Court Opinion

ID: 9643711
Source: CourtListenerOpinion
Date Created: 2023-08-22 20:38:22.544835+00
Date Added: 2024-06-11T12:27:58.473009
License: Public Domain

ROBERTS, Chief Justice,
concurring.
[1.2] I agree with the determination that neither James Vattimo nor his parents may seek recovery against appellant, Lower Bucks Hospital, Inc., for the cost of defending either the criminal prosecution brought against James Vattimo or the civil suit instituted against appellant by the deceased patient’s estate, in which James Vattimo was named as an additional defendant. Nor may appellees recover for any consequences of the criminal prosecution, including incarceration and involuntary commitment. On this record, recovery may be sought only for any of the remaining damages alleged to have been caused by appellant’s failure to provide James Vattimo with proper supervision upon his admission to appellant’s emergency psychiatric care unit.
NIX, Justice, concurring and dissenting.
[1] This appeal further illustrates the difficulties encountered when we attempt to define the extent of negligence *256liability in terms of causation.1 The real issue is how far as a matter of law should the hospital be held monetarily responsible for the claimed consequences of its alleged breach of duty. To become engrossed in. a factual assessment of causes and effects obscures the policy considerations that should control the determination. A metaphysical analysis of causes and effects ignores the fault predicate of common law negligence and frequently produces responsibility far out of proportion to the conduct of the wrongdoer.2
The same evil is present when attempts are made to use foreseeability as a panacea. While foreseeability of the injury is clearly a factor in defining duty, if it is accepted as the sole criteria we could not logically confine the extension of liability within reasonable limits. Even a limited imagination can create innumerable hypotheses, accompanied by staggering implications, by using foreseeability as the sole basis for defining the extent of liability. Foreseeability is best utilized as a basis to limit liability for consequences which are not foreseen, rather than as the basis for an extension of liability to that which can be theoretically foreseen.
This appeal presents the question of the parameters of liability of an alleged tortfeasor for the actions of one who was entrusted to its care and supervision and who negligent*257ly discharged that responsibility. My initial disagreement is with the suggestion by Mr. Justice Flaherty that any portion of this inquiry is properly assigned to the factfinder for resolution. Questions such as when the duty arises, what would constitute a breach of that duty, and the consequences for which the tortfeasor may be held legitimately responsible are questions of law requiring judicial determination. Only after these guideposts are clearly articulated can the factfinder proceed to determine whether the case in question supports the requested relief.
The duty alleged here is predicated upon James Vattimo’s mental illness (schizophrenic, paranoid-type) with an irresistible fascination for fire. It is alleged that as a result of accepting Vattimo in this condition as a patient, the hospital undertook to provide a standard of supervision and surveillance over the patient that would have prevented him from setting the fire and causing the resultant harm.3 Accepting these allegations in this procedural posture,4 it nevertheless must be emphasized that the hospital’s actions did not set the fire. The dereliction assigned to the hospital was its failure to prevent the occurrence. The undisputed genesis of the fire and the resultant damage was the underlying mental illness of Vattimo. Thus placed in proper perspective, we must decide what the hospital can be fairly held accountable for as a result of its failure to prevent the occurrence. In making such a judgment, it should be our *258objective to reasonably and fairly compensate for the cognizable loss but not to provide a windfall.5
Under well established precedent, if plaintiff produces sufficient evidence to demonstrate the mental condition of James warranted the duty asserted,6 the hospital would clearly be responsible for injury to the person or property of third parties where such injury resulted from a hospital’s negligent failure to meet its responsibility. See, e.g., Rhines v. Herzel, 481 Pa. 165, 392 A.2d 298 (1978); Semler v. Psychiatric Institute of Washington, D.C., 538 F.2d 121 (4th Cir.), cert. denied, 429 U.S. 827, 97 S.Ct. 83, 50 L.Ed.2d 90 (1976); Rum River Lumber Co. v. State, 282 N.W.2d 882 (Minn.1979); Doctors Hospital, Inc. v. Kovats, 16 Ariz.App. 489, 494 P.2d 389 (1972); Annot., 48 A.L.R.3d 1288 (1973); Restatement (Second) of Torts § 319 & comment (a), illus. (2) (1965); cf. Annot., 38 A.L.R.3d 699 (1971). The hospital is also unquestionably liable for actual physical harm to the person and property of its mentally disturbed patient resulting from its failure to use due care in the supervision of that patient. See, e.g., Bell v. New York City Health and Hospitals, 90 A.D.2d 270, 456 N.Y.S.2d 787 (1982); Payne v. Milwaukee Sanitorium Foundation, Inc., 81 Wis.2d 264, 260 N.W.2d 386 (1977); Meier v. Ross General Hospital, 69 Cal.2d 420, 71 Cal.Rptr. 903, 445 P.2d 519 (1968); Vistica v. Presbyterian Hospital, 67 Cal.2d 465, 62 Cal.Rptr. 577, 432 P.2d 193 (1967); Annot., 19 A.L.R. 4th 7 (1983); Annot., 17 A.L.R. 4th 1128 (1982); Annot., 70 A.L.R.2d 347 (1960); W. Prosser, Law of Torts § 33, at 172 (4th ed. 1971).7
