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Greco v. United States

Citation. Greco v. United States, 531 U.S. 1027, 121 S. Ct. 600, 148 L. Ed. 2d 513, 69 U.S.L.W. 3364 (U.S. Nov. 27, 2000)
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Brief Fact Summary.

The United States District Court for the District of Maryland submitted to the Supreme Court of Nevada a certification order requesting the court to answer certain questions related to the negligently caused unwanted birth of a child, who suffered birth defects.

Synopsis of Rule of Law.

Medical malpractice, like other forms of negligence, involves a breach of duty which causes injury. To be tortiously liable a physician must have departed from the accepted standard of medical care in a manner that results in injury to a patient.


The Grecos (Plaintiff), mother and child, sought damages in an action alleging negligence on the part of physicians who, they contended, failed to detect prenatal defects and anomalies. Their purported negligence, Plaintiffs asserted, denied Greco the opportunity to terminate her pregnancy and avoid the birth of a deformed and unwanted child. On behalf of the child, the mother brought a “wrongful life” action claiming that the denial of right to terminate resulted in the child’s life of abnormality, pain and deprivation.


May a plaintiff bring a medical malpractice claim when physicians failed to inform her of birth defects in her unborn fetus thus denying her the opportunity to terminate her pregnancy?
* May a mother seek recovery for “wrongful life” after delivering a severely deformed child when, had she been informed of the status of the fetus’ health, she would have elected to terminate her pregnancy?


The court held that the malpractice complaint had a claim for negligent malpractice, but she did not have a complaint on behalf of her minor child for wrongful life.


Several jurisdictions have upheld wrongful birth claims where physicians have failed to warn expectant parents that the fetus was in genetic difficulty. The standard employed is the plaintiff’s showing the defendant’s negligent failure to diagnose the condition that gave rise to the birth defect deprived the plaintiff the opportunity to terminate the pregnancy. In contrast, a wrongful life action is an action, brought by parents on behalf of the infant born in an impaired condition, claiming, in essence, that being born was the injury. The court in Greco was not yet prepared to do so: “[i]mplicit in [the wrongful life claim] is the assumption that the child would be better off if he had never been born. These kinds of judgments are very difficult if not impossible to make.”
With regard to the medical malpractice claim, however, the court takes an interesting approach. Initially, the plaintiff did not allege medical malpractice, but rather rested her claim on the assertion of “wrongful life.” The court declined to alter the course of jurisprudence in Nevada with regard to such claims, and instead elected to treat Greco’s claim like other claims of medical malpractice under the rubric of professional negligence. The court then applies the following standard: “[t]o be tortiously liable a physician must have departed from the accepted standard of medical care in a manner that results in injury to a patient.” The court rejects the opposition’s two central arguments, that 1) she had suffered no injury; and 2) even if she had, the injury was not caused by her physicians. With regard to the first argument, the court notes that the United States relied on inapplicable case law, i.e., asserting that there was no distinction between the deliveries of a healthy vers
us a deformed child. In the latter instance, the emotional anguish and exorbitant costs, in the court’s view, constituted injury in fact. Second, the court stated that the United States mischaracterized the plaintiff’s legal argument; she had not asserted that the physicians’ actions had caused the fetus’ deformity, but that their failure to inform her denied her the opportunity to terminate her pregnancy. Thus, the court concluded, the harm suffered was causally connected to the physicians’ malprac.

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