Superior Court Addresses Scope of Immunity Provisions Under the Mental Health Procedures Act

In the case of Toth v. Chambersburg Hospital, No. 208 MDA 2024 (Pa. Super. Oct. 15, 2024 Stevens, P.J.E., Panella, P.J.E., and Lane, J.) (Op. by Stevens, P.J.E.), the Pennsylvania Superior Court affirmed the entry of a summary judgment in a case involving a Plaintiff who was diagnosed with dementia and who was injured after falling while pushing an aide away and attempting to run while under the care of a hospital.

A central issue raised in this matter was whether the Defendant was entitled to immunity under the Mental Health Procedures Act.  The Plaintiff argued that the process of walking a patient in a medical facility did not fall under the types of "treatment" for which immunity is afforded under the Act.  

The Superior Court agreed with the trial court's ruling that decisions regarding the ambulatory care of mental health facility residents within a facility are governed by the Mental Health Procedures Act and subject to the statutory immunity limits under the Act.

The Court separately ruled that the facts of the case did not support the claim of gross negligence asserted by the Plaintiff.  More specifically, the Court noted that the circumstances of the Plaintiff’s injury, which involved a Plaintiff falling after pushing an aide away and attempting to run, could not possibly rise to the level of an allegation of gross negligence on the part of the Defendants. The Pennsylvania Superior Court noted that legislature intended that “gross negligence” refer to a form of flagrant negligence where the facts support findings of liability substantially more than ordinary carelessness.

Anyone wishing to review a copy of this decision may click this LINK.


I send thanks to Attorney James M. Beck of the Philadelphia office of Reed Smith law firm for bringing this case to my attention.

Court Denies Summary Judgment For Defendant Claiming Immunity Under the Mental Health Procedures Act

In the case of Redos v. UPMC Susquehanna, No. 19-00528 (C.P. Lyc. Co. Sept. 6, 2023 Carlucci, J.), the court denied Defendant medical providers’ Motion for Summary Judgment on a Plaintiff’s claim alleging professional liability regarding the treatment of a patient who was allegedly suffering from a mental illness.

According to the Opinion, the Plaintiff’s decedent sought emergency room treatment for symptoms allegedly stemming from his alleged recent drug use. The decedent was transported to another hospital for medical clearance prior to being admitted to a third facility for in-patient psychiatric treatment.

While at the Defendant’s hospital, the decedent was assessed as suffering from delirium. On his third day at that facility, the decedent exhibited bizarre behavior and jumped off the hospital’s roof, resulting in multiple injuries. The decedent died several years later from unrelated reasons.

This lawsuit was brought relative to the care provided to the decedent. After discovery, the Defendants moved for summary judgment based, in part, on the limited immunity afforded under 50 Pa. C.S.A. §7114 of the Mental Health Procedures Act.

 The court denied the Defendants’ motion where the Plaintiff’s expert opined that the Defendants acted in gross deviation from the standard of care for a patient suffering from delirium.

As a result, the court found that the Defendants could be ineligible to assert the limited immunity afforded under the Mental Health Procedures Act.

Anyone wishing to review a copy of this decision may click this LINK.

Pennsylvania Superior Court Reviews Immunity Provisions of Mental Health Procedures Act in Case of Voluntary In-Patient Examinations

In the case of Matos v. Geisinger Medical Center, No. 1189 MDA 2021 (Pa. Super. March 10, 2023 Stabile, J., Bender, P.J.E., Stevens, P.J.E.) (Op. by Stabile, J.), the court, addressing an interlocutory appeal that was allowed by permission, affirmed the trial court's denial of the Defendant's motion for summary judgment in a medical malpractice case involving the application of the Mental Health Procedures Act.

The Superior Court agreed that a Defendant is not absolutely immunized from a Plaintiff’s lawsuit under the Mental Health Procedures Act.

According to the Opinion, in this matter, the Defendants allegedly refused a patient’s attempt to commit himself voluntarily for in-patient treatment and, shortly thereafter, that patient killed his girlfriend, who was the Plaintiff’s decedent.

The court found that the immunity requirements under the Mental Health Procedures Act are different for involuntary and voluntary treatment scenarios.

The Pennsylvania Superior Court ruled that mental health facilities can be liable for the refusal to provide voluntary in-patient examinations and treatment when the refusal amounts to a willful misconduct or gross negligence on the part of the Defendant.

