Court Opinion

ID: 9583559
Source: CourtListenerOpinion
Date Created: 2023-08-21 22:39:48.848011+00
Date Added: 2024-06-11T13:39:04.242484
License: Public Domain

Pope, Judge,
concurring specially.
I concur in our decision here that summary judgment for the four defendants was appropriate under the doctrine of sovereign immunity. I offer the following remarks, however, in response to the special concurrences of my brethren.
1. The issue pretermitted by our decision in this case is whether state and county employees of mental health facilities have a legal duty to control the conduct of a former patient to prevent him from causing physical harm to others. Appellant alleges that defendants Grigsby and Oguz (hereinafter “hospital defendants”) were negligent in their recommendation to release Reed from involuntary commitment. In addition, appellant alleges that defendants Dunlap and Crofford (hereinafter “clinic defendants”) were negligent in failing to keep Reed on an outpatient basis. The Supreme Court addressed a similar issue in 1982 in Bradley Center v. Wessner, 250 Ga. 199 (296 SE2d 693) (1982), in which a cause of action was allowed against a private mental hospital and its staff for failure to warn the victim of one of its patients. In Bradley Center, the appellant mental health hospital was held civilly liable for the murder of appellees’ mother by their father, a patient at appellant’s facility. The hospital had given appellees’ father an unrestricted weekend pass after he had indicated that if given the opportunity, he would hurt his wife. The Supreme Court invoked an exception to the general rule that there is no legal duty to control the conduct of third persons to prevent them from causing physical harm to others. According to the court, “ ‘where the course of treatment of a mental patient involves an exercise of “control” over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls upon the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient.’ ” 250 Ga. at 201, citing Bradley Center v. Wessner, 161 Ga. App. 576, 581 (287 SE2d 716) (1982). By holding the hospital liable, the Supreme Court stated it was not creating a new tort but rather applying “traditional tort principles of negligence.” 250 Ga. at 202.
The holding in Bradley Center parallels cases in other jurisdictions that have imposed liability on psychotherapists for failing to use reasonable care to give threatened persons warnings sufficient to avert *384foreseeable danger arising from his patient’s condition. For example, in Tarasoff v. Regents of Univ. of Cal., 529 P2d 553 (Cal. 1974), a psychotherapist was held to be subject to liability for the wrongful death of the victim of one of his patients. The California Supreme Court in Tarasoff found that a special relationship exists between the patient and his psychotherapist and is sufficient to impose an affirmative duty on the therapist to warn affected third persons of impending danger from the patient. A duty exists “[i]f in the exercise of reasonable care the therapist can warn the endangered party or those who can reasonably be expected to notify him. . . .” 529 P2d at 561. The rule in Tarasoff was followed in McIntosh v. Milano, 403 A2d 500 (N.J. Super. 1979). The New Jersey court imposed liability on a psychiatrist who failed to warn the victim of one of his patients of the danger imposed by that patient. According to the court, “a psychiatrist or therapist may have a duty to take whatever steps are reasonably necessary to protect an intended or potential victim of his patient when he determines, or should determine . . . that the patient is or may present a probability of danger to that person.” 403 A2d at 511-12.
The decisions in Bradley Center, Tarasoff and McIntosh all base liability on the aspect of the foreseeability of the harm to third persons or the harm to the mental patient himself. The Bradley Center rule, however, goes one step further. The plaintiff must establish foreseeability of the harm and the defendant’s ability to control the actions of the patient. Although the Supreme Court has thus recognized a cause of action against mental health facilities in circumstances similar to the facts at bar, I find that appellant has not established the foreseeability or control necessary to prevail in the case at bar under the Bradley Center rule.
Hospital defendants, Grigsby and Oguz, were governed by OCGA § 17-7-131 (a) in effect at the time pertinent to this case in their release recommendation. That section provides that a person adjudicated not guilty by reason of insanity and committed to a state mental hospital shall not be released unless a court finds that he does not meet criteria for civil commitment. According to OCGA § 37-3-1 (12) a person meets the criteria if he is mentally ill and presents a substantial risk of imminent harm to himself or others. As is pertinent here, the risk of harm is to be determined by recent overt acts or recent expressed threats of violence which present a probability of physical injury to himself or others. The record shows that during Reed’s confinement at West Georgia Regional Hospital, Reed did not show any violent or threatening behavior. Tests designed to determine mental illness revealed that Reed’s mental illness was in remission. Based on that information, there was no evidence that the hospital defendants knew or should have known that Reed presented a *385substantial risk of imminent harm.
