Title: Williams v. Steward Health Care System, LLC
Citation: N/A
Docket Number: SJC-12451
State: Massachusetts
Issuer: Massachusetts Supreme Court
Date: August 14, 2018

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revision and are superseded by the advance sheets and bound 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-12451 
 
CYNTHIA WILLIAMS, personal representative,1 & another2  vs.  
STEWARD HEALTH CARE SYSTEM, LLC, & another.3 
 
 
 
Suffolk.     April 5, 2018. - August 14, 2018. 
 
Present:  Gants, C.J., Lenk, Gaziano, Lowy, Budd, Cypher, 
& Kafker, JJ. 
 
 
Hospital.  Wrongful Death.  Negligence, Hospital, Wrongful 
death, Gross negligence, Causing loss of consortium.  
Wilful, Wanton, or Reckless Conduct.  Consortium.  
Practice, Civil, Summary judgment. 
 
 
 
 
Civil action commenced in the Superior Court Department on 
November 24, 2014. 
 
 
The case was heard by Heidi E. Brieger, J., on a motion for 
summary judgment. 
 
 
The Supreme Judicial Court granted an application for 
direct appellate review. 
 
 
 
Chester L. Tennyson, Jr., for the plaintiffs. 
 
Edward F. Mahoney for the defendants. 
                     
1 Of the estate of Mary L. Miller. 
 
2 Ashley Gomes, individually and on behalf of her minor 
daughter. 
 
3 Steward Carney Hospital, Inc. 
2 
 
 
John J. Barter, for Professional Liability Foundation, 
Ltd., amicus curiae, submitted a brief. 
 
 
 
GAZIANO, J.  On February 21, 2012, Mary L. Miller was 
fatally stabbed in her home by "N," her neighbor and a former 
patient of Steward Carney Hospital.4  In this appeal, we consider 
whether the hospital owed Miller and her family a duty of care 
and, if so, whether a breach of that duty occurred when one of 
its physicians released "N" from involuntary psychiatric 
commitment.   
 
From January 9 through January 30, 2012, "N" had been held 
involuntarily at the hospital pursuant to several court orders.  
From January 7 through January 8, 2012, he was a patient in the 
hospital's emergency room because no psychiatric beds were 
available.  After a January 9, 2012, order for a three-day 
commitment pursuant to G. L. c. 123, § 12 (a) and (b), expired, 
on January 12, 2012, the hospital's superintendent filed a 
petition for commitment under G. L. c. 123, §§ 7 and 8.  A 
hearing on the petition was conducted on January 19, 2012, 
before a Boston Municipal Court judge, and an order of 
                     
4 The defendant Steward Health Care System, LLC, argued 
that, as the parent company of the defendant Steward Carney 
Hospital, Inc., it had no liability for any actions by Steward 
Carney Hospital.  The parties agreed to stay that argument 
pending a decision on the motion for summary judgment, which 
could make the matter moot.  For convenience in this appeal, we 
refer to both defendants as "Steward Carney Hospital" or 
"hospital." 
3 
 
commitment "for a period not to exceed six months or until there 
is no longer a likelihood of serious harm by reason of mental 
illness, whichever period is shorter," issued on the same day. 
 
On January 30, 2012, "N"'s treating physician, who had 
submitted the initial petition for involuntary hospitalization, 
determined that "N" no longer posed a likelihood of serious harm 
by reason of mental illness and ordered that he be discharged, 
pursuant to the terms of the commitment order.  Twenty-two days 
after his release, "N" broke into Miller's apartment and killed 
her in the presence of her eight year old granddaughter. 
 
The plaintiffs, a representative of Miller's estate and the 
mother of Miller's granddaughter, commenced an action in the 
Superior Court raising claims of, among other things, wrongful 
death; wilful, wanton, and reckless infliction of emotional 
distress; negligence in violating the terms of an order of civil 
commitment; and loss of consortium.  A Superior Court judge 
concluded that the hospital did not owe the plaintiffs any duty 
of care, and allowed the defendants' motion for summary 
judgment. 
 