Anyone wishing to review a copy of this decision may click this LINK.


I send thanks to Attorney James M. Beck of the Philadelphia law office of the Reed Smith law firm.

Scope of Civil Liability Under the Mental Health Procedures Act

In the case of Leight v. Univ. of Pittsburgh Physicians, No. 2018 Pa. Super. 359 (Pa. Super. Dec. 31, 2018 Bender, P.J.E., Lazarus, J., and Musmanno, J.) (Op. by Musmanno, J.), the Plaintiffs appealed from a dismissal of their personal injury claims under the Mental Health Procedures Act against the University of Pittsburgh Medical Center and other physicians who had treated a mentally ill person that had injured the Plaintiff in a shooting incident.  

The Plaintiffs filed suit against the medical providers alleging a failure to warn and negligence of their treatment of the shooter.   The Plaintiffs alleged that, although the shooter had increasingly violent encounters and had been treated for both schizophrenia and medication non-compliance, the medical providers allegedly failed to file commitment papers and had, instead, terminated their relationship with that mentally ill patient.  
 The Defendants filed Preliminary Objections asserting that there was no duty to warn or to protect the Plaintiff from the shooter under the Mental Health Procedures Act.  

The Superior Court affirmed the trial court's dismissal of the claims based upon a ruling that the Mental Health Procedures Act did not apply to voluntary outpatient treatment.  

More specifically, the Superior Court noted that the physicians’ mere consideration, during voluntary outpatient treatment of a patient, of  possibly initiating an involuntary examination of a suspected mentally ill person was insufficient to trigger the scope and provisions of the Mental Health Procedures Act.  

The court further specified that a plain reading of the Act showed that it only applied to involuntary treatment and voluntary inpatient treatment of mental ill persons.   Accordingly, the court held that the cause of action provision of the Act did not apply to the voluntary outpatient treatment that the shooter had received from the physicians in this case.   

Anyone wishing to review a copy of the decision may click this LINK. 

Source: “Digests of Recent Opinions.” Pennsylvania Law Weekly (Jan. 22, 2019).  
 

Pennsylvania Superior Court Applies Intricacies of Limited Immunity Provision of the Mental Health Procedures Act in a Med Mal Case

In the case of Dean v. Bowling Green-Brandywine, No. 963 MDA 2017 (Pa. Super. July 2, 2018 Gantman, P.J., Panella, J., and Dubow, J.)(Op. by Panella, J.), the Pennsylvania Superior Court addressed the issue of whether a trial court properly entered a nonsuit against the Plaintiff under an application of the limited immunity provision of the Mental Health Procedures Act (MHPA).

Ultimately, the Superior Court affirmed the entry of the nonsuit in favor of some Defendants but not others in the matter.

The court noted that the limited immunity provision of the Act is intended to limit the criminal and civil liability of those charged with treating the mentally ill.  Under the Act, those engaged in treating mentally ill individuals "under the act" cannot be held liable absent "willful misconduct or gross negligence."

The court generally noted that the Act applies to the "voluntary inpatient treatment of mentally ill persons."  Prior to this decision, the term "mentally ill persons" had not been defined by the Act or case law.

According to the Opinion, the case involved a twenty-three year old individual who voluntarily applied to a treatment facility to address his addiction to pain medications he had been taking as prescribed for injuries following an ATV accident.  Less than ten days after his admission, the individual was found unresponsive on the floor of his room in the treatment center.  He subsequently passed away.

Thereafter, a medical malpractice suit was filed against several Defendants, some of whom pled the limited immunity provision of the MHPA as a defense.  During the course of trial, the remaining Defendants requested, and were granted, permission to add that defense to their pleadings.

At the close of the Plaintiff's case, the trial court granted a nonsuit in favor of all of the Defendants, finding that the Plaintiff had failed to show evidence of willful misconduct or gross negligence on the part of the Defendants and that, as such, the Defendants were entitled to the protections of the limited immunity provision.

In its Opinion, the Superior Court affirmed that the limited immunity provision was an affirmative defense ("immunity from suit") that has to be pled as an affirmative defense in a defendant's pleadings.

The appellate court reviewed the entry of the nonsuit with regards to each specific Defendant, finding that some Defendants were indeed entitled to a nonsuit, and others were not.  A critical question in this case was whether the treatment of the decedent's addiction amounted to a treatment of a mental illness with respect to each particular Defendant.

