Court Opinion

ID: 9752867
Source: CourtListenerOpinion
Date Created: 2023-08-28 18:40:27.545853+00
Date Added: 2024-06-11T07:27:24.287297
License: Public Domain

ROGERS, Chief Judge,
dissenting:
As the result of a brief meeting of three to five minutes between appellant and a person who disguised her identity as a doctor, and who failed to indicate on the emergency application form that she had personally examined appellant, appellant was deprived of her liberty for 48 hours. All of this is contrary to the plain language of the District of Columbia Hospitalization of the Mentally Ill Act (Ervin Act), D.C.Code §§ 21-521, -582 (1989), which contains specific requirements that must be followed by particularly identified persons before anyone may be deprived of his or her liberty incident to an emergency hospitalization.
The majority “affirm[sj the action of the trial court” by concluding that the statutory requirement for observation and examination was met under the circumstances of this case. See majority opinion at 2, 12. The net result of the majority’s conclusion, however, is to render the statutory requirement for observation and examination virtually meaningless.
To reach its result, the majority states that the court should apply “a certain leeway in interpreting” the requirement of D.C.Code § 21-582(b) that an application be “based on personal observation and examination.” See majority opinion at 13. This is a new standard for interpreting the Er-vin Act, contrary to long-standing prior decisions. See In re Lomax, 386 A.2d 1185, 1188 (D.C.1978) (en banc) (the Ervin Act is narrowly construed where its application results in the curtailment of individual liberty). As the United States Court of Appeals for the District of Columbia Circuit observed in Covington v. Harris, 136 U.S.App.D.C. 35, 41, 419 F.2d 617, 623 (1969), civil commitment
entails an extraordinary deprivation of liberty justifiable only when the respondent is ‘mentally ill to the extent that he is likely to injury himself or other persons if allowed to remain at liberty.’ A statute sanctioning such a drastic curtailment of the rights of citizens must be narrowly, even grudgingly, construed in order to avoid deprivations of liberty without due process of law. [Footnote omitted.]
Similarly, the majority’s conclusion that the requirements for observation and examination mean no more than very limited *540personal contact, see majority opinion at 11 (referring to “several minutes”), is contrary to the statutory language and legislative history. The Ervin Act requires that the certificate of a physician “shall set forth in detail the facts and reasons on which the physician ... based his opinions and conclusions.” D.C.Code § 21-582(b) (emphasis added). The requirement for personal observation and examination was inserted at the bequest of Judge Alexander Holtzoff of the United States District Court for the District of Columbia who was concerned about “some loose certificates which occasionally ha[d] been presented.” 1 Protecting the Constitutional Rights of the Mentally III, S.Rep. No. 925, 88th Cong., 2d Sess. 6 (1964). In its ordinary meaning, the word “examination” suggests a detailed, pointed quest for information which will aid in reaching a diagnosis. See Random House College Dictionary 459 (rev. ed. 1986) (“examine” means “to inspect or scrutinize carefully”). The statutory language requires no less. Standards of care in medical malpractice cases involving erroneous commitment require, moreover, that the physician or psychiatrist must evaluate the patient in a careful and meaningful way.2 Given the “profound congressional concern” for protecting the rights of a prospective patient, Lomax, supra, 386 A.2d at 1188, and the statutory preference for voluntary commitment, D.C.Code §§ 21-511, -514; S.Rep. No. 925, 88th Cong., 2d Sess. 15 (1964); H.R.Rep. No. 1833, 88th Cong., 2d Sess. 5 (1964), it necessarily follows that the examination requirement must be strictly construed to require proof that the examining physician has examined the potential patient in a careful manner. See Nova Univ. v. Educ. Inst. Licensure Comm’n, 483 A.2d 1172, 1179-80 (D.C.1984), cert. denied, 470 U.S. 1054, 105 S.Ct. 1759, 84 L.Ed.2d 822 (1985) (court’s interpretation should not render any provision of statute meaningless); Lomax, supra, 386 A.2d at 1188.
Other than evidence of the fact that Dr. Goetcheus (while hiding her identity as a doctor) met with appellant for three to five minutes, there is very little evidence regarding their conversation, if any.3 Sandra Porter, a social worker at the homeless shelter, testified only that the meeting occurred. Dr. Goetcheus did not testify, and Ms. Porter did not testify about the nature of the contact between appellant and Dr. Goetcheus. Nor did Dr. Goetcheus indicate, as called for on the application form, that she had examined and observed appellant.4 Under these circumstances, it is difficult, at best, to conclude that the government met its burden to show that the contact between appellant and Dr. Goetcheus constituted an examination within the meaning of the statute. See Williams v. Meredith, 407 A.2d 569, 574 (D.C.1979); In re Barnard, 147 U.S.App.D.C. 302, 306-07, 455 F.2d 1370, 1374-75 (1971) (government has burden of proof and must offer live testimony where patient challenges the adequacy of the papers (including the application) on which the judge relies upon to *541authorize commitment under D.C.Code § 21-524).
A further difficulty in the majority opinion arises from the fact that the failure of Dr. Goetcheus to conduct a proper examination of appellant was not the only violation of the Ervin Act’s emergency hospitalization provisions. As the majority concedes, see majority at 9, Dr. Goetcheus was not a physician of the person under D.C.Code § 21-521. To cure this defect the majority relies upon In re Rosell, 547 A.2d 180 (D.C.1988). Consequently, in determining that these violations are of no legal consequence — one because it was cured, the other on the ground that there was no violation — the majority has rendered superfluous the requirements of D.C.Code §§ 21-521, -582(b).
Heretofore, the court has excused violations of clear statutory requirements, explaining that such irregularities, other than violations of a statutory time limit,5 could be cured by a subsequent judicial determination of probable cause of the need for further detention. In none of our prior decisions was there a deviation from more than one element of the statutory requirements.6 By contrast, appellant was deprived of both an examination and a physician of the person.7 Furthermore, the failure of the doctor to certify that she had personally examined appellant caused the application to be invalid on its face. Thus, no element of the emergency hospitalization application requirements, other than timeliness, had been met. Notwithstanding that the burden of proof is on the government, the majority has blamed appellant for deficiencies in the government’s evidence, see majority opinion at 538 n. 11, effectively turning the statute on its head.
The courts in this jurisdiction have long acknowledged the importance that Congress attached to the statutory requirements for emergency involuntary hospitalization. In the instant case the Emergency Psychiatric Response Division of District of Columbia General Hospital examined appellant the day before she was seen by Dr. Goetcheus and concluded that appellant did not require emergency hospitalization. Yet the very next day appellant was detained based on an application completed by a doctor who did not have the patient loyalty required by the statute and whose examination did not meet the proper standard of care and who was not otherwise eligible to apply for appellant’s emergency detention. The government has offered no explanation for its failure to comply with the statutory requirements for emergency hospitalization applications, and, contrary to the majority’s suggestion, majority opinion at 539, in view of the court’s interpretation of the statute and application of the cure doctrine, the government has little incentive to assure rigorous compliance with the statutory requirements.
The effect of the majority’s opinion, therefore, is to extend a general rule that defects in the initial application for emergency hospitalization under D.C.Code § 21-521 can, except when statutory time limitations are violated, be cured by a subsequent judicial determination that there is probable cause to continue detention. See majority opinion at 539. Here, neither the “physician of the person” nor the “personal observation and examination” requirements of the Ervin Act, D.C.Code §§ 21-*542521, -582(b), nor other requirements relating to persons authorized to sign the emergency application form, § 21-582(a), were met. Thus, this is not a case involving minimal procedural deficiencies; instead the due process interests of appellant were infringed. See In re DeLoatch, supra note 5, 532 A.2d at 1345 (comprehensive statutory scheme protecting constitutional rights).
Most respectfully, I suggest that it is time for the en banc court to reexamine its interpretation of the statutory prerequisites for emergency hospitalization and the application of the cure doctrine to those provisions of the Ervin Act. No principled basis exists on which to distinguish between the violation of statutory timetables and the denial of other statutory rights that are designed to prevent erroneous involuntary commitments as well as unwarranted and unlawful detention. Without en banc review the court will be bound in the future to continue to render superfluous the statutory requirements for emergency hospitalization and the Ervin Act’s protections will have become a mockery.
Accordingly, I respectfully dissent.

