Title: Hobart v. Shin
Citation: N/A
Docket Number: 84667
State: Illinois
Issuer: Illinois Supreme Court
Date: December 17, 1998

Hobart v. Shin, No. 84667 (Ill. S.Ct.) 
Docket No. 84667-Agenda 24-September 1998.
Opinion filed December 17, 1998.
JUSTICE HEIPLE delivered the opinion of the court:
The primary question presented by this appeal is whether a decedent's 
contributory negligence may be raised as a defense in a wrongful death suit 
brought against a physician whose patient commits suicide while under mental 
health treatment. The answer is yes.
FACTUAL AND PROCEDURAL HISTORY
Mildred Hobart filed this case in the circuit court of Cook County after her 
daughter, Kathryn, committed suicide by taking an overdose of Doxepin, a 
prescribed antidepressant medication. At the close of trial, the jury returned a 
verdict in favor of the defendant, Daniel C. Shin, M.D. The appellate court 
reversed and remanded for a new trial, holding that the circuit court improperly 
allowed defendant to file an affirmative defense alleging Kathryn's contributory 
negligence. 292 Ill. App. 3d 580. We granted defendant's petition for leave to 
appeal. 166 Ill. 2d R. 315.
The following facts were adduced at trial. In 1988, defendant was a family 
practice physician employed at the University of Illinois-Chicago's student 
health facility. On August 9, 1988, Kathryn Hobart, a 27-year-old student at the 
University, sought treatment from defendant, who was assigned as her primary 
care physician. During this appointment, Kathryn reported that she had recently 
been experiencing fatigue, changing moods, loss of appetite, irritability, 
dizziness, nausea, and breathing difficulty. Kathryn denied that she had 
thoughts of committing suicide. Defendant diagnosed Kathryn as suffering from 
general anxiety disorder. On August 18, defendant saw Kathryn again, and 
observed that she was feeling better and her mood was stable. On September 21, 
Kathryn had defendant examine a sore spot in her breast, but she did not mention 
her mental condition. On October 26, Kathryn saw another doctor at the clinic 
for a sore throat.
On November 21, Kathryn's mother, Mildred, telephoned defendant and reported 
that Kathryn was panicked and could not sleep. Mildred also said that Kathryn 
had been seen by the Hobart's family physician, who prescribed an antianxiety 
medication and recommended that she be examined by a psychiatrist. Defendant 
authorized Kathryn to see a psychiatrist at Hinsdale Hospital that day. The next 
day, November 22, defendant spoke over the phone to the psychiatrist at Hinsdale 
who had seen Kathryn. The psychiatrist told defendant that Kathryn had a 
long-term history of depression and panic attacks. The Hinsdale psychiatrist did 
not believe that Kathryn was suicidal, but recommended that she receive 
psychotherapy.
Later that day, defendant saw Kathryn in his office. Defendant noted that 
Kathryn could not stand, had no appetite, had difficulty sleeping, was worried 
about failing in school, and was experiencing general hopelessness and 
insecurity. Defendant was concerned that Kathryn might be having suicidal 
thoughts, and was aware that she had attempted suicide on two occasions 
approximately seven years earlier. Defendant recommended that Kathryn be 
hospitalized, but she refused. Defendant agreed instead to have her see a 
psychologist at the student counseling service. Kathryn went immediately to the 
counseling service, and after an hour or so, returned to defendant's office with 
a psychologist. The psychologist reported that, after some discussion, Kathryn 
had agreed to be hospitalized. Kathryn was admitted to the University of 
Illinois Hospital on November 23.
Dr. Rachel Fargason, a psychiatrist, treated Kathryn during her hospital 
stay. Although Kathryn was admitted under suicide precautions, Fargason lifted 
those precautions after the initial examination because she did not believe 
Kathryn posed a suicide risk. Fargason diagnosed Kathryn as suffering from 
recurrent major depression, and prescribed Doxepin, an antidepressant. On 
December 12, Kathryn was no longer displaying symptoms of depression, and she 
was discharged.