Anyone wishing to review a copy of this decision may click this LINK.

I sent thanks to Attorney Cynthia L. Brennan of the Berwyn, PA law office of Post & Post for bringing this case to my attention.

Judge Minora of Lackawanna County Denies Motion for Reconsideration in Medical Malpractice Case

In a recent decision in the case of Rarrick v. Silbert, No. 2002-CV-4951 (C.P. Lacka. Co. June 23, 2015 Minora, J.), Judge Carmen D. Minora, of the Lackawanna County Court of Common Pleas, denied a Defendant’s Motion for Reconsideration of his previously denial of the Defendant’s Motion for Summary Judgment in a medical malpractice case against a psychiatrist and another Defendant entity in a case involving allegations that the Defendants failed to take appropriate steps to avoid a situation with an emotionally unstable individual from escalating into a hostage-taken event for the Plaintiff and her family members that had to be defused by police intervention.  

Judge Minora laid out the standard of review for Motions to Reconsideration and found that the Defendant’s motion had been timely filed.

Judge Minora rejected the defense contention that, since the Court found in its previous decision in the matter that there was no common law duty owed to the Plaintiff, there could be no valid claim by the Plaintiff.   To the contrary, Judge Minora found that the Mental Health Procedures Act created a statutory duty of care owed to the Plaintiff that allowed the claim to proceed. 

The Court also rejected the defense argument that the Plaintiff failed to produce expert report as required by Pennsylvania law to move forward on the claims presented.   In so ruling, Judge Minora found that this case fell within those types of cases where the alleged negligence and/or the alleged lack of skill and/or the alleged lack of due care averred was so obvious as to be within the realm of a layperson’s normal understanding based upon the ordinary experience and comprehension such that expert testimony is not required.    

As such, the court denied the Defendants’ Motion for Reconsideration.  

 

Anyone desiring a copy of this decision may contact me at dancummins@comcast.net.

Judge Minora of Lackawanna County Addresses Liability of Mental Health Professionals for Harm Caused by Mentally Unstable Patients

In the case of Rarrick v. Silbert, No. 2002 CV 4951 (C.P. Lacka. Co. March 24, 2015 Minora, J.), Judge Carmen D. Minora denied a motion for summary judgment filed by the defense in a medical malpractice case against a psychiatrist and another defendant entity in a case involving allegations that the defendant(s) failed to take appropriate steps to avoid a situation with an emotional unstable individual from escalating into a hostage-taking event for the Plaintiff and her family members that had to be defused by police intervention.

The defense argued that it was entitled to summary judgment because Pennsylvania law does not recognize a duty by mental health providers to protect unidentified third parties from the actions of mental health patients.  The defense also asserted that the Plaintiff had failed to offer evidence of gross negligence as allegedly required by the Mental Health Procedures Act.

The Plaintiffs countered with an argument that the Defendants stood in a special relationship with the Plaintiff that required the Defendants to take action to protect the Plaintiff and imposed upon the Defendants a professional duty to warn the Plaintiff of potential danger from her allegedly mentally unstable husband.  The Plaintiffs also asserted that there were issues of fact on the gross negligence question that prevented the entry of summary judgment.

Judge Carmen D. Minora
Lackawanna County

After reviewing the applicable law, Judge Minora agreed that, under the Restatement of Torts, there was no duty to control the conduct of third persons unless a special relationship existed.  However, there was case law noted by the court that a mental health professional may have a duty to protect by warning others of potential danger in extremely limited circumstances involving specific and immediate threats of serious bodily injury to a specifically identified individual or a readily identifiable individual.

Here, while there was evidence that the family members of the allegedly mentally unstable individual contacted the psychiatrist leading up to the incident, there was no threat voiced by the allegedly mentally unstable person to the psychiatrist found in the record.  Accordingly, Judge Minora found that the Plaintiff's argument failed to support a finding of a creation of a duty owed by the psychiatrist to the Plaintiff in this regard.

However, Judge Minora found that issues of fact on the gross negligence allegations of liability under the Mental Health Procedures Act question, prevented the entry of summary judgment in this matter.

Judge Minora also address issues with respect to the production of expert reports 1042.28.

Anyone wishing to review a copy of this decision by Judge Minora in the Rarrick case, may click this LINK.