicus curiae New York Times, Co.
(Carpenter, Bennett & Morrissey, attorneys;
Jennifer L. Kapell, on the brief).
Christopher B. Leitner submitted a brief on
behalf of amicus curiae Donald Hawksby as
Workers' Compensation Petitioner (Shebell &
Shebell, attorneys; Raymond P. Shebell of
counsel).
The opinion of the Court was delivered by
COLEMAN, J.
This case revisits the issue of whether there should be tort
liability for co-employee physicians. The question raised is
whether a doctor who is also an employee of an injured worker's
employer may be sued in the Law Division for medical malpractice
for allegedly injuring that worker while providing authorized
medical treatment for a compensable accident. The Law Division
held that the action was precluded based upon immunity under the
New Jersey Workers' Compensation Act (Act), N.J.S.A. 34:15-8, and
that the exclusive remedy was to pursue the claim in the Division
of Workers' Compensation (Division). The Appellate Division
affirmed in a published opinion.
319 N.J. Super. 89, 102 (1999).
We hold that whenever a worker is treated for a work
connected condition by an authorized doctor or nurse, who is also
an employee of the injured worker's employer-owned and -operated
health care facility, the injured worker's exclusive remedy for
alleged malpractice is to pursue the claim in the Division.
The relevant facts are not disputed. Plaintiff Donald Hawksby (plaintiff) worked for some time prior to the date of his accident as a pressman for The New York Times Co. (The Times) at its Edison, New Jersey plant. While performing his duties on December 13, 1993, plaintiff fell from a ladder causing injuries to his left elbow, left knee, and left leg extending from the back of the knee into the calf and thigh. The Times operates its own healthcare facility that provided medical care to plaintiff. After initial minor treatment on the day of the accident by The Times nurse and an emergency room doctor, plaintiff consulted defendant Dr. Joseph DePietro on December 23, 1993. Dr. DePietro is the full-time director of The Times on-site clinic that treated plaintiff for approximately one year. All of the treatment rendered by Dr. DePietro was in his capacity as an employee of the clinic and The Times.
Dr. DePietro's treating diagnosis was probable slight strain of the hamstring muscle for which Advil, stretching exercises, and application of heat were prescribed. When the treatment plan did not resolve plaintiff's medical problems, which included persistent severe pain, plaintiff returned to the clinic on October 14, 1994, complaining of pain in the posterior left thigh. An X-ray and a magnetic resonance imaging test (MRI) were taken on October 26, 1994, and plaintiff was referred to an orthopedic oncologist because the MRI showed a solid lesion in plaintiff's left thigh. Plaintiff was examined by Dr. John H. Healey, an orthopedic oncologist, at Memorial Sloan Kettering Cancer Center on November 15, 1994. He performed an open biopsy of a mass on plaintiff's left calf on November 16, 1994. A large grade sarcoma of the left calf was diagnosed. Plaintiff received chemotherapy and radiation therapy from Sloan Kettering until at least April 1995. The record does not reveal plaintiff's medical condition and treatment since that time.
On January 25, 1995, plaintiff filed a verified petition with the Division against The Times for the December 3, 1993 accident. While that claim was still pending in the Division, plaintiff filed the present action in the Law Division on November 14, 1995, alleging medical malpractice against Dr. DePietro and other medical professionals. The Appellate Division has accurately summarized most of the remaining relevant procedural history:
In October 1996, the trial court granted Dr. DePietro's motion for summary judgment on the ground that Dr. DePietro, being a fellow employee, was immune from a tort action under N.J.S.A. 34:15-8. The trial court denied plaintiff's request that the matter be placed on the inactive list pending the workers' compensation matter. The summary judgment order was interlocutory because the medical malpractice action continued against other medical professionals. This court denied plaintiff's motion for leave to file an appeal from the summary judgment.
The workers' compensation claim was disposed of on May 22, 1997 by entry of an order approving settlement. See N.J.S.A. 34:15-20. The order awarded Hawksby “10" of the left leg for residuals of a hamstring pull.” It also stated that “[t]he spindle cell sarcoma is not causally related to the petitioner's employment or the accident of 12/13/93.”