After Kathryn left the hospital, she saw defendant only once, on December 21. 
Defendant noted that Kathryn was smiling and upbeat, had no thoughts of 
hopelessness or suicide, and talked of her plans to become a teacher. Kathryn 
expressed concern about running out of medication and about the cost of filling 
small prescriptions frequently. Accordingly, defendant wrote Kathryn a 
prescription for 90 Doxepin pills of 50 milligrams each, a one-month supply, 
with one refill.
Fargason saw Kathryn on a weekly basis after she left the hospital. During 
three separate visits, on December 16, 23, and 30, Kathryn displayed no signs of 
depression and no active or passive suicidal tendencies. Fargason testified that 
although defendant did not notify her when he prescribed Kathryn additional 
medication on December 21, such notification between treating doctors would have 
been unusual and unnecessary for a prescription refill.
On January 4, 1989, after Kathryn's backpack containing her school notes was 
stolen, she became severely depressed. Her mother urged her to contact her 
doctors, but she refused because she did not want to be hospitalized again. On 
January 6, Kathryn was found dead in a motel room in which she had registered 
under a fictitious name. She had ingested approximately 224 Doxepin pills of 25 
milligrams each, for a total of 5,600 milligrams. A lethal dose is 500 
milligrams.
At the conclusion of the evidence, the court denied plaintiff's request to 
instruct the jury on the issue of contributory negligence using a nonpattern 
jury instruction. The court instead instructed the jury on contributory 
negligence pursuant to Illinois Pattern Jury Instructions, Civil, Nos. B10.03, 
10.02 (3d ed. 1995) (hereinafter IPI Civil 3d). The jury returned a verdict for 
defendant.
On appeal, the appellate court reversed the judgment and remanded for a new 
trial, holding that the affirmative defense of contributory negligence is 
inappropriate in a wrongful death suit brought against a physician whose patient 
commits suicide while under treatment for mental health. 292 Ill. App. 3d at 
588. The appellate court also held that the affirmative defense was untimely 
filed. 292 Ill. App. 3d at 586.
ANALYSIS
Defendant contends that the appellate court erred in holding that the 
affirmative defense of contributory negligence is inappropriate in a suit 
brought against a physician whose patient commits suicide while under mental 
health treatment. Defendant argues that the propriety of a contributory 
negligence defense should be determined by the trial court based on the facts of 
each case.
Plaintiff counters that the appellate court was correct in holding that 
"contributory negligence in a suicide malpractice case *** is inappropriate and 
irrelevant." 292 Ill. App. 3d at 588. Plaintiff argues that when a physician is 
treating a patient for suicidal tendencies, actions taken by the patient leading 
to suicide cannot constitute contributory negligence because the physician is 
under a duty to prevent precisely those actions. Plaintiff urges this court to 
follow the holding of Peoples Bank v. Damera, 220 Ill. App. 3d 1031 
(1991).
In Damera, a doctor who was treating a patient for suicidal 
tendencies prescribed a two-week supply of antianxiety and antidepression 
medication just before discharging the patient from the hospital. A few hours 
after discharge, the patient committed suicide by ingesting all of the 
medication. Damera, 220 Ill. App. 3d at 1032. The appellate court 
reversed the jury's verdict for the defendant, holding that "in a suicide 
malpractice case against the decedent's psychiatrist, the comparative fault of 
the decedent is not likely ever to be an appropriate or relevant issue ***." 
Damera, 220 Ill. App. 3d at 1035-36.
Section 2-1116 of the Code of Civil Procedure provides that a plaintiff whose 
contributory negligence is more than 50% of the proximate cause of the injury or 
damage for which recovery is sought shall be barred from recovering any damages. 
