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A New Jersey appeals court has ruled that a doctor is not liable for negligently prescribing drugs to a patient who was involved in a fatal crash.

Affirming a lower court ruling, the appeals court said psychiatrist Stefan Lerner of Princeton was not liable for the death of Judith Schrope, who was riding a bicycle when she was struck and killed by a vehicle driven by Lerner's patient, Barbara Mulford Dera. The appeals court said Lerner could not be found liable for the death because there was no evidence the drugs he prescribed caused Dera to strike Schrope.

The case drew amicus curiae participation from the American Medical Association and the Medical Society of New Jersey.

Schrope, 71, was riding on the right side of a residential road when Dera approached her from behind. A police report concluded Dera, 63, made no effort to move over to the left and safely pass Schrope, even though the roadway provided ample space to do so. There was no evidence that police conducted a field sobriety check, requested a blood draw or administered an Alcotest examination. Dera was convicted of careless driving after a municipal court trial.

At the time of the crash, Dera was prescribed at least six psychiatric medications—duloxetine (Cymbalta), lamotrigine (Lamictal), lithium carbonate (Lithobid), trasazone, dexmethylphenidate hydrochloride (Focalin), and methylphenidate (Concerta). In testimony, Dera knew little about the purposes or side effects of each drug, and admitted she often changed her dosages without consulting the doctor. Dera said Lerner never warned her against driving after taking her medication. She was diagnosed with major depressive disorder, attention deficit disorder and panic disorder, and exhibited symptoms of bipolar disorder.

Schrope's estate filed a lawsuit against Dera, and later filed an amended complaint naming Lerner as a defendant. Lerner moved for summary judgment, arguing he owed no duty of care to Schrope because she was not a readily identifiable victim. The estate opposed the motion and offered reports from two experts. Robert Pandina opined that Dera's ability to operate a motor vehicle was impaired when she hit Schrope, and Alberto Goldwaser said that Lerner's treatment of Dera fell outside the standards of care, and that the deviation was a contributing factor in Schrope's death.

Assignment Judge Yolanda Ciccone of Somerset County granted summary judgment to Lerner in May 2018. She relied on McIntosh v. Milano, a 1979 Superior Court case where a therapist was found to have a duty to protect a readily identifiable victim because the therapist had reason to know his patient presented a danger to the victim. Ciccone held that unless the victim of a therapist's patient is readily identifiable, there is not duty to act for the victim's benefit.

On appeal, the estate argued that New Jersey law is ripe for an extension of a prescribing doctor's duty of care. The estate asked the panel to adopt reasoning from other states that a prescribing practitioner owes a duty of warn a patient of adverse side effects of drugs for the benefit of third parties. But Judges Marie Simonelli, Mary Gibbons Whipple and Lisa Firko declined to make such a finding.

Whipple, writing for the appeals court, said that Ciccone's reliance on McIntosh was misplaced.

In analyzing the duty of care owed in a special relationship, the principal question is whether the defendant had a duty to act for the benefit of another but failed to do so, Whipple wrote.

Lerner had a duty to warn Dera of the side effects of the medications he prescribed, the court said. Therefore, Lerner can only be held liable for the foreseeable consequences of his actions, and the issue in the case should be framed as one of proximate cause, not duty of care, the court said.

The plaintiff's experts concluded that if Dera took all the medication she was being prescribed at the time of the crash, she would have experienced debilitating side effects, the panel said. However, this conclusion was not based on Dera's behavior at the time of the crash, the panel said.

“Considering the record's lack of direct or circumstantial evidence indicating [Dera] was impaired, the expert reports alone are insufficient to generate a genuine issue of material fact on the issue of [Dera's] impaired driving,” the panel said.

Justin Lee Klein of Hobbie, Corrigan & DeCarlo in Eatontown, who represented the estate of Schrope, did not respond to a request for comment. Sam Rosenberg of Rosenberg Jacobs Heller & Fleming in Morris Plains, who represented Lerner, and Philip Goldberg of Shook, Hardy & Bacon in Kansas City, who represented the AMA and Medical Society of New Jersey, also did not respond to a request for comment.