Court Opinion

ID: 9546808
Source: CourtListenerOpinion
Date Created: 2023-08-07 17:35:27.645801+00
Date Added: 2024-06-11T15:16:51.690827
License: Public Domain

JACOBSON, Presiding Judge,
dissenting,
I respectfully dissent. This is a medical malpractice case. The alleged malpractice is that Samaritan Health Services, in the operation of its hospital, negligently failed to provide adequate care to and supervision of Anthony J. Peacock. Specifically the negligent care and supervision consisted of placing Peacock in a 4th floor room with unsecured windows from which Peacock jumped.
The issue before the trial court and this court is whether expert medical testimony was necessary to establish that the hospital knew or should have known that Peacock was suicidal (or so disoriented that he would wander out of a 4th floor window) and that the defendant breached the applicable standard of care for a person having Peacock’s mental condition.
The majority solves this problem by stating that since the hospital has a policy that all windows in the Mental Health Unit were to be secured so that they could not be *128opened from the inside and since Peacock was placed in the Mental Health Unit, the standard of care applicable to Peacock was that he was to be placed in a room with windows which could not be opened from the inside. Since there is a question of fact as to whether the particular window in Peacock’s room was in fact so securable, a jury issue is presented.
The problem with this syllogism is that it presupposes that a policy adopted by the hospital always establishes the standard of care regardless of the particular idiosyncrasies of the patient to which the policy is applied. It is like stating that if a hospital establishes a policy that all admittees to the hospital are only to be given blood tests upon admission, the standard of care for diagnostic purposes is only the administration of a blood test. More importantly the majority rationale would find medical malpractice on the part of the hospital for temporarily placing a non-mental patient in the Mental Health Unit and the patient while there decides to commit suicide by jumping out of a window. The adoption of a policy cannot, in an of itself, establish a standard of care absent evidence that the policy comports with the community standard of care for the particular patient involved.1 Bell v. Maricopa Medical Center, 157 Ariz. 192, 755 P.2d 1180 (App. 1988).
While the cases cited by the majority can be distinguished on their facts (cases in which there were clear suicidal attempts prior to admission which were known to the hospital authorities) in my opinion the facts in this case are more akin to those in Dimi-trijevic v. Chicago Wesley Memorial Hospital, 92 Ill.App.2d 251, 236 N.E.2d 309 (1968). In Dimitrijevic, the plaintiff’s decedent, who was suffering from depression, was placed in a room on the 11th floor of the hospital next to an unsecured window. The decedent leaped from the window to his death. Although there was evidence that the decedent had “suicidal thoughts” and that it was suggested that the decedent be placed in a ward with locked doors and windows, there was also expert testimony that he was not a “suicidal risk.” In reviewing whether the expert testimony was properly admitted, the court noted the general rule that expert testimony is usually necessary to show that defendant doctors and hospital did not use the requisite care. An exception to this rule, which allows the jury to pass on the adequacy of care given patients who commit suicide without the benefit of expert testimony, exists when the alleged negligence is “grossly apparent” or within the “common knowledge” of laymen. Id. The court then distinguished the cases cited by the plaintiff as falling within this exception.
In those cases there was no question but that the patients were suicidal risks. The patients had made previous attempts on their lives, the defendants acknowledged the serious risk of suicide and took precautions. The jury was allowed to evaluate whether the patients were watched closely enough in view of their admittedly pronounced suicidal tendencies. In the instant case the question is much farther from the ken of the lay mind: were the symptoms of the decedent such that a reasonably skillful doctor using customary methods would have regarded decedent as a suicidal risk requiring special precautions?
Id. at 255, 236 N.E.2d at 313. This analysis is equally applicable to those cases cited by the majority.
As was summarized in plaintiff’s response to defendants’ motion for summary judgment, Peacock’s “suicidal tendencies” were not that evident. On March 13, 1987, after not showing up for work, two coworkers found him at home, naked. There was a burned hole in the rug and a rifle nearby. This episode was related to the admitting doctors. At the time he was admitted at Good Samaritan he had apparently returned to normal and was embarrassed about his behavior and talked freely to the admitting doctor, Dr. Hicks. He related that he was “in a dream world” that “someone was out to get him” and that he was the last man on earth. He was admitted to the Mental Health Unit and *129was to be “observed, monitored and watched for worsening of his symptoms or evidence of delirium.” The nurse, on his admission found him to be pleasant and cooperative. At midnight he was found in his street clothes and remained awake until 2:00 a.m. At 5:30 a.m. was cooperative and anxious to get his “head on straight.” He talked about the pressures of the job and the need to get new accounts. He was ashamed of his-behavior of the past few days.
On March 14, he was diagnosed as having the “possibility of manic episodes,” “inability to sleep” and “agitation.” On the same day, his co-workers found him “fairly normal.”
On March 15, the co-worker thought he “had that funny look about him, a blank expression on his face.” At 2:30 the coworker’s concerns were expressed to the charge nurse, who upon observing him concluded that “there was obviously a problem” and “there was a change in his behavior.” At 3:07 Peacock was admitted to the emergency room after being found on the hospital grounds.
Under these circumstances I am not prepared, as the trial judge was not prepared, to say that it is completely obvious to a layman that the hospital knew or should have known that Peacock was suicidal and that precautions were necessary to keep him from harming himself.
The fact that the hospital has adopted a blanket policy concerning the operation of its mental unit, does not answer the question of whether it fell below the applicable standard of care as to Mr. Peacock. In my opinion that standard of care as to Mr. Peacock can only be established by expert testimony.
Peacock was not able to supply that testimony and even the affidavit, belatedly submitted 6 weeks after summary judgment was granted, does not supply the necessary standard.
I would affirm.

. Admittedly there may well exist standards of care applicable to all hospital patients, regardless of their underlying illness. However, it has not been suggested that all patients who suffer mental problems are required to be placed in a tamper-free environment.