On July 23, 1997, plaintiff moved in the
medical malpractice action, under R. 4:50-1,
to set aside the summary judgment. The court
denied this motion on October 24, 1997. That
order was also interlocutory because the
medical malpractice case had not been
disposed of as to all parties. However, a
stipulation of dismissal with regard to
defendant, William H. Ross, M.D., the last
party in the case, was filed on November 6,
1997. Plaintiff filed his timely notice of
appeal on December 3, 1997, appealing from
the October 24, 1997 order denying the motion
to vacate the summary judgment entered on
September 18, 1996.
With few exceptions, we agree with the Appellate Division's
legal analysis that led it to hold that “Hawksby may not maintain
a tort action against Dr. DePietro based on his failure to
diagnose the cancer during his treatment of Hawksby's compensable
injury.” Id. at 102. The Appellate Division examined cases from
around the country and concluded that “[t]he majority of the
courts which have addressed this issue have concluded, as New
Jersey has, that an injured employee may not maintain a
malpractice action against a co-employee physician for the
negligent aggravation of his or her existing injury.” Id. at 93
94.
Hawksby filed his petition for certification on March 26,
1999. While that petition was pending, on April 4, 1999, he
filed an application for review or modification, pursuant to
N.J.S.A. 34:15-27, of his ten percent disability award for the
left leg injury. That claim is still pending in the Division.
We granted certification on May 26, 1999.
160 N.J. 479 (1999).
Plaintiff argues that his malpractice claim should not have been dismissed because the cancer in his leg was non-work related, and was instead the result of a disease process that was unrelated to the workplace. He also contends that Dr. DePietro's failure to timely diagnose the tumor was independent of his employment status as the physician authorized by The Times to treat employees for work-related conditions. He argues further, that he has been placed in the untenable position of having The Times contend in the Division that the cancer is not compensable, and having Dr. DePietro contend in the Law Division that immunity under N.J.S.A. 34:15-8 requires dismissal of the tort action.
Dr. DePietro argues that plaintiff's predicament, of having the claim of alleged failure to make an early cancer diagnosis found to be non-compensable in the Division based on a stipulation, not the result of a litigated trial, and the dismissal of the tort claim in the Law Division based on the fellow-employee immunity under N.J.S.A. 34:15-8, is simply the result of plaintiff's litigation strategy. In other words, Dr. DePietro contends that plaintiff settled his case in the Division in an effort to obtain a more lucrative award or settlement in the tort action. He continues to maintain that the exclusive forum was the Division, where plaintiff should have proceeded on the theory that Dr. DePietro had aggravated a preexisting cancer and that a tort action is barred by the exclusive remedy rule, N.J.S.A. 34:15-8.
The procedural posture in this case is strikingly similar to that involved in a case we decided two terms ago. As we observed there: “This is a workers' compensation case in which the parties have taken reverse factual and legal positions. The injured worker . . . is denying that an accident arose out of and in the course of employment . . . in order to escape the exclusive remedy rule of the New Jersey Workers' Compensation Act . . . while the employer is admitting the compensability of that accident.” Kristiansen v. Morgan, 153 N.J. 298, 301-02 (1998). Here, plaintiff is asserting that aggravation of his cancer is not compensable to escape the co-employee immunity rule that provides: If an injury or death is compensable under this article, a person shall not be liable to anyone at common law or otherwise on account of such injury or death for any act or omission occurring while such person was in the same employ as the person injured or killed, except for intentional wrong.
With Kristiansen fresh in our minds, following oral
argument, we requested each counsel who had handled the case in
the Division “to submit a brief to the Court on the availability
of Workers' Compensation on the ground that [Dr. DePietro's]
failure to diagnose was an 'accident' within the intendment of
[N.J.S.A. 34:15-7].” In response to that request, counsel for
The Times conceded that no distinction should be made between a
claim that an authorized treating physician has aggravated a
work-related injury and that an aggravation of a non-work related
condition was caused by that physician. Counsel reasons that in
both instances, treatment would be administered by an authorized
treating physician for compensable conditions and but for the
injured employee's employment, the worker would not have been
injured on the job and would not have been treated by the
employer's authorized doctor, here Dr. DePietro. Counsel for the
employer further concedes that plaintiff's claim of aggravation
of his cancer, based on alleged professional malpractice under
the workers' compensation no-fault system, is to be treated as an
accident that arose out of and in the course of employment within
the meaning of N.J.S.A. 34:15-7, without the necessity of proving
negligence.
