Title: Nguyen v. Massachusetts Institute of Technology

State: massachusetts

Issuer: Massachusetts Supreme Court

Document:

NOTICE:  All slip opinions and orders are subject to formal 
revision and are superseded by the advance sheets and bound 
volumes of the Official Reports.  If you find a typographical 
error or other formal error, please notify the Reporter of 
Decisions, Supreme Judicial Court, John Adams Courthouse, 1 
Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-
1030; SJCReporter@sjc.state.ma.us 
 
SJC-12329 
 
DZUNG DUY NGUYEN, administrator,1  vs.  MASSACHUSETTS INSTITUTE 
OF TECHNOLOGY & others.2 
 
 
 
Middlesex.     November 7, 2017. - May 7, 2018. 
 
Present:  Gants, C.J., Gaziano, Lowy, Cypher, & Kafker, JJ. 
 
 
Wrongful Death.  Negligence, Wrongful death, College.  Damages, 
Wrongful death, Conscious pain and suffering, Breach of 
contract.  Practice, Civil, Amendment of complaint.  
Workers' Compensation Act, Exclusivity provision. 
 
 
 
 
Civil action commenced in the Superior Court Department on 
September 6, 2011. 
 
 
The case was heard by Bruce R. Henry, J., on motions for 
summary judgment. 
 
 
The Supreme Judicial Court granted an application for 
direct appellate review. 
 
 
 
Jeffrey S. Beeler for the plaintiff. 
 
Kevin P. Martin (Yvonne W. Chan also present) for the 
defendants. 
 
Alan D. Rose, B. Aidan Flanagan, & Antonio Moriello, for 
Amherst College & others, amici curiae, submitted a brief. 
                                                 
 
1 Of the estate of Han Duy Nguyen. 
 
 
2 Birger Wernerfelt, Drazen Prelec, and David W. Randall. 
2 
 
Jonathan A. Karon, Thomas R. Murphy, Mark F. Itzkowitz, & 
Lisa DeBrosse Johnson, for Massachusetts Academy of Trial 
Attorneys, amicus curiae, submitted a brief. 
 
 
 
KAFKER, J.  The plaintiff, Dzung Duy Nguyen, commenced a 
wrongful death action against the defendants, Massachusetts 
Institute of Technology (MIT), MIT Professors Birger Wernerfelt 
and Drazen Prelec, and MIT assistant dean David W. Randall, 
arising out of the suicide of his son, Han Duy Nguyen (Nguyen).  
The defendants are alleged to have been negligent in not 
preventing Nguyen's suicide.  The motion judge allowed summary 
judgment for MIT and the individual defendants, finding no duty 
to prevent Nguyen's suicide.  Although we conclude that, in 
certain circumstances not present here, a special relationship 
and a corresponding duty to take reasonable measures to prevent 
suicide may be created between a university and its student, we 
affirm the decision of the motion judge that the defendants are 
entitled to judgment as a matter of law.3 
 
Background.  We summarize the facts in the record in the 
light most favorable to the plaintiff.  Godfrey v. Globe 
                                                 
 
3 We acknowledge the amicus brief filed by the Massachusetts 
Academy of Trial Attorneys; and the amicus brief filed in 
support of defendants by Amherst College, Bentley University, 
Berklee College of Music, Boston College, Boston University, 
Brandeis University, College of the Holy Cross, Emerson College, 
Endicott College, Harvard University, Northeastern University, 
Simmons College, Smith College, Stonehill College, Suffolk 
University, Tufts University, Williams College, and Worcester 
Polytechnic Institute. 
3 
Newspaper Co., 457 Mass. 113, 114 (2010).  We reserve additional 
facts for our discussion of the legal issues. 
 
1.  The parties.  At the time of his death on June 2, 2009, 
Nguyen was a twenty-five year old graduate student in the 
marketing program at MIT's Sloan School of Management (Sloan) 
and lived off-campus.  Prelec was a Sloan faculty member and 
served as Nguyen's graduate research advisor.  Wernerfelt was a 
Sloan faculty member and head of the Marketing Group Ph.D. 
program whose responsibility included advising graduate students 
concerning their coursework and research.  Randall was an 
assistant dean in MIT's student support services (student 
support) office. 
 
2.  MIT support resources.  In May, 2007, after his first 
academic year at MIT and two years before his death, Nguyen 
contacted Sloan's Ph.D. program coordinator, Sharon Cayley, for 
assistance with test-taking problems.  Nguyen explained to 
Cayley that he was "failing all of my classes because I don't 
know how to take [examinations (exams)].  I know the course 
material, but it just won't happen for me on exams."  Cayley 
then referred Nguyen to an MIT student disability services 
office coordinator, who described some of MIT's accommodations 
for individuals with disabilities.  Nguyen declined such 
accommodations.  In her notes from her meeting with Nguyen, the 
coordinator wrote that Nguyen "does not want to connect with MIT 
4 
Medical.  (I recommended that he do so.)  Says it won't be 
helpful; no reason to do so" (emphasis in original).  After two 
meetings with the coordinator, Nguyen reported to Cayley that 
the meetings were of "absolutely no use . . . [the coordinator] 
seemed to think that because I was referred to her, that meant 
that I was disabled, and therefore had only disability 
accommodations to offer me." 
 
On June 25, 2007, Cayley referred Nguyen to MIT's mental 
health and counselling service (MIT Mental Health) and informed 
Wernerfelt that this referral was Cayley's "response to 
[Nguyen's] expressed need for remedial study skills."  On July 
9, 2007, Nguyen met with Dr. Celene Barnes, a psychologist at 
MIT Mental Health.  On meeting Barnes, Nguyen stated that he did 
not know why he "was referred here.  My issues have nothing to 
do with [mental health]."  During the intake meeting, Nguyen 
denied suicidal ideation.  Barnes "provided [a] brief overview 
of [information] on test anxiety and gave him handouts used in 
the test anxiety workshop [and] [o]ffered to work with him on 
this issue."  Nguyen "declined, stating again that he did not 
want to seek[] services at [MIT Mental Health] due to the stigma 
associated with it." 
 
On July 25, 2007, Nguyen had a second appointment with 
Barnes.  She conducted a general intake, which irritated Nguyen 
because "he didn't know what other [mental health] issues had to 
5 
do with his test taking problem."  During this meeting, Nguyen 
disclosed to Barnes that he had had a long history of depression 
with two prior suicide attempts during college but denied any 
present suicidal ideation.  Nguyen also disclosed that he had 
been in treatment prior to coming to MIT and that he had resumed 
treatment with a psychiatrist in the area.  Although Nguyen had 
hoped that his test anxiety issue would be resolved in one 
appointment, he agreed to follow up with Barnes at the start of 
the school year. 
 
On July 29, 2007, Nguyen told Cayley that he found MIT 
Mental Health to be "useless," that Barnes "proceeded to turn me 
into a mental patient, and I was forced to discuss things that I 
really didn't want to," and that he doubted that MIT Mental 
Health was the "correct agency to solve my problem."  Further, 
Nguyen questioned why Wernerfelt had to be informed of the 
referral to Barnes because Nguyen was "hoping to keep the circle 
as small as possible, since I'm very ashamed and embarrassed 
about [my test-taking problems]." 
 
On August 9, 2007, Nguyen reported to Barnes that he was 
receiving treatment from Dr. John J. Worthington, a psychiatrist 
at Massachusetts General Hospital (MGH), not MIT Mental Health.  
Barnes offered to consult about treatment planning, but Nguyen 
declined.  Subsequently, Nguyen informed Barnes that he had 
"been able to make other arrangements for treatment, so there 
6 
will be no need to search any further, but I really appreciate 
all of your effort thus far." 
 
On September 6, 2007, Nguyen met with Randall, the 
assistant dean in the student support office.4  Before meeting 
with Randall, Nguyen had sent an electronic mail (e-mail) 
message to another student support dean, inquiring whether the 
student support office could help him with his problem, which 
was that he had "difficulty with taking exams, to the extent 
that [he was] failing classes" and asked if the student support 
office offered "any kind of counseling service that teaches 
study skills."  In their first meeting, Randall reported that 
Nguyen was "very committed to this not being seen as a 'problem' 
and [was] looking for a quick fix."  Toward the end of the 
meeting, Nguyen acknowledged that he had a long history of 
mental health issues and depression and that he was seeing a 
psychiatrist, Dr. Worthington, off campus. 
 
