Torts—Duty of Psychiatric Hospital to Mentally Ill Patient
Estate of Timothy Maudsley v. Meta Services, Inc., __Ariz. Adv. Rep. __ 1 CA-CV 10-0494 (App. Div. I, June 23, 2011) (J. Morris)
ARIZONA'S MENTAL HEALTH STATUTES AND A DOCTOR-PATIENT RELATIONSHIP EACH CREATE A DUTY BY PSYCHIATRIC HOSPITAL AND PSYCHIATRIST TO EXERCISE REASONABLE CARE IN INTAKE, EVALUATION, TREATMENT AND DECISION TO HOSPITALIZE MENTALLY ILL PATIENT
Plaintiffs brought a wrongful death action against defendants alleging psychiatric malpractice. The trial court granted defendant summary judgment finding no duty was owed the plaintiffs' decedent Timothy Maudsley by the defendants and the Arizona Court of Appeals reversed.
Maudsley was a patient at the defendants' psychiatric facility when a psychiatrist there petitioned for a court ordered evaluation of him. The petition was supported by an affidavit from Maudsley mother and his case manager establishing he did not appreciate his need for medication and treatment, walked away from the treatment center and refused voluntary evaluation. Twenty one minutes after the filing Maudsley was picked up with a swollen ankle by ASU police on the Tempe campus. Maudsley told the police he was mentally ill and needed help. He was referred to a crisis care organization which established that he had a pending petition hearing and that he needed to be taken to the defendants' hospital. He was in fact taken there and the receptionist was told he was a patient there and had a hearing regarding a court ordered evaluation that very morning. Maudsley was then interviewed and found to be in a “chronic psychotic condition” by a staff psychologist. Despite this, he was put in a wheelchair and wheeled across the street to Maricopa Hospital to have his ankle treated. While unattended he walked out of the waiting room at Maricopa Hospital. That night he was seen “jumping up and down” and “causing a scene” near a Phoenix intersection before being struck and severely injured by a car as he entered the roadway. He died from these injuries ten months later.
The court of appeals found the existence of a duty to Maudsley on two basis: public policy by virtue of Arizona's Mental Health statutes and by virtue of a doctor-patient relationship.
First under ARS sec. 36-501 to -591 the state legislature has expressed a strong public policy in favor of the initial screening of potential patients and voluntary versus involuntary treatment. As such, under the facts presented here the defendants had a duty to exercise reasonable care in screening Maudsley and encouraging voluntary treatment. Specifically, ARS sec. 36-526 (A) provides that a patient may be admitted on an emergency basis without court action if there is “reasonable cause to believe” the person is a danger to self or others and is likely to suffer serious harm or seriously harm others if not immediately hospitalized. This statute required defendants to exercise reasonable care in screening and evaluating Maudsley and to hospitalize him immediately if he reasonably appeared to be in danger.
Finally, Maudsley interaction with the defendants' staff and psychiatrist creates a question of fact as to whether a doctor-patient relationship existed. If it did exist, this special relationship in and of itself would require the defendants to exercise reasonable care in the intake, evaluation and decision not to immediately hospitalize Maudsley.