Court Opinion

ID: 9461496
Source: CourtListenerOpinion
Date Created: 2023-08-04 22:15:58.971095+00
Date Added: 2024-06-11T17:37:05.741169
License: Public Domain

TAMM, Circuit Judge,
concurring with whom
McGOWAN, Circuit Judge, joins:
I concur in Judge Fahy’s well reasoned opinion. Specifically, I agree that since proximate causation is a question of fact, the scope of our review is limited to determining whether the trial judge’s finding of proximate causation was clearly erroneous. I believe that Judge Fahy amply demonstrates that Judge Curran’s finding was not clearly erroneous. I also agree that under the statutory scheme St. Elizabeth’s Hospital owes a duty to the courts to disclose information in its possession that would undermine or cast doubt on its diagnosis, as well as to divulge facts consonant with that diagnosis. However, in considering Judge Fahy’s opinion, I became concerned with the relationship between the hospital’s obligation of disclosure and its duty of reasonable care in making its diagnosis. I therefore take this opportunity to set forth what I believe to be the relationship between the two, and how their interaction affects the hospital’s liability.
It is obvious that the courts cannot make informed judgments concerning the necessity or desirability of civil commitment proceedings without the expert guidance of the staff of institutions such as St. Elizabeth’s. Nevertheless, the commitment decision is a legal, rather than a medical, one; the court must convert medical findings and opinions into legal conclusions having the profoundest effect on an individual’s liberty. The court cannot intelligently fulfill its responsibility unless it knows of facts that are dissonant to the hospital’s diagnosis as well as those facts that are consonant to it.
While this duty is owed to the courts, appellees are logical persons to enforce it. Unless persons injured by the hospital’s failure to properly perform its functions can recover for their injury, society’s ability to insure that the hospital conscientiously performs its duties is rendered haphazard at best.
*423However, private enforcement of the duty of disclosure is not a panacea, for, as I perceive our holding, the potential range of recovery for breach of the hospital’s duty of disclosure is narrowly confined. Initially, recovery in the case sub judice must be predicated upon the fact that the hospital’s diagnosis was incorrect even if it were not negligent. As Judge Curran pointed out: “There is no explanation how Morgan could have become incompetent from his drinking during three weeks of freedom and the subsequent diagnosis of chronic brain syndrome associated with alcohol associated with behavioral reaction.” Hicks v. United States, 357 F.Supp. 434, 439 (D.D.C.1973). If the original diagnosis, “acute brain syndrome associated with alcohol— recovered,” had been correct, I fail to see how there would be a causal connection between the hospital’s conduct and the homicide. Unfortunately, acts of violence are constantly committed for reasons that are not associated with mental dysfunction as we know it, and this case would then fall into this category.
Moreover, the hospital can discharge its obligation, even if its diagnosis is incorrect, by disclosing information in its possession that could reasonably aid the court in carrying out its functions. I do not suggest, nor do I believe that my brethren suggest, that the hospital alter its normal diagnostic procedures out of fear that it will be charged with the failure to disclose information that would have been discovered had the hospital performed further tests. Such problems remain in the realm of the reasonableness of the diagnostic procedures, where the judgments of the institution and its staff must be given great deference. See Drope v. Missouri, 420 U.S. 162, 95 S.Ct. 896, 43 L.Ed.2d 103 (1975). I am certain that the courts in this jurisdiction will be diligent in insuring that issues involving negligence in diagnosis or treatment are not confused with negligent disclosure.
Finally, I agree with Judge Fahy that the trial judge’s finding of negligence cannot be set aside. The negligence issue is one that is submitted to the trier of fact and we do not approach the issue de novo. On this record, it was reasonable for the trial judge to find that the hospital breached its duty in failing to disclose information of recognized importance.