Prosecutor Suicides After Being on TV, Suit May Proceed

Here.

Vengeful Parents Sue MySpace After Daughter Has Sex with Adult, Hangs Self

Here. The daughter hanged herself after the adult suggested stopping having sex, not because they had sex. The parents tried to control their daughter. They failed to do so, despite their having control over her body and over her computer. They fail in their parental duty, but they sue a provider of a service. The making of accusations runs in the family. After the adult just wanted to be friends, the girl says, she was raped.

Some tort savvy sarcasm about the scope of duty from readers:

They should sue whoever paved the road he traveled on to pick her up.

Posted by: Woody | Feb 26, 2008 10:46:47 AM

So if I meet a women at supermarket and she commits suicide, then the supermarket is to blame?

Posted by: Robert | Feb 26, 2008 10:57:43 AM

Social Network Postings Subject to Discovery

Here. That should include all family members, expert, and the opposing counsel. One is searching for facts for the defense, and for improper motives. The latter are for the counter suit.

Radio Interview of Plaintiff Family and Skippy

Here. I found it unfortunate the hospital chose to settle. They invited more of these cases, since lawyers learn from case experience. No case should settle, to protect clinical care from the plunder of these lawyer predators. All plaintiffs and plaintiff attorney should be countersued. Ethics charges should be brought against the plaintiff attorney, since all suicide cases are facially frivolous. They scapegoat the defendant for an intentional act of another that cannot be stopped.

All plaintiff experts should be be disqualified. If they cannot be disqualified, they should be impeached for promulgating ideologically based garbage science. Every word of their testimony should be parsed for perjury. If perjury about a fact is found, it should be referred to the District Attorney for investigation and possible prosecution.

The psychiatrist interviewer promulgates dubious science. She is a frequent expert witness. She presents no balance whatsoever, to the biased and misleading claims of the plaintiff side. "Oh well, that is so sad," she agrees. She blames the prescribing of anti-depressants by non-psychiatrists as a factor in skyrocketing suicide. Suicide rates have been dropping, as more family doctors have chosen to treat depression. This psychiatrist self-serving claim has no evidence. The psychiatrist list deviations from her own invented standards of care. None carries any evidence of preventing suicide. He should have been seen in one hour of arrival. His belt should have been removed.

The vengeful, scapegoating family contains mental illness. The suicider experienced relationship problems. Skippy chimes in with his psychiatric expertise. He knows all about the thinking and tactics of the suicider. "You can kill yourself easily in 15 minutes," he asserts. "Of course, it was about money, the $1000 a day." "This is across the country, 1600 patients a year die of suicide." (in hospitals). Skippy tells us that patients be made to waive confidentiality. Perhaps, Skippy can get an injunction against the patient who wants nothing to do with his toxic family. Make sure what observation level is selected, and accept no less than observations every 5 minutes apart. Review the after care plan to insure safety after discharge, and seen on a frequent basis. He refers those who want to learn about managing suicidal patients to this site. So advises Skippy.

These plaintiffs will not share the plaintiff expert opinion for public review. I do not know why.

The biased interviewer forgot to ask, 1) was this an open facility, and the suicider a voluntary patient?; 2) if staff had laid a hand on the suicider, what criminal charges (plus this) and torts could they have generated for themselves? Skippy failed to address a standard of care that is breaks the law, and is an intentional tort itself.

Poor Communicators Get Sued - Good

Reviewed here. The complaints of the plaintiff listed in the article should be elicited during depositions. These are outside of compensation. They show the scapegoating of the defendant by the plaintiff, and the exploitation of a family tragedy for pecuniary gain. They may represent improper motives for the lawsuit.

Rage May Be an Improper Motive in Litigation

Here, father expresses his emotions. These feelings should be explored in any deposition, and may support a motion to dismiss the case.

Use of Web Widespread

According to this survey.

This means the reasonable person in the US of the recent past has access to the Internet. That establishes a duty to inform oneself about any medication or other treatment.

The claim of lack of informed consent no longer has any merit.

$13 Million To Brothers of Woman Who Committed Suicide Day After Refused Treatment for Lack of Insurance

Mentioned in this article, toward the bottom. I don't know how treatment would have prevented a suicide the next day. Only long term treatment can prevent suicide. I would like to get more facts about the case.