On September 24, 2007, Nguyen returned to see Randall.  
Nguyen described a "long history of depression dating back to 
high school," and treatment by "several . . . therapists during 
college."  He also "acknowledged two suicide attempts in the 
                                                 
 
4 At the time, Randall was a licensed clinical psychologist.  
Both parties are in agreement, however, that Randall did not 
have a clinician-patient relationship with Nguyen in his 
nonclinical capacity as assistant dean in the Massachusetts 
Institute of Technology (MIT) student support services office. 
7 
past and frequent suicidal thoughts."  Nguyen, however, stated 
that he "did not identify a specific plan [to commit suicide] 
. . . and [was] not imminently suicidal."  Although perceiving 
that Nguyen was not an imminent threat, Randall "strongly 
encouraged" Nguyen to visit MIT Mental Health.  But after his 
recent MIT Mental Health meeting with Barnes, Nguyen was 
resistant and stated that his current psychiatrist was already 
aware of his prior suicidal ideation and that Nguyen also had 
plans to see another therapist, Dr. Stephen Bishop, in Rhode 
Island. 
 
By the end of the September 24 meeting, Nguyen gave Randall 
permission to contact Worthington, Bishop, and Barnes.  Later 
that day, Randall left a voice message for Worthington.  
Subsequently, Nguyen revoked Randall's permission to contact 
Worthington and stated in an e-mail message that he would "like 
to keep the fact of my depression separate from my academic 
problems.  I'd prefer that we not any further discuss the 
depression, that my academic problems can be framed in terms of 
a deficit in study skills instead.  If you can offer any such 
aid, I'd be happy to further employ your services."  On 
September 25, Randall acknowledged Nguyen's decision and replied 
that he "would still like to meet with you and think that I can 
be helpful."  Randall also stated in the e-mail message that 
Nguyen was permitted "to schedule another [appointment]."  
8 
Nguyen did not respond to Randall's e-mail message and did not 
have any further meetings or contact with Randall after 
September, 2007. 
 
Worthington followed up with Randall on September 27, 2007.  
Worthington was unable to share any information or confirm that 
Nguyen was his patient, but said that he could listen to 
Randall's concerns, especially regarding Nguyen's safety.  
Randall informed Worthington that Nguyen appeared "agitated, a 
little suspicious, and anxious, both at [the student support 
office] and MIT [Mental Health]," and of Nguyen's "suicidal 
thoughts and previous attempts."  Worthington did not discuss 
the case further, but agreed the information should be taken 
seriously.  On September 28, 2007, Randall told Barnes that he 
had spoken with Worthington about Nguyen, and wrote, "Let's keep 
in touch about this student."  Barnes responded, "I agree, let's 
definitely keep in touch about [Nguyen]."  Nguyen did not return 
to see Barnes or any other mental health provider at MIT Mental 
Health. 
 
3.  Nguyen's mental health history.  Although Nguyen 
briefly sought out the student disability services office, MIT 
Mental Health, and the student support office between May and 
September, 2007, he extensively consulted with clinicians not 
affiliated with MIT.  Between July, 2006, when Nguyen moved to 
Massachusetts, and May, 2009, Nguyen saw at least nine private 
9 
mental health professionals who collectively recorded over 
ninety in-person visits during this period.  There was no 
indication from any of these mental health professionals that 
Nguyen was at an imminent risk of committing suicide. 
 
From July, 2006, two months before enrolling at MIT, to 
November, 2008, Nguyen was treated by Worthington, a 
psychiatrist at MGH.  Over the course of their forty-three in-
person appointments, Worthington discerned nothing indicating 
that Nguyen was at an imminent risk of suicide.  Nguyen 
requested electroconvulsive therapy to treat his depression, and 
received six rounds of it at MGH in August and September, 2006. 
 
Starting in September, 2006, Nguyen began therapy with a 
social worker at MGH and was scheduled for sixteen sessions.  
Nguyen disclosed to the social worker that he had occasional 
suicidal thoughts, but no suicidal intent or plan.  After their 
twelfth visit, Nguyen canceled his remaining appointments 
stating that his "time together [with the social worker had] not 
resulted in an inch of progress." 
 
Nguyen's next therapist was Bishop, whom he saw for several 
months in Rhode Island beginning in October, 2007.  Bishop 
diagnosed Nguyen with dysthymic disorder, a chronic depressive 
condition.  Nguyen saw Bishop six times between October, 2007, 
and March, 2008, but stopped seeing him because of the distance 
and because Bishop did not accept his health insurance plan. 
10 
 
From April, 2008, to March, 2009, Nguyen sought treatment 
from a doctor at a private practice group who specialized in 
sleep disorders.  This doctor did not think that Nguyen was at 
risk of suicide during the time she was treating him.  Starting 
in August, 2009, Nguyen saw a psychologist affiliated with the 
same private practice group.  In February, 2009, Nguyen canceled 
his future appointments with the psychologist because he 
believed his "sleep patterns [were] beginning to converge on 
nonpathology." 
 
Next, in November, 2008, Nguyen met twice with another 
doctor to complete a psychological test.  During the interview, 
Nguyen told that doctor that he was "not imminently suicidal."  
That same month, Nguyen stopped seeing Worthington because 
Nguyen believed him to be "too autocratic and didn't consider 
[Nguyen's] input."5  Nguyen then began seeing yet another doctor 
and continued to see him through May, 2009.  At Nguyen's initial 
appointment, that doctor noted that Nguyen "made two 'half-
assed' suicide attempts.  He denies suicidal ideation."  At each 
appointment, the doctor and Nguyen discussed whether Nguyen had 
"any self-destructive thoughts . . . [or felt like] giving up."  
                                                 
 
5 Nguyen had made a similar point in June, 2008, when he 
sent an electronic mail (e-mail) message to Worthington stating, 
"I need you to consider me as part of the team when it comes to 
my own treatment. . . .  After all I am a PhD student at one of 
the world's top universities.  Please give me a little credit 
here." 
11 
Nguyen denied any such thoughts or feelings. 
 
In March, 2009, Nguyen began seeing a different doctor, 
with whom he had six visits.  Nguyen told the doctor about his 
two prior suicide attempts but denied any current suicidal 
ideation.  Throughout this time, the doctor did not believe that 
Nguyen was at an imminent threat of self-harm. 
 
Nguyen's last appointment with this doctor was on May 28, 
2009, five days before Nguyen's death.  The doctor noted that 
Nguyen "did not say anything that sounded imminently suicidal or 
hopeless, and we discussed more things that he would do toward 
exploring thesis and career options, and we made a next 
[appointment] for [June 18]." 
 
4.  Nguyen's academic challenges.  At times during his 
studies at Sloan, Nguyen struggled academically and performed 
"well below average" in some of his courses.  During Nguyen's 
time at MIT, neither Wernerfelt nor Prelec was aware of Nguyen's 
history of severe depression or prior suicide attempts.  
Wernerfelt knew only that Nguyen had insomnia and test taking 
anxiety, and that he was consulting off-campus mental health 
professionals. 
 