We discern no error in the judge's ruling that the hospital 
did not owe the victim or her family any duty of care at the 
time of the killing.  The order of civil commitment to hold "N," 
which arose out of the actions of an individual medical 
professional's clinical judgment, did not impose an independent 
4 
 
duty on the hospital for "N"'s treatment, and did not require 
the hospital to exercise any medical judgment as to the 
appropriateness of release.  Accordingly, while Miller's death 
was tragic, because the hospital did not owe a duty of care to 
Miller or to her family at the time of her death, we affirm the 
judge's decision to grant summary judgment to the hospital. 
 
1.  Background.  The following facts are drawn from the 
summary judgment record.  We view them in the light most 
favorable to the nonmoving party, here, the plaintiffs.  See 
Godfrey v. Globe Newspaper Co., 457 Mass. 113, 119 (2010). 
 
"N"'s family took him to Steward Carney Hospital for a 
psychiatric evaluation on January 7, 2012.  The Boston area 
emergency services program recommended that "N" be admitted for 
stabilization and medical evaluation.  A medical evaluation form 
dated January 8, 2012, noted that "N" said that he had 
threatened to kill a family member; the form noted that the 
family member "N" reported as having threatened to kill was not 
the same person that the family had reported as the subject of 
the threat.  The family also reported that "N"'s behavior had 
been "bizarre" and that he had been talking to himself and to a 
television in his room.  The evaluation form stated that "N" had 
a history of psychiatric illness, including a previous episode 
in which "N" had been brought to the hospital after police had 
5 
 
responded to a report that he was threatening his mother with a 
knife. 
 
"N" remained in the emergency room until a bed in the 
hospital's psychiatric unit became available on January 9, 2012.  
On that date, "N"'s treating physician filed a petition for 
emergency restraint and hospitalization pursuant to G. L. 
c. 123, § 12 (a) and (b).  That statute authorizes a licensed 
physician to hospitalize a patient for a three-day period if the 
physician "has reason to believe that failure to hospitalize 
such person would create a likelihood of serious harm by reason 
of mental illness."  G. L. c. 123, § 12 (a). 
 
At the expiration of the three-day period, the 
superintendent of the hospital filed a petition for commitment 
under G. L. c. 123, §§ 7 and 8; these statutes allow the 
superintendent of a psychiatric facility to seek an initial 
commitment of up to six months, and thereafter an extension of a 
commitment for up to one year, see G. L. c. 123, § 8 (d), when 
the superintendent "determines that the failure to hospitalize 
would create a likelihood of serious harm by reason of mental 
illness," see G. L. c. 123, § 7 (a).  Following a hearing, a 
judge of the Boston Municipal Court found that "N" was "mentally 
ill and that . . . failure to retain ['N'] in a facility would 
create a likelihood of serious harm, and there is no less 
restrictive alternative for said person."  The judge ordered "N" 
6 
 
"be committed to the [hospital] for a period not to exceed six 
months or until there is no longer a likelihood of serious harm 
by reason of mental illness, whichever period is shorter." 
 
On January 30, 2012, "N"'s treating physician examined him 
and determined that he no longer presented a serious risk of 
harm due to his mental illness.  The physician noted that his 
behavior had improved with medication, he appeared to be at his 
usual "baseline" level of functioning, and his aggression 
towards other patients had ceased.  Accordingly, under the terms 
of the order of commitment, "N" was released that day. 
 
On February 21, 2012, "N" broke into the home of Miller, 
his neighbor, and stabbed her to death.  Miller's then eight 
year old granddaughter was present in the apartment at the time; 
she was not attacked and was physically unharmed. 
 
2.  Prior proceedings.  The plaintiffs filed a complaint in 
the Superior Court, asserting claims of wrongful death due to 
negligence; wrongful death by gross negligence; wrongful death 
by wilful, wanton, and reckless conduct; conscious pain and 
suffering due to wilful, wanton, and reckless conduct; conscious 
pain and suffering due to gross negligence; and conscious pain 
and suffering due to negligence; as well as claims brought on 
behalf of Miller's granddaughter for reckless infliction of 
emotional distress, and grossly negligent infliction of 
emotional distress; and claims of the granddaughter's mother for 
7 
 
consequential damages for loss of consortium and expenses for 
mental health care.  The claims were alleged separately against 
each of the defendants.  All of the claims were premised on the 
plaintiffs' assertion that the hospital "violated the January 
19, 2012 Order of the Justice of the Municipal Court of the City 
of Boston ordering that 'N' be committed to the [hospital] 'for 
a period not to exceed six months or until there is no longer a 
likelihood of serious harm by reason of mental illness, 
whichever period is shorter . . . ,' by releasing . . . 'N' 
eleven days later, at which time there was a likelihood of 
serious harm to all persons who came in contact with . . . 'N', 
including Mary L. Miller." 
 
