Sombrotto v. Christiana W.

50 A.D.3d 63, 852 N.Y.S.2d 57
Appellate Division of the Supreme Court of the State of New York·Decided January 31, 2008·Published·Cited by 2 cases

Opinions

OPINION OF THE COURT

Nabdelli, J.

In this appeal, we are asked to determine whether Supreme Court properly granted petitioner hospital’s petition to involuntarily administer psychotropic medications to the then 14-year-old respondent over her and her parents’ objections, after conducting a hearing to which the parents were not parties.

On December 26, 2006, respondent, who was then 14 years old with no formal psychiatric history, was at the home of a friend when she became upset after her friend’s mother began making offensive comments about respondent’s mother. Respondent attempted to telephone her mother and, after receiving no response, ran to the bathroom and ingested approximately 15 tabs of amoxicillin and five Motrin. Respondent immediately told her