. Prior to the enactment of the District of Columbia Court Reform and Criminal Procedure Act of 1970, Pub.L. No. 91-358, 84 Stat. 473 (1970), civil commitment proceedings were handled by the federal courts of the District of Columbia.

. See, e.g., Maben v. Rankin, 55 Cal.2d 139, 358 P.2d 681, 10 Cal.Rptr. 353 (1961) (en banc); Kleber v. Stevens, 39 Misc.2d 712, 241 N.Y.S.2d 497 (N.Y.Sup.Ct.1963), aff’d, 20 A.D.2d 896, 249 N.Y.S.2d 668 (1964); James v. Brown, 637 S.W.2d 914 (Tex.1982); see abo J. Smith, Medical Malpractice Psychiatric Care, § 12.06, at 493 (1986) ("physicians and psychiatrists should avoid certifying for commitment a patient whom they have not actually observed or evaluated in some reasonable way’’); A. Holder, Erroneous Commitment, 219 J.Am.Med.A. 1389 (1972) (“in most states an examining physician owes the patient the legal duty to examine him in a duly careful manner before certifying the necessity for commitment. Failure to do so may be negligence”).

. The unchecked box states: "that I am not related by blood or marriage to the alleged mentally ill person; that I am not financially interested in the hospital to which said person is to be detained; and that the statements made hereinafter are based on my personal observations and examination of said person not more than 72 hours prior to the making of this application.”

. Dr. Brown had diagnosed appellant’s condition as “paranoid schizophrenia.”

. In re Reed, 571 A.2d 801 (D.C.1990); In re Feenster, 561 A.2d 997 (D.C.1989); In re DeLoatch, 532 A.2d 1343, 1345 (D.C.1987).

. In In re Rosell, supra, 547 A.2d at 180, the doctor who examined the person for an hour was not "a physician of the person.” In In re Morris, 482 A.2d 369, 373 (D.C.1984), the patient’s physician had not examined the patient within 72 hours of preparing the application. In Meredith, supra, 407 A.2d at 573-74, the examining physician was a physician member of the Commission on Mental Health and not a "physician of the person.”

.The court has previously acknowledged congressional concern and the reasons for the requirement of a physician of the person. See Rosell, supra, 547 A.2d at 184 (Rogers, J., concurring) (discussing significance that Congress placed on requiring a physician of the person, rather than just any doctor, to apply for emergency hospitalization, because the former would "possess a patient-oriented role identification”); Williams v. Meredith, supra, 407 A.2d at 572-73 (same).