The defendants filed a motion for summary judgment, arguing 
that (1) they owed no legal duty to the plaintiffs; (2) there is 
no cause of action in negligence for violating a court order; 
and (3) there was no special relationship that gave rise to a 
duty to control "N."  Following oral argument and supplemental 
briefing, a Superior Court judge granted the defendants' motion 
for summary judgment.  The judge "decline[d] to apply common law 
[to the plaintiffs' claims, as they requested,] where there is 
clear, unambiguous statutory guidance to the contrary," in the 
form of G. L. c. 123, § 36B.  That statute provides that a 
licensed mental health professional owes no duty "to take 
reasonable precautions to warn or in any other way protect a 
8 
 
potential victim or victims of said professional's patient," 
except in a narrow set of circumstances not present here.  
Relying on G. L. c. 123, § 36B, and a decision of the Appeals 
Court, Shea v. Caritas Carney Hosp., Inc., 79 Mass. App. Ct. 
530, 541 (2011), the judge concluded that the hospital owed no 
duty of care to the plaintiffs.  The plaintiffs filed a timely 
notice of appeal, and we allowed their motion for direct 
appellate review. 
 
3.  Discussion.  a.  Legal standard.  "Summary judgment is 
appropriate where there are no genuine issues of material fact 
and the moving party is entitled to judgment as a matter of 
law."  Boazova v. Safety Ins. Co., 462 Mass. 346, 350 (2012), 
citing Mass. R. Civ. P. 56 (c), as amended, 436 Mass. 1404 
(2002).  A moving party is entitled to summary judgment where a 
nonmoving party, who bears the burden of proof, has no 
reasonable expectation of proving an essential element of the 
claim.  Kourouvacilis v. General Motors Corp., 410 Mass. 706, 
716 (1991).  "Our review of a motion judge's decision on summary 
judgment is de novo, because we examine the same record and 
decide the same questions of law."  Kiribati Seafood Co. v. 
Dechert, LLP, 478 Mass. 111, 116 (2017). 
 
"To prevail on a negligence claim, a plaintiff must prove 
that the defendant owed the plaintiff a duty of reasonable care, 
that the defendant breached this duty, that damage resulted, and 
9 
 
that there was a causal relation between the breach of the duty 
and the damage."  Jupin v. Kask, 447 Mass. 141, 146 (2006).  
Whether a party owes a duty of care to another is a legal 
question, "determine[d] 'by reference to existing social values 
and customs and appropriate social policy.'"  Id. at 143, 
quoting Cremins v. Clancy, 415 Mass. 289, 292 (1993).  The 
question here is whether the hospital owed a duty of care to 
third-party victims, either arising out of the court order or 
through a common-law, special relationship between the hospital 
and its patient, "N." 
 
b.  Statutory duty of care.  In their complaint, the 
plaintiffs argued that the hospital violated the commitment 
order issued under G. L. c. 123, §§ 7 and 8, by negligently 
releasing "N" when his treating physician certified that he no 
longer presented a serious risk of imminent harm due to mental 
illness; the plaintiffs maintained that the order was directed 
at the hospital alone, the hospital delegated the duty to a 
particular physician, and the hospital was responsible for the 
decision to release "N."  At a hearing on the motion for summary 
judgment, the plaintiffs' attorney asserted that, because the 
order was directed at the hospital, the case did not raise any 
question of respondeat superior, as it was the hospital's 
specific duty to comply with the order and to decide whether "N" 
should be released. 
10 
 
 
On appeal, the plaintiffs contend that the order was 
directed at the hospital, thus creating a duty on its part, and 
that a hospital may not delegate such a duty to an employee.  In 
support of this argument, the plaintiffs point to the text of 
the commitment order, which required that "N" "be committed to 
[the hospital]," as well as to deposition testimony by the 
superintendent in which he stated that he understood the 
commitment order to have been directed at the hospital.  In 
addition, they claim that the duty created by the order exists 
independently of any duty owed by the licensed medical providers 
who signed the petitions for commitment and the release and, 
therefore, any duty that might have been imposed on the hospital 
under the doctrine of respondeat superior. 
 
