# FILED Nov. 15, 19 95 Cecil Crowson, Jr . Appellate Court Clerk JUNE R. HUSTED, ) mother and next-of-kin of ) TODD E. HUSTED, Deceased, ) ) Plaintiff /Appella nt, )

) Davidson

Sixth Circuit ) No. 89C-2247 VS. ) ) Appeal No. ) 01-A-01-9507-CV-00286 EVERETT ECHOLS, I

II , M.D., )

) Defendant/Appellee, ) ) METROPOLI

TAN GOVERNMENT OF ) NASHVIL

LE AND DAVI

DSON COUNTY,) TEN NES SE E, E T AL, ) ) Defend ants. )

IN THE COURT OF APPEALS OF TENNESSEE MIDD LE S EC TION AT N AS HVILLE
APPEAL FROM THE SI XTH CIRCUI

T COURT OF DAVIDSON COUN TY AT NASHVIL

LE, TENNESSEE
HONORABLE THOMA S W. BROTHERS, JUDGE

JOSEPH H. JOHNSTON P.O. Box 120874 Nashville, Tennessee 37212 ATTORNEY FOR PLAI

NTIFF/APPEL

LANT
Lawrence E. Levine Jill A. Hanson LEVI NE, MATTSON, ORR & GERACIOTI 210 Third Avenue, North P.O. Box 190683 Nashville, Tennessee 37219-0683 ATTORNEYS FOR DEFENDANT/APPEL LEE
REVERSED AND REMANDED
HENRY F. TODD PRESIDING

JUDGE, MIDDL

E SECTION CONCUR: SAMUEL L . LEWIS, JUDGE BEN H. CANTRELL , JUDGE-2-

JUNE R. HUSTED, ) mother and next-of-kin of ) TODD E. HUSTED, Deceased, ) ) Plaintiff /Appella nt, )

) Davidson

Sixth Circuit ) No. 89C-2247 VS. ) ) Appeal No. ) 01-A-01-9507-CV-00286 EVERETT ECHOLS, I

II , M.D., )

) Defendant/Appellee, ) ) METROPOLI

TAN GOVERNMENT OF ) NASHVIL

LE AND DAVI

DSON COUNTY,) TEN NES SE E, E T AL, ) ) Defend ants. ) O P I N I O N This is a suit for wrongful death by suicide allegedly

resulting from negligenc e of the defendant, a psy chiatrist. After a jury could not agree upon a verdict, the Tr ial Judge directed a verdict and dismissed the suit. Plaintiff has appealed and presented a single issue as follows: Whether th e negli gent mis conduct o f defen dant Dr. Everett Echol s was a prox imat e cause of the death of pla inti ff's decedent, Todd Husted.
The record contains evidence fr om which the following facts could be found: On May 30, 1988, dec eased was incarcerate d in the Metropolitan Jail of Metropolitan Nashville. The defendant was employ ed to treat the inmates of the jail on a part time basis. On May 31, 1989, def

endant examined deceased, prescribed lithium, cog entin and amoxipen, and ordered two blood tests for presence of dr ugs, one immediately

and one seven day s later. One of the purposes of the first test was to ascertain the a mount of antipsychotic medication present in the blood of deceased prior to inge sting the drugs prescribed by defendant. One of the purposes of the second test was to ascertain the blood level of medication resulting from the ingestion of the drugs prescribed by defendant as a guide to the amount of drug s to be prescribed thereafter.-3- On June 3, 19 88, the mot her of deceased

mailed to t

he jail psy

cholog ist certa

in medical and psyc

hiatric records of deceased w hich listed four previous suicide attempts. On June 7, 1988, the mother and the psychologist talked by phone. On the same date, the psy cholog ist conve

ye d to defe

ndant the informat ion rece ived abou t previou s suicide

attempts.
On June 14, 1988, defendant renewed the same three prescriptions without reexamining deceased or his medical records. O n June 20, 1988, deceased committed suicide. A test of his blood at that time showed no measurable content of lithium. No blood samples were ever taken or tested as or dered by de

fendant. Deceased committed suicide while in a psychotic state bec ause of the lack of medication in his blood. Defendant had no idea of whether deceas ed was ta

king the prescr ibed medi cations b ecause he neve r saw an y bl ood test results.
The general rule is that a finding of negligence of a

physician must be based upon competent expert testimony of "the recognized standard of acce ptable medical practice in the profess ion and specialty

thereof , if any , that the

defenda nt pract ices in the

community

in which he practices or in a similar community at the time the alleged injury or wrongful action occurred." T.C.A. Section 29-26-115. Stokes v. Leung, Tenn. App. 1982, 651 S.W.2d 704.
There is evidence in this record to support a jury finding that the death of deceased was due, at least in part, to the negligenc e of defendant. Dr. James F. Hooper, a qua lified psy chiatris t, testified in part a s follows:

A. Dr. Echols saw this man, evaluated him, decided that he was psyc

hotic, and started him on medication. He put him on medications for a 14-day period. He re-prescribed that medication without seeing the patient, without reviewing the chart, without looking at any of the lab data that he had ordered, rely ing, basically , on the word of someone that wor

ked at the jail who sa

id this gu y seems to be doing okay . And I think that's below a re asonable standard of care.

. . . .-4- THE WI TNESS: At a minimum , Dr. Ech ols should have re-examined the patient, before he re -prescribed the medication. He had or dered so me lab tes ts. They had not co me back. He did not bother to find out whether these lab tests had been done or not, or what the results were, so he ha d no idea as to whethe r his L ithium leve

l was hig h, low, or what. He had been advise d by

his super visor, ac cording

to this hypothetical, that he should see the patient and reevaluate him. He did not

reeval uate him. He had expressed an interest in receiving f urther history. He had not re

viewed any

further history, e

ither from the medical chart, or a direct phone ca ll to Dr. Husted, the patient's mother, herself a psy chologist, or even communicating with Mr. Trageser, to see if there were other records available. Somebody just said the patient seems like they 're doing okay, so he re -prescribed the medications.

. . . . A. I believe that Todd Husted' s suicidal behavior made him a clearly

foreseeable suicide risk, and that Dr. Echols' failure to adequately evaluate and treat Todd Husted was a direct proximal cause of his death by suicide. In a jury case, the issues of negligenc e and proximate cause are gene rally for the jur

y. Such issue s may

be pre- empted by

the Tria l Judge onl

y where the

evidenc e and re asonable inferences therefrom are

so free of conflict that all reasonable minds would ag ree with the decision of the Trial Judge. Williams v. Brown, Tenn. 1993, 860 S.W.2d 854, 857.
Defendant insists that the proof of proximate cause was incomplete beca use there was no evidence that the suicide of deceased w as foreseeable. On June 14, 1988, when defenda nt re-prescribed medication without seeing deceased or his record, the rec ord, if examined, would have included a letter from the psy chologist-mother of deceased nar rating his history of attempted suicide and self-mutilation.

Under the circu

mstance s, it was e

rror to d irect a v erdict f

or the defendant

and dismiss the suit.-5- The judgment of the Trial Court dismissing the suit against this defendant is reve rsed and vacated, and the cause is remanded for a new jury trial. Costs of this appeal are taxed against the defendant-appellee
.

Reversed and Remanded.

_______________________________________ HENRY F. TODD PRESIDING

JUDGE, MIDDL

E SECTION

CONCUR:

_____________________________________ SAMUEL L . LEWIS, JUDGE

_____________________________________ BEN H. CANTRELL , JUDGE