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11 Willamette L.J. 152 (1974-1975)
Helling v. Carey: Medical Malpractice Standard of Care Determined by Court

handle is hein.journals/willr11 and id is 160 raw text is: WILLAMETTE LAW JOURNAL HELLING V. CAREY: MEDICAL MALPRACTICE STANDARD OF CARE DETERMINED BY COURT The Washington Supreme Court has unanimously refused to apply the medical profession's standard of care in an ophthalmolo- gist malpractice action. In Helling v. Carey,' the court determined as a matter of law the applicable standard, suggesting that the pre- vailing practice of the profession must meet a judicial criterion of sufficient care, rather than merely reasonable care. FACTS Barbara Helling was 23 years old when she first consulted de- fendant ophthalmologists, Drs. Carey and Laughlin, for nearsight- edness. At that time, in 1959, she was fitted with contact lenses. In September and October of 1963 she again visited the doctors, complaining of contact lens irritation. Eight consultations followed between February 1967 and October 1968. Until the October 1968 session, defendants considered their patient's visual problems to be related solely to complications associated with her contact lenses. During the October 1968 visit, when defendant Carey tested Mrs. Helling's eye pressure and field of vision for the first time, he dis- covered that she had glaucoma.2 Barbara Helling was then 32 years old. 1. 83 Wash. 2d 514, 519 P.2d 981 (1974). 2. Glaucoma is a condition of the eye that interferes with the normal flow of intraocular fluids from the interior of the eye, with a resulting in- creased pressure upon the optic nerve. If pressure is not reduced, the re- sult is nerve atrophy and loss of vision. The first loss usually occurs in the periphery of vision, and one who has the disease is often unaware of it until the vision loss has become extensive. By the time a loss of pe- ripheral vision is realized, it is usually irreversible. DORLAND'S ILLUSTRATED MEDIcAL DICTIONARY 491 (23d ed. 1957). The primary diagnostic tools available to defendants were: 1. The ophthalmoscope through which the optic nerve itself may be seen (a cupping of the optic nerve can indicate nerve damage which can be verified by a visual field test). Atrophied optic nerves can be seen with the ophthalmoscope. 2. The Schiotz tonometer and the Goldman applanometer, each of which measures intraocular pressure, a test which takes approxi- mately 60 seconds, involves no damage to the patient and consists merely of placing the instrument against the eyeball. An abnor- mally high reading in the tonometer would require an immediate testing of the visual fields and immediate efforts to reduce the intra- ocular pressure. 3. The Tangent Screen, a five minute test used to test the visual fields, is likewise of no danger to the patient. If the visual fields are found to be reduced, a pressure test must be taken. Defendants, on two occasions in February of 1967 and in May of 1968, ex- amined plaintiff's eyes with an ophthalmoscope, but did not conduct a pres- sure test or a visual field test. Brief for Appellant at 5, Helling v. Carey, 83 Wash. 2d 514, 519 P.2d 981 (1974). [Vol. 11

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