Therefore, the plaintiffs maintain, "by releasing . . . 'N' 
eleven days [after his commitment under G. L. c. 123, §§ 7 and 
8,] at which time there was a likelihood of serious harm to all 
persons who came in contact with ['N']," the hospital violated a 
nondelegable duty of care.  The clinical determination to 
release "N," however, was made, and could only have been made, 
by an individual mental health professional, here, his treating 
physician.  We conclude that any duty involving the release of 
"N," and any negligence in authorizing his release under the 
terms of the order of commitment, belonged to this treating 
clinician, who was required to use professional medical judgment 
11 
 
in determining that commitment was required and when it was no 
longer needed. 
 
"[A] duty finds its source in existing social values and 
customs" (citation and quotations omitted).  Jupin, 447 Mass. at 
146.  When considering whether to recognize a duty, we consider 
any acts of the Legislature relevant to the issue in question.  
See, e.g., id. at 153–154 (relying on "legislative enactments 
acknowledging that the unauthorized use of firearms is a 
significant problem and placing requirements on owners of guns 
for the purpose of preventing their use by persons not competent 
to use them" in recognizing existence of "a duty of the person 
in control of the premises to exercise due care with regard to 
the storage of guns on the premises").  That the duty to make a 
clinical determination whether release is appropriate falls on 
an individual medical professional is consistent with the 
statutory scheme involving involuntary psychiatric commitment, 
which reflects the Legislature's understanding of the 
professional role of health care professionals in making 
clinical judgments. 
 
Here, the initial petition to hold "N" under G. L. c. 123, 
§ 12, was filed by his treating mental health clinician, 
following her clinical determination that "N" presented a 
"[s]ubstantial risk of physical harm to other persons as 
manifested by evidence of homicidal or other violent behavior."  
12 
 
See G. L. c. 123, § 12 (a) ("Any physician who is licensed . . . 
who, after examining a person, has reason to believe that 
failure to hospitalize such person would create a likelihood of 
serious harm by reason of mental illness may restrain or 
authorize the restraint of such person and apply for the 
hospitalization of such person for a [three]-day period . . .").  
The superintendent of the hospital then filed the petition for 
"N"'s commitment under G. L. c. 123, §§ 7 and 8.  The petition 
provides:  "[the superintendent] has determined that failure to 
hospitalize ['N'] would create a likelihood of serious harm by 
reason of mental illness."  See G. L. c. 123, § 7 (a) ("The 
superintendent of a facility may petition the district 
court . . . for the commitment to said facility [of the 
patient] . . .").  The notice of the hearing on "N"'s commitment 
states that the "petition for involuntary commitment has been 
filed by . . . Medical Director of the [hospital]."  The order 
of commitment itself specifies that "N" is to be delivered to 
the superintendent of the hospital. 
 
In deciding whether to impose a duty of care, we also must 
bear in mind that the statute was written in recognition of 
psychiatric patients' fundamental right to liberty.  See 
O'Connor v. Donaldson, 422 U.S. 563, 576 (1975); Newton-
Wellesley Hosp. v. Magrini, 451 Mass. 777, 785 (2008) (emergency 
commitment under G. L. c. 123, § 12 [b], implicates "significant 
13 
 
liberty interests").  "The right of an individual to be free 
from physical restraint is a paradigmatic fundamental right."  
Matter of E.C., 479 Mass. 113, 119 (2018), quoting Commonwealth 
v. Knapp, 441 Mass. 157, 164 (2004).  See Matter of N.L., 476 
Mass. 632, 637 (2017) ("The infringement of a person's liberty 
interest resulting from involuntary commitment for six months is 
massive" [quotation omitted]).  Thus, a psychiatric civil 
commitment should involve the "least burdensome or oppressive 
controls over the individual that are compatible with the 
fulfilment of the dual purposes of our statute, namely, 
protection of the person and others from physical harm and 
rehabilitation of the person."  Commonwealth v. Nassar, 380 
Mass. 908, 917-918 (1980). 
 
