Saturday, November 3, 2007

Hesitation to Sign a Safety Contract Not a Basis to Keep an Inpatient

In this case, the patient was not sure about contracting for safety. He committed suicide before his outpatient appointment. The plaintiff expert second guessed the release. Vengeful wife claimed a wrongful death. In such a claim, the plaintiff would get what the deceased should have were he alive to sue. Because the deceased killed himself, in general, in the common law, wrongful death claims are not logical. The appellate court reversed the verdict.

"... discharge team had departed from accepted standards of psychiatric care by failing carefully and competently to evaluate decedent following the discussion of the contract for safety at the March 8, 2001 discharge meeting. They concluded that such departure deprived decedent of a substantial possibility of avoiding suicide on March 14, 2001. Specifically, plaintiff testified that during the March 8, 2001 meeting, decedent "hesitated" when asked whether he would contract for safety with her. In its verdict, [*2]the jury found that the failure to reevaluate the discharge plan following decedent's "hesitation" constituted a deviation from accepted medical practice. We disagree."

Then, ""The prediction of the future course of a mental illness is a professional judgment of high responsibility and in some instances it involves a measure of calculated risk. If a liability were imposed on the physician or the State each time the prediction of future course of mental disease was wrong, few releases would ever be made and the hope of recovery and rehabilitation of a vast number of patients would be impeded and frustrated." (Centeno v City of New York, 48 AD2d 812, 813 [1975], affd 40 NY2d 932 [1976].)"

Where is the evidence from the plaintiff expert that any reassessment, or that keeping the patient an inpatient for weeks or months more would have prevented this suicide? The trial court permitted garbage science. It is unfortunate that the court fails to name the experts, so they may be held accountable.

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