On December 11, 2025, the Oregon Supreme Court confirmed that a medical professional can face ordinary negligence claims by nonpatient third parties for physical injuries caused by their patient, at least where the medical professional’s conduct unreasonably created a foreseeable risk of the kind of harm that occurred. Until Stone v. Witt, 374 Or 524 (Dec. 11, 2025), the prevailing view was that medical professionals were only liable for harm to their patients or certain others with a special relationship with the medical professional. The Court rejected this notion.

Crucially, however, the decision recognizes a limiting principle: a medical professional who meets the applicable standard of care will not be liable for harm later caused by their patient. In other words, the Court expanded who may sue, but it did not dilute the centrality of the professional standard of care as the measure for liability.

What happened?

The case arose from a tragic roadway incident in which an allegedly impaired driver struck and killed a cyclist. The cyclist’s estate sued the driver and also sued the driver’s physician and pharmacist alleging they negligently prescribed and dispensed highly addictive medications for pain and anxiety despite knowing (or having reason to know) the patient was addicted to and abusing the medications. The estate asserted that the medical professionals should be liable under ordinary negligence principles for the harm caused by their patient because it was foreseeable that their patient would drive while impaired and injure others on the road.

The trial court dismissed the case for failure to state a claim, reasoning that medical professionals could not be liable to nonpatient third parties for their professional negligence. The Supreme Court affirmed the reversal by the Oregon Court of Appeals in a 30-page opinion that drew two separate concurrences.

In reaching its decision, the Oregon Supreme Court explained that there is no “protective bubble” around medical professionals that limits their liability only to patients for conduct that creates a foreseeable risk of physical harm.  Instead, ordinary common-law negligence principles apply to medical professionals, like all others.  That is, to the extent that breaches in the applicable standard of care in treating a patient also create risks of physical injuries to others, nonpatients foreseeably injured by that breach can sue a medial provider or pharmacist.

Importantly, Stone does not otherwise change the elements of an ordinary negligence claim. Under Oregon common-law negligence principles, a plaintiff generally may not recover for purely emotional or economic injuries absent “special” circumstances that create a legally cognizable protected interest and corresponding obligation, even if the injury was foreseeable.  Special obligations can arise from sources such as statutes, court orders, or special relationships (including the physician–patient relationship).  Thus, while a medical professional should not ordinarily face claims of negligence by nonpatients absent physical harm, patients and others with whom there is a special relationship (for example, in some circumstances, the patient’s parents) may be able to state a claim for purely emotional or economic harm. See Tomlinson v. Metropolitan Pediatrics, LLC, 362 Or 431, 412 P3d 133 (2018) (recognizing that the parents of a child had a sufficient relationship with the child’s physician to pursue a negligence claim for emotional injuries they allege to have suffered when a diagnosis was missed).

As with other defendants, a medical professional is not ordinarily liable in “failure to rescue” scenarios, that is, for merely failing to intervene to prevent harm from a risk the professional did not create (again—absent a special relationship or circumstance).

Regardless, the Court’s holding in Stone makes clear that liability for a medical professional’s conduct is broader than what had been generally understood, and in Oregon, a nonpatient third party need only plead and prove that the medical professional’s conduct breeched the standard of care and caused them foreseeable physical harm.

Why does this matter for healthcare organizations and medical professionals?

1. 1. Divided loyalties and chilling effect. The expansion of ordinary negligence liability to nonpatient third parties may threaten the integrity of the physician-patient relationship by creating divided loyalties: the threat of liability places the interests of others in competition with those of the patient in the exam room. While there can be no liability when the standard of care is met, it is possible that Stone may have a chilling effect on certain medically necessary treatments.Medical professionals treat patients prospectively, but tort liability is imposed retrospectively. Even the most competent and diligent providers cannot be sure a jury will later agree that their sound choices met the standard of care. And where the standard of care may permit more than one reasonable option—for example, where prescribing or not prescribing could both be appropriate—fear of third-party suits could unduly influence the provider’s exercise of judgment to the detriment of their patient.

      Indeed, the decision provides yet one more reason that some medical providers may decline taking certain individuals as patients, such as those who have known histories of violent behavior, drug abuse, or other unpredictable conditions. In 2022, OHSU published a study indicating that Oregon has the fourth highest rate in the nation of people who cannot access mental health care. And it is well known that psychiatrists and other mental health care providers rarely take on new Medicaid patients. So, people with serious addiction and mental health issues, especially if they are poor, may find it even harder to find the medical help they need in light of Stone.

1. 2. Day-to-day prescribing decisions may require explicit “foreseeability thinking.” The Court’s framing of the issues invites plaintiffs to argue that certain patient histories and “red flags” make third-party harm foreseeable (g., known misuse, escalating doses, early refill requests, dangerous drug combinations, repeated warnings, prior overdoses, documented impairment, or continued driving). Because courts may scrutinize why a patient’s therapy was commenced, continued, or altered, especially when impairment risks are apparent, clinicians and pharmacists may want to consider their policies and practices for documenting counseling and impairment warnings.
   3. Documentation and stewardship become even more central “front-line” tools. Because liability is still a matter of whether conduct was reasonable under the applicable standard of care, expect cases to turn on the paper trail: charting of risk assessment, Prescription Drug Monitoring Program review, red-flag evaluation, counseling (including impairment/driving warnings), and the clinical rationale for dose/refill decisions.Stone thus increases the value of consistent, systemwide approaches because inconsistency (across sites or providers) is often used as evidence of “unreasonableness.”

1. 4. Broader liability exposure. Plaintiffs’ firms will view Stone as a roadmap for wrongful death and serious injury claims by nonpatients tied to alleged prescribing and dispensing failures where impairment-related harm to friends, family, or the public is alleged as foreseeable, especially those involving opioids, benzodiazepines, and other sedating medications.
   5. Increased defense costs. Without a clear bar on liability to nonpatient third parties, lawsuits from such parties are likely to survive early motions practice, at least where physical harm and foreseeability are plausibly alleged. Knowing that courts are likely to allow these cases to proceed, the potential burden of litigation just increased.

Is this the final word?

Stone is unlikely to be the final word on medical professionals’ ordinary negligence liability to nonpatient third parties, especially because third-party exposure may threaten the integrity of the physician-patient relationship by dividing loyalties and chilling the provision of much needed mental health care.

Do the societal benefits of allowing tort remedies for nonpatients outweigh the costs that potential liability to third parties may impose on the relationships between medical professionals and their patients? Reasonable minds can disagree.

Given the potential for patient care to be compromised, the Legislature may wish to carefully weigh the public policy implications and consider raising the bar on liability to nonpatient third parties.

This article summarizes aspects of the law and opinions that are solely those of the authors. This article does not constitute legal advice. For legal advice regarding your situation, you should contact an attorney.