Those concessions would be controlling in a case in which
the worker was claiming that professional negligence aggravated
the compensable injury being treated. Here, however, the worker
is claiming that Dr. DePietro failed to diagnose cancer in the
leg he was treating for a probable hamstring muscle strain.
Under these circumstances, to establish compensability based on
Dr. DePietro's alleged failure to diagnose the non-compensable
cancer, the worker must prove professional negligence. Walck v.
Johns-Manville Products Corp.,
56 N.J. 533, 560-62 (1970).
“[T]he doctor's malpractice would be an incident of the
employment.” Id. at 562. We recognize that “our analysis makes
compensation depend on proof of fault, in the face of the
statute's direction that compensation be awarded or withheld
'without regard to the negligence of the employer.' R.S. 34:15
7. . . . But the fact is that in the circumstances of this case
it is only the alleged negligence that makes the” aggravation
compensable. Dudley v. Victor Lynn Lines, Inc.,
32 N.J. 479, 495
(1960).
Both Walck, supra, and Dudley, supra, involved claims of
professional negligence that had to be prosecuted in the
Division. The Judges of Compensation are at least as capable, if
not more capable, of handling such claims as juries. Indeed,
Florida and Virginia have adopted a workers' compensation
approach for handling some of the more serious and complicated
common-law medical malpractice claims. Fla. Stat. Ann. § 766.303
(West 1999) (dealing with birth-related neurological injury
claims); Va. Code Ann. § 38.2-5002 (Michie 1999) (same); see also
Randall R. Bovbjerg & Frank A. Sloan, No-Fault for Medical
Injury: Theory and Evidence,
67 U. Cin. L. Rev. 53, 83 (1998)
(discussing Florida and Virginia statutes); Practicing Law
Institute, Medical Malpractice Developments 576 (1994) (same).
See generally Randall R. Bovbjerg, et al., Administrative
Performance of “No-Fault” Compensation for Medical Injury, 60 Law
& Contemp. Probs. 71, 72 (1997) (“The first actual implementation
of no-fault for medical liability occurred . . . in Virginia and
Florida, largely under the workers' compensation model.”).
We reject plaintiff's contention that a company doctor in a medical facility that is owned and operated by the injured worker's employer acts in a dual capacity of co-employee and physician and, therefore, owes plaintiff an independent duty of care, the breach of which should permit him to pursue a tort action. This same contention has already been soundly rejected by this Court. What we said then is dispositive of the issue presented now:
We note that when the Legislature added a provision for co-employee immunity to the Workers' Compensation Act in 1961, L. 1961, c. 2 (codified at N.J.S.A. 34:15-8), some employers had medical clinics staffed by employee doctors and nurses. If the Legislature had intended to exclude this class of co-employees, it could have expressed that intent. Indeed the Legislature made a comprehensive review of the Act in 1979, L. 1979, c. 283, without modifying the co-employee immunity provision despite the pronouncement in Bergen v. Miller, 104 N.J. Super. 350 (App. Div.), certif. denied, 53 N.J. 582 (1969), of the principle enunciated in this case. The employee's recovery under the Act includes, of course, the consequences of malpractice, the injuries being deemed to arise out of and in the course of employment. Flanagan v. Charles E. Green & Son, 122 N.J.L. 424 (E. & A. 1939).
We agree with the Appellate Division that the majority of
jurisdictions that have addressed the issue align with the New
Jersey rule that an injured worker may not maintain a malpractice
action against a co-employee physician. Hawksby, supra, 319 N.J.
