Court Opinion

ID: 9781283
Source: CourtListenerOpinion
Date Created: 2023-08-30 16:28:24.443447+00
Date Added: 2024-06-11T07:34:23.527691
License: Public Domain

ANDREWS, Judge,
dissenting.
In cases involving whether a doctor may be held liable for a patient’s injury to a third person, Georgia law requires that the doctor have control over the patient before liability may be imposed. See Bradley Center v. Wessner, 250 Ga. 199, 200 (296 SE2d 693) (1982); Gilhuly v. Dockery, 273 Ga. App. 418, 419 (615 SE2d 237) (2005); Bruscato v. Gwinnett-Rockdale-Newton Community Svc. Bd., 290 Ga. App. 638 (660 SE2d 440) (2008). In cases involving whether a doctor *384may be liable for patients’ injuries to themselves, we have held that the doctor may be held liable where the patient is hospitalized at the time of the suicide or injury. See Brandvain v. Ridgeview Institute, 188 Ga. App. 106, 112 (372 SE2d 265) (1988) (finding a duty to the extent possible under reasonable medical practice to prevent suicide of a hospitalized patient). We have never held that a doctor may be liable for failing to involuntarily commit someone or failing to prevent a suicide where the patient was not under the doctor’s control.
Because the existence of a legal duty in a negligence action is a question of law for the court, City of Rome v. Jordan, 263 Ga. 26, 27 (1) (426 SE2d 861) (1993), and because the majority provides no authority for creating a legal duty of the psychiatrist in this case,15 and because of the numerous reasons set forth below which would militate against doing so, I respectfully dissent.
The undisputed facts in the record show that Reeves had a lengthy psychiatric history dating from at least 2001. Peterson was a psychiatrist who worked only two days a week at Horizons, which housed only voluntary patients, not patients who have been involuntarily committed.
On August 7, 2005, following a suicide attempt, Reeves was involuntarily committed to Northwest Georgia Regional Hospital. On August 15, 2005, she was discharged to Horizons. Her discharge papers stated that her condition had improved and she no longer had thoughts about wanting to hurt herself.16
On August 17, 2005, Reeves requested that she be discharged from Horizons. She returned for inpatient care on August 23, 2005, and Peterson examined her on August 26, 2005. Peterson noted that Reeves was psychotic and that her “meds will take a while.” That was the last time Peterson saw Reeves. Three days later, Reeves again asked to be discharged from Horizons. Peterson was not working at Horizons on August 29, and he was not consulted about Reeves’s discharge. Reeves was nonetheless discharged. She attended a group therapy session at Horizons on August 30, 2005, but she did not see Peterson. The next day, Reeves attempted suicide.
*385The basis for Reeves’s complaint is that Peterson failed to properly assess her when she saw him on August 26. But it is undisputed that, at that time, Reeves was a voluntary in-patient being treated until her medications could take effect.17
1. In order to sustain this cause of action, Reeves must prove: (1) a legal duty; (2) a breach of this duty; (3) a legally attributable causal connection between the breach and the resulting injury; and (4) loss or damage as a result of the alleged breach of the legal duty. See Bradley Center v. Wessner, supra. Under the circumstances of this case, I fail to see how Reeves can establish proximate cause. Reeves attempted suicide after she voluntarily left Horizons. Peterson did not discharge Reeves from the facility, and he was not consulted prior to her discharge. Notably both of plaintiff’s experts refused to state that when Peterson saw Reeves on August 26, his treatment fell below the standard of care because he did not anticipate that she might attempt suicide and did not involuntarily commit her. Dr. Alpern was asked: “Do you agree or disagree that... on August 26th Ms. Reeves was not a danger to herself or others?” Answer: “I have no way of knowing.” Dr. Reid was asked: “Was it below the standard of care for a physician not to try to commit her on August 26, 2005?” Answer:
The short answer is no. . . . What was required was a good evaluation, including adequate risk assessment and then adequate consideration of what to do to both protect her and help her. I don’t believe I can come to the conclusion based on what’s in the record, that the standard required someone to put her in the hospital.
“It is clear that a plaintiff cannot recover for medical malpractice, even where there is evidence of negligence, unless the plaintiff establishes by a preponderance of the evidence that the negligence either proximately caused or contributed to cause plaintiff harm.” Miranda v. Fulton DeKalb Hosp. Auth., 284 Ga. App. 203, 206 (644 SE2d 164) (2007), quoting Zwiren v. Thompson, 276 Ga. 498, 502-503 (578 SE2d 862) (2003) (a medical expert’s statement of proximate cause as being merely possible, as opposed to reasonably probable, is insufficient to establish liability). Thus, Reeves must submit some evidence that Peterson’s negligence proximately caused her attempted suicide and without that negligence, the attempted suicide would not *386have occurred. See Miranda, supra at 208 (no proximate cause as a matter of law where hospital did not release patient who escaped restraints and left without permission); compare Purcell v. Breese, 250 Ga. App. 472, 475 (1) (552 SE2d 865) (2001) (question of fact existed as to negligence where doctor was consulted and authorized release of suicidal patient from facility without talking to patient or reviewing most recent records).