735 ILCS 5/2-1116 (West 1994). The statute thus makes clear that people 
generally have a duty to exercise ordinary care for their own safety. We are not 
prepared to hold, as did the appellate court in the instant case and in 
Damera, that this principle is inapplicable to all patients who commit 
suicide while under treatment for suicidal tendencies. Rather, we believe the 
better-reasoned approach is as another court has written on this subject:
To rule otherwise would be to make the doctor the absolute insurer of any 
patient exhibiting suicidal tendencies. The consequence of such a ruling would 
be that no health care provider would want to risk the liability exposure in 
treating such a patient, and, thus, suicidal persons would be denied necessary 
treatment. Public policy cannot condone such a result.
Plaintiff contends, however, that even if a defense of contributory 
negligence is sometimes appropriate in cases of a mental health patient's 
suicide, the trial court abused its discretion by allowing the defense to be 
raised in the instant case. Plaintiff points out that defendant knew of 
Kathryn's previous suicide attempts and diagnosed her as having suicidal 
thoughts only a few weeks before her death. Plaintiff argues that these strong 
suicidal tendencies show that Kathryn was incapable of taking responsibility for 
her actions.
We believe, on the contrary, that the trial court's decision to allow the 
defense of contributory negligence was supported by the evidence. By the time 
Kathryn was released from the hospital, she was no longer experiencing symptoms 
of depression. The last time defendant saw her, more than two weeks before her 
death, she was smiling and upbeat, and spoke positively of her plans for the 
future. Both defendant and Dr. Fargason testified that, in light of Kathryn's 
improved condition, they considered her request for a larger prescription to be 
both natural and rational. Furthermore, on the day of her death, Kathryn acted 
in a premeditated and deliberate fashion: she left home, refused to contact her 
doctors, and checked into a motel under a fictitious name. Given these facts, 
the trial court was justified in concluding that the issue of Kathryn's 
contributory negligence was appropriate for the jury's consideration.
Plaintiff further contends, however, that the appellate court correctly held 
that the affirmative defense should have been barred as untimely filed. 
Defendant counters that the trial court acted properly in allowing him to file 
the defense.
A trial court has broad discretion to allow the addition of new defenses on 
just and reasonable terms at any time before final judgment so long as other 
parties do not thereby sustain undue prejudice or surprise. See 735 ILCS 5/2-616 
(West 1994); Loyola Academy v. S&amp;S Roof Maintenance, Inc., 146 Ill. 2d 263, 273-74 (1992). The procedural history in this case shows that plaintiff 
filed her complaint on December 26, 1989. On April 6, 1990, defendant answered 
the complaint, denying that his conduct caused Kathryn's death. On January 21, 
1992, defendant filed a motion for summary judgment, arguing that Kathryn's 
conduct in taking her own life was the proximate cause of her death. On December 
1, 1994, Dr. Rachel Fargason testified by deposition that Kathryn's death was 
caused by Kathryn's choice not to call her treating doctors when she was upset 
and by her carefully planned behavior in going to the motel room to end her 
life. On December 12, 1994, plaintiff was granted leave to depose a rebuttal 
expert on the issue of causation. On May 5, 1995, defendant filed a motion for 
leave to file the affirmative defense of Kathryn's contributory negligence. On 
May 30, 1995, plaintiff filed a motion to strike the affirmative defense as 
untimely. On June 1, 1995, trial began, and the court entered an order allowing 
the filing of the affirmative defense and denying plaintiff's motion to strike. 
The jury heard from the first witness on June 7, and returned its verdict on 
June 28.
After carefully considering the record in this case, we conclude that the 
trial court did not abuse its discretion in allowing defendant to file the 
affirmative defense. The court heard extensive argument from both sides 
concerning the timeliness of the defense. During its deliberations on this 
matter, the court conducted a thorough examination of the pleadings and 
discovery in order to assess whether plaintiff would suffer prejudice if the 
defense were filed. The court concluded that the issue of Kathryn's 
responsibility for her own death was sufficiently prominent in the pleading and 
discovery process as to afford plaintiff ample opportunity to rebut the defense. 