Alleged Abuser of Suicider Sues Hospital for her Suicide

The judge in the case should be immediately impeached.

No Criminal Charges for Suicide After Cyberbullying

Reported here. Social consequences of cyber bullying reviewed here.

The defense should demand all electronic communications to review them for cyber-bullying. The defendant should file a cross claim against any cyber-bully and any enabler. The insurance company lawyer may refuse to attack back. The private lawyer might have to defend the rights of the defendant when the insurance defense lawyer refuses.

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.

Why Patients Sue

Findings without comment here. These motivations represent a checklist of questions to be posed during depositions of the plaintiff.

As reviewed in Physician Protect Thyself, by Alan G. Williams, JD, Margol, Denver, CO, 2007. Pp. 23-30. They felt deserted. They felt their concerns were not taken seriously enough. Providers failed to convey information well enough. They felt the provider did not understand them. They cited poor communication after an adverse event and an attempt to cover it up. They filed a lawsuit to find out more.

Arch Phys Med Rehabil. 2007 May;88(5):589-96. What patient attributes are associated with thoughts of suing a physician? Fishbain DA, Bruns D, Disorbio JM, Lewis JE.

RESULTS: The highest percentage (11.5%) of patients affirming the S-MD statement were those involved in workers' compensation and personal injury litigation, compared with only 1.9% of community-living subjects. Stepwise regression of BHI 2 variables produced a 13-variable model explaining 38.04% of the variance. A logistic regression of demographic variables (eg, education, ethnicity, litigiousness) explained 20% of the variance. CONCLUSIONS: Anger (P<.001), mistrust (P<.001), a focus on compensation (P<.001), addiction (P<.001), severe childhood punishments (P<.001), having attended college (P<.001), and other patient variables were associated with thoughts of suing a physician.


N Engl J Med. 2006 May 11;354(19):2024-33. Claims, errors, and compensation payments in medical malpractice litigation. Studdert DM, Mello MM, Gawande AA, Gandhi TK, Kachalia A, Yoon C, Puopolo AL, Brennan TA.

RESULTS: For 3 percent of the claims, there were no verifiable medical injuries, and 37 percent did not involve errors. Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy--nonpayment of claims associated with errors. When claims not involving errors were compensated, payments were significantly lower on average than were payments for claims involving errors (313,205 dollars vs. 521,560 dollars, P=0.004). Overall, claims not involving errors accounted for 13 to 16 percent of the system's total monetary costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including those involving lawyers, experts, and courts). Claims involving errors accounted for 78 percent of total administrative costs. CONCLUSIONS: Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant.

N Engl J Med. 1996 Dec 26;335(26): Relation between negligent adverse events and the outcomes of medical-malpractice litigation. Brennan TA, Sox CM, Burstin HR.

RESULTS: Of the 51 malpractice cases, 46 had been closed as of December 31, 1995. Among these cases, 10 of 24 that we originally identified as involving no adverse event were settled for the plaintiffs (mean payment, $28,760), as were 6 of 13 cases classified as involving adverse events but no negligence (mean payment, $98,192) and 5 of 9 cases in which adverse events due to negligence were found in our assessment (mean payment, $66,944). Seven of eight claims involving permanent disability were settled for the plaintiffs (mean payment, $201,250). In a multivariate analysis, disability (permanent vs. temporary or none) was the only significant predictor of payment (P=0.03). There was no association between the occurrence of an adverse event due to negligence (P = 0.32) or an adverse event of any type (P=0.79) and payment. CONCLUSIONS: Among the malpractice claims we studied, the severity of the patient's disability, not the occurrence of an adverse event or an adverse event due to negligence, was predictive of payment to the plaintiff.

Med Care. 2000 Mar;38(3):250-60. Negligent care and malpractice claiming behavior in Utah and Colorado. Studdert DM, Thomas EJ, Burstin HR, Zbar BI, Orav EJ, Brennan TA.

