The decedent, a 36 year old male, was transported to the Emergency Room involuntarily and subsequently admitted to the Emergency Department pursuant to M.G.L. c. 123, sec. 12. Upon arrival, the decedent was examined by an emergency room physician and two psychiatric clinicians. The plan, following the patient’s evaluation, was to transfer the patient, pursuant to Section 12, to a secure inpatient psychiatric unit as soon as a bed was available. Unfortunately, no bed was available so the patient/decedent remained in the Emergency Room with security observing him overnight.
The next morning the hospital nursing staff and psychiatric clinician found him to be calm and cooperative. Following a discussion with the decedent, the psychiatric clinician spoke with one of the two emergency room physicians on duty. One of the two emergency room physicians authorized the discharge of the decedent to a non-Section 12 psychiatric facility. The emergency room physician never examined the decedent and never spoke with him prior to authorizing the discharge. While the identity of the physician who authorized the discharge was never confirmed, it was undisputed that one of the two on duty emergency room physicians that morning had authorized the discharge. The two physicians on duty were identified through the printed “rotation schedule.” The following morning, the decedent escaped from the non-Section 12 psychiatric facility and died.
The Estate alleged that the practice group that employed the two physicians on duty at the time the decedent was discharged was vicariously liable for the negligent acts of its employee. The plaintiff alleged that the physician who authorized the discharge breached the standard of care when the physician discharged him to an inappropriate facility. The plaintiff, through expert testimony, established that at a minimum a qualified medical professional, pursuant to Section 12, was required to evaluate the decedent to determine whether he remained in need of Section 12 protection. The plaintiff’s experts all testified that the psychiatric clinician that examined the decedent was not a qualified medical professional as required by the statute. As a result of the inappropriate discharge, the decedent was in an inadequate facility from which he escaped and died within twenty-four hours of his discharge from the hospital.
The defense focused on the alleged change in the decedent’s condition on the date of discharge. The defense further argued that the change in the condition of the decedent warranted a lifting and/or withdrawal of the Section 12 order issued the prior day.
The case was tried before a fourteen (14) member jury for seven days. The jury was out for approximately twelve hours before returning a verdict in favor of the decedent’s estate and against the Emergency Room Practice Group.
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