Super. at 93-101. A contrary holding would result “in burdening
the employer indirectly with common-law damages superimposed upon
[its] workmen's compensation liability by reason of either a
legal, moral or practical obligation to indemnify the sued
[doctor], director, officer or supervisory employee, or with the
expense of carrying insurance to cover the personal liability of
such . . . personnel.” Miller v. Muscarelle,
67 N.J. Super. 305,
321 (App. Div.), certif. denied,
36 N.J. 140 (1961). These are
some of the specific concerns N.J.S.A. 34:15-8 was intended to
eliminate.
We recognize that no one has appealed from the order approving settlement in the Division. Hawksby, supra, 319 N.J. Super. at 91, n.1. Because our ultimate disposition is to affirm the dismissal of the tort claim, we think it only fair to afford plaintiff a chance to litigate the claim of aggravation of his cancer in the Division, in light of the employer's concessions and our conclusion that the alleged malpractice constitutes an accident under N.J.S.A. 34:15-7. The issue of medical malpractice has yet to be litigated between these parties.
Under the Act, there are two types of orders approving settlement. One is pursuant to N.J.S.A. 34:15-20, and operates as a “dismissal of the claim petition.” Ibid. The other is pursuant to N.J.S.A. 34:15-58, and has the same operative effect as a litigated judgment in that it is final and conclusive between the parties and may be appealed pursuant to N.J.S.A. 34:15-66 and/or reopened in accordance with N.J.S.A. 34:15-27. The order approving settlement in the present case involved both N.J.S.A. 34:15-20 and -58. That part of the order providing that “[t]he spindle cell sarcoma is not causally related to the petitioner's employment or the accident of 12/13/93" falls under N.J.S.A. 34:15-20. By that stipulation, the parties intended to have the aggravation claim dismissed in the Division because that claim was being pursued in the tort action. That portion of the settlement that awarded ten percent partial permanent disability of the left leg was entered pursuant to N.J.S.A. 34:15-58. That aspect of the award has been reopened and is currently pending in the Division. We exercise original jurisdiction, Rule 2:10-5; Karins v. City of Atlantic City, 152 N.J. 532, 541 (1998), and vacate the dismissal of the aggravation claim in the order approving settlement because it is in the public's interest to get this litigation back on track. See Estelle v. Board of Educ., 14 N.J. 256, 260-61 (1954). In the future, however, such a disposition pursuant to N.J.S.A. 34:15-20 shall effectively preclude litigating the issue in either the Division or the Law Division.
We affirm the judgment of the Appellate Division dismissing the tort action. We remand the matter to the Division, which has exclusive jurisdiction, for further proceedings in accordance with this opinion.
CHIEF JUSTICE PORITZ and JUSTICES O'HERN, GARIBALDI, and VERNIERO join in JUSTICE COLEMAN's opinion. JUSTICE STEIN filed a separate dissenting opinion in which JUSTICE LONG joins.
SUPREME COURT OF NEW JERSEY
A- 104 September Term 1998
DONALD HAWKSBY and JOANNA HAWKSBY,
his wife,
Plaintiffs-Appellants,
v.
JOSEPH A. DEPIETRO, M.D.,
Defendant-Respondent,
and
WALTER URS, M.D., MATTHEW
GARFINKEL, M.D., WILLIAM H. ROSS,
D.O., METUCHEN ORTHOPAEDIC GROUP,
JOHN DOE, M.D. 1-50, JANE DOE,
M.D. 1-50, JOHN DOE, R.N. 1-50,
JANE DOE, R.N. 1-50, JOHN DOE
1-50, JANE DOE 1-50 and JOHN DOE
CORP. 1-50, (Fictitious Names),
Defendants.
STEIN, J., dissenting.
The Court holds that plaintiff must pursue a medical
malpractice claim in the Division of Workers' Compensation
(Division) because the doctor who committed the alleged
malpractice was provided by the employer. The Court affirms the
lower courts' holding immunizing plaintiff's doctor from tort
liability pursuant to N.J.S.A. 34:15-8 on the basis that the
doctor was a fellow employee. That holding insulates company
doctors from tort liability for negligent conduct, thereby
depriving employees harmed by their negligence of an adequate
forum to redress their injuries. I disagree and would adopt the
dual capacity doctrine relied on by Justice Handler in Boyle v.