On May 9, 2008, Prelec was informed by one of his MIT 
colleagues that Nguyen was reportedly "out of it" and 
"despondent," potentially because Nguyen was "having trouble 
sleeping as of late."  On May 12, Prelec met with Nguyen and 
12 
reported to Wernerfelt that Nguyen is "sleep deprived . . . and 
is taking something on prescription to help him sleep.  He is 
seeing a psychiatrist regularly, at Mass General (not MIT).  
Same person he has been seeing since he got here."  Wernerfelt 
replied that Nguyen "has had some serious issues with exam 
anxiety, so I worry about the general[] [exams].  Perhaps we can 
give them in a less concentrated form . . . [t]hat way he can 
get a good grade under his belt . . .  I think that it would be 
good to give him some confidence."6 
 
On May 26, 2008, Wernerfelt was informed that Nguyen had 
performed poorly in a course that an MIT colleague taught.  
Nguyen had told that colleague that he had "medical problems 
that have prevented him from focusing on classes . . . [and] 
asked [the colleague] to consider his weakened health when he 
[took] the final."  Wernerfelt responded to his colleague that 
Nguyen was "having serious problems.  Some of his issues seem to 
peak at exam time, but there is much more to it than that.  He 
has been seeing a psychiatrist at MGH (not MIT) as long as he 
has been here.  I thus have no official information, but I do 
                                                 
 
6 Wernerfelt testified that "general exams" were required 
for all MIT Sloan School of Management Ph.D. students.  Students 
typically take these examinations at the end of their second 
year, over a period of several days. 
 
13 
believe that he is at risk."7  Wernerfelt suggested that his 
colleague be lenient and "grade him based on the problem sets" 
rather than his final examination. 
 
On June 2, 2008, Wernerfelt sent an e-mail message to seven 
of Nguyen's professors, informing them that Prelec and he had 
"decided to reduce the pressure on [Nguyen] by spreading out his 
general[] [exams] over several weeks."  On June 4, Wernerfelt, 
"[i]n an attempt to reduce the pressure on [Nguyen] as much as 
possible," further modified Nguyen's examination schedule 
allowing Nguyen to take the examinations when he was ready. 
 
In a June, 2008 self-evaluation form, Nguyen stated that 
his academic performance was "[b]elow average, due to my medical 
condition."  Nguyen indicated that the "primary nature of this 
illness [was] insomnia" and that he had "been seeing a team of 
doctors at [MGH] and elsewhere who have been trying to help me."  
Nguyen described how "horrendously bad" his medical condition 
was, stating that "[t]here were days during which I was so 
completely debilitated for the entire day that I was unable to 
get out of bed at all, much less function properly" and that at 
one point he "had to be hospitalized because I was so delirious 
                                                 
 
7 Wernerfelt testified that he meant "risk" to refer to 
"some adverse reaction if [Nguyen] were to get a really low 
grade" in Nguyen's economics course.  Wernerfelt stated that a 
low grade was "not a big deal" because if Nguyen got "a bad 
grade . . . he [could] take a makeup exam or . . . take another 
course instead" to satisfy the graduate school requirement. 
14 
and incoherent after not being able to sleep for over [seventy-
two] hours."  Nguyen further stated that he "would not be 
surprised if I have to be hospitalized again in the near 
future."  Nguyen also stated that he was on his ninth different 
sleeping pill prescription and that he was still not functioning 
well.  Nguyen did not disclose any history of depression, 
suicidal ideation, or his prior suicide attempts in his self-
evaluation.  After receiving Nguyen's self-evaluation, 
Wernerfelt offered to help Nguyen obtain a "leave from the 
program . . . such that [he] could return to a good situation 
once the [doctors] lick [his] sleeping problems." 
 
On October 30, 2008, Nguyen sent an e-mail message to 
Wernerfelt and requested an examination schedule that would take 
place between January 12 and January 26, 2009, with his oral 
examination during the week of January 26 through January 30, 
2009.8  Prelec testified that Nguyen's performance "varied some, 
but overall it was not a good performance." 
 
After Nguyen had completed his general examinations, the 
faculty in his department met in January, 2009, to discuss 
Nguyen's performance and whether he had passed.  Wernerfelt 
advocated that "Nguyen should be passed and that the faculty 
should counsel him to pursue a master's degree."  Wernerfelt 
                                                 
 
8 Nguyen's general examinations originally had been 
scheduled for the summer of 2008. 
15 
also stated that "they might end up with 'blood on their hands'" 
if the faculty were to fail Nguyen.9  One of Wernerfelt's 
colleagues testified that the phrase, "blood on our hands," was 
repeated several times.  After the faculty passed Nguyen, 
Wernerfelt met with Nguyen to inform him that he had passed, 
although he was required to take certain additional courses to 
remain in the Ph.D. program.  Further, Wernerfelt "laid out the 
path to a [Master's degree] . . . [and] [s]aid that all members 
of the faculty felt that he would be unhappy in a professorial 
job."  In March, 2009, Nguyen sent an e-mail message to Prelec, 
telling him that "to be a professor" is what Nguyen "want[ed] 
more than anything. . . . [and he was not] convinced that anyone 
has really taken [his] health issues into consideration."  
Nguyen remained insistent that he would "still do everything in 
[his] power to ensure that [he] will finish the PhD." 
 
Prelec met with Nguyen weekly during the spring of 2009 and 
noticed that Nguyen "seemed better" and was having fewer sleep 
problems.  That semester, Nguyen served as a teaching assistant 
and, at the end of the semester, was offered another teaching 
assistant position for the fall of 2009, which he accepted.  In 
                                                 
 
9 In contrast to failing a course, failing general 
examinations could lead to dismissal from the graduate program.  
Wernerfelt testified that if Nguyen were to fail his general 
examinations, there was a "very small chance that . . . 
something bad could happen . . . such as [Nguyen] hurting 
himself or others." 
16 
May, 2009, Prelec recommended Nguyen for a summer research 
assistant position in an MIT laboratory.  On May 27, 2009, 
Nguyen sent an e-mail message to the project investigator that 
he was "very excited about [the] project . . . [and] would be 
eager to begin very soon."  Nguyen also requested an update 
about funding logistics, as he was under the impression that the 
MIT laboratory's "coffers were bottomless."  Prelec was copied 
on this message and forwarded it to Wernerfelt, stating that he 
was "mildly nervous" about recommending Nguyen because "[w]ith 
this talk of bottomless coffers . . . [Nguyen] will rapidly 
offend . . . folks."  In response, Wernerfelt suggested that 
"someone should talk to [Nguyen] about sending more respectful 
e-mails" and that "[p]erhaps we should offer to prescreen his e-
mails . . . after two or three [Nguyen] might get the idea."  
Wernerfelt offered to take the lead on speaking with Nguyen 
about e-mail etiquette. 
 
5.  Nguyen's suicide.  At approximately 7 A.M. on June 2, 
2009, Nguyen sent the project investigator an e-mail message, on 
which he blind-copied Prelec: 
 
"I forgot to mention that this upcoming Monday I have 
a doctor's appointment that I had scheduled a long time 
ago, so I won't be able to come into the office until about 
11:30 that day.  I hope that that won't be a problem. 
 
 
"If we can quickly follow up on the conversation that 
we had yesterday, if you'll forgive me, I'd like to be 
honest with you about something.  [Prelec] recommended me 
for this position . . .  [a]nd I'm not an undergrad 
17 
anymore; I'm a grad[uate] student now.  For those reasons, 
it was disturbing, as well as a little insulting, to me 
that yesterday you took pains to express your expectations 
of me in a manner that presumed that I would give you 
anything less than this project deserved, that you would 
'give me a signal' if you didn't think that my contribution 
amounted to something deserving of authorship credit, that 
'there would be a problem' if it turned out that '[you] 
could do [the work] faster [your]self,' that you threatened 
me that you could tell by visual inspection whether my work 
was up to par.  I like to feel like I've earned the right 
not to have my effectiveness or my integrity questioned 
anymore, and to hear you do that yesterday was kind of 
hurtful.  I'm not sure that if you continue to do this that 
I'll be able to work as effectively as I'd like to be able 
to.  Although I keep asking about it, I'm not just doing 
this for the money.  I want to learn something and make a 
meaningful contribution . . . . Would it be possible that 
we could move forward with an understanding of good faith 
on my part?" 
 
After receiving Nguyen's e-mail message, Prelec and the project 
investigator spoke about it.  The project investigator told 
Prelec that Nguyen had taken his comments out of context and 
that Nguyen misinterpreted his intentions and the tone of the 
meeting. 
Prelec forwarded the e-mail message to Wernerfelt, asking 
if Wernerfelt could "talk to [Nguyen] as a somewhat neutral 
party . . . [Nguyen] is misreading things.  Even so, the tone of 
reply is totally out of line."  Wernerfelt responded, "I am so 
sorry.  I will talk to [Nguyen] and let you know what he says." 
 
