Opinion ID: 1304744
Heading Depth: 1
Heading Rank: 2

Heading: events prior to september 5, 1992

Text: The evidence reveals that Baldwin became a student at the University of Nebraska-Lincoln (the University) in the fall of 1988, where he received a full athletic scholarship to play football. In 1991, Baldwin began the football season as a starting running back for the University, but suffered a number of injuries that prevented him from playing the entire season. The University's football team played in the Orange Bowl in Miami, Florida, following the 1991 season. In January 1992, after accompanying the team to Miami, Baldwin became increasingly depressed about not being able to play football. Although Baldwin testified that he had no mental problems prior to that time, Baldwin's mental condition deteriorated rapidly and significantly on January 18. While riding in a car in Lincoln with other teammates on that date, Baldwin jumped out of the car and ran toward the Lincoln Municipal Airport in a futile effort to return to his family in New Jersey. Shortly thereafter, Baldwin ran naked through a residential neighborhood and came upon a woman who was walking her dog. Baldwin beat her severely and fought with at least three Lincoln police officers who were called to the scene. Baldwin was subsequently charged in the Lancaster County District Court with first degree assault on the woman and third degree assault on one of the Lincoln police officers. During the course of the criminal proceedings, Baldwin was hospitalized at the University of Nebraska Medical Center, where Baldwin was treated primarily by Dr. Donald Swanson, a board-certified psychiatrist. Swanson diagnosed Baldwin as having a severe mental illness, specifically, major depression with psychotic features. Swanson described the psychotic features as those aspects of a patient's condition which leave him out of touch with reality. Swanson concluded that medications were necessary to control Baldwin's condition. On June 10, 1992, Baldwin was found not responsible for either assault by reason of insanity; however, the Lancaster County District Court retained jurisdiction over Baldwin to oversee an appropriate mental health treatment plan which was to be developed and implemented by Swanson. While the actual mental health treatment plan was not admitted into evidence in the instant case, the district court found that the Lancaster County District Court had insisted on safeguards against further violence and that mandatory compliance was expected of Baldwin. Swanson testified in the instant case that Baldwin was somewhat hesitant about fulfilling his drug regimen and that Swanson explained to Baldwin that noncompliance could result in Baldwin's being readmitted to the hospital. Swanson continued to serve as Baldwin's primary psychiatrist and treated Baldwin regularly through September 1992. During that time, Swanson monitored Baldwin's symptoms, adjusted Baldwin's medication (lithium carbonate) accordingly, and was the only physician prescribing medication to Baldwin. Swanson testified that he spoke with Baldwin about the lithium carbonate's uncomfortable side effects (nausea being the most common) and instructed Baldwin on how to deal with such side effects. According to Swanson, Baldwin showed no explosive symptomology, but experienced varying degrees of depression on different occasions between April and September 1992. Swanson said that blood samples taken from Baldwin once a month indicated that the levels of lithium carbonate in Baldwin's system were always within the therapeutic range. Baldwin acknowledged that he was prescribed certain medications for his psychiatric condition between January and September 1992 and that he took the medications during the summer of 1992. Baldwin said that he understood that the purpose of the medication was to prevent him from having psychotic episodes. Baldwin testified that he could understand things and could read and comprehend instructions while taking the medication. Baldwin planned to refrain from playing football during the 1992 season. Since he was still interested in returning to college football in 1993, Baldwin continued physical workouts and training on his own during the summer of 1992. Baldwin felt, however, that the lithium carbonate interfered with his workouts, particularly insofar as it seemed to cause dry mouth, dizziness, nausea, and cramping in Baldwin's arms and legs. Although Baldwin could recall the events of January 18, 1992, he was not concerned about the possibility of such an episode recurring because he knew for sure what his frame of mind was during that episode and he could deal with it. Baldwin said that he discussed strategies to deal with psychotic feelings with his psychiatrist and that such strategies were explored in the context of Baldwin's continuing to take his medication. The Lancaster County District Court held an evidentiary hearing on August 24, 1992, to determine whether Baldwin presented a danger to himself or others and whether Baldwin should be committed for treatment at an appropriate facility. Swanson examined Baldwin on August 27 and noted that Baldwin expressed some anger and hostility about having to continue treatment. Based on evidence presented at the evidentiary hearing, the Lancaster County District Court found that Baldwin presented a danger to himself and others and ordered Baldwin committed to the St. Joseph Center for Mental Health (St. Joseph Center) in Omaha on September 2. At the same time, the Lancaster County District Court permitted St. Joseph Center to allow Baldwin to leave this facility if St. Joseph Center determined that releasing Baldwin was consistent with the safety of the public. On September 2, 1992, Baldwin and Swanson reviewed the district court's order, and Swanson noted that Baldwin was frustrated, angry, and embarrassed by that day's events. Swanson also conducted a mental status exam on Baldwin that day, but did not have a blood test performed to determine whether Baldwin had been taking the lithium carbonate. Swanson said that Baldwin was in compliance with the drug regimen as late as August 27 and that a blood test was scheduled for September 8. Swanson testified that Baldwin still suffered from a major mental illness on September 2, 1992, but concluded that Baldwin appreciated the risks of noncompliance with his drug regimen. Moreover, Swanson said that he had explained those risks to Baldwin that very day. Swanson also testified that lithium is a mood stabilizer and it was not likely that Baldwin would be able to adequately control his moods or psychotic symptoms if Baldwin went without the lithium carbonate for a period of 2 to 4 days. Nevertheless, according to Swanson, Baldwin secretly stopped taking the lithium carbonate sometime prior to September 2, 1992. Without saying precisely when, Baldwin confirmed at trial that he had stopped taking the medication sometime during the week prior to September 5. Baldwin said he did so because he felt better about himself and had things in front of him. Moreover, Baldwin said he believed he could recognize the frame of mind that he had experienced prior to his previous psychotic episode and would be able to control it if he started getting into such a frame of mind again. After discussing Baldwin's case on September 2, 1992, Swanson and the medical director for St. Joseph Center concluded that Baldwin posed no danger and discharged Baldwin to outpatient treatment that day. Baldwin did not want to attend the season-opening Nebraska football game in Lincoln on September 5 and decided instead to attend a different football game at the University of Nebraska-Omaha with Mickey Joseph, a former teammate. Baldwin admitted that he did not take his medication on that specific day.