The Legislature has determined that the judgment of a 
qualified mental health professional is necessary in order to 
restrain an individual's liberty by involuntary psychiatric 
commitment.  In addition, because of the fundamental liberty 
interests at issue, a court must consider and approve an order 
of involuntary psychiatric commitment, after a hearing and after 
making findings; an involuntary commitment is appropriate only 
where it is established beyond a reasonable doubt that "(1) such 
person is mentally ill, and (2) the discharge of such person 
from a facility would create a likelihood of serious harm."  
G. L. c. 123, § 8 (a).  See Superintendent of Worcester State 
14 
 
Hosp. v. Hagberg, 374 Mass. 271, 276 (1978).  See generally 
O'Connor, 422 U.S. at 575 ("there is still no constitutional 
basis for confining such persons involuntarily if they are 
dangerous to no one). 
 
Concordantly, the Legislature has determined that a 
qualified mental health professional may make a clinical 
determination to release a psychiatric patient, consistent with 
"the highest possible standards of professional treatment," 
without notifying the court that issued the order of commitment, 
because a clinician is in the best position to determine whether 
a patient no longer poses a threat of serious harm.  See Nassar, 
380 Mass. at 912 n.5, quoting 1970 House Doc. No. 5021, at 2.  
The Legislature chose not to impose a separate duty on a 
hospital, and not to delay the release of a patient that the 
hospital no longer has a legal right to confine.  Continuing to 
hold a patient where a mental health professional has determined 
that there is no threat of serious harm would result in a 
violation of the patient's constitutional liberty interest and 
would be a violation of G. L. c. 123, §§ 7 and 8.  Consistent 
with its view of medical and legal standards, the Legislature 
left such determinations to qualified mental health 
professionals. 
 
The same standard of serious harm guides mental health care 
professionals' responsibility to report; "foreseeability of harm 
15 
 
to the plaintiff" is one of the "major" considerations in 
determining if a mental health professional has a duty to warn a 
potential victim.  See Tarasoff v. Regents of Univ. of Cal., 17 
Cal. 3d 425, 434 (1976).  General Laws c. 123, § 36B, defines an 
individual mental health professional's narrow duty to warn in 
the Commonwealth.  In balancing a patient's right to privacy 
with public safety, the statute strongly favors a patient's 
right to privacy, as is evident in the narrowness of the duty to 
warn.  See G. L. c. 123, § 36B; Tarasoff, supra at 440–441 
("recogniz[ing] the public interest in supporting effective 
treatment of mental illness and in protecting the rights of 
patients to privacy," while acknowledging narrow duty to warn 
specific, identifiable victim about threat).  The right to be 
free from physical restraint is at least as fundamental as a 
patient's right to privacy.  We are reluctant to disrupt the 
Legislature's careful balancing and to impose a duty on 
hospitals, which do not make individual clinical judgments, 
where the Legislative mandate and constitutional protections 
counsel against doing so. 
 
Nonetheless, a hospital is not necessarily free from all 
liability arising out of a clinical determination that a patient 
no longer presents an imminent risk of serious bodily harm due 
to mental illness.  A hospital may be liable under a theory of 
respondeat superior, arising out of an employment relationship, 
16 
 
for the actions of its medical professionals.  See Dias v. 
Brigham Med. Assocs., Inc., 438 Mass. 317, 323 (2002) (hospital 
may be vicariously liable for negligent conduct of employee 
doctor, notwithstanding hospital's "inability to exert direction 
and control over his clinical decisions").  In this case, 
however, the plaintiffs' did not raise any claim of vicarious 
liability; they also did not bring separate claims against the 
individual medical professionals who provided care to "N" and 
who ordered his release.5 
 
In addition, a hospital owes third parties a duty of 
reasonable care in hiring, training, and supervising the medical 
professionals who care for its patients.  See Roe No. 1 v. 
Children's Hosp. Med. Ctr., 469 Mass. 710, 714 (2014) ("there is 
little doubt that [defendant hospital] had a duty to supervise 
and monitor [third party's] conduct while he was employed as a 
physician"); id. ("an employer whose employees have contact with 
members of the public in the course of conducting the employer's 
                     
