Summary
In Workman v. Cleveland Psychiatric Institute, 61 Ohio Misc.2d 190, 577 N.E.2d 131 (Ct.Cl. 1987), a plaintiff brought an action against a hospital for failing to admit her mentally ill husband, who died four days later in a shoot-out with the police.
Summary of this case from Tolton v. American Biodyne, Inc.Opinion
No. 84-08032.
Decided July 8, 1987.
Marvin H. Schiff and Thomas M. Tyack, for plaintiff.
William J. McDonald, R. Kevin Kerns and William J. Brown, for defendant.
This matter involves claims made by plaintiff, Rita Workman, Administratrix of the Estate of Mennis David Workman, now deceased, that the proximate cause of his death, directly resulting from being shot by members of the Cleveland Police Department, was the negligence of the defendant because of its failure and refusal to accept him as a patient and provide necessary observation and treatment.
The defendant denies any negligence on its part and asserts that there was never a refusal by any staff person or physician to treat or examine plaintiff's decedent. Furthermore, defendant asserts if defendant were negligent, which it specifically denies, then plaintiff's decedent was negligent to a greater degree which bars plaintiff's recovery, or in the alternative, plaintiff's recovery must be apportioned according to the Ohio Comparative Negligence Statute, R.C. 2315.19.
The primary issue before this court is whether or not the defendant failed to treat, diagnose and admit the plaintiff's decedent in the Cleveland Psychiatric Institute ("CPI") and if so whether this was a direct and proximate cause of the decedent's death.
On November 13, 1983, Mennis D. Workman voluntarily went to the emergency room of Cleveland Metropolitan General Hospital ("Metro") seeking help for psychiatric difficulties which he was experiencing. Mr. Workman came to the hospital accompanied by his wife. For several weeks prior to his going to Metro, the decedent, a thirty-year-old metal worker, had heard voices, had experienced fear that someone was going to kill or hurt him, and held the belief people were staring at him.
The decedent was seen by Michael Jordan, a physician who had no training in psychiatry. Dr. Jordan had a temporary license to practice medicine in Ohio for the purposes of serving his residency. His specialty is internal medicine.
Dr. Jordan determined that Mr. Workman was a mentally ill person who represented a substantial risk of physical harm to himself by evidence of threats of, or attempts at, suicide or serious infliction of bodily harm. Dr. Jordan diagnosed Mr. Workman as depressed and schizophrenic. He wrote an order pursuant to R.C. 5122.10 authorizing the decedent to be transferred to CPI, which is right across the street from Metro.
Dr. Jordan ordered a routine transfer to CPI, because Mr. Workman was there voluntarily and was not violent.
The policy at Metro, at the time of this occurrence, was to transfer all emergency psychiatric patients to CPI, via a short connecting tunnel, by wheelchair accompanied by an orderly and a security guard. Mrs. Workman also accompanied her husband. It was approximately 10:30 p.m. on November 13, 1983. From this point on there is a serious dispute of the facts.
Plaintiff testified that the guard from Metro handed the emergency application papers, which were marked at trial as plaintiff's exhibit 16, to the admissions clerk at CPI. Mrs. Workman describes the admissions clerk as being a heavy-set black woman in her forties. The defendant had the admissions clerk on duty at the time of the occurrence appear at trial to be identified by the plaintiff, which Mrs. Workman failed to do.
Mrs. Workman further testified that she and her husband sat down on the bench across from the admissions clerk and waited for approximately forty-five minutes before another individual came out and spoke with the couple. Then a doctor came out to see her husband. She described the physician as "looking phillipino" [ sic]. Mrs. Workman testified that the doctor, whom she later learned was a Dr. Park, came out on the morning in question to see her husband in the lobby where they had been waiting on the bench. She stated that the doctor told the couple that, "he understood Mr. Workman was experiencing difficulties. He wanted to help Mr. Workman and he was busy with other patients and that it would be two or three o'clock in the morning before he would be able to examine Mr. Workman."
Mrs. Workman indicated to Dr. Park that her husband had a court hearing the next morning and that they could not wait until the time the doctor was available. The doctor, according to Mrs. Workman, indicated that it would be all right for Mr. Workman to leave and that if it was necessary, he could come back.
Officer Abdul Waghoni of the Metro Security Department testified that he had no independent recollection of the events of November 13, 1983 and kept no records of his activities. He then read from the records kept in the dispatcher's office at Metro. He stated that he was shown in the Metro emergency room log as being on duty. Plaintiff's exhibit 24 indicates two individuals were transferred from Metro to CPI that evening. The first transfer was made of patient D.S. at 8:00 p.m. and the second of Mr. Workman at 10:15 p.m. The daily log (plaintiff's exhibit 23) states that at 10:36 p.m., Officer Waghoni was requested to transfer a patient from the emergency room to CPI and same was completed at 10:43 p.m. He then testified his routine practice was that he would hand the papers to someone at the admissions desk and then wait until he was told he could leave by CPI Security or by the doctor; not by the admissions clerk.
The security guard at CPI, Mr. Clarence Hawkins, testified he was on duty from 10:30 p.m. on the 13th until 6:30 a.m. on the 14th. The security office is adjacent to the admissions area and lobby and these areas can be observed from it. He had no independent recollection of November 13, 1983, but testified from his routine practice and from his own record of activities. His shift report (defendant's exhibit K) shows that from 10:30 p.m. until about 11:10 p.m. he was in the security office and was observing the admissions and lobby area. He then took a few minutes to escort a patient to a ward and then returned to the security office and stayed there until about midnight when he answered a page for an AWOL report on another patient. He stated that if a patient from Metro had been brought over by Metro Security with emergency application papers during the time that he was in the security office, he would have noted that in his report. Moreover, Mr. Hawkins testified that Metro sends patients over to CPI by themselves.
