Psychiatric Institute of Washington v. Allen

509 A.2d 619, 1986 D.C. App. LEXIS 330
CourtDistrict of Columbia Court of Appeals
DecidedMay 20, 1986
Docket84-114
StatusPublished
Cited by101 cases

This text of 509 A.2d 619 (Psychiatric Institute of Washington v. Allen) is published on Counsel Stack Legal Research, covering District of Columbia Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Psychiatric Institute of Washington v. Allen, 509 A.2d 619, 1986 D.C. App. LEXIS 330 (D.C. 1986).

Opinion

TERRY, Associate Judge:

On August 12, 1981, thirteen-year-old Daniel .Allen was admitted to the Psychiatric Institute of Washington (“the Institute”), a private psychiatric hospital. One month later, on September 12, an Institute employee walked into Daniel’s room and found him lying on the floor unconscious, with a belt around his neck. Efforts to revive him were unavailing. He was taken to Georgetown University Hospital, where he died without regaining consciousness.

Daniel’s parents, James and Bonita Allen, brought this action against the Institute and Dr. Judith Forgotson, the psychiatrist in charge of Daniel’s treatment there, alleging that his death was a direct and proximate result of their negligence. The jury returned a verdict in favor of Dr. Forgotson, but it found the Institute liable to the Allens and to Daniel’s estate in the amount of $270,000. On appeal from the judgment entered on that verdict, the Institute contends that there was insufficient evidence to permit the case to go to the jury, that the court erred in refusing to give certain jury instructions, and that counsel for the Allens made improper comments during his closing argument which deprived the Institute of a fair trial. We find no reversible error and accordingly affirm the judgment.

I

The evidence at trial established that Daniel Allen had a history of serious psychiatric problems. When, at the age of twelve, he was involved in several fire-setting episodes, his parents sought profes *621 sional assistance from Dr. Myron Hafetz, a clinical psychologist. After treating Daniel for approximately three months, Dr. Haf-etz concluded that he might “hurt himself or be a danger to the community.” 1 Dr. Hafetz therefore referred him to Children’s Hospital, where he was treated on an emergency basis for approximately six weeks. At the time of his admission, the following entry was made in Daniel’s file:

Child requires emergency hospitalization for escalating firesetting, potentially life-threatening. ...
******
Diagnostic impression —severe neurotic character, narcissistic personality; no evidence on initial exam of borderline pathology.

His admission note stated:

Daniel is a 12 [year] old [white] male referred by private [doctor because of a history] of firesetting.... [History] of setting fire to his bed and then climbing into bed to sleep — seemingly unaware of suicidal gesture.

Within a few days after his admission to Children’s Hospital, a staff psychiatrist, Dr. Taiw Okusami, and several of his colleagues devised a comprehensive treatment plan for Daniel. This treatment plan, which became a part of Daniel’s file, was in the form of a table. Under the heading “Problem Description” appeared the entry “Suicidal Ideation.” In the next column, under the heading “Plan,” was written the following:

Observe on ward. Limit to ward. Review next Wednesday. Explore ideation in extended psychiatric and psychological evaluation.

In the next column immediately to the right, under the heading “Goals,” was written “Prevent Suicide.” The fourth column listed the names of the hospital staff members responsible for Daniel’s care. Finally, in the fifth column, headed “Current Status of Problem,” appeared this entry:

Passive suicidal ideations and frequent talk about death; sometimes wishing [he] were dead.

About three weeks later, a nurse found Daniel in a compromising sexual situation with another patient. While the nurse and Daniel were discussing the incident, Daniel “expressed wishes that he were dead”; he was then placed on a twenty-four-hour suicide watch. Some time thereafter Dr. Okusami concluded that Daniel needed extended treatment in a residential program and referred him to the Institute.

Daniel was admitted to the Institute on June 23, 1980. Records prepared at that time said that he was being admitted because:

1. Suicidal or destructive behavior [was] an immediate threat.
2. Magnitude of deviant behavior [was] no longer tolerable to patient or society.
3. Treatment [could not] be initiated or continued unless in a supervised setting.
4. Previous hospitalization [had] not used approach available here.
5. Ambulatory treatment [had] been unsuccessful in halting or reversing the course of mental illness.

The Institute gave Daniel a series of tests which revealed that he had a “serious emotional disturbance characterized both by an unsocialized aggressive reaction with fire-setting behavior as well as a depressive reaction with poor self-esteem and self-destructive impulses.” The tests also established that “[s]uicidal ideation [was] indicated yet intellectually defended against.”

Daniel attended special education classes and participated in individual, group, and family therapy sessions on a regular basis. Despite the therapy, Daniel continued to place himself in dangerous situations and suffered a series of injuries. In August the following notations were made in his file:

*622 Family Problems: There [is] some difficulty with the family’s understanding of Daniel’s accident-proneness. There is a tendency for them to underestimate the constant danger and self-destructive trends that Daniel engages in....
#***:}:*
Somatic Complaints: Daniel continues to use his real medical problems in addition to other complaints about his body in an effort to gain attention. Since he has been on the program to avoid self-destructive activity, he has put himself in a number of dangerous positions.
* * * * * *
Accident Prone Behavior: This problem was added today with the recognition of the fact that he has not had any day while on the program in which he was able to take care of himself without putting himself in a dangerous position. This whole area needs to be further explored with the parents to see how they set limits on his potentially dangerous activities.
* sjs * * *
In regard to Daniel’s need for hospitalization, it is apparent that his self-destructive activity, which prior to admission was manifest in fire-setting and other more acting out behavior, has now been turned more upon his own body. He has had a series of injuries often sustained when he has, put himself into dangerous positions.

Daniel remained at the Institute until October 1980, when he was discharged for eye surgery at Walter Reed Army Hospital. 2 At the time of his discharge, his doctor, Dr. Judith Forgotson, noted in Daniel’s file that he had shown some improvement in certain areas but nevertheless “required further extended psychiatric treatment.”

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Bluebook (online)
509 A.2d 619, 1986 D.C. App. LEXIS 330, Counsel Stack Legal Research, https://law.counselstack.com/opinion/psychiatric-institute-of-washington-v-allen-dc-1986.