Neade v. Portes

Anthony Neade (plaintiff) was a 37-year-old man who was overweight, smoked, suffered from hypertension, and had a high cholesterol count. Anthony began to experience chest pain and shortness of breath and visited his primary-care physician, Dr. Steven Portes (defendant), who worked at a family center under contract with a health-maintenance organization (HMO). Portes admitted Anthony to the hospital for a thallium stress test and an electrocardiogram. Another physician interpreted the test results as normal and diagnosed Anthony with non-cardiac-related conditions. Portes discharged Anthony from the hospital. Anthony continued to experience intermittent symptoms of coronary artery blockage over the following year and visited Portes at the family center on multiple occasions to report these symptoms. Portes’s associates at the family center twice recommended that Anthony undergo an angiogram, a specific test for diagnosing coronary artery disease, but Portes relied on the earlier test results and did not authorize an angiogram. Three months later, Anthony suffered a massive myocardial infarction due to coronary artery blockage and died. Anthony’s wife, Theresa Neade (plaintiff) brought an action against Portes, alleging claims for medical negligence and breach of fiduciary duty. Theresa claimed that a contract between Portes and the HMO provided a medical incentive for Portes not to order outside tests for patients. Theresa claimed that Portes breached his fiduciary duty to Anthony by failing to disclose this HMO incentive not to authorize the recommended angiogram. Portes moved to dismiss the breach-of-fiduciary-duty cause of action. The trial court dismissed the cause of action. Theresa appealed. The appellate court reversed and held that Theresa pleaded different facts, thus supporting a separate breach-of-fiduciary-duty claim against Portes. Portes appealed.