7/21/2019 Liability of the Psychiatrist for Improper Commitment

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Liability ofthe Psychiatristfor Improper Commitment

A n importantcategory of cases ofallegedpsychiatric mal-/-\

practice involves actions for false andimproper com

mitment o f a person to a mental institution, an action sometimes based upon statute but more often arrived at by acommon law false imprisonment or malicious prosecutionaction. Thisconsideration poses an interesting concrete question: If a psychiatristconspires with a patient's relative tocommit the patient to an institution because of alleged insanity, and writes to a court requesting confinement of thepatient, is the psychiatrist liable fordamages wherethe courtlater finds the patient was not insane and orders him released ?

Malicious Prosecution

The answer to this intriguing query is to be found inLoweii vs Hilton (351 P 2d 881), decidedby the SupremeCourt ofColorado in I960. Inthat case the plaintiffbroughta suit for malicious prosecution against his brother and apsychiatrist. He charged that they had conspired to institutelunacyproceedings against him. The plaintiff'sbrother hadsigned a petition and thepsychiatrist had written a letter tothe Denver County Court requesting that the plaintiff beconfined. Pursuant to their request, the court issued a "Holdand Treat Order" authorizing the plaintiff's confinement.The plaintiff was dischargedeight days thereafter when thecourt found that he was not insane and that it was unneces

sary that he beconfined.The trial court dismissed the plaintiff'scomplaint for ma

licious prosecution on the basis of a Colorado statute whichprovides that a

"

'Hold andTreat Order' ..

.

shall be a com

pleteprotection for the confinement ... of such patient asagainst all persons." The Supreme Court of Colorado, inreversingthe decision ofthe trial court, held that this statutedoes not bar this action. The courtstated: "A person who ad

mittedly has beenmaliciouslywrongedby persons who con-

spire to prosecutehim as an insane person withoutprobablecause cannot

bedeprivedofa

judicialremedyfor

thewrong."Wrongful But Nonnegligent Diagnosis

as Bar to Malicious Prosecution

In Daniels vs Finney (262 SW 2d431,434), decidedbythe Court of Civil Appeals of Texas in 1953, a minister ofthe Gospel called a psychiatristwhom heknew on the telephone on the night ofJune 6, 1951, and made an appointment fortheplaintiff'swifeto comewithhim (theminister)tothe psychiatrist'sofficefor consultationaboutthe plaintiff'scondition for the following afternoon. The minister hadbeen called in by the plaintiff with the hope that matterscouldbe

straightenedoutbetweenhim andhis

wife,particularly for the sake of their four young children. It wasafterthe minister had conferred with the plaintiff's wife that hedeemed it proper to make an appointment for consultationwith a psychiatrist and this was known to the plaintiff andtheplaintiff did not object.

The psychiatristbased hisdiagnosis ofthepatient'scondition principallyupon the facts communicated to him bytheplaintiff's wife in the consultation held at his office, at whichshe was accompanied by the minister. Such facts were: Somefourmonths prior theretoshe had confessed to adulterywithone of the hired hands who worked at the plaintiff'sdairy.The plaintiffmadeher go with him toconfront the man, andcarried a pistol, and at the time shot the man in the hand.The plaintiff beat her up at that time. Thereafter from timeto time he accused herofhavinglike affairs with other men.The plaintiff even accused her of having such an affair withhis father, andof alsohaving such affairs with Negroes. Healsomade her say that he was not the father o f two of theirchildren. He accused herofbeing a nymphomaniac, and alsoofbeing a pervert. He once locked her in thebathroom andthreatened to cut her throat. Another time he threatened toshoot her. At the time she appeared at the psychiatrist's office she had a black eye and bruises which she stated the

plaintiff hadgiven her a night or two before. She told the

psychiatrist that she contemplatedobtaining a divorce.

Prepared by the AMA Law Department.Reprint requests to Law

Department, American Medical

Association,535 N Dearborn St, Chicago 60610.

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That same day the psychiatrist delivered to the plaintiff'swife the followingwritten diagnosis orstatement: "ForL. E.Daniels (theplaintiff) : The above named manissuffering aserious mental illness, paranoidschizophrenia. At this timehe is extremely dangerous to his wife and should be committed to an institution as he does not know right fromwrong." At the time the psychiatrist delivered this writtenstatement to theplaintiff'swife, heknew thatsuch statement

wouldbe usedbyher in connectionwith

thechargeoflunacywhich she was going to file. Subsequently, theplaintiff wascharged with lunacy and confined prior to trial on suchcharge. However, when tried on thelunacycharge, he wasacquitted.

