Dr. Skin, a dermatologic surgeon and head of a resident training program at a well-recognized academic center performed a surgical excision on an eyelid growth on Mrs. Smith. Mrs. Smith is a healthy 50-year-old woman, and she is not on any medication. Her visual acuity, prior to the procedure, was corrected quite easily with contact lenses. The surgical procedure went smoothly and lasted less than one hour. The patient left the office without any difficulty at 11 a.m. in the morning. At 4 p.m., Dr. Skin called Mrs. Smith to check on her post-operative course. She reported some ecchymosis, but otherwise no difficulties. At 6 p.m., Dr. Skin called his covering physician (Dr. Ecchymosis) and signed out to him. He discussed Mrs. Smith’s surgery with Dr. Ecchymosis.
At 8 p.m., Mrs. Smith called Dr. Skin’s office with a concern about her surgery. Dr. Skin’s answering service immediately paged Dr. Ecchymosis, the covering physician. Dr. Ecchymosis returned the page within 15 minutes. In their discussion, Mrs. Smith described the ecchymosis. She also now described significant blurring of vision in her right eye. When she tried to correct her vision with an old set of glasses, she found no improvement. Dr. Ecchymosis discussed the situation with Mrs. Smith and reassured her that such findings are not unusual. He suggested she try to go to sleep and call Dr. Skin in the morning.
The next morning, Mrs. Smith awakened to find she had no vision in her right eye. She immediately returned to Dr. Skin’s office and from there was sent to an ophthalmologist. He noted that she had evidence of a retrobulbar hemorrhage. Although, he immediately performed surgery to correct the problem, the blindness was permanent. Had Dr. Skin and/or Dr. Ecchymosis made the correct diagnosis and referred his patient for immediate surgery, the blindness would have been prevented.
Mrs. Smith brings a negligence cause of action against both Dr. Skin and the covering physician, Dr. Ecchymosis. The basis of her case against Dr. Skin is that he was in a “joint-venture” with Dr. Ecchymosis. After all, they cover each other’s practices every night. It should be noted that there are no payments made for the cross-coverage and the two practices share neither staff nor facilities.