At approximately 9 A.M. on June 2, Nguyen arrived at a 
laboratory in a building on MIT's campus.  The laboratory 
coordinator noted that Nguyen's demeanor appeared "pretty 
18 
normal" and that Nguyen was preparing for a research project.  
After a number of missed calls between Nguyen and Wernerfelt, at 
10:51 A.M., Nguyen reached Wernerfelt by telephone.  Nguyen left 
the laboratory to take the call.10  After the telephone call 
ended at approximately 10:59 A.M., Nguyen went to the roof of 
the building and jumped off the building to his death.  A first 
responder administered first aid to Nguyen "a few seconds" after 
he landed and did not identify any signs of breathing, eye 
movement, pulse, or consciousness.  It was determined that the 
immediate cause of Nguyen's death was "blunt trauma with head, 
skull, torso and extremity injuries" and that it occurred within 
"seconds." 
 
Meanwhile, after Wernerfelt finished speaking with Nguyen, 
at 11:04 A.M., Wernerfelt sent an e-mail message to Prelec: 
 
"I read [Nguyen] the riot act 
"Explained what is wrong about the e-mail 
"Told him that you or I would look over future e-mails he 
                                                 
 
10 Wernerfelt testified that he contacted Nguyen because he 
had been forwarded Nguyen's e-mail message to the project 
investigator and that he wanted to help with Nguyen's "social 
skills."  Wernerfelt testified that he "went through point for 
point" giving "advice and explanations" on what was improper 
with Nguyen's e-mail.  Wernerfelt recommended that Nguyen, in 
the future, let him or Prelec review Nguyen's e-mail drafts.  
Wernerfelt reiterated that Nguyen "would be happier outside the 
academe" and "should think about getting a [M]aster's degree and 
pursuing a nonacademic job."  At the conclusion of the telephone 
call, Wernerfelt told Nguyen that "some patching up would have 
to be done after this e-mail, and [Wernerfelt] thought [Nguyen] 
should . . . contact [Prelec] and the two of them could together 
figure out what the next steps would be." 
19 
send[s] . . .  
"I said that we know that he is not out to offend anyone 
but that he seems poor at navigating the academe 
"Said that this is an example of why we all recommended 
that he take a [Master's Degree] and go out to get a job 
"I talked about some papers he could turn into [a Master's] 
thesis and volunteered to supervise it 
"Said that he made you look bad vs [the laboratory] and 
that some patching up was necessary 
"He will call you about what to do" 
 
Later in the afternoon on June 2, 2009, one of Wernerfelt's 
colleagues sent an e-mail message to Wernerfelt that "I know you 
were worried about suicide, but you can feel positive that we 
tried very hard to help [Nguyen] (and especially you did so much 
to help him)."11 
 
In 2011, the plaintiff commenced an action in Superior 
Court, alleging that the defendants' negligence caused Nguyen's 
death.  In March, 2016, the defendants moved for summary 
judgment and the plaintiff filed a cross motion for summary 
judgment.  In October, 2016, the defendants' motion for summary 
judgment was allowed and the plaintiff's cross motion for 
summary judgment was denied.  The plaintiff appealed from the 
denial of his motion, and we granted his motion for direct 
appellate review. 
 
Discussion.  The plaintiff contends that the defendants 
owed Nguyen a duty of reasonable care and committed a breach of 
                                                 
 
11 The colleague testified that Wernerfelt "didn't actually 
say suicide.  He said serious consequences, which I interpreted 
. . . as a risk for suicide." 
20 
this duty.  Additionally, the plaintiff argues that the record 
supports claims for punitive damages, conscious pain and 
suffering, and breach of contract.  The plaintiff also asserts 
that the Superior Court judge improperly denied the plaintiff's 
motion to amend the complaint to assert claims against former 
MIT chancellor Phillip Clay.  Lastly, the plaintiff contends 
that summary judgment should be entered in his favor that Nguyen 
was not an MIT employee at the time of his death for workers' 
compensation purposes. 
 
1.  Standard of review.  Where the parties have cross-moved 
for summary judgment, we review a grant of summary judgment de 
novo to determine whether, viewing the evidence in the light 
most favorable to the unsuccessful opposing party and drawing 
all permissible inferences and resolving any evidentiary 
conflicts in that party's favor, the successful opposing party 
is entitled to judgment as a matter of law.  Epstein v. Board of 
Appeal of Boston, 77 Mass. App. Ct. 752, 756 (2010).  See Cabot 
Corp. v. AVX Corp., 448 Mass. 629, 636–637 (2007), citing Augat, 
Inc. v. Liberty Mut. Ins. Co., 410 Mass. 117, 120 (1991). 
 
2.  Negligence claim.  a.  General negligence principles.  
"To prevail on a negligence claim, a plaintiff must prove that 
the defendant owed the plaintiff a duty of reasonable care, that 
the defendant [committed a breach of] this duty, that damage 
resulted, and that there was a causal relation between the 
21 
breach of the duty and the damage."  Jupin v. Kask, 447 Mass. 
141, 146 (2006).  Generally, there is no duty to prevent another 
from committing suicide.  Under our case law, "we do not owe 
others a duty to take action to rescue or protect them from 
conditions we have not created."  Cremins v. Clancy, 415 Mass. 
289, 296 (1993) (O'Connor, J., concurring).  "[T]he law has 
persistently refused to impose on a stranger the moral 
obligation of common humanity to go to the aid of another human 
being who is in danger, even if the other is in danger of losing 
his life."  W.L. Prosser & W.P. Keeton, Torts § 56, at 375 (5th 
ed. 1984). 
 
b.  Special relationships and the duty to prevent suicide.  
We have, however, recognized that special relationships may 
arise in certain circumstances imposing affirmative duties of 
reasonable care in regard to the duty to rescue, including the 
duty to prevent suicide.  The classic case is the custodial 
relationship, particularly jails or hospitals.12  In Slaven v. 
                                                 
 
12 In noncustodial cases, a defendant is also "liable for 
another's death by suicide when, as a consequence of a physical 
impact, death results from an 'uncontrollable impulse, or is 
accomplished in delirium or frenzy.'"  Slaven v. Salem, 386 
Mass. 885, 886–887 (1982), quoting Daniels v. New York, N.H. & 
H.R.R., 183 Mass. 393, 399-400 (1903).  The plaintiff asserts 
that the second scenario applies, that Wernerfelt triggered 
Nguyen's uncontrollable suicidal impulse by the "riot act" 
telephone call.  In this case, the "uncontrollable impulse" 
scenario does not apply, as there has been no prior physical 
 
22 
Salem, 386 Mass 885, 888 (1982), we addressed the duty and 
accompanying responsibilities of a jailor for the suicide of a 
prisoner in his custody. 
 
"One who is required by law to take or voluntarily 
takes the custody of another under circumstances such as to 
deprive the other of his normal opportunities for 
protection is under a duty (1) to protect them against 
unreasonable risk of physical harm, and (2) to give them 
first aid after it knows or has reason to know that they 
are ill or injured, and to care for them until they can be 
cared for by others." 
 
Id. at 887, citing Restatement (Second) of Torts § 314A (1965).  
We further explained that "[t]he comments to § 314A state that a 
'defendant is not liable where he neither knows nor should know 
of the unreasonable risk, or of the illness or injury.'"  
Slaven, supra, citing Restatement (Second) of Torts, supra at § 
314A comment e.  Finally, we noted that in cases in other 
jurisdictions "that have addressed the issue of the liability of 
a jailor for the suicide of one in his custody, most have 
required that there be evidence that the defendant knew, or had 
reason to know, of the plaintiff's suicidal tendency."  Slaven, 
supra at 888. 
 