Bireme,
93 N.J. 569, 570-77 (1983) (Handler, J., dissenting), and
permit injured plaintiffs to assert medical malpractice claims
against a co-employee company doctor.
Moreover, in my view the Division is not the appropriate
forum to litigate complex issues of medical causation.
Plaintiff's claim should be litigated in the Law Division, the
customary forum for the trial of medical malpractice claims.
I
A
The Workers' Compensation Act (the Act) was enacted to
insure that employees who are injured during the course of
employment are compensated for their losses without having to
prove the fault of the employer. Harris v. Branin Transp., Inc.,
312 N.J. Super. 38, 46 (App. Div.), certif. denied,
156 N.J. 408
(1998). We have discussed previously the development of the Act
and the purpose of workers' compensation legislation. Millison
v. E.I. du Pont de Nemours & Co.,
101 N.J. 161, 173-76 (1985).
The Act “involve[s] a historic trade-off whereby employees
relinquished their right to pursue common-law remedies in
exchange for automatic entitlement to certain, but reduced,
benefits whenever they suffered injuries by accident arising out
of and in the course of employment.” Id. at 174. Thus, a
balanced no-fault system was enacted where “employees would
receive assurance of relatively swift and certain compensation
payments, but would relinquish their rights to pursue a
potentially larger recovery in a common-law action.” Ibid.
In 1961, the Legislature amended the Act to provide for co
employee immunity. L. 1961, c. 2. N.J.S.A. 34:15-8, as amended,
provides fellow employees with immunity from tort liability for
their own negligent acts in the workplace. Volb v. G.E. Capital
Corp.,
139 N.J. 110, 117 (1995); Wellenheider v. Rader,
49 N.J. 1, 9 (1967). The purpose of that amendment was to relieve
employers from the burden of paying
common-law damages superimposed upon [their]
workmen's compensation liability by reason of
either a legal, moral or practical obligation
to indemnify [a] sued director, officer or
supervisory employee, [and] the expense
of carrying insurance to cover the personal
liability of such supervisory personnel.
[Miller v. Muscarelle, 67 N.J. Super.
305, 321 (App. Div.), certif. denied,
36 N.J. 140 (1961).]
See also Maggio v. Migliaccio,
266 N.J. Super 111, 116 (App.
Div. 1993) (noting that N.J.S.A. 34:15-8 defense applies where
plaintiff's employer provides workers' compensation benefits and
would be responsible for plaintiff's injuries). Professor Larson
notes that pursuant to workers' compensation laws an employer
“gives up its normal defenses and assumes automatic liability” in
exchange for immunity from employee common-law suits, and that
that reasoning can be extended to a co-employee who is “entitled
to expect in return for what he or she has given up . . . freedom
from common-law suits based on industrial accidents in which that
coemployee is at fault.” 6 Arthur Larson & Lex K. Larson,
Larson's Workers' Compensation Law § 111.03[2] (2000). N.J.S.A.
34:15-8 thus protects fellow employees from common-law tort
actions filed by workers who are injured or killed in the
workplace. Volb, supra, 139 N.J. at 117; Wellenheider, supra, 49
N.J. at 9; Estrada v. Hendricksaw Corp.,
302 N.J. Super. 262, 266
(App. Div. 1997); Bustamante v. Tuliano,
248 N.J. Super 492, 494
(App. Div.), certif. denied,
126 N.J. 385 (1991).
B
Because of the unique service provided by company doctors,
some courts, although a distinct minority, wisely have declined
to extend co-employee immunity to them and have adopted the dual
capacity doctrine. Declaring that “[m]edical malpractice is not
an inherent risk of the brewing business,” in Wright v. District
Court,
661 P.2d 1167, 1171 (1983), the Supreme Court of Colorado
held that a brewery employee whose back injury was aggravated by
the malpractice of a company doctor could maintain a malpractice
claim against the company doctor because the doctor's
relationship with the employee
was identical to that of a doctor in private
practice with a patient. This relationship
is distinct from the employment relationship;
it entails different rights and duties.