Furthermore, in allowing the defense to be filed, the court specifically 
prohibited defendant from introducing any new evidence at trial on the issue, 
confining defendant's proof to the opinions of witnesses who testified during 
pretrial discovery. Conversely, the court explicitly permitted plaintiff to 
elicit during trial previously undisclosed opinions of witnesses on the question 
of Kathryn's contributory negligence. Although plaintiff claimed in her motion 
to strike that the timing of the filing prejudiced her, she failed to identify 
any issues which she was unable to fully examine or witnesses she was unable to 
call as a result of the trial court's ruling. In light of all these 
circumstances, we believe the trial court's decision to allow the affirmative 
defense was within its discretion.
Finally, plaintiff contends that the trial court gave the jury an improper 
instruction on the issue of contributory negligence. The appellate court 
declined to address this question. At the close of the evidence, plaintiff 
requested that the following nonpattern instruction be given to the jury:
The court refused plaintiff's requested instruction, and instead granted 
defendant's request to give the jury the following instructions, based on 
Illinois Pattern Instructions No. B10.03 and 10.02:
Plaintiff argues that the standard IPI instruction on contributory negligence 
was inadequate in this case because it failed to take into account the fact that 
Kathryn was being treated for mental illness at the time of her death. Plaintiff 
argues that Kathryn should not have been held to the IPI standards of "ordinary 
care" and a "reasonably careful person," because her mental condition prevented 
her from exercising such care.
Whenever an IPI instruction is applicable in a civil case, the trial court, 
giving due consideration to the facts and the prevailing law, is required to use 
that instruction. 134 Ill. 2d R. 239. A non-IPI instruction may be used if the 
court determines that the pattern instruction does not accurately state the law. 
134 Ill. 2d R. 239. The determination of whether an instruction is applicable 
and accurately states the law in a given case is within the trial court's 
discretion. Burge v. Morton, 99 Ill. App. 3d 266 (1981).
In the instant case, the trial court concluded that the IPI instructions were 
applicable and accurately stated the law on the issue of Kathryn's contributory 
negligence. Although the instructions required the jury to measure Kathryn's 
conduct by a standard of "ordinary care," the instructions defined this standard 
as "the care a reasonably careful person would use under circumstances 
similar to those shown by the evidence." (Emphasis added.) In light of the 
evidence in this case that Kathryn was competent and rational in the days and 
weeks immediately preceding her death, we cannot say that the trial court erred 
in concluding that the IPI instructions on contributory negligence were 
appropriate. The instructions allowed the jury to evaluate Kathryn's 
contributory negligence, if any, based on the particular circumstances of this 
case. The giving of the pattern instructions thus did not constitute an abuse of 
the trial court's discretion.
CONCLUSION
For the reasons stated, we reverse the judgment of the appellate court and 
affirm the judgment of the circuit court.
Appellate court judgment reversed;
circuit court judgment affirmed.
CHIEF JUSTICE FREEMAN, concurring in part and dissenting in part:
I agree with the majority to the extent it holds that (i) defendant may raise 
the issue of plaintiff's contributory negligence as an affirmative defense and 
(ii) defendant raised this affirmative defense in timely fashion. I part company 
with the majority, however, on the issue of whether the jury was properly 
instructed. Because I believe that a reduced capacity instruction was warranted 
in this case, I would reverse and remand the matter for a new trial.
Relying heavily on De Martini v. Alexander Sanitarium, Inc., 
192 Cal. App. 2d 442, 13 Cal. Rptr. 564 (1961), the majority initially concludes 
that the issue of contributory negligence of a mentally disturbed person is 
generally a question of fact and, thus, upholds the circuit court's submission 
of the issue to the jury. In addressing plaintiff's argument concerning the jury 
instructions in this case, however, the majority inexplicably ignores the 
guidance provided on this subject by the court in De Martini. It 
must be noted that in De Martini, the court expressly approved the 
use of an instruction which told the jury that it was "necessary for you to 
visualize a person in a similar condition when ascertaining what acts 
or omissions would be negligent and what would not be." (Emphasis added.) 
