Rueda v. Charmaine D.

76 A.D.2d 443, 906 N.Y.S.2d 246

This text of 76 A.D.2d 443 (Rueda v. Charmaine D.) 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
Rueda v. Charmaine D., 76 A.D.2d 443, 906 N.Y.S.2d 246 (N.Y. Ct. App. 2010).

Opinion

Order, Supreme Court, Bronx County (Mary Ann BriganttiHughes, J.), entered June 11, 2009, which, to the extent ap[444]*444pealed from, granted the petition to retain respondent at the Montefiore facility, affirmed, without costs.

Although respondent’s release from the hospital has rendered this appeal moot as to her, we address the merits pursuant to the exception to the mootness doctrine for issues likely to recur (see Mental Hygiene Legal Servs. v Ford, 92 NY2d 500, 505-506 [1998]).

The main issue before us is whether the emergency room psychiatrist who treated respondent properly made an application pursuant to Mental Hygiene Law § 9.27 for her involuntary admission to a hospital, when such involuntary admission could also have been made pursuant to Mental Hygiene Law § 9.39. We hold that although section 9.39 provides for emergency involuntary admissions, it does not preclude applications by emergency room psychiatrists for nonemergency involuntary admissions pursuant to section 9.27. The trial court’s determination that respondent could have been involuntarily admitted under section 9.39 does not alter the fact that her admission pursuant to section 9.27 was proper.

Petitioner asserts, without contradiction, that section 9.27 has for years been relied on by hospitals for this type of admission. The crux of the problem is that while there are different admission standards as well as different retention periods, there are overlapping elements between the two sections. A close reading of each section shows how, in some cases, a patient could meet the criteria of both.

In section 9.39, entitled “Emergency admissions for immediate observation, care and treatment,” two criteria must be met for admission. The patient must have a mental illness for which “immediate observation, care and treatment in a hospital is appropriate and which is likely to result in serious harm to himself or others” (§ 9.39 [emphasis added]). Section 9.01 defines the likelihood of resulting in serious harm as

“(a) a substantial risk of physical harm to the person as manifested by threats of or attempts at suicide or serious bodily harm or other conduct demonstrating that the person is dangerous to himself or herself, or

“(b) a substantial risk of physical harm to other persons as manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm.”

Moreover, as respondent has conceded, there must a present need for such immediate observation and treatment under section 9.39 (see Matter of Boggs v New York City Health & Hosps. Corp., 132 AD2d 340, 362 [1987], appeal dismissed 70 NY2d [445]*445972 [1988]), as manifested by a recent homicidal or suicidal threat, attempt or act (see Mem of Off of Mental Health, 1985 Session Laws of NY, at 3064 [accompanying enactment of L 1985, ch 343]).

Admission under section 9.27, on the other hand, allows admission of an individual who is mentally ill and “in need of involuntary care and treatment.” Although not specifically set forth in section 9.27, for a hospital to involuntarily admit a patient for psychiatric treatment, there must also be a showing, by clear and convincing evidence, that “the patient poses a substantial threat of physical harm to himself and/or others” (New York City Health & Hosps. Corp. v Brian H.. 51 AD3d 412, 415 [2008]).

Both sections thus permit the involuntary admission of a patient for care and treatment where the patient poses a threat of harm to himself or others. Although section 9.39 requires the additional element of recent suicidal or other violent behavior, the nature of the illness may be such that the patient could, at the time of the admission, evidence “other conduct demonstrating that [s]he is dangerous to [her]self.” Both sections also provide that a patient admitted to a facility must be examined by a psychiatrist from that facility.

The mere fact that a patient is brought into an emergency room for initial treatment of a mental illness does not, by itself, make it an emergency admission within the meaning of section 9.39. It is the condition of the patient, not the location or the circumstances of the admission, that determines which section of the Mental Hygiene Law controls the patient’s involuntary admission.

There is no issue that respondent, upon presentation to the emergency room, met the requirements of sections 9.27 and 9.39. Here, respondent was, inter alia, psychotic, disrobing in public and incoherent. The record does not show that the examining physicians classified her actions as “likely to result in serious harm,” the hallmark requirement of admission under section 9.39. However, the physician certifications utilized in her admission contained the following preprinted language: “[A]s a result of his or her mental illness, this person poses a substantial threat of harm to self or others (‘substantial threat or harm’ may encompass [i] the person’s refusal or inability to meet his or her essential need for food, shelter, clothing, or health care, or [ii] the person’s history of dangerous conduct associated with noncompliance with mental health treatment programs).”

While respondent clearly met the criteria of a mentally ill person in need of involuntary care and treatment pursuant to [446]*446section 9.27, there is no evidence in the record of affirmative, overt conduct on her part, at the time of her admission, that would constitute suicidal or other violent behavior, as defined in section 9.39. However, her actions, particularly with respect to disrobing in public, could constitute “other conduct demonstrating that the person is dangerous to . . . herself,” as well as a “substantial risk of physical harm” to herself (§ 9.01).

The dissent argues that the Legislature could not have intended for these sections to be used interchangeably, and the statutory scheme must thus be harmonized to carry out the legislative intent. But as the dissent acknowledges, the statute provides different criteria for involuntary admission under each section. There is no legislative intent that these sections be used interchangeably, although there may well be situations, as here, where the admission standards overlap and the patient meets the criteria of both.

The issue that appears to trouble the dissent is that section 9.39 provides for a much shorter involuntary commitment period before judicial review than that authorized by section 9.27. The nature of an involuntary admission under either section is per se a serious restriction of one’s liberty (see Project Release v Prevost, 722 F2d 960, 971 [2d Cir 1983]).

Recognizing this fact, the statutory scheme provides that upon admission by medical certification under section 9.27, the director of the medical facility must “forthwith” provide notice to the mental hygiene legal service (§ 9.29 [a]), thus triggering immediate legal representation for the patient. In addition, the director must provide to the nearest relative—and up to three additional persons as designated by the patient—notice of the patient’s rights, including the right to a hearing, not later than five days after admission (§ 9.29 [b]). The patient, either personally or through another, may seek judicial intervention to challenge his or her confinement at any time, and such hearing must be held within five days of the request, unless the applicant consents to a longer period of time (§ 9.31).

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Bluebook (online)
76 A.D.2d 443, 906 N.Y.S.2d 246, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rueda-v-charmaine-d-nyappdiv-2010.