Clearly, a private doctor would be liable to
[the employee] for malpractice. There is no
logical reason to treat company physicians
differently. Thus, the rule which immunizes
employees from suits by their co-employees
for negligence within the course of
employment is inapplicable here.
The majority view of this Court has been that company doctors are entitled to co-employee immunity for their negligent treatment of employee-patients. See Boyle, supra, 93 N.J. at 570. Justice Handler, however, has argued persuasively against extending co-employee immunity to company doctors. In Boyle, Justice Handler reviewed the purposes of workers' compensation laws and the implications of immunizing company doctors from liability as co-employees. 93 N.J. at 572-77 (Handler, J., dissenting). He concluded that [b]ecause of the lack of control exerted by the employer over the medical and patient-treating aspects of a house physician's work, the independence ascribed to the medical profession, and the degree of skill, care and judgment associated with the practice of medicine, the house physician, when treating other employees, cannot be viewed simply as a servant in a master-servant relationship.
[Id. at 574.]
Regarding the legislative intent underlying N.J.S.A. 34:15-8, Justice Handler observed that
in enacting the coemployee immunity provision of workers' compensation laws, the Legislature did not contemplate that a physician . . . was a fellow employee of patients whom he was medically treating. This result _ excluding the licensed treating physician from coemployee immunity _ does not unduly broaden the dual capacity doctrine or disserve the legislative purpose in furnishing such an immunity. Medical malpractice is not an inherent or normal risk of the business and employment of such an entity as [the defendant doctor's government employer]. N.J.S.A. 34:15-8 was intended to cover accidental injuries arising out of and in the course of employment _ the kinds of injuries that involve employment risks that are commonly and most frequently associated with an employer's enterprise. In light of the unique stature of the medical profession and the professional obligations that devolve upon licensed physicians, which transcend any duties that may be imposed by an employer, it is unreasonable to conclude that the Legislature, through its coemployee immunity provision, intended to abrogate or narrow the rights, duties and obligations that flow from the doctor-patient relationship.
[Id. at 577.] In his concurring and dissenting opinion in Millison, supra, Justice Handler again challenged the application of N.J.S.A. 34:15-8 to immunize negligent company doctors:
In enacting the 1961 amendments to N.J.S.A. 34:15-8 granting co-employees immunity for negligent acts, the Legislature did not express or effectuate an intention to include doctors within the scope of that privilege. Indeed, granting doctors "co-employee immunity" does not further the underlying purpose of the 1961 amendment, but does undermine New Jersey's public policy in deterring negligent conduct and fully compensating negligently-inflicted injuries. The "co-employee immunity" amendment was designed to abolish "cause[s] of action in tort against a fellow employee . . . [that] ha[d] frequently resulted in burdening the employer indirectly with common law damages superimposed upon workmen's compensation liability by reason of either a legal, moral or practical obligation to indemnify the sued . . . employee."
[Millison, supra, 101 N.J. at 202 (Handler, J., concurring and dissenting) (quoting Miller, supra, 67 N.J. Super. at 321).]
In contrast to most employees whose workplace conduct implicates the responsibility of their employers, and who therefore are entitled to co-employee immunity, Justice Handler noted that employers ordinarily exert no control over the treatment rendered by company doctors:
In this case of doctors employed by companies, the lack of employer control and direction, the medical profession's skill and distinct occupational personality, and the fact that medical services are not a product marketed by [the employer] militate strongly towards viewing doctors as independent contractors.
Since employers would not be liable for the negligence of the doctors they employ, applying the co-employee immunity to company physicians does not comport with the underlying purpose of the 1961 amendments in protecting employers from double liability. No public policy is advanced by including doctors within N.J.S.A. 34:15-8's co-employee immunity. On the other hand, the Boyle rule perniciously allows company-employed physicians to operate undeterred at a level of performance beneath that which is expected of other members of the medical profession at the expense of workers' lives and limbs.
[Id. at 203-04 (citations omitted).]