5 We note that, had a claim been made against any of the 
individual mental health care professionals involved in "N"'s 
care, the immunity provisions of G. L. c. 123, § 36B (1), would 
have been applicable to them, and the professionals involved 
almost certainly would have had individual immunity.  Although 
we need not decide whether an exception applied in this case, in 
order for the statutory exception to the immunity provisions of 
G. L. c. 123, § 36B (1), to apply, a patient must make a 
specific threat about a specific person, and must have an 
apparent ability and intent to carry out that threat.  Here, 
there is no indication in the record that the defendant ever 
threatened Miller or her family. 
17 
 
business has a duty to exercise reasonable care in selecting and 
supervising its employees").  See Tucson Med. Ctr., Inc. v. 
Misevch, 113 Ariz. 34, 36 (1976) ("Hospitals have been given and 
have accepted the duty of supervising the competence of the 
doctors on their staffs"); Johnson v. Misericordia Community 
Hosp., 99 Wis. 2d 708, 744 (1981) ("a hospital owes a duty to 
its patients to exercise reasonable care in the selection of its 
medical staff and in granting specialized privileges")."6  As 
with potential liability under a theory of respondeat superior, 
however, the plaintiffs did not allege negligent hiring, 
training, or supervision in their complaint. 
 
c.  Duty arising from a special relationship.  The 
plaintiffs maintain that the hospital owed them a duty of care 
because of the special relationship between the hospital and 
                     
6 Some courts in other jurisdictions have determined that, 
in limited circumstances, hospitals may be directly liable for 
care provided in their emergency rooms, and that hospitals have 
a duty to provide adequate emergency care.  At least three 
States have recognized a hospital's "nondelegable duty" to 
provide adequate emergency medical care.  See Simmons v. Tuomey 
Regional Med. Ctr., 341 S.C. 32, 44-46 (2000) (observing that 
"Alaska, Florida, and New York courts have applied the 
nondelegable duty doctrine to care provided by a hospital's 
emergency room physicians," noting that some States have 
explicitly rejected it, and that still others have not addressed 
it and instead have relied on claims of vicarious liability).  
We are not aware of any court that has recognized a nondelegable 
duty on the part of a hospital to provide inpatient mental 
health care, or of any State that has extended such a 
nondelegable duty of care to liability to third parties who are 
injured as a result of the care provided.  See Simmons, supra at 
44-45, and cases cited. 
18 
 
"N."  The Restatement (Third) of Torts provides that 
"[c]ustodians of those who pose risks to others have long owed a 
duty of reasonable care to prevent the person in custody from 
harming others."  Restatement (Third) of Torts:  Liability for 
Physical and Emotional Harm § 41(f) (2012).  The Restatement 
continues, "well-established custodial relationships include 
hospitals for the mentally ill."  Id.  Such a relationship is a 
qualifying "[c]ustodial relationship[]" because it "exist[s], in 
significant part, for the protection of others from risks posed 
by the person in custody."  Id.  Cf. Rogers v. Commissioner of 
the Dep't of Mental Health, 390 Mass. 489, 495 (1983) (noting 
that commitment under G. L. c. 123, §§ 7 and 8, "is for public 
safety purposes"). 
 
A special relationship arises out of the level of control 
exercised by the custodian.  Compare Bradley Ctr., Inc. v. 
Wessner, 161 Ga. App. 576, 581-582, aff'd, 250 Ga. 199 (1982) 
(mental health facility owed duty of care to third parties 
arising out of its special relationship with patient because 
facility had sufficient control over patient who could not leave 
premises during his commitment without being issued leave pass), 
with Davenport v. Community Corrections of the Pikes Peak 
Region, Inc., 962 P.2d 963, 968 (Colo. 1998), cert. denied, 526 
U.S. 1068 (1999) (private correction facility did not have duty 
to control its residents, where many residents had full-time 
19 
 
employment, provided their own transportation, and "readily 
obtain[ed]" passes to be off premises).  We agree that "N"'s 
involuntary commitment under G. L. c. 123, §§ 7 and 8, arising 
out of the order, created a special relationship under the 
common law.  Contrast Leavitt v. Brockton Hosp., Inc., 454 Mass. 
37, 42–43 (2009) (in absence of "statutory responsibilities," 
hospital had no duty to control voluntary outpatient). 
 