We likewise conclude that there are other special 
relationships, outside the custodial context, that may impose 
affirmative, albeit limited, duties in regard to suicide 
                                                                                                                                                             
injury causing the uncontrollable impulse.  Slaven, supra at 
887. 
23 
prevention.  We therefore turn to the scope of the university-
student relationship, and the duties, if any, it imposes 
regarding suicide prevention.13 
 
c.  The modern university-student relationship.  We begin 
with the Restatement (Third) of Torts, which states that "[a]n 
actor in a special relationship with another owes the other a 
duty of reasonable care with regard to risks that arise within 
the scope of the relationship."  Restatement (Third) of Torts: 
Liability for Physical and Emotional Harm § 40(a) (2012).  
Included in the list of special relationships giving rise to 
such duty is "a school with its students."  Id. at § 40(b)(5).  
This, of course, is the beginning and not the end of the 
analysis.  There is a wide range of schools -- from elementary 
to graduate school -- and great differences in the scopes of 
student-school relationships.  Additionally, the Restatement 
(Third) of Tort's formulation of special relationship is not 
focused on the specific question of student suicide. 
 
The particularities of the university-student relationship 
are of paramount importance in defining any duty.  Universities 
are clearly not bystanders or strangers in regards to their 
students.  See Mullins v. Pine Manor College, 389 Mass. 47, 51-
                                                 
 
13 Our use of the term "university" encompasses other 
institutions of higher education, including but not limited to 
colleges and universities. 
24 
52 (1983).  The primary mission of universities is academic in 
nature.14  Universities also sponsor and have special 
relationships with their students regarding athletics and other 
potentially dangerous activities.  See, e.g., Kleinknecht v. 
Gettysburg College, 989 F.2d 1360, 1370 (3d Cir. 1993) (duty of 
care to lacrosse player during practice); Davidson v. University 
of N. Carolina at Chapel Hill, 142 N.C. App. 544, 555-556 (2001) 
(duty of care to cheerleader during practice).  See also Massie, 
Suicide on Campus:  The Appropriate Legal Responsibility of 
College Personnel, 91 Marq. L. Rev. 625, 641 (2008) (Suicide on 
Campus).  Cf. Kavanagh v. Trustees of Boston Univ., 440 Mass. 
195, 202 (2003) (special relationship does not extend to 
athletes from other schools).  They are also property owners and 
landlords responsible for their students' physical safety on 
campus.  See Mullins, 389 Mass. at 51-52; Massie, Suicide on 
Campus, supra at 642.  Furthermore, university involvement 
extends widely into other aspects of student life.  See Dall, 
Determining Duty in Collegiate Tort Litigation:  Shifting 
Paradigms of the College-Student Relationship, 29 J.C. & U.L. 
485, 519 (2003) (universities "do not conceive of their 
                                                 
 
14 For example, "[t]he mission of MIT is to advance 
knowledge and educate students in science, technology, and other 
areas of scholarship that will best serve the nation and the 
world in the 21st century]." http://web.mit.edu/facts 
/mission.html [https://perma.cc/KF4R-PQ3W]. 
25 
educational role narrowly . . . and foster many aspects of 
student life and community involvement such as residential life, 
multicultural programs, student organizations, student 
government, student media, community service, internships and 
externships, technology, health and fitness, and spirituality").  
Accord Regents of the Univ. of Cal. vs. Superior Court of Los 
Angeles, Supreme Court of California, No. S230658, slip op. at 
27 (Mar. 22, 2018) (Regents) ("Along with educational services, 
colleges provide students social, athletic, and cultural 
opportunities. Regardless of the campus layout, colleges provide 
a discrete community for their students."). 
 
But universities are not responsible for monitoring and 
controlling all aspects of their students' lives.  "There is 
universal recognition that the age of in loco parentis has 
passed, and that the duty, if any is not one of a general duty 
of care to all students in all aspects of their collegiate 
life."  Massie, Suicide on Campus, 91 Marq. L. Rev. at 640.  See 
Mullins, 389 Mass. at 52 (describing major "changes in college 
life," and "the general decline of the theory that a college 
stands in loco parentis to its students"); Schieszler v. Ferrum 
College, 236 F. Supp. 2d 602, 610 (W.D. Va. 2002) ("colleges are 
not insurers of the safety of their students").  See also 
Bradshaw v. Rawlings, 612 F.2d 135, 139 (3d Cir. 1979) 
(describing end of loco parentis relationship "between college 
26 
and student that imposed a duty on the college to exercise 
control over student conduct and, reciprocally, gave the 
students certain rights of protection by the college"). 
 
University students are young adults, not young children.  
Indeed, graduate students are adults in all respects under the 
law.  Universities recognize their students' adult status, their 
desire for independence, and their need to exercise their own 
judgment.  Consequently the modern university-student 
relationship is respectful of student autonomy and privacy.  See 
Bradshaw, 612 F.2d at 138 ("Trustees, administrators, and 
faculties have been required to yield to the expanding rights 
and privileges of their students"); Furek v. University of Del., 
594 A.2d 506, 516-517 (Del. 1991) (describing "realities of 
modern college life where students are regarded as adults in 
almost every phase of community life" [quotations and citation 
omitted]).  This includes students' personal mental health 
decisions.  Indeed, the privacy of student mental health records 
are generally protected, absent the student's consent or an 
emergency where disclosure is necessary to protect the health or 
safety of the student or other persons.  See Family Educational 
Right and Privacy Act of 1974, 20 U.S.C. § 1232g (2012).  See 
also Health Insurance Portability and Accountability Act of 
1996, 42 U.S.C. § 1320d-6 (2012) (imposing limitations on rights 
of nonclinicians in obtaining or disclosing individually 
27 
identifiable health information); Massie, Suicide on Campus, 91 
Marq. L. Rev. at 648.15 
 
In deciding whether a special relationship and accompanying 
duty exists between a university and a student in regard to 
suicide prevention, and whether a breach of such a duty has 
occurred, we must therefore take into account a complex mix of 
competing considerations.  Students are adults but often young 
and vulnerable; their right to privacy and their desire for 
independence may conflict with their immaturity and need for 
protection.  As for the universities, their primary mission is 
to educate and they no longer are acting in loco parentis, but 
they still have a wide-ranging involvement in the lives of their 
students.  See, e.g. Mullins, 389 Mass. at 52; Bradshaw, 612 
F.2d at 138.  See also Regents, slip op. at 17. 
 
d.  A university's duty regarding suicide prevention.  In 
analyzing whether a duty to prevent suicide falls within the 
scope of the complex relationship that universities have with 
their students, we consider a number of factors used to 
delineate duties in tort law.  Irwin v. Ware, 392 Mass. 745, 756 
                                                 
 
15 Universities must also be attentive to the requirements 
of the Federal Rehabilitation Act of 1973, 29 U.S.C. § 794(a) 
(2012), which states, "No otherwise qualified individual with a 
disability in the United States . . . shall, solely by reason of 
her or his disability, be excluded from the participation in, be 
denied the benefits of, or be subjected to discrimination under 
any program or activity receiving Federal financial assistance." 
28 
(1984).  See Massie, Suicide on Campus, 91 Marq. L. Rev. at 639.  
"Foremost among these is whether a defendant reasonably could 
foresee that he [or she] would be expected to take affirmative 
action to protect the plaintiff and could anticipate harm to the 
plaintiff from the failure to do so."  Irwin, supra.  A related 
factor is "reasonable reliance by the plaintiff [on the 
defendant], impeding other persons who might seek to render 
aid."  Id.  Other factors that have been considered relevant to 
special relationships and the creation of a duty in the 
university context are the "degree of certainty of harm to the 
plaintiff; burden upon the defendant to take reasonable steps to 
prevent the injury; some kind of mutual dependence of plaintiff 
and defendant upon each other, frequently . . . involving 
financial benefit to the defendant arising from the 
relationship; moral blameworthiness of defendant's conduct in 
failing to act; and social policy considerations involved in 
placing the economic burden of the loss on the defendant."  
Massie, Suicide on Campus, supra.  See Mullins, 389 Mass. at 51-
53.  See also Lake, Still Waiting:  The Slow Evolution of the 
Law in Light of the Ongoing Student Suicide Crisis, 34 J.C. & 
U.L. 253, 257-277 (2008) (Still Waiting) (catalog of key cases 
and factors used by courts to determine duty); Regents, slip op. 
at 18 ("Students are comparatively vulnerable and dependent on 
their colleges for a safe environment.  Colleges have a superior 
29 
ability to provide that safety with respect to activities they 
sponsor or facilities they control"). 
 