The admissions clerk, Virginia Oates, testified that she was the individual who was behind the admissions desk at CPI on November 13, 1983. She states that she was on duty from 2:00 p.m. to 11:30 p.m. and that no one replaced her because CPI did not have a third shift at the admissions desk on weekends. She was the only one on duty in the admissions area from 2:00 p.m. to 11:30 p.m. with the exception of a security guard and the medical doctor on duty. She further stated that under no circumstances has she ever simply handed over medical records or emergency application papers to a patient or a patient's family.
She further testified that as admissions clerk, she would immediately enter a patient's name in the "admission evaluation book," which is defendant's exhibit E.
Dr. Park testified that he was the medical doctor on duty on November 13, 1983. Dr. Park had no independent recollection of the events of November 13, but he based his testimony on his routine practice and his own notes of his activities that evening. These notes were entered into a logbook entitled "O.D. Record," which is defendant's exhibit H. Dr. Park stated that he never examines a patient unless he is first presented with the documentation from the admissions clerk. The logbook contains a record of each patient he evaluated, regardless of whether the patient he evaluated was admitted or not. He examined nine patients in a twenty-four-hour period surrounding the time at issue here, which he stated was above average. His logbook reveals that he finished his evaluation of one patient at about 10:50 p.m., another at 11:50 p.m., and that he did not have another patient until 2:00 p.m. He stated that the time 2:00 p.m. at the bottom of page 295 of the logbook was a mistake and it should have been 2:00 a.m. He further testified that his evaluation generally takes thirty minutes or so, so he would not have been busy between 11:50 p.m. and about 1:30 a.m.
The court notes that none of the documented evidence shows that the decedent was properly transferred to CPI. The only testimony which might have raised the possibility of a proper transfer was from Mrs. Workman. However, her testimony, coupled with that of Virginia Oates, the admissions clerk, brings into question how the admissions papers were in plaintiff's possession at the time of trial.
It is the opinion of this court that based upon all of the facts presented, plaintiff has failed to prove by a preponderance of the evidence that anyone at CPI was notified in any manner either that plaintiff's decedent was present or that emergency application papers had been filled out at Metro and the patient transferred to CPI.
Plaintiff asserts that R.C. 5122.10 establishes a duty of CPI to examine the decedent. Section 5122.10 of the Ohio Revised Code states in part:
"Any * * * licensed physician * * * may take a person into custody * * * and may immediately transport him to a hospital * * * if the * * * licensed physician * * * has reason to believe that the person is a mentally ill person subject to hospitalization by court order under division (B) of section 5122.10 of the Revised Code and represents a substantial risk of physical harm to himself or others if allowed to remain at liberty pending examination.
"A written statement shall be given to such hospital by the transporting * * * licensed physician * * * stating the circumstances under which such person was taken into custody and the reasons for the * * * licensed physician's belief * * *.
"A person transported or transferred to a hospital or mental health clinical facility under this section shall be examined by the staff of the hospital or facility within twenty-four hours after his arrival at the hospital facility."
This court further finds that plaintiff failed to prove by a preponderance of evidence that her decedent was transported or transferred to CPI in a manner that would invoke the statutory duty to examine.
In order for the plaintiff to sustain her burden of proof, she must prove by a preponderance of the evidence that the defendant was negligent by failing to treat or examine plaintiff's decedent and that such negligence was a proximate cause of the decedent's death.
A proximate cause is an act or omission which in a natural and continuous sequence produces the injury and without which the result would not have occurred. Proximate cause exists when the injury is a natural and probable result of a negligent act or omission.
If the cause is remote, it is immaterial that no injury would have occurred if such condition had not existed. If a new independent and unforeseeable act or omission directly causes injury where a remote cause existed the party who created the original condition is not responsible and is not the proximate cause of the injury.
In the instant case, there were superseding causes intervening to contribute to the decedent's death. Plaintiff states that when she went to court on the morning of November 14, 1983, she looked at her husband's admission papers and saw that he had been diagnosed as paranoid and schizophrenic. Knowing the seriousness of the diagnoses, plaintiff made no attempt to get her husband back to Metro or to CPI, nor did she make any attempt to get him to one of the mental health clinics.
Furthermore, plaintiff left a gun and bullets where the decedent could have access to them and he subsequently used the gun in an exchange of gun fire with the Cleveland Police which resulted in his death. This occurred three days after the plaintiff took the decedent to Metro.
The defendant, as a matter of law, is not responsible for the actions of an applicant who is denied admission for treatment when such acts took place four days following the date of his alleged application. Harris v. State (1976), 48 Ohio Misc. 27, 2 O.O.3d 358, 358 N.E.2d 639.
Even if the act of the defendant in not treating or examining plaintiff's decedent arguably constituted negligence, any possible causal connection between that negligence and the decedent's death is outweighed by the plaintiff's contributory negligence to such a degree that she is precluded from any recovery.
Plaintiff's case is ordered dismissed and judgment entered in favor of defendant.
Judgment accordingly.
GUY G. CLINE, J., retired, of the Pickaway County Probate/Juvenile Court, sitting by assignment.