RESULTS: Eighteen patients from our study sample filed claims: 14 were made in the absence of discernible negligence and 10 were made in the absence of any adverse event. Of the patients who suffered negligent injury in our study sample, 97% did not sue. Compared with patients who did sue for negligence occurring in 1992, these nonclaimants were more likely to be Medicare recipients (odds ratio [OR], 3.5; 95% CI [CI], 1.3 to 9.6), Medicaid recipients (OR, 3.6; 95% CI, 1.4 to 9.0), > or =75 years of age (OR, 7.0; 95% CI, 1.7 to 29.6), and low income earners (OR, 1.9; 95% CI, 0.9 to 4.2) and to have suffered minor disability as a result of their injury (OR, 6.3; 95% CI, 2.7 to 14.9). CONCLUSIONS: The poor correlation between medical negligence and malpractice claims that was present in New York in 1984 is also present in Utah and Colorado in 1992. Paradoxically, the incidence of negligent adverse events exceeds the incidence of malpractice claims but when a physician is sued, there is a high probability that it will be for rendering nonnegligent care. The elderly and the poor are particularly likely to be among those who suffer negligence and do not sue, perhaps because their socioeconomic status inhibits opportunities to secure legal representation.

The Plaintiff Legal Case

From:Robert K. Jenner and Bryant Welch, Suicide watch: liability for negligent psychiatric care, Trial, 37(5), 2001.

1) Mentally ill patients receive negligent care for their life threatening behavior. The foreseeable result is death. Should the court allow defenses of contributory negligence or assumption of the risk when patients die from the very behaviors for which they sought treatment? The courts have said, no. (Brandvain v. Ridgeview Inst., Inc., 372 S.E.2d 265. Ga. Ct. App. 1988, and McNamara v. Honeyman, 546 N.E.2d 139. Mass. 1989).

2) A New Jersey patient flung herself from a height in the hospital. The defense appealed the failure of the judge to give the jury an instruction on the contributory negligence defense. The appellate court found, contributory negligence, in any sense, was not a relevant issue. The duty to exercise reasonable care to prevent her from engaging in self-damaging conduct; because it would serve to excuse defendants’ own failure to exercise reasonable care, such conduct by the plaintiff could not be the basis of a contributory negligence defense." Cowan v. Doering, 522 A.2d 444, 450. N.J. Super. Ct. App. Div. 1987. "The acts which plaintiff’s mental illness allegedly caused him to commit were the very acts which defendants had a duty to prevent, and these same acts cannot, as a matter of law, constitute contributory negligence."

The concurring appellate courts of other states want to prevent, "strict nonliability" for mental health care professionals. They "recognized a "special relationship" between mental health patients and professionals who are deemed to have training and expertise that enables them to detect mental illness or the potential for suicide and who have the power or control necessary to prevent attempts at suicide,... so long as the suicide was reasonably foreseeable, and the defendants breached the applicable standard of care."

The plaintiff lawyer authors assert, "With the assistance of expert testimony, the plaintiff attorney should be able to explain that a mentally ill person can be expected to care for himself or herself only to the extent that the patient’s diminished capacity permits. As the suicidal patient’s capacity decreases, the medical provider’s responsibility increases."

Then, the lawyers state, "A competent psychiatrist will take an extensive history of the patient and make an assessment of all the risk factors in the context of the other current psychiatric symptoms before agreeing to a discharge. If the doctor makes a cursory assessment and, as is often the case today, simply discharges the patient because of pressure from a managed care company, that psychiatrist may be liable for malpractice. If the assessment is done properly, in the vast majority of cases, suicide can be prevented."

They propose excluding jurors who believe in personal responsibility for one's intentional acts, or that suicide is a sin.

From Law and the Mental Health System, 4th Ed., by R. Reisner, C. Slobogin, A. Rai, West, St. Paul, MN. pp. 729-731.

The prediction of violence has an 80% false positive rate. The lawyer argues that predictive studies also result in intervention, preventing the violent act. The overwhelming majority of patients attempting suicide were glad someone stopped them. The suicide attempt is an attempt to improve one's life. The degree of compentency is irrelevant. The burden of proof is "clear and convincing" (about 2 of 3 times likely). There is no right to commit suicide, and the liberty to do so does not fall under the protection of the Due Process Clause. Nor is any right to receive assistance in doing so (Washington v Glucksberg, 521 U.S. 702, 117 S.Ct. 2258, 2269, 2271, 138 L.Ed. 2d 772 (1997)).