With these considerations in mind, we conclude that a 
university has a special relationship with a student and a 
corresponding duty to take reasonable measures to prevent his or 
her suicide in the following circumstances.  Where a university 
has actual knowledge of a student's suicide attempt that 
occurred while enrolled at the university or recently before 
matriculation, or of a student's stated plans or intentions to 
commit suicide,16 the university has a duty to take reasonable 
                                                 
 
16 The Columbia Lighthouse Project, under the auspices of 
Columbia University, created the Columbia-Suicide Severity 
Rating Scale(C-SSRS), a suicide risk assessment tool that 
provides useful guidance.  See Columbia-Suicide Severity Rating 
Scale.  http://cssrs.columbia.edu/the-columbia-scale-c-
ssrs/about-the-scale/ [https://perma.cc/TR7Y-S8JB].  More 
specifically, C-SSRS category four or five behavior is 
informative of what constitutes a student's stated plans or 
intentions to commit suicide: 
 
"4. Active Suicidal Ideation with Some Intent to Act, 
without Specific Plan -- Active suicidal thoughts of 
killing oneself and subject reports having some intent to 
act on such thoughts, as opposed to 'I have the thoughts 
but I definitely will not do anything about them.'  
 
"5.  Active Suicidal Ideation with Specific Plan and Intent 
-- Thoughts of killing oneself with details of plan fully 
or partially worked out and subject has some intent to 
carry it out." 
 
(Emphasis in original.)  See Posner, Brent, Lucas, Gould, 
Stanley, Brown, Fisher, Zelazny, Burke, Oquendo, & Mann, 
Columbia-Suicide Severity Rating Scale (C-SSRS), Lifetime 
Recent, Version 1/14/09 m9/12/17 (2008). 
30 
measures under the circumstances to protect the student from 
self-harm.  See Mullins, 389 Mass. at 52 ("Parents, students, 
and the general community still have a reasonable expectation, 
fostered in part by colleges themselves, that reasonable care 
will be exercised to protect . . . students from foreseeable 
harm"); Schieszler, 236 F. Supp. 2d at 608-609 ("relationship 
between a college or university and its students can give rise 
to a duty to protect students from harms of which the school has 
knowledge," including risk of suicide); Restatement (Third) of 
Torts, § 40(b)(5); Massie, Suicide on Campus, 91 Marq. L. Rev. 
at 631 ("where college or university personnel are aware that a 
student has made serious suicidal threats or attempts, they have 
a duty to take reasonable steps to protect the student's 
safety").  See also Pavela, Questions and Answers on College 
Student Suicide:  A Law and Policy Perspective 8-9 (2006) 
("[I]nstitutions of higher education face heightened risk of 
liability for suicide when they ignore or mishandle known 
suicide threats or attempts. . . . The main obstacle to better 
suicide prevention on campus is underreaction, especially the 
failure to provide [perhaps even require] prompt professional 
evaluation and treatment for any student who threatens or 
attempts suicide" [emphasis in original]).  We have sought to 
define here the circumstances creating the special relationship 
and the duty realistically recognizing the scope of the suicide 
31 
problem on university campuses, the capacities of nonclinicians, 
and the nature of the modern university-student relationship.17  
                                                 
 
17 It is estimated that 1,100 university students die by 
suicide ever year.  See Jed Foundation's Framework for 
Developing Institutional Protocols For the Acutely Distressed or 
Suicidal College Student 2 (2006), available at 
https://www.jedfoundation.org/wp-content/uploads/2016/07 
/framework-developing-institutional-protocols-acutely-
distressed-suicidal-college-student-jed-guide_NEW.pdf 
[https://perma.cc/8MLG-2T3U] ("Jed Framework"). "According to 
the Center for Disease Control and Prevention (CDC), suicide is 
the 'second leading cause of death among [twenty-five to thirty-
four] year olds and the third leading cause of death among 
[fifteen to twenty-four] year olds.'  Thus, suicide prevention 
is not simply a focus for traditional college- and university-
aged populations, but must also be a focus for graduate and 
professional schools.  The [twenty-five to thirty-four] year-old 
demographic factors prominently in most graduate and 
professional school programs and applies to the many college and 
university students who extend their education" (footnote 
omitted).  Lake, Still Waiting:  The Slow Evolution of the Law 
in Light of the Ongoing Student Suicide Crisis, 34 J.C. & U.L. 
253, 254–255 (2008).  See Center for Disease Control, National 
Center for Injury Prevention and Control, 10 Leading Causes of 
Death by Age Group, United States -- 2015, https://www.cdc.gov 
/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2015-
a.pdf [https://perma.cc/A8TN-N2HQ] (from most recent statistics 
available from CDC, in 2015, suicide was second leading cause of 
death among both fifteen to twenty-four and twenty-five to 
thirty-four year olds). 
 
 
The number of students with suicidal thoughts is even more 
alarming.  According to an Internet-based survey of 26,000 
undergraduate and graduate students administered by the National 
Research Consortium of Counseling Centers in Higher Education, 
six per cent of undergraduate and four per cent of graduate 
students reported seriously considering suicide within the past 
twelve months.  See Drum, Brownson, Denmark, & Smith, New Data 
on the Nature of Suicidal Crises in College Students:  Shifting 
the Paradigm, 40 Prof. Psychol.:  Res. & Prac. 213, 214-216 
(2009).  Similarly, in the American College Health Association's 
National College Health Assessment, which surveyed over 63,000 
students at ninety-two colleges and universities in 2017, 10.3 
 
32 
 
It is important to understand the limited circumstances 
creating the duty.  It is definitely not a generalized duty to 
prevent suicide.  Nonclinicians are also not expected to discern 
suicidal tendencies where the student has not stated his or her 
plans or intentions to commit suicide.  Even a student's 
generalized statements about suicidal thoughts or ideation are 
not enough, given their prevalence in the university community.  
The duty is not triggered merely by a university's knowledge of 
a student's suicidal ideation without any stated plans or 
intentions to act on such thoughts. 
 
 As previously explained, this duty hinges on 
foreseeability.  See Irwin, 392 Mass. at 756; Mullins, 389 Mass. 
at 52.  See also Massie, Suicide on Campus, 91 Marq. L. Rev. at 
639.  Where a student has attempted suicide while enrolled at 
the university or recently before matriculation, or has stated 
plans or intentions to commit suicide, suicide is sufficiently 
foreseeable as the law has defined the term, even for university 
nonclinicians without medical training.  Reliance of the student 
                                                                                                                                                             
per cent of students reported that they had "seriously 
considered" suicide within the previous twelve months, and 1.5 
per cent of students had attempted to commit suicide within the 
previous twelve months.  See American College Health Association 
National College Health Assessment (2017), at 2, 14, 
http://www.acha-ncha.org/docs/NCHA-II_SPRING_2017_ 
REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf [https://perma.cc/F3NN-
U9XD]. 
 
33 
on the university for assistance, at least for students living 
in dormitories or away from their parents or guardians, is also 
foreseeable.  Universities are in the best, if not the only, 
position to assist.  See Mullins, supra.  They have also 
"fostered" expectations, at least for their residential 
students, that reasonable care will be exercised to protect them 
from harm.  Id. at 52, 54.  See Irwin, supra. 
 