*259I am convinced that a reasonable reading of the instant complaint indicates that the damages sought here are beyond those areas where the right to recovery has been previously recognized. I am also of the belief that the presently recognized limits of liability are fair and adequate to compensate for injuries from negligent acts of this nature and that the extensions instantly requested are not warranted. I, therefore, agree with Mr. Justice Flaherty’s conclusion sustaining the preliminary objections to the Appellee’s claim for damages related to defending the criminal and civil actions.
I am equally convinced that the remaining claims should also be dismissed and would affirm in entirety the April 17, 1977 order of the Administrator of Arbitration Panels for Health Care. The damage claims remaining on behalf of the parents were expenditures for medical and psychiatric care.8 The damages asserted on James’ behalf were for mental anguish, loss of employment and public humiliation. From the complaint it is clear that these damages are alleged to have resulted from the emotional distress resulting from his involuntary commitment to another hospital and the experience of being charged with murder in the first degree and arson.
The basis for the rejection of these claims are obvious. First, the relationship between the alleged negligent conduct and the asserted harm is tenuous at best. When the complained of incident occurred, James was at that time invol*260untarily committed because of his mental difficulties. There is no indication in the complaint that his subsequent continued involuntary confinement resulted from any reasons other than the underlying mental condition that caused him to be placed involuntarily in the care of appellant. Thus there is no nexus between the appellant’s alleged negligence and the complained of involuntary confinement to justify compensation for that experience by appellant.
Equally as tenuous is any argument attempting to hold appellant responsible for the decision to bring prosecution. Appellees are urging that the hospital be held responsible for the independent judgment of a branch of government to commence prosecution. It is the prosecution for the act, rather than the occurrence of the act, which is alleged to be the basis of this claim. Wherein it is reasonable to hold the hospital for the direct consequences of its act, it is not reasonable to extend the liability to the consequences of governmental responses to the conduct in question over which the hospital had no control. Nor can legitimacy be given to such a position by a strained causation analysis or by the fact that the result may conceivably have been foreseeable.
Second, the award of compensation for the decision to bring criminal prosecution would offend the cardinal premise justifying the award of damages in negligence cases. Damages are awarded to compensate for an injury or harm. The institution of criminal process is designed to serve a societal purpose and cannot be properly classified as a harm or an injury. To conclude otherwise would result in the anomaly of charging one with fault for the occurrence of a societal good. We should not recognize individual distress or displeasure that may flow from the proper functioning of government deemed to be in the best interest of society as a whole.
Even those who would insist upon interpreting the complaint as alleging that the emotional distress of James flowed from the occurrence of the fire itself must confront the question that the allowance of recovery here would *261require a far greater erosion of the traditional doctrine requiring physical injury or impact than has ever been suggested before. Prior to our decision in Niederman v. Brodsky, 436 Pa. 401, 261 A.2d 84 (1970), no recovery could be had for emotional distress negligently inflicted unless it was accompanied by physical injury or physical impact. See, Bosley v. Andrews, 393 Pa. 161, 142 A.2d 263 (1958); Gefter v. Rosenthal, 384 Pa. 123, 119 A.2d 250 (1956); Potere v. Philadelphia, 380 Pa. 581, 112 A.2d 100 (1955); Hess v. Philadelphia Transportation Co., 358 Pa. 144, 56 A.2d 89 (1948); Huston v. Freemansburg Borough, 212 Pa. 548, 61 A. 1022 (1905); Ewing v. Pittsburgh Railway Co., 147 Pa. 40, 23 A. 340 (1892); Fox v. Borkey, 126 Pa. 164, 17 A. 604 (1889). In Niederman, we discarded the “impact rule” with the language:
We today choose to abandon the requirement of a physical impact as a precondition to recovery for damages proximately caused by the tort in only those cases like the one before us where the plaintiff was in personal danger of physical impact because of the direction of a negligent force against him and where plaintiff actually did fear the physical impact.
436 Pa. at 413, 261 A.2d at 90.