The plaintiffbrought suit againstthe psychiatrist toobtaindamages for malicious prosecution on account of beingchargedwith lunacyand beingconfinedprior to trial onsuchcharge. At thetrial the psychiatrist testified that from whatthe wife told him he could see that the plaintiff's mentalfuries were becoming more and more frequent, in an ever-tightening spiral, and that an explosion was about due. In

addition, the

psychiatrist testified that he

thought the

plaintiff couldonly get better if removed at once from where hecould see or come intocontact withhis wife. The psychiatristalso testifiedthathe expected, atthe timeof the consultation,that the plaintiff, in obedience to suspicions which weresymptomatic of the plaintiff's mental illness, would shortlyput in his appearance, and that twice that afternoon the

plaintiff did call at the psychiatrist's office. Thepsychiatristfurther testified that the fact that the minister had madethe

appointment and had accompanied the wife to the consultation lent, to hismind, acertain degreeof verity to the communications.

Counsel for the

psychiatristmade a motion for a directed

verdict in favor of the psychiatrist. The trial court grantedthe motion and renderedjudgment in favor of the psychiatrist. The plaintiff appealed. The Texas Court of Civil Appeals sustained the decision of the trial court. The courtdeclared: "... defendant is being charged with maliciousprosecution because ofthe diagnosiswhich he madeof plaintiff's mentalcondition. It seems to us, uponprinciple, that nodifferent rule should be applied to hold a doctor liable formalicious prosecution based upon a wrongdiagnosis than toholdhim liable for malpracticebased upon a wrong diagnosis." The court concluded that while the psychiatrist'sdiagnosis mayhave been wrong it was not such as to constitute

negligence.Alleged Lack of Psychiatric Examination

In Woodruff vsShores (190 SW 2d994), decidedbytheSupreme Court of Missouri in 1945, theplaintiff's husbandfiled an information in the County Court of Buchanan

County on Sept 17, 1936, alleging that the plaintiff wasinsane. A psychiatrist onthat date executed a certificate stating he had that day seen and examined the plaintiff andbelieved her to beinsaneand a properpatient to be sent tothe state hospital for the insane. The psychiatrist appearedbefore the county court and verified the certificate which

caused the court to commit the plaintiff as an

insane person

to State HospitalNo. 2, St. Joseph, where she was confineduntil Dec 17, 1936, onwhich datethe superintendent ofthehospitalparoled the plaintiff to herhusband, who thereafterconstantly threatened her with reincarceration. On Aug 28,1944, the Probate Court of Buchanan County found anddeclaredthe plaintiff tobe a personofsoundmind anddulyrestored her as such for a ll purposes.

The plaintiff instituted an action against the psychiatristto obtain damages for commitment as an insane person dueto thepsychiatrist'sallegedwrongful representation that hehad examined her and believed her to be insane. A statestatute permitted an action to bebrought within two yearsafter the removal of a disability, andspecifiedinsanity as adisability.Thepsychiatrist made a motion that the plaintiff'sactionbedismissed on thegroundthatinsanity as a disabilitydid not include a sane personwrongfully committed as insane and, therefore, that the plaintiff's action could not bemaintained in 1944. The trial court sustained the psychiatrist'smotion, and the plaintiffappealed.TheSupremeCourtof Missouri upheld the trial court's decision dismissing the

plaintiff'ssuit.

False ImprisonmentInBlitz vs Boog (328 F 2d596), theUnited StatesCourt

of Appeals for the Second Circuit in 1964 ruled that apatient was not entitled to recover damages in a suit againsta psychiatrist employed by the government who caused hertobe detained in aVeterans Administrationhospitalagainstherwill.

In March I960, the patient went to the 24th Street VAHospital in New York city for outpatient emergency treatment for an emotional upset. She was given an injectionandwhen she attempted toleave, she was prevented fromdoingso onthe orderof thepsychiatrist. Sincethe VA hospitalhadno facilities for treating emotionally disturbedpatients, thepsychiatrist had her held until attendants from BellevueHospital arrived totransfer her tothat hospital. The patientspent eight days in Bellevue Hospital, where she allegedlysufferedbeatings and indignities and did not receive propertreatment.

The patient went to the Bronx VA Hospital in OctoberI960, for treatment of a "fever of undetermined origin."She was examined by hospital psychiatrists for psychiatricsymptoms rather than for feversymptoms.

Although thepatient described her detention at the New

Yorkcity VA hospitalin her complaint in terms of "wantonand willfulnegligence," the factspleaded made out a claimfor falseimprisonment, the courtsaid.

Thepsychiatrist was not liable for damages for false imprisonmentforhaving detained the patient at the New Yorkcity VA hospital and having her transferred to BellevueHospital. In doing so, sheacted in pursuance of her officialduties in whatreasonablyappeared toher to be an emergencysituation, the court said.In conclusion, in order to avoid liability, a psychiatrist

must base his diagnosis on an examination. His diagnosismaybe incorrectwithoutnecessarilybeingnegligent, if pred-

icated uponprobable cause.- Howard Newcomb Morse.

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