In re Patrick B. v. Maine District Court

• Court: Superior Court of Maine
• Decided: June 4, 2014
• Docket: KENap-13-38
• Status: Unpublished

Opinion

ENT ERED OCT 3 0 1014

STATE OF MAINE SUPERIOR COURT KENNEBEC, SS. CIVIL ACTION DOCKET NO. AP-13-38 (f)/ LJ/?C>I L( IN RE: PATRICK B. ORDER

Patrick B. appeals from an order of the District Court committing him to

hospitalization for a period not to exceed four months at the Department of Veterans

Affairs at Togus pursuant to 34-B M.R.S. § 3864. The District Court found by clear and

convincing evidence that Patrick was mentally ill, that his behavior posed the likelihood

of serious harm, that adequate community resources for care and treatment for mental

health are not available and that in-patient hospitalization is the best available means

for treatment of Patrick.

This appeal is predicated upon a question of law wherein the District Court ruled

that the statutory provisions for involuntary hospitalization had been complied with.

Patrick complains that he did not receive the appropriate examination within the time

period required by statute. 1

The facts, as found by the District Court, are that on Saturday, July 20, 2013,

Patrick (the patient) was taken to the Eastern Maine Medical Center by the Bangor

Police Department for emergency treatment, because of escalating behaviors and

medication noncompliance. There was a concern that he presented a danger of harm to

himself. Eastern Maine Medical Center then applied for emergency involuntary

admission to a mental hospital pursuant to 34-B M.R.S. § 3863. On July 20, 2013, at

1 The Order for hospitalization in a mental hospital issued by the Maine District Court, is dated July 31, 2013. It was an order for hospitalization not to exceed four months. This court is not aware of the current status of the patient, but is satisfied that the legal issue is not moot as an exception to the collateral consequences doctrine, in this case, the public interest exception, In re Christopher H., 2011 ME 13; In re Walter R., 2004 ME 77; In re Kevin C., 2004 ME 76. 11:10 a.m., a judge of the District Court authorized the Bangor Police Department to

take the patient into custody and to take him to the V.A. Hospital in Togus. Because a

bed was not available at the Togus Veterans Administration Medical Center, the patient

was transferred to Acadia Hospital, a non-state psychiatric hospital as defined by 34-B

M.R.S. § 3801(1)(A). Later that same day, a bed became available and the patient was

transferred to Togus where the time of admission as recorded by the hospital and

verified by the V.A. doctor's testimony, was Saturday, July 20, 2013, at 1:52:20 p.m. The

hospital performed the required post-admission examination at 12:55 p.m. on Sunda·y,

July 21, pursuant to 34-B M.R.S. § 3863(7).

The patient argues that the case involves the transition from emergency

hospitalization to a continuation of hospitalization pursuant to sections 3863 and 3864

and that admission must be determined to run from the time of the judicial

endorsement committing the alleged incapacitated person to the psychiatric hospital.

Patient seeks the dismissal of the application for involuntary admission and a vacation

of the involuntary commitment.

Pursuant to 34-B M.R.S. § 3863(1), a health officer, law enforcement officer, or

other person may apply to admit a person to a psychiatric hospital on the basis that the

person is mentally ill and because of the person's illness poses a likelihood of serious

harm. In subsection 2, the application must be accompanied by a dated certificate

signed by a medical practitioner asserting that he or she has examined the patient on

the date of the certificate, that the medical practitioner is of the opinion that the person

is mentally ill and poses a likelihood of serious harm. It must further go on to indicate

that there are no adequate community resources for the care and treatment of the

person's mental illness and the grounds for the medical practitioner's opinion. Under

subsection 3, the application and certificate must be reviewed by a justice of the

2 Superior Court, judge of the District Court, judge of Probate Court, or justice of the

peace. Further, if finding the documentation to be in accordance with the law, it is

required to endorse the application and send them to the admitting psychiatric hospital.

Under subsection 3(B),

A person may not be held against the person's will in a hospital under this section, except that a person for whom an examiner has executed the certificate under subsection 2 may be detained in a hospital for a reasonable period of time, not to exceed 24 hours, pending endorsement by a judge or justice

Under subsection 7,

Every patient admitted to a psychiatric hospital under this section must be examined as soon as practicable after the patient's admission. If findings required for admission under subsection 2 are not certified in a 2nd opinion by a staff physician or licensed clinical psychologist within 24 hours after admission, the person must be immediately discharged.

The statutory meaning of "admission" in the statutory scheme in issue appears

clear. The law enforcement officer may take the patient to a "hospital", in this case the

emergency room at the Eastern Maine Medical Center, where the person is to undergo a

certifying examination by a medical practitioner pursuant to 34-B M.R.S. § 3862(2). That

examination must take place within twenty-four hours which then provides the basis

for an application to a judicial officer for the involuntary admission to a psychiatric

hospital. Once the patient is admitted to a psychiatric hospital, there must be a second

opinion to the certification for admission by a staff physician or licensed clinical

psychologist within twenty-four hours after admission. There is no evidence that

Eastern Maine Medical Center is a psychiatric hospital, or a non-state mental health

institution, or a designated non-state mental health institution as defined in 34-B M.R.S.

§ 3801(7)(B). Therefore, the requirement under § 3863(7) applies to admission to a

psychiatric hospital defined as a state mental health institute, non-state mental health

institution, or designated non-state mental health institution.

3 By plain reading, the protection of the rights of an individual are clearly obvious

within the statutory scheme. A non-medical person is not qualified to determine

whether someone is mentally ill in the context of having them committed so, to the

extent they determine a person is likely to cause serious harm himself or others, it

requires the patient to be taken to a hospital. The first protection for the patient is that a

medical practitioner must examine the individual as soon as is reasonably possible but

no later than 24 hours after being taken to the facility. The medical practitioner then

creating the certificate for the judicial officer to approve, puts in action the removal of

the individual to a psychiatric hospital where the second protection for the individual

takes place, that is, the first certification must be affirmed by an appropriate

psychological medical practitioner at the psychiatric hospital within twenty-four hours.

Therefore, the presence at a hospital in the first instance is not an admission, but the

presence at the psychiatric hospital on order of the judicial officer is an admission. In

the present case, with very few minutes to spare, the patient received the required

mental health examination within the twenty-four hours of his admission.

For the reasons stated above, the entry will be:

The decision of the District Court in the matter of In re: Patrick B. is AFFIRMED.

DATED: June 4, 2014

Donald H. Marden Superior Court Justice