The test espoused in Niederman became known as the zone of danger theory.

In 1979, in the case of Sinn v. Burd, 486 Pa. 146, 404 A.2d 672, it was found that the “zone of danger” test was too restrictive when the plaintiff actually witnessed the accident which caused serious injury to one having a close relationship with the plaintiff and, as a result of the impact of the event, sustained emotional shock resulting in mental as well as physical injuries to the witnessing plaintiff.
However, in the case of Yandrich v. Radic, 495 Pa. 243, 433 A.2d 459 (1981), this court was evenly divided as to the recognition of a claim for damages for infliction of emotional distress upon a father whose son was fatally injured after being struck by an automobile but the father was neither a witness to the incident nor in the immediate vicinity. Those *262members of the court in favor of recognizing a cause of action there were willing to expand the rule of Sinn to include recovery for emotional injury to a parent who does not witness, but is told of, physical injury to his child. Up to this time the expanded view of Sinn has yet to be adopted by a majority of this Court. Moreover, the requested recovery here far exceeds even that urged in Yandrich.
The justification for the exception in Sinn to the physical injury or physical impact rule of Bosley v. Andrews; supra, or the zone of danger theory of Niederman v. Brodsky, supra, was:
Where a parent or close blood relative actually witnesses a traumatic serious injury to a loved one, we expressed in Sinn that the emotional impact reverberating from that event was at least as potent as that which flowed from the personal exposure to danger under the zone of danger theory articulated in Niederman.
The common theme between the three theories is that in each instance the negligence of the actor results in a sensory experience that causes the resulting mental distress.
Yandrich v. Radic, supra, 495 Pa. at 250-251, 433 A.2d at 462, 463, (Opinion in Support of Affirmance, Nix, J.)
As noted in Yandrich all of the accepted theories supporting recovery are premised upon the negligence of an actor which results in a sensory experience causing the alleged resulting mental distress. Under the old rule it was of course a traumatic encounter with the tortfeasor which caused the injury or harm from which the emotional distress followed. Under the “zone of danger” theory it was the eminent exposure to immediate physical harm emanating from the actions of the tortfeasor placing the plaintiff in fear of injury or harm. In Sinn it was the witnessing of the traumatic, negligent act of the tortfeasor causing serious injury or death to a child. Even in Yandrich, where recovery was not allowed, there was a traumatic event in which *263the child of the plaintiff was killed as a result of the tortfeasor’s negligence. The disagreement as to whether recovery should be allowed centered upon the fact that the event was not witnessed by the plaintiff.
The instant factual setting is distinguishable because the traumatic event was physically set in motion by the plaintiff. As has been previously stressed, the alleged negligence of the hospital was passive. Thus the allowance of this claim is tantamount not only to a complete abrogation of all former restrictions upon recovery for emotional distress claim, it also permits the non-action of the defendant to be the predicate of liability against it for consequences directly resulting from the overt act of the plaintiff himself. Such a grotesque distortion of traditional law and a normal understanding of fault must be condemned.
McDERMOTT, J., joins in this concurring and dissenting opinion.