The probability of the harm must of course be considered 
along with its gravity including the death of the student.  See 
Schieszler, 236 F. Supp. 2d at 609 ("there was an imminent 
probability that [the decedent] would try to hurt himself"); 
Lake, Still Waiting, 34 J.C. & U.L. at 284 & n.204 (referencing 
in article on risk of student suicide and violence Justice 
Learned Hand's United States v. Carroll Towing Co., 159 F.2d 
169, 173 [2d Cir. 1947], formulation that "if the probability be 
called P; the injury, L; and the burden, B; liability depends 
upon whether B is less than L multiplied by P: i.e., whether B 
[is] less than PL"); Eisel v. Board of Educ. of Montgomery 
County, 324 Md. 376, 386 (1991) (discussing magnitude of harm 
and statistical possibility of risk of suicide).  Thus, where a 
student has attempted to commit suicide while enrolled at the 
university or recently before matriculation or stated plans or 
intentions to commit suicide, that probability is sufficient to 
justify imposition of a duty on the university.  See Eisel, 
34 
supra.  The burden on the university is not insubstantial, but 
so is the financial benefit received from student tuition.  See 
generally Mullins, 389 Mass. at 53 (relating tuition to duty to 
provide adequate protection);  Regents, slip op. at 13.  Moral 
blameworthiness on the part of a university in failing to act to 
intervene to save a young person's life, when it was within the 
university's knowledge and power to do so, is understood and 
accepted by our society.  See Eisel, supra at 391 ("if 
classmates of [a middle school decedent] found her lying on the 
floor of a lavatory, bleeding from slashed wrists, and those 
students told one or more teachers of the emergency, society 
would be outraged if the teachers did nothing and [the decedent] 
bled to death"); Ames, Law and Morals, 22 Harv. L. Rev. 97, 112-
113 (1908) ("We should all be better satisfied if the man who 
refuses to throw a rope to a drowning man or to save a helpless 
child on the railroad track could be punished and be made to 
compensate the widow of the man drowned and the wounded child"). 
 
Reasonable measures by the university to satisfy a 
triggered duty will include initiating its suicide prevention 
protocol if the university has developed such a protocol.18  In 
                                                 
 
18 One resource that provides universities with guidance for 
drafting is Jed Foundation's Framework for Developing 
Institutional Protocols For the Acutely Distressed or Suicidal 
College Student.  See Jed Framework, supra at 2-3, 10-16. 
 
35 
the absence of such a protocol, reasonable measures will require 
the university employee who learns of the student's suicide 
attempt or stated plans or intentions to commit suicide to 
contact the appropriate officials at the university empowered to 
assist the student in obtaining clinical care from medical 
professionals or, if the student refuses such care, to notify 
the student's emergency contact.19  In emergency situations, 
reasonable measures obviously would include contacting police, 
fire, or emergency medical personnel.  By taking the reasonable 
measures under the circumstances presented, a university 
satisfies its duty. 
 
We stress that the duty here, at least for nonclinicians, 
is limited.20  It is created only by actual knowledge of a 
                                                 
 
19 We recognize that for college and university students the 
emergency contact will often be the student's parents.  But it 
might not always be a parent or guardian, such as where the 
student is married or where the student has informed the 
University that the suicide attempt or stated plans or 
intentions to commit suicide derive in part from a toxic home 
environment (including parental pressures or abuse inflicted by 
a parent).  See Susan R. Furr, Westefeld, McConnell, & Jenkins, 
Suicide and Depression Among College Students:  A Decade Later, 
32 Prof. Psychol.: Res. & Prac. 97, 98 (2001) (survey of 1,455 
college and university students demonstrated that twenty per 
cent of students who identified themselves as having suicidal 
thoughts considered "parental problems" to be contributor to 
their suicidal ideation and behavior). 
 
 
20 For university-employed medical professionals, the duty 
and standards of care are those established by the profession 
itself.  See Stepakoff v. Kantar, 393 Mass. 836, 841 (1985) 
("plaintiff has not directed our attention to any case in which 
 
36 
student's suicide attempt that occurred while enrolled at the 
university or recently before matriculation, or of a student's 
stated plans or intentions to commit suicide.  It also is 
limited to initiating the university's suicide prevention 
protocol, and if the school has no such protocol, arranging for 
clinical care by trained medical professionals or, if such care 
is refused, alerting the student's emergency contact.  Finally, 
the duty is time-bound.  Medical professionals may, for example, 
conclude that the student is no longer a suicide risk and no 
further care or counselling is required. 
 
This limited duty takes a number of the complex and 
competing considerations discussed above into account.  First, 
it respects the privacy and autonomy of adult students in most 
circumstances, relying in all but emergency situations on the 
student's own capacity and desire to seek professional help to 
                                                                                                                                                             
a court has bifurcated the duty owed by a psychiatrist to a 
suicidal patient by declaring that, when diagnosing a patient, 
the psychiatrist must exercise the care and skill customarily 
exercised by an average qualified psychiatrist, while, after 
diagnosing a patient as suicidal, the psychiatrist's duty to 
take preventive measures becomes one of 'reasonableness.'  We 
are unwilling to disturb our longstanding rule that a physician, 
practicing a specialty, owes to his or her patient a duty to 
comply in all respects with the standard set by the average 
physician practicing that specialty").  See also McNamara v. 
Honeyman, 406 Mass 43, 49 (1989), citing Stepakoff, supra at 840 
("psychiatrist must exercise the same degree of skill and care 
as is exercised by the average qualified practitioner in that 
specialty, taking into account the advances in that profession 
and the resources available to the physician"). 
37 
address his or her mental health issues.  Second, it recognizes 
that nonclinicians cannot be expected to probe or discern 
suicidal intentions that are not expressly evident.  It also 
acknowledges the scope of the suicide risk on campus and seeks 
to impose realistic duties and responsibilities on the 
universities, allowing them to respond with their own suicide 
prevention protocols if such protocols have been developed.  
Finally, this limited duty is consistent with the modern 
university relationship with its students, which is no longer in 
loco parentis but rather provides for the students' independence 
and self-determination. 
 
e.  Whether a duty was created in this case and, if so, 
whether a breach of that duty occurred.  For reasons that will 
be explained in detail below, we conclude that there was no duty 
created in the instant case, and if there arguably was such a 
duty two years before Nguyen's death, the defendants did not 
commit a breach of it as a matter of law.  In sum, Nguyen never 
communicated by words or actions to any MIT employee that he had 
stated plans or intentions to commit suicide, and any prior 
suicide attempts occurred well over a year before matriculation.  
He also was a twenty-five year old adult graduate student living 
off campus, not a young student living in a campus dormitory 
under daily observation.  Nguyen repeatedly made clear that he 
wanted to keep his mental health issues separate from his 
38 
academic performance problems and that he was seeking 
professional help from psychiatrists and psychologists outside 
the MIT Mental Health system. 
 
i.  The relationship with Dean Randall in 2007.  In the 
instant case, the question whether Randall, and therefore MIT, 
had a special relationship with Nguyen to take reasonable 
measures to prevent suicide in 2007 requires consideration of 
Randall's knowledge of Nguyen's prior suicide attempts and 
Nguyen's statements about present suicidal thoughts.  First, 
Nguyen's prior suicide attempts in December, 2002, and April, 
2005, were as an undergraduate student at a different university 
and preceded his September, 2006, enrollment as an MIT graduate 
student.  Additionally, although Nguyen had frequent suicidal 
thoughts, which, in the light most favorable to the plaintiff, 
can be read as present not past suicidal thoughts, Nguyen denied 
suicidal ideation in 2007.  Thus, Randall had no actual 
knowledge of Nguyen having attempted suicide while enrolled at 
or recently before matriculating to MIT, or whether Nguyen had 
stated plans or intentions to commit suicide.  Consequently, 
Randall had no special relationship with Nguyen and thus no duty 
to take reasonable measures to prevent Nguyen's suicide two 
years before his death.  Nonetheless, Randall properly 
encouraged Nguyen to seek professional help at MIT, which 
Nguyen, as was his right, refused.  Nguyen also informed Randall 
39 
that he was seeking professional help elsewhere and Randall 
sought permission to communicate with that psychiatrist, which 
Nguyen allowed and then promptly revoked. 
 
