Bell v. New York City Health & Hospital Corp.

90 A.D.2d 270, 456 N.Y.S.2d 787, 1982 N.Y. App. Div. LEXIS 18836
CourtAppellate Division of the Supreme Court of the State of New York
DecidedDecember 6, 1982
StatusPublished
Cited by56 cases

This text of 90 A.D.2d 270 (Bell v. New York City Health & Hospital Corp.) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bell v. New York City Health & Hospital Corp., 90 A.D.2d 270, 456 N.Y.S.2d 787, 1982 N.Y. App. Div. LEXIS 18836 (N.Y. Ct. App. 1982).

Opinion

OPINION OF THE COURT

Titone, J.

The primary issue presented on appeal is whether the decision to release a psychiatric patient from a hospital without a proper medical examination may provide a basis [271]*271for the imposition of liability for injuries suffered as a result of the patient’s attempted suicide shortly after his discharge. We hold that it does.

Plaintiff John Bell was admitted to the adult psychiatric unit of Kings County Hospital on September 3, 1976, pursuant to a court order obtained by his wife, plaintiff Linda Bell. He was released on September 10, 1976 upon the recommendation of his treating psychiatrist, Dr. Allan J. Hermann, one of the named defendants. On September 17, Mr. Bell attempted suicide by dousing himself with gasoline and setting himself on fire.

Subsequently, Bell and his wife commenced this action to recover damages for malpractice. The jury awarded Bell $564,225, but found in favor of the defendants with respect to Linda Bell’s claim for damages for loss of consortium. An appeal has been taken by the defendants, who raise only the question of liability as to John Bell; no challenge is made to the amount of damages awarded. Linda Bell has not cross-appealed from the portion of the judgment in favor of the defendants and against her.

John Bell has a long history of psychiatric disorder. He was given a medical discharge by the Army in 1971 and obtained treatment from the Veteran’s Administration (V.A.) Hospital following a suicide attempt. Indeed, the records of the V.A. Hospital state that Bell had attempted suicide on three occasions.

According to Linda Bell, for a period of time before September, 1976, her husband was acting “strangely”. He had religious hallucinations and preoccupations and believed that he and his oldest son had to die. On September 3,1976 Mrs. Bell sought assistance from the Family Court, Kings County, due to her husband’s assaultive behavior

Dr. David Fuchs, a court-appointed psychologist, examined Mr. Bell and found him to be “actively psychotic and suspicious” and concluded that he “poses [a] threat to himself and others”. Mrs. Bell stated that she informed Dr. Fuchs of her husband’s prior suicide attempts, but the Family Court records contain no indication to that effect. According to Dr. Fuchs, Bell appeared to be “no longer in contact with reality” and his schizophrenia appeared to be [272]*272“a worsening” of “a chronic condition”. Dr. Fuchs was of the view that unpremeditated suicide was a possibility. Bell was remanded on September 3,1976 to Kings County Hospital for 30 days for stabilization and planning. Typically, adults are returned to the Family Court 7 to 15 days after such a commitment.

Bell was physically examined upon his admission' to the hospital and was given thorazine. It was conceded by the admitting physician that her note of admission in the medical chart was not “specific enough” concerning the patient’s condition. Linda Bell visited her husband daily after work and found his condition unchanged. According to Mrs. Bell, every night her husband told her not to visit him and stated that “[tjomorrow I’m not going to be here, so don’t bother to come back.”

Dr. Allan J. Hermann, chief of the adult psychiatric unit at Kings County Hospital since 1972, first saw the patient on September 7. Dr. Hermann estimated that he saw anywhere from 20 to 60 patients per week. He explained that his primary purpose was to stabilize patients and make a recommendation for aftercare treatment or continued hospitalization.

The doctor was informed about the recent death of Bell’s parents and brother, his history of drug abuse and his medical discharge. He denied that he was told anything by Mrs. Bell about the patient’s prior suicide attempts. After speaking with the patient and Mrs. Bell, Dr. Hermann made the following diagnosis: “1. Schizophrenic Reaction, Acute Paranoid type. 2. Chronic Drug Abuse”. With regard to the patient’s condition the psychiatrist wrote: “He claims that he has been hearing voices telling him not to use drugs for the past week * * * [T]he voices he has been hearing for a week repeats [sic] Jesus Christ giving him his ‘abundance’. By abundance he means better times are coming. He refuses to discuss his past psychiatric history”.

Dr. Hermann further noted that the patient: “does not feel he belongs in a hospital and wishes to go home * * * [H]e claims that Jesus Christ loves him and [the patient] walks about the ward clinging to his bible. There is no evidence of any formal thinking disturbance. However, he [273]*273is very suspicious in that he expects the interviewer to allow him to read the medical chart * * * There is no clear delusional thinking but there is a considerable amount of suspiciousness on his part and preoccupation of Jesus Christ loving him. He is a potential danger to others * * * No evidence of suicidal risk * * * Insight and judgment are impaired.” The recorded “disposition” was “observation”.

Dr. Hermann acknowledged at trial that he made no effort to obtain information concerning the patient’s medical and treatment history while he was at the V.A. Hospital. The doctor admitted that this was a departure from accepted medical practice since such information may have been helpful regarding the objective of stabilization and future treatment.

A nurse interviewed Bell on September 7. During the interview he observed that the patient “became quite restless as though he was hallucinating”. The nurse noted that Bell “was interrupted several times during the interview because of hearing voices”. He wrote, “I’ll continue talking with the patient on a one-to-one basis and build trust with him and doctor.” No inquiry was made by the nurse concerning the auditory hallucinations.

Dr. Hermann acknowledged at trial that auditory hallucinations could lead a patient to kill himself or others, depending on the hallucinations. With respect to the voices the patient was hearing on September 7, Dr. Hermann admitted that it was a departure from accepted medical practice for him not to inquire as “to what he [Bell] was hearing, who he was hearing it from, when he was hearing it, and whether he could control it or not, and whether he believed it or not.”

Dr. Hermann agreed that proper medical practice required that inquiry be made into the nature and circumstances of a patient’s delusions. The delusions presented a possibility of harm to Bell and others.

A nurse’s note dated September 8 reads that the patient was “[a]wake since change of tour. Delusional and restless.”

On September 9, several significant events occurred with reference to the patient. Barbara Martin, head nurse [274]*274on the floor for the midnight to 8:00 a.m. tour, deemed the patient to have been worse on that day than on any other day. A nurse’s note for September 9 reads that the patient was “[a]wake, delusional, became physically resistive when attempts made to medicate patient. Necessary to place in [restraint]”. Bell, pursuant to orders of another physician, was placed in a straight]acket from 1:00 a.m. until 6:00 a.m. Dr. Hermann also prescribed more thorazine for Bell on September 9 than on any other day during the patient’s hospitalization.

On the same day, however, Dr. Hermann determined that Bell could be released.

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Bluebook (online)
90 A.D.2d 270, 456 N.Y.S.2d 787, 1982 N.Y. App. Div. LEXIS 18836, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bell-v-new-york-city-health-hospital-corp-nyappdiv-1982.