The defendants argue that G. L. c. 123, § 36B, abrogated 
any common-law duty that the hospital owed to the plaintiffs, 
including a duty to control.  The defendants' argument is 
unavailing.  The statute specifically addresses mental health 
care professionals and the limitations on their duty as 
professionals to protect third parties.  Such statutory immunity 
would run to hospitals under a claim based on a theory of 
respondeat superior for alleged negligence by an employee; the 
statute does not, however, absolve a hospital of its 
institutional responsibilities, including a duty to control a 
lawfully admitted patient.  See Riley v. Davison Constr. Co., 
381 Mass. 432, 438 (1980) ("A statute is not to be interpreted 
as effecting a material change in or a repeal of the common law 
unless the intent to do so is clearly expressed" [citation 
omitted]); A. Scalia & B.A. Garner, Reading Law:  The 
Interpretation of Legal Texts § 52, at 318-319 (2012) ("statutes 
20 
 
will not be interpreted as changing the common law unless they 
effect the change with clarity"). 
 
As did the Superior Court judge, the defendants rely on 
Shea, 79 Mass. App. Ct. at 541, in support of their claim that 
the hospital may not be directly liable for the clinical 
judgments of its mental health professional.  In that case, the 
Appeals Court rejected the plaintiff's argument that a mental 
health professional owed a common-law duty to a third-party 
victim of a former patient.  The court held that G. L. c. 123, 
§ 36B, does not show "the intention to permit additional 
liability based on common law."  Shea, supra.  The court did not 
consider whether the hospital in that case might have had an 
independent duty to control; rather, the court held that the 
statute "clearly abrogated any common-law duty owed by a mental 
health professional to a patient," id. at 540, and that "[a]ny 
liability of the corporate defendants would be based on the 
theory of respondeat superior."  Id. at 531 n.3.  We agree that 
the language of G. L. c. 123, § 36B, that a mental health 
professional has no duty to "warn or in any other way protect a 
potential victim" would prevent the imposition of a duty to 
control on a mental health professional and, accordingly, on a 
hospital under a theory of respondeat superior.  See G. L. 
c. 123, § 36B.  As discussed, however, the statute does not 
address the independent, common-law duty of a hospital to 
21 
 
control a patient who has been civilly committed, and the 
legislative history does not suggest an intent to displace a 
duty owed by an institution. 
 
Nonetheless, the hospital's duty to control is more narrow 
than the plaintiffs contend.  The hospital had a duty to hold 
"N" while he was lawfully "committed to the [hospital] for a 
period not to exceed six months."  "The [hospital's] duty of 
care is limited to the period of actual custody."  Restatement 
(Third) of Torts, supra at § 41(f).  The hospital's duty to 
control "N" ceased when his treating physician reached the 
clinical judgment that "N" no longer presented a likelihood of 
serious harm by reason of mental illness, and released "N."  
Under the terms of the commitment order, "N"'s commitment to the 
hospital was no longer authorized once the clinical 
determination was made.7  The hospital's act of releasing him was 
not merely proper, it was required by the terms of the order. 
 
The plaintiffs argue that the treating physician's clinical 
judgment about the risk "N" posed was inaccurate and incorrect, 
that "N" should not have been released, and that the hospital 
                     
7 By contrast, where a release was as a result of clerical 
error, or where a patient escaped, the fact that a patient is no 
longer in the hospital's custody does not necessarily end the 
duty to control.  See Jean W. v. Commonwealth, 414 Mass. 496, 
514 & n.16 (1993) (Liacos, C.J., concurring) (Department of 
Corrections and parole board may owe duty to injured third 
parties arising from special relationship with prisoner who was 
released in error). 
22 
 
retained control over him.  As discussed supra, however, the 
hospital had no role in the clinical determination that "N" was 
in a suitable condition to be released.  As the duty to hold "N" 
followed directly from the order of commitment, when his 
treating mental health professional determined that he no longer 
presented a likelihood of serious harm and ordered his release, 
the hospital no longer had actual control of "N" or the 
authority to hold him.  In the absence of this special 
relationship, the hospital had no duty to hold, or otherwise to 
control, "N" three weeks later when he attacked the victim in 
her home. 
 
 
 
 
 
 
 
Order allowing motion for 
 
 
 
 
 
 
 
  summary judgment affirmed.