II
A
Plaintiff claims that Dr. DePietro “negligently failed to exercise the degree of care required by accepted standards of good medical practice” in failing to recognize the cancerous tumor in his left leg during almost one year of treatment for continuous pain in that leg. In order to prove that medical malpractice claim, plaintiff must show that Dr. DePietro's failure to diagnose his cancer aggravated that condition and increased the risk of recurrence. We first identified the essential elements of that cause of action in Evers v. Dollinger, 95 N.J. 399 (1984).
In Evers, the defendant failed to diagnose breast cancer. During the ensuing months plaintiff experienced severe pain and detected an increase in the size of the cancerous tumor. Id. at 402-403. The Court acknowledged the existence of a cause of action finding that a “progressive evolution of the malignancy during the period of delay until plaintiff received proper medical attention, occasioned by defendant's earlier failed diagnosis, is a cognizable injury and constituted an actionable element of damages.” Id. at 407. In addition to recognizing the growth and spread of the cancer as “an injury in and of itself,” id. at 408, the Court found that “[a]n additional element of injury and damage derives from plaintiff's claims of anxiety, emotional anguish and mental distress.” Id. at 409. The Court also adopted a more flexible standard of proof, concluding that
plaintiff should be permitted to demonstrate,
within a reasonable degree of medical
probability, that the seven months delay
resulting from defendant's failure to have
made an accurate diagnosis and to have
rendered proper treatment increased the risk
of recurrence or of distant spread of
plaintiff's cancer, and that such increased
risk was a substantial factor in producing
the condition from which plaintiff currently
suffers.
[Id. at 417.]
In Evers, the Court noted “that the difficulties of
identifying, defining, and proving injury in certain types of
medical malpractice cases justif[y] the application of a standard
of causation that is more flexible than that used in conventional
tort claims.” Id. at 413. Because of the inherent difficulty of
proving negligence when the plaintiff is afflicted with a
preexisting condition, the Court has continued to apply a lower
burden-of-proof standard for plaintiffs to establish a prima
facie case of negligence in this increasingly complex area of
law. Gardner v. Pawliw,
150 N.J. 359, 377 (1997) (involving
prenatal medical malpractice); Fischer v. Canario,
143 N.J. 235,
241 (1996) (concerning tumor misdiagnosis); Scafidi v. Seiler,
119 N.J. 93, 108-09 (1990) (involving prenatal medical
malpractice); Dubak v. Burdette Tomlin Memorial Hosp.,
233 N.J.
Super. 441, 449 (App. Div. 1989) (concerning fatal internal
bleeding).
B
The majority has determined that the Division is the
exclusive forum in which plaintiff's claim should be tried. The
Division, however, is a forum not well suited to the trial of a
medical malpractice claim where an injured plaintiff must prove
negligence in order to receive compensatory damages. The
Division's customary function is to adjudicate causation in the
context of no-fault claims. See Brock v. Public Serv. Elec. &
Gas Co.,
325 N.J. Super. 582, 588 (App. Div. 1999) (noting that
workers' compensation court “was designed to establish a no fault
system of compensation for workers who are injured or contract
disease in the course of employment”). The Division's judges are
unfamiliar with medical malpractice litigation and with the
determination of whether a physician deviated from generally
accepted standards of medical practice, an issue customarily
submitted for resolution to a jury. In my view, the trial of
plaintiff's malpractice claim belongs in the Law Division.
III
For the reasons stated, I would reverse the judgment of the
Appellate Division and remand the matter for trial in the Law
Division. Justice Long joins in the dissent.
NO. A-104 SEPTEMBER TERM 1998
ON APPEAL FROM
ON CERTIFICATION TO Appellate Division, Superior Court
DONALD HAWKSBY and JOANNA HAWKSBY,
his wife,
Plaintiffs-Appellants,
v.
JOSEPH A. DEPIETRO, M.D.,
Defendant-Respondent,
and
WALTER URS, M.D., et al.,
Defendants.
DECIDED July 25, 2000
Chief Justice Poritz PRESIDING
OPINION BY Justice Coleman
CONCURRING OPINION BY
DISSENTING OPINION BY Justice Stein