Finally, Randall invited further conversations with Nguyen, 
which he declined.  That being said, Randall left Nguyen in the 
care of competent outside professionals as Nguyen demanded.  In 
these circumstances, as a matter of law, a twenty-five year old 
graduate student's rights to privacy, autonomy, and self-
determination were properly respected. 
 
ii.  The relationship with Professors Wernerfelt and 
Prelec.  In contrast to Randall's circumstances, no such special 
relationship was even arguably created between Nguyen and the 
defendants Wernerfelt and Prelec.  There was no evidence that 
Wernerfelt and Prelec had actual knowledge of Nguyen's plans or 
intentions to commit suicide.  Both were academics; neither was 
a trained clinician.  Nguyen's communications to them about his 
mental health problems related to insomnia and test-taking, not 
to suicidal thoughts.  There was also no evidence that 
Wernerfelt or Prelec were informed by MIT Mental Health, the 
student support office, or Randall about Nguyen's two suicide 
attempts in 2002 and 2005.  Even if Wernerfelt or Prelec had 
such knowledge, the prior attempts were not close in time to 
Nguyen's enrollment at MIT.  Given Nguyen's express request that 
his academic issues be kept separate from his mental health 
40 
issues and his assurances that he was being treated elsewhere, 
there also was no duty to communicate this information to either 
Wernerfelt or Prelec.  Finally, even though Wernerfelt commented 
about possible "blood on their hands," it was stated 
metaphorically in the entirely different context of persuading 
his colleagues to allow Nguyen to pass his examinations.  We 
note that Wernerfelt's expressed anxieties at the time of the 
general examinations that Nguyen might harm himself were not 
based on express statements or actions by Nguyen or information 
from trained clinicians and were more than five months before 
the time of the suicide.  As none of the medical professionals 
treating Nguyen considered him "imminently suicidal," this was 
certainly not something Wernerfelt could have intuited on his 
own.21  Because the circumstances at hand did not trigger a 
                                                 
 
21 Dr. Worthington, who treated Nguyen over the course of 
forty-three appointments over more than two years, testified 
that he "never thought [Nguyen] was at that imminent risk [of 
suicide] that he had to be admitted."  Dr. Jeffrey Fortgang, the 
last medical professional that Nguyen saw, also noted that 
Nguyen did not seem "imminently suicidal or hopeless." 
 
 
Although clinicians commonly assess the "imminence of the 
risk of suicide," such assessment, even for clinicians, is 
difficult and disputed.  See, e.g., Hawes, Yaseen, Briggs, & 
Galynker, The Modular Assessment of Risk for Imminent Suicide 
(MARIS):  A proof of concept for a multi-informant tool for 
evaluation of short-term suicide risk, 72 Comprehensive 
Psychiatry 88 (2017); Simon, Imminent Suicide:  The Illusion of 
Short-Term Prediction, 36 Suicide and Life-Threatening Behavior 
296 (2006).  We do not here in any way impose such assessment on 
a nonclinician. 
41 
special relationship, we need not consider the duty of 
reasonable care and whether a breach of such a duty occurred. 
 
f.  Voluntary assumption of a duty of care.  The plaintiff 
also claims the defendants had a duty stemming from their 
voluntary assumption of a duty of care.  "[A] duty voluntarily 
assumed must be performed with due care."  Mullins, 389 Mass. at 
52.  This duty, however, can lead to liability only where a 
"failure to exercise such care increases the risk of such harm, 
or "the harm is suffered because of the other's reliance upon 
the undertaking."  Id. at 53.  Although MIT voluntarily offers 
mental health student support services, there is no evidence 
that these services increased Nguyen's risk of suicide.  
Additionally, there was no evidence that Nguyen relied on MIT's 
mental health services.  The facts bear out Nguyen's rejection 
of such services.  Nguyen briefly consulted with MIT Mental 
Health and the student support office for only a few months in 
2007, nearly two years before his death.  Nguyen wanted 
assistance from MIT only as it pertained to test-taking and 
wanted to keep his mental health treatment separate.  Nguyen 
declined further MIT services and instead engaged with nine off-
campus mental health professionals while remaining enrolled as 
an MIT graduate student.  Cf. Mullins, supra at 54 (prospective 
residential students rely on university's security features).  
Accordingly, the plaintiff cannot succeed on a "voluntarily 
42 
assumed duty" theory. 
 
3.  Punitive damages for wrongful death, conscious pain and 
suffering, and breach of contract.  The plaintiff asserts that 
he is entitled to punitive and emotional distress damages 
because the defendants' reckless or grossly negligent conduct 
was the proximate cause of Nguyen's death.  As we concluded 
above, there was no evidence of the defendants' negligence and 
consequently the plaintiff cannot succeed on such claims.  The 
plaintiff also cannot succeed on his breach of contract claim, 
as references to MIT Mental Health and the student support 
office's coordination of services is merely generalized and not 
sufficient to form an enforceable contract.  See Guckenberger v. 
Boston Univ., 974 F. Supp. 106, 150 (D. Mass. 1997).  Further, 
even if such a contract existed, the claim would still fail, as 
Nguyen rejected assistance from both MIT Mental Health and the 
student support office. 
 
4.  Motion to amend.  The plaintiff contends that his 
motion to amend the complaint to assert claims against former 
MIT chancellor Clay should have been allowed.  The Superior 
Court judge denied the motion on grounds of futility. 
 
We review the denial of a motion to amend the complaint for 
abuse of discretion.  Murphy v. I.S.K.Con. of New England, Inc., 
409 Mass. 842, 864 (1991), cert. denied, 502 U.S. 865 (1991).  
Although leave to amend should be "freely given when justice so 
43 
requires," Mass. R. Civ. P. 15 (a), 365 Mass. 761 (1974), such 
leave may be denied where there is undue delay, undue prejudice 
to the opposing party, or futility in the amendment (citation 
omitted).  Mathis v. Massachusetts Elec. Co., 409 Mass. 256, 264 
(1991).  Here, Clay, who served as chancellor of MIT from 2001 
through 2011, directed efforts in implementing MIT's mental 
health task force.  At the time of Nguyen's death, several key 
recommendations had not yet been implemented.  There was no 
indication that Clay had any personal knowledge of Nguyen's 
mental health issues or was personally involved with Nguyen in 
any other way.  Clay had no common-law duty to prevent Nguyen's 
suicide, nor any special relationship with Nguyen, and he had 
not voluntarily assumed a duty of care.  Furthermore, Clay had 
no individual liability solely on the basis of his "general 
supervisory role."  Lyon v. Morphew, 424 Mass. 828, 833 (1997).  
Consequently, the proposed claims against Clay would be futile, 
and we conclude that there was no abuse of discretion in denying 
the plaintiff's motion to amend. 
 
5.  Workers' compensation.  The plaintiff argues that 
Nguyen was not an MIT employee at the time of his death and 
consequently his tort claims were not barred by the exclusivity 
provision of the workers' compensation act, G. L. c. 152.  The 
defendants claim that Nguyen was acting as an MIT employee and 
the tort claims were barred.  We conclude, as did a judge in the 
44 
Superior Court in his written decision on cross motions for 
summary judgment that were filed on this issue, "that there are 
too many conflicting pieces of material evidence presented for 
this court to determine, as a matter of law, the unique question 
of whether or not Nguyen was an MIT employee at the time of his 
death."  The factual record is undeveloped and unclear and the 
briefing inadequate on this difficult question involving paid 
summer research outside of Nguyen's ordinary graduate school 
activity for which he received a stipend.  Further complicating 
matters, the financial and other documentary evidence is unclear 
as to Nguyen's work status at MIT on June 2, 2009.  
Additionally, whether the June 2, 2009, telephone call prior to 
the suicide was work or school-related is also in question.  
Consequently, there was no error in the denial of summary 
judgment on this issue.  See Maxwell v. AIG Domestic Claims, 
Inc., 460 Mass. 91, 97 (2011). 
 
Conclusion.  For the foregoing reasons, we conclude that 
summary judgment was properly granted for the defendants on the 
tort claims as a matter of law.  We further conclude that the 
Superior Court judge properly denied summary judgment on the 
workers' compensation claim, as there are material disputed 
facts. 
 
 
 
 
 
 
 
So ordered.