. Vinson, Proximate Cause Fog Spreads, 69 American Bar Journal, 1042 (1983); Green, the Causal Relation Issue in Negligence Law, 60 Mich.L.Rev. 543 (1962); Williams, Causation in the Law, Comb.L.J. 62 (1961); Pound, Causation, 67 Yale L.J. 1 (1957); Morris, Duty, Negligence and Causation, 1014. Pa.L.Rev. 189 (1952); Myers, Causation and Common Sense, 5 U.Miami L. 2, 238 (1951); Prosser, Proximate Cause in California, 38 Cal.L.Rev. 369 (1950); Green, Proximate Cause in Texas Negligence Law, 28 Tex.L.Rev. 71, 621, 755 (1950).

. In determining the existence of a duty of care, it must be remembered that the concept of duty amounts to no more than “the sum total of those considerations of policy which led the law to say that the particular plaintiff is entitled to protection” from the harm suffered. (Citation omitted) To give it any greater mystique would unduly hamper our system of jurisprudence in adjusting to the changing times.
Sinn v. Burd, 486 Pa. 146, 164, 404 A.2d 672, 681 (1979).

. As a general rule hospitals have a duty to provide such care and attention for the safety of their patients as their mental and physical conditions may require, to the degree their physical and/or mental disabilities cause them to be unable to manage for themselves. See, 19 ALR 4th 7 (1983); see generally, 40 Am Jur 2d, Hospitals and Asylums § 26.

. As an appellate court reviewing a ruling on a demurrer we accept as true all well-pleaded material facts in the complaint as well as all inferences reasonably deducible therefrom. Guy v. Liederbach, 501 Pa. 47, 459 A.2d 744 (1983); Speck v. Finegold, 497 Pa. 77, 439 A.2d 110 (1981); Allstate Insurance Co. v. Fioravanti, 451 Pa. 108, 299 A.2d 585 (1973).

. The temptation to be overly generous in compensating the victim must be sobered by a recognition of the ultimate result such an unwise election will produce. The disproportionate recovery for a loss sustained by this patient will inevitably result in an inflated charge for a future innocent patient’s need for critical services. One of the most threatening phenomena to our present way of life is the every spiraling cost for needed medical care. We cannot entrust to the jury the responsibility for adjusting this component of the equation when courts fail to assure the legitimacy of the equation itself.

. See, Doctors Hospital, Inc. v. Kovats, 16 Ariz.App. 489, 494 P.2d 389 (1972).

. We note, in a malpractice case involving a teenaged schizophrenic, the Missouri Court of Appeals analytically delineated the duty with *259which hospitals are charged. In M.W. v. Jewish Hospital Association of St. Louis, 637 S.W.2d 74 (Mo.App.1982), the court distinguished between admissions for cure and treatment involving professional judgments, and admissions for observation or incarceration which involve merely non-medical or ministerial judgments. However, the general allegations of the instant complaint and its lack of specificity do not permit such an analysis.

. The complaint contained a claim on behalf of the parents for their emotional distress. That claim was properly rejected by the Commonwealth Court on the grounds that Charles and Doris Vattimo were not present at the hospital during the fire and were not exposed to trauma flowing from the type of sensory experience which justified the allowance of recovery in Sinn v. Burd, 486 Pa. 146, 404 A.2d 672 (1979).