In addition, clinic defendants Crofford and Dunlap had no reason to know that Reed was likely to cause bodily harm. Crofford met with Reed during Reed’s first visit at the clinic. Reed told Crofford that he was fine and did not need the clinic’s services. Such a statement along with knowledge of the court’s release of Reed from involuntary commitment, does not reveal that Crofford did know or should have known about Reed’s substantial risk of harm to others. Dunlap had only one contact concerning Reed. Reed’s sister and mother contacted Dunlap the day prior to the shooting. Reed’s relatives informed Dunlap that Reed had not harmed or threatened anyone but had bought a gun which the pawnshop was taking back. Based on that information and no evidence to show that Dunlap should have been familiar with Reed’s case, Dunlap had no reason to know, nor should he have known, that Reed was likely to cause bodily harm.
The second element of the Bradley Center rule — control — also cannot be found from the facts at bar. In Bradley Center the hospital was held to have control because it allowed the patient an unrestricted weekend pass during which time the murder was committed. In this case, however, the hospital and clinic defendants did not have the ability to control Reed at the time of the murder. Reed had not been a patient at either the hospital or the clinic for several months. Therefore, since (1) it was not foreseeable that Reed was likely to cause harm, and (2) defendants did not have the ability to control Reed, the rule in Bradley Center does not apply.
2. According to my brethren, OCGA § 17-7-131 (b) in effect at the time pertinent to this case allows only two possibilities upon an application for release: unconditional release or continued involuntary commitment. I respectfully disagree. OCGA § 17-7-131 (b) merely allows for release if the civil commitment criteria is not met and continued commitment if such criteria is present. The section, therefore, does not preclude a superior court from rendering any other decision it deems reasonably necessary. A superior court has general and broad powers in cases over which it has jurisdiction. See Johnson v. State, 177 Ga. 881 (la) (171 SE 699) (1933). Subsections (4) and (8) of OCGA § 15-6-9 provide that superior courts have authority to “exercise all other powers necessarily appertaining to their jurisdiction” and to “grant all other writs . . . which may be necessary to the exercise of their jurisdiction and which are not expressly prohibited.” As indicated above, OCGA § 17-7-131 (b) does not expressly prohibit other actions by the superior court. Therefore, the court in the case at bar could have conditioned the patient’s release or given any other order to secure the safety of the patient and others. The very nature of mental illness demands that such procedures be implemented by the courts. A mentally ill person may not show signs of his illness *386while institutionalized, yet, upon release or at some later time, symptoms of his illness may reoccur. Therefore, to help the patient with his mental illness as well as to protect the public from potential harm, a type of conditional release is an option for superior courts.
A form of conditional release, analogous to parole of convicted persons, is featured in nearly one-half of state criminal commitment statutes. See Note, “Commitment & Release of Persons Found Not Guilty By Reason of Insanity: A Georgia Perspective,” 15 Ga. L. Rev. 1065, 1101 n. 221 (1981). Under a conditional release order, the superior court could release the patient on conditions the court deems necessary. If the conditions are not fulfilled, the court can order re-commitment. Such conditions could include discharge of the patient to the custody of the family, outpatient care and periodic check-ups. See, e.g., 111. Ann. Stat. Ch. 38 § 1005-2-4 (Smith-Hurd Supp. 1980).
A type of conditional release was proposed by the Mental Health Committee of the Georgia State Bar Association in 1980 in a draft of an amendment to then Code Ann. § 27-1503 (now OCGA § 17-7-131). The amendment would have given the court three alternatives in handling a person found not guilty by reason of insanity and meeting the civil commitment criteria. First, the court could order that the patient be hospitalized. Second, the patient could be ordered to comply with an outpatient plan for treatment. Finally, the patient could be hospitalized for a limited period followed by a court-ordered outpatient plan. The proposed amendment further provided that at anytime during a period of outpatient treatment, a patient could be hospitalized if his condition deteriorates or there is a probability of physical harm to himself or others. 15 Ga. L. Rev. at 1102 n. 227, supra.
I believe that a superior court has the power to order a conditional release even without a statutory amendment. Because the court possesses such power, there .exists an issue for the jury as to whether the hospital defendants were negligent in not fully informing the court of Reed’s condition. The record shows that the hospital defendants did find that Reed no longer met the civil commitment criteria. However, the record also reveals that Reed was referred to the Adult Mental Health Clinic for further therapy. According to defendant Oguz, patients are routinely referred to the health clinic if they need a “follow-up.” In addition, defendant Oguz stated that had he known Reed would decline follow-up treatment, he might have changed his decision to release him. Had the hospital defendants informed the court that they believed Reed needed outpatient therapy, the court might have conditioned his release or not released him at all. Since the clinic defendants were not involved in recommending Reed’s release, they had no duty to inform the court and therefore summary judgment in their favor should be affirmed.