Losen v. Allina Health System

767 N.W.2d 703, 2009 Minn. App. LEXIS 128, 2009 WL 1920086
CourtCourt of Appeals of Minnesota
DecidedJuly 7, 2009
DocketA08-1478
StatusPublished
Cited by6 cases

This text of 767 N.W.2d 703 (Losen v. Allina Health System) is published on Counsel Stack Legal Research, covering Court of Appeals of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Losen v. Allina Health System, 767 N.W.2d 703, 2009 Minn. App. LEXIS 128, 2009 WL 1920086 (Mich. Ct. App. 2009).

Opinion

OPINION

HALBROOKS, Judge.

This appeal arises out of a medical-negligence and wrongful-death action against three physicians, a hospital, and a clinic for alleged negligent treatment of a patient who later killed his mother and injured his father and stepmother. Appellants assign error to the district court’s grant of partial summary judgment arguing that immunity under Minn.Stat. § 253B.23, subd. 4, does not apply to respondents’ good-faith decision to not place a 72-hour emergency hold on a proposed patient; alternatively, appellants assign error to the district court’s determination that statutory immunity precludes a common-law claim of medical negligence. Because the good-faith decision to not place a hold on the proposed patient was made pursuant to the Minnesota Commitment and Treatment Act (CTA), we affirm. We also extend discretionary review to certain dismissed claims.

FACTS

Ryan C. Miller (Ryan) was diagnosed with epilepsy at the age of two. For many years, physicians employed by respondent Minnesota Epilepsy Group, P.A. (MEG) provided treatment to him. In June 2003, an MEG physician altered then-25-year-old Ryan’s seizure medication. After this *705 change, Ryan’s family noticed that he was exhibiting bizarre behavior and experiencing auditory hallucinations.

On July 28, 2003, Ryan’s mother, Deborah Miller, brought him to United Hospital, where he was seen by respondent Deanna L. Dickens, M.D., an MEG physician. Dr. Dickens noted that Ryan “present[ed] with an acute psychosis with medication change as the only potential correlate,” and she requested a psychiatric consultation.

Respondent Paul Goering, M.D., a psychiatrist employed by United Hospital, subsequently examined Ryan. In his consultation report, Dr. Goering stated:

I do think that [Ryan] would benefit from psychiatric intervention. I have discussed hospitalization (transfer) as well as antipsychotic medications. He adamantly refuses each, identifying, in his logic, that he does not need them. He declines to allow me to speak with his mother at all. He makes it clear that were he to leave the hospital, he would not agree to psychiatric followup but he would agree to continued compliance with epilepsy decisions related to his care.
I do not see the patient as holdable given the absence of imminent risk. However, I am concerned about his long-term risk. He is moderately psychotic and he does have poor insight. As well, it appears that at least once recently he responded to hallucination by stopping his medications. If he develops more dangerous behavior, certainly the consideration of admitting him under a 72-hour hold would be reasonable.

Ryan was monitored overnight in the hospital to determine if he was experiencing seizures. On July 29, 2003, Ryan removed the monitoring equipment and an intravenous line, and he attempted to leave the hospital. The parties disagree as to the details of this incident, but do not challenge the district court’s characterization of it: “[Ryan] was restrained by hospital staff from leaving. Before he was placed in restraints, he struggled with the staff, yelled profanities, and spit at staff. It was necessary to physically grab him by the arms and wrestle him to the ground in order to restrain him.”

Dr. Dickens telephoned Dr. Goering, and the two discussed this incident. They decided that an emergency hold could not be placed on Ryan if he agreed to take all of his medications and to attend a followup visit with a psychiatrist. According to Dr. Dickens, Ryan was discharged on July 29, 2003 “after extensive counseling took place with the patient, his mother, father, and sister.” 1 Dr. Dickens noted:

The patient’s father agreed to have the patient return home with him as long as the patient was willing to take his an-tiepileptic medications as well as Risper-dal, the antipsychotic medication that Dr. Goering had suggested. Both the patient and family were in agreement with this plan. Family verbalized an understanding that the patient was not thinking clearly (i.e., psychotic) and that he was exhibiting impaired judgment. The plan was agreed upon for the patient to return home with his father with an agreement for the patient to take his antiepileptic medications as well as the Risperdal. The patient was also in agreement to have anticonvulsant levels checked in 1 week. Parents verbalized an understanding to call 911 if the patient’s behavior became unmanageable or escalating or posed potential for harm to the patient or others. Family was *706 instructed to seek further psychiatric treatment and management for the patient as an outpatient. Additionally, family was instructed on safety concerning the removal of potentially harmful objects/weapons from the home while the patient was clearly exhibiting limited judgment and insight.

Dr. Dickens’s discharge summary also indicated that Ryan was to follow up with respondent Patricia E. Penovich, M.D., another MEG physician.

After his discharge from United Hospital, Ryan’s parents contacted MEG several times with concerns regarding his behavior and medication. On August 11, 2003, Randolph Miller, Ryan’s father, called Dr. Pe-novich’s office and requested that Ryan be taken off Risperdal, his antipsychotic medication, due to Ryan’s drowsiness, fatigue, occasional slurred speech, and intermittent numbness in his face, legs, and arms. Ryan’s father was advised that it was not safe to alter Ryan’s medication before he was evaluated by a psychiatrist. Randolph Miller was advised to schedule an appointment for Ryan with a local psychiatrist. Randolph Miller’s journal reflects that he and his ex-wife discussed the recommendation and decided not to schedule an appointment with a psychiatrist and instead to reduce Ryan’s Risperdal dosage.

On August 12, 2003, Randolph Miller dropped Ryan off at his mother’s home for a pre-arranged visit. When Randolph Miller returned home later, he saw Ryan wandering around by the driveway. When Randolph Miller approached Ryan, he saw that Ryan had a rifle. Ryan shot his father in the neck. Moments later, Ryan’s stepmother pulled into the driveway; Ryan shot at her as well and continued firing until Randolph Miller was able to get into his wife’s car and the two drove away. Both survived. Ryan’s mother was later found dead in her home.

Ryan was charged with murder and attempted murder. His trial was bifurcated with the guilt phase tried first. Ryan was convicted of both crimes. The second phase of trial concerned Ryan’s defense of insanity. The district court determined that Ryan was laboring under such a defect of reasoning that he did not know the nature of his acts or that they were wrong. As a result, Ryan was indeterminately committed to the Minnesota Security Hospital as mentally ill and dangerous.

On January 19, 2007, appellants Regina C. Losen (Ryan’s sister, as trustee for the heirs and next-of-kin of their mother Deborah Miller), Randolph C. Miller (Ryan’s father), and Laurie A. Miller (Ryan’s stepmother) filed a complaint against respondents Allina Health System (United Hospital), MEG, Dr. Goering, Dr. Dickens, and Dr. Penovich.

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767 N.W.2d 703, 2009 Minn. App. LEXIS 128, 2009 WL 1920086, Counsel Stack Legal Research, https://law.counselstack.com/opinion/losen-v-allina-health-system-minnctapp-2009.