De Martini, 192 Cal. App. 2d  at 448, 13 Cal. Rptr.  at 567. 
Moreover, my research reveals that this approach has been similarly endorsed by 
other courts in foreign jurisdictions. For example, the New Jersey Supreme Court 
has acknowledged that
Likewise, the Court of Appeals of North Carolina has held that a person whose 
mental faculties are diminished is not exempt from the doctrine of contributory 
negligence. However, that person is not to be held to the objective reasonable 
person standard. Rather, the court stressed that such a person should be held 
only to the exercise of such care as he or she was capable of exercising, 
"i.e., the standard of care of a person of like mental capacity under 
similar circumstances." See Stacy v. Jedco Construction, Inc., 119 N.C. 
App. 115, 120, 457 S.E.2d 875, 879 (1995) (and cases cited therein).
Notwithstanding the above, the majority rejects plaintiff's contention that 
the standard Illinois pattern instruction (IPI) on contributory negligence, 
given to the jury here, was inadequate. Plaintiff argues that the instruction 
failed to take into account the fact that Kathryn was being treated for mental 
illness at the time of her death. Plaintiff further asserts that Kathryn should 
not have been held to the IPI standards of "ordinary care" and "a reasonably 
careful person" because her mental condition prevented her from exercising such 
care. In upholding the use of the given IPI instruction, the majority points out 
that the given instruction permitted the jury to consider ordinary care as the 
care a reasonably careful person would use under "circumstances similar to those 
shown by the evidence." The majority implies that this quoted language permitted 
the jury to consider Kathryn's mental state.
Unlike my colleagues in the majority, I am not at all confident that the 
quoted language would have caused the jury to measure Kathryn's conduct under 
the reduced standard of care as contemplated by the court in 
De Martini. Indeed, in view of the given instruction's earlier 
reference to the "reasonably careful person," I do not see how the jury would 
have known that it was to consider Kathryn's actions against the standard of 
care of a person of like mental capacity under similar circumstances. The jury 
in this case was simply not given any indication that it was to measure 
Kathryn's actions in light of her diminished capacity. Rather, the jury 
instruction given in this case merely related to the standard of care that 
governs an adult's contributory negligence, without regard to that adult's 
diminished capacity.(1)
The majority's acceptance of an instruction on contributory negligence which 
refers to a reasonable person standard of care is inconsistent with the very 
case law utilized by the majority to recognize the doctrine of contributory 
negligence in suicide cases in the first instance. For this reason, I believe 
that the lack of an instruction which related to the jury the reduced standard 
of care applicable to Kathryn constituted reversible error. I, therefore, would 
remand the matter for a new trial.
JUSTICES BILANDIC and McMORROW join in this partial concurrence and partial 
dissent.
Footnote:
1. I note that in a contributory negligence case 
which involves a minor, IPI Civil 3d No. 10.05 is to be used. This instruction 
explains to the jury the concept of the minor's reduced capacity by instructing 
that ordinary care means "that degree of care which a reasonably careful 
[person] [minor] [child] of the age, mental capacity and experience of the 
[plaintiff] [defendant] [decedent] would use under circumstances similar to 
those shown by the evidence." IPI Civil 3d No. 10.05. The inclusion of the 
phrase "under circumstances similar to those shown be the evidence" in this 
instruction contradicts the majority's implication that this same phase in the 
standard instruction serves to direct the jury to consider the concept of 
reduced capacity. If that were true, then IPI Civil 3d No. 10.05 would be 
unnecessary in cases involving minors. In any event, had an instruction similar 
to IPI Civil 3d No. 10.05 be given in this case, it would have more accurately 
explained to the jury the reduced capacity standard at issue than the standard 
instruction approved today by the majority.