Do Hospitals Owe a Duty to Protect Others Against Violence of a One-Time Patient?

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From the desk of Brian Schiewe:

In Washington, a person usually does not have a duty to control another’s behavior. There are few scenarios where someone can be found liable for another individual harming a third party. One of those scenarios is in the mental health context.

Claims Pointer:

The Washington Court of Appeals held that a hospital cannot be held liable for the actions of an individual experiencing a mental health crisis, if the individual only came to the hospital for a single emergency department visit. This is true even if the hospital chose not to call a mental health professional to decide if the individual should have been committed to involuntary treatment. 

Konicke v. Evergreen Emergency Servs., PS, 16 Wn. App. 2d 131 (Feb. 8, 2021)

Facts:

This case stems from an unfortunate series of events. In 2015, Zachary Konicke (“Zachary”) began engaging in increasingly odd behavior. In January 2016, while living with his brother, Zachary threatened to light himself on fire and made other troubling statements. The next day, Zachary’s brother grew even more concerned about his frightening behavior and called the police. After emergency services arrived, Zachary was placed in an ambulance and transported to EvergreenHealth Medical Center’s emergency room. While in the emergency room, Zachary was evaluated, and ultimately, released a few hours later. A mental health professional was not summoned to evaluate Zachary to determine if he should be submitted to involuntary treatment.

After Zachary was released, he went to his parents’, Victoria and Michael Konicke, house. The following day Zachary killed Victoria, attacked Michael, and set the house on fire. Michael, the plaintiff in this case, filed a suit against Evergreen Emergency Services, the defendant, on behalf of himself and his wife’s estate. The plaintiff’s first complaint alleged negligent supervision, medical negligence, and gross negligence. The defendant filed a motion to dismiss and in response, the plaintiff amended his complaint to just assert a claim of gross negligence. The defendant filed another motion to dismiss, which the court granted. The plaintiff appealed.

Law:

Generally, an individual does not have a responsibility to prevent a person from harming another individual. However, such a duty may exist when there is a “special relationship.” The Washington Supreme Court previously found a psychiatrist owes a duty to a third party because a “special relationship” exists between the psychiatrist and the patient. In that Washington Supreme Court case, Volk v. DeMeerleer, the psychiatrist’s patient killed two individuals and attempted to kill a third. The court held that psychiatrist may be liable to his patient’s victims under a theory of medical negligence. A “special relationship” exists if the relationship is “definite, established, and continuing.” A one-time appointment, interaction, or visit is not enough to create this type of relationship.

In the alternative, the plaintiff argued that a Washington statute, RCW 71.05.050, creates an independent duty on healthcare providers to protect third parties from mentally ill patients. RCW 71.05.050(3) provides that if a person is brought to an emergency department and medical staff believe that person is presenting “an imminent likelihood of serious harm” or “imminent danger” the hospital staff “may detain such person for sufficient time.” The Washington Court of Appeals engaged in an established three-factor test to determine if the legislature intended to create statutory cause of action. The three factors in this test are: (1) whether the plaintiff is within the class of people the statute was enacted to benefit; (2) whether legislative intent supports creating a remedy; and (3) whether implying a remedy is consistent with the underlying purpose of the statute. Ultimately, the court held that the legislature did not intend to create a statutory cause of action. First, the statute was enacted to protect those suffering from behavioral health disorders and not third parties. Second, the statute’s permissive language means that the legislature did not intend to impose an affirmative duty on healthcare providers to detain patients. Third, the underlying purpose of the statute was to safeguard the individual rights of those suffering from behavioral health disorders. Creating a cause of action could cause medical professionals to over-detain individuals for fear of liability, which would undermine the purpose of the statute.

Analysis:

For the plaintiff’s medical negligence claim to proceed, a special relationship must exist. Given that Zachary only had a single emergency room visit, the required “definite, established, and continuing” relationship did not exist here. Therefore, the defendant did not have a duty to protect the plaintiff and his wife from Zachary. The Washington Court of Appeals ultimately found that because the defendant did not have this duty, the trial court was correct in dismissing the plaintiff’s medical negligence claim. As for the statutory claim under RCW 71.05.050, the court found that this statute did not create a cause of action. Thus, the defendant could not be liable for failing to detain Zachary under this statute. Ultimately, the Washington Court of Appeals affirmed the trial court’s dismissal of this case in its entirety.

The Big Picture:

Generally, Washington law does not impose a duty on an individual to prevent another person from harming a third party. However, there are rare circumstances where one might owe a duty to prevent harm. However, this opinion makes clear that such a duty cannot be imposed on hospital staff who briefly treat an individual experiencing a mental health crisis. This decision helps better define the circumstances where one could be held liable for not controlling the behavior of another.