2. In Division 2, the majority rejects Peterson’s contention that he had no duty to prevent Reeves from attempting suicide in this instance because he had no control over her at the time of the attempted suicide. The majority cites Purcell, supra, to support this holding, but Purcell cannot do so. In that case, a teenager was released from the hospital psychiatric unit at his mother’s request. Before releasing him, a call was made to Purcell, his treating psychiatrist, who authorized the discharge. Id. at 473-474. Here, it is undisputed that Peterson was never consulted about Reeves’s discharge and therefore had no opportunity to consider whether she should be discharged or involuntarily committed.
The crux of Peterson’s argument on appeal is that he cannot be held liable for the attempted suicide of a patient who was not under his control. The other case cited by the majority, Brandvain v. Ridgeview Institute, supra, concerns the duty to prevent the suicide of a hospitalized patient, id. at 112, and therefore is not analogous because the patient was under the control of the healthcare provider.
More persuasive is Ermutlu v. McCorkle, 203 Ga. App. 335, 336 (1) (416 SE2d 792) (1992), which held that for a physician to be under a special relationship of control of such person so that liability may attach for failure to exercise ordinary care to protect others from such mental patient, a two-part test must be satisfied: “(1) the physician must have control over the mental patient; and (2) the physician must have known or reasonably should have known that the patient was likely to cause bodily harm to others.” Id. Although Ermutlu is a case in which the patient harmed a third person, the reasoning should also apply in this case. As stated, the majority has cited no authority for making a different standard applicable in cases where the patient is a danger to herself.
3. In Division 3, the majority addresses Peterson’s contention that he was under no duty to involuntarily commit Reeves. In support of its holding that failure to involuntarily commit Reeves fell below the applicable standard of care, the majority again relies on Brand-vain, an in-patient case where the patient committed suicide while at *387Ridgeview Institute.18 That is not the issue before us. Further, we note again that neither of Reeves’s experts could state that failure to hospitalize Reeves was a breach of the applicable standard of care.
4. In Peterson’s last enumeration of error, he contends that imposing a duty to involuntarily commit patients violates the purpose of OCGA § 37-3-161. That Code section provides:
It is the policy of the state that the least restrictive alternative placement be secured for every patient at every stage of his medical treatment and care. It shall be the duty of the facility to assist the patient in securing placement in noninstitutional community facilities and programs.
Peterson points out that the “least restrictive alternative placement” is designed to prevent a plethora of patients from being improperly committed to facilities with possible tragic consequences. He argues that it is recognized in the profession that suicides are virtually impossible to predict, and that involuntarily committing patients could lead to more suicides and will expose doctors to an increased risk of liability in suits for false imprisonment. See Krachman v. Ridgeview Institute, 301 Ga. App. 361, 365 (687 SE2d 627) (2009) (material issues of fact exist as to claim of false imprisonment by involuntarily committed patient).
Finally, Peterson correctly points out that Georgia’s involuntary commitment statute does not create an affirmative duty to involuntarily commit a patient, providing only:
Any physician within this state may execute a certificate stating that he has personally examined a person within the preceding 48 hours and found that, based upon observations set forth in the certificate, the person appears to be a mentally ill person requiring involuntary treatment. . . .
(Emphasis supplied.) OCGA § 37-3-41 (a).
Thus, for any and all of the above reasons, the trial court erred in not granting summary judgment to Peterson on the legal duty of care. Accordingly, this case must be reversed.
*388Decided March 30, 2012
Lawrence A. Stagg, for appellant.
Ragland & Jones, Evan W. Jones, for appellees.

 The majority’s attempt to characterize its holding as not stating that Peterson had a duty to involuntarily commit Reeves or a duty to prevent her suicide attempt fails, because that is what the complaint alleges that Peterson failed to do; and, that is also the effect of the majority’s conclusion that Reeves has raised an issue of fact as to whether Peterson’s treatment fell below the standard of care in not involuntarily committing her and in not preventing her suicide attempt.

 The discharging doctor and Northwest Georgia Regional Hospital have settled with Reeves and are no longer in the case.

 Reeves was discharged from Horizons by Beverly Chapman. Reeves has already settled her case against Chapman and Horizons.

 The majority also cites Misfeldt v. Hosp. Auth. &c. of Marietta, 101 Ga. App. 579 (115 SE2d 244) (1960), another case in which a patient was injured while hospitalized and under the doctor’s control.