Copithorne v. FRAMINGHAM UNION HOSPITAL.

Lynch, J.

(dissenting). I dissent for the following reasons. First, I do not agree that the hospital owed a duty to Copithome in the circumstances of this case. The existence of a duty is an essential prerequisite to liability for negligence. Yet no decision in Massachusetts, or elsewhere of which I am aware, imposes a duty of care in similar circumstances.

The court’s reliance on Mullins v. Pine Manor College, 389 Mass. 47, 62-63 (1983), is misplaced. In Mullins, a college student was raped on campus as a result of the college’s negligent provision of security measures. The duty discerned there was grounded on two principles of law. First, a duty of the college, found in “existing social values and customs,” to protect the security and well-being of its resident students, and second, on the notion that the college, once having undertaken *867to provide security measures, was duty-bound to provide those measures with due care. See id. at 51-54.

It may very well be that a hospital owes the patients of a visiting staff physician, who are also under its care, a similar duty. It cannot be said, however, that existing values and customs establish a duty of the hospital to protect its patients from the criminal acts of independent physicians occurring off the hospital premises and arising from a private and independent doctor-patient relationship. On the contrary, existing values and customs compel the conclusion that no such duty exists. The hospital is under no more obligation to such a physician’s patient than Pine Manor College would have been if that rape had occurred off campus during a holiday or vacation. Even those States that have imposed a direct duty of care on a hospital with respect to the patients of staff physicians, where the traditional doctrine of respondeat superior would have absolved the defendant, have not gone so far as to impose civil liability on a hospital for an act committed off the hospital premises. See cases cited in Note, Hospital Corporate Liability: An Effective Solution to Controlling Private Physician Incompetence?, 32 Rutgers L. Rev. 342, 360-367 (1979). Where the doctrine of corporate liability has been applied to impose liability on a hospital for the negligence of staff physicians who are independent contractors, it has been done because of the duty of care that the hospital owes to its patients. “The hospital’s liability is based on a duty of care owed by the institution directly to patients to ensure their safety and welfare while within its confines’’’ (emphasis supplied). Id. at 360. To extend a hospital’s duty of care for physicians’ acts occurring off hospital premises is not only not based on existing values and customs but, also, it seems to me, contrary to both good policy and common sense. Sound policy may suggest that a hospital have some responsibility for acts occurring on its premises in order to ensure that a hospital exercises care in supervising the activities that occur within its boundaries. Since it can have no control over the activities that occur off hospital premises, imposing liability would only increase the already skyrocketing cost of inpatient hospital care (see Schramm, A State-Based *868Approach to Hospital-Cost Containment, 18 Harv. J. on Legis. 607, 609-614 [1981]), because of conduct over which the hospital has no control. I can see no justification for hospital patients’ ameliorating (by paying the hospital’s charges) the risks attendant upon a private doctor-patient relationship simply because a given physician has been granted visiting staff privileges by the hospital. The plaintiff’s allegations that she would not have consulted Dr. Helfant had he not had staff privileges in spite of the fact that she had known him for four years, had a brief affair with him, and worked with him in a professional relationship until the events in question do not require imposing such liability. Therefore, I would hold the hospital had no duty to protect the plaintiff from the risk of being raped in her own home by a fully accredited neurosurgeon who was a member of the hospital’s visiting staff.

I also conclude that no act of the hospital was the proximate cause of the plaintiff’s injuries. Basic tort principles teach that the intentional and unforeseeable criminal act of a third party is a superseding intervening cause. Restatement (Second) of Torts § 448 (1965). J.R. Nolan, Tort Law § 204, at 320 n.51 (1979), and cases cited.

It is not enough to declare that the doctor’s actions were “foreseeable” and that, hence, there is no obligation to deal with the question of proximate cause. What events are foreseeable necessarily depends upon the underlying conduct of the defendant. Here that conduct was the hospital’s failure to revoke the physician’s staff privileges in the face of allegations of sexual misconduct on hospital premises. Certainly if fair investigation of these complaints indicated that there was reason to believe that the misconduct complained of had taken place and no remedial action had been taken, it would have been foreseeable that similar incidents might recur. In this instance, however, the hospital responded to the complaints by prohibiting Helfant from unchaperoned contact with its female patients. If the hospital had failed to act, it may have been foreseeable that Helfant would commit sexual assaults on hospital premises, but the hospital’s response would appear to have eliminated that possibility. Helfant’s hospital staff privileges had no rela*869tion to Helfant’s ability to assault his private patients sexually in their homes or at his office. That opportunity existed in the absence of his visiting staff privileges. Since that is so, Helfant’s criminal acts were not legally foreseeable and the hospital’s failure to terminate his staff privileges cannot be the legal cause of the plaintiff’s injuries because they were caused by the intervening or superseding criminal act of a third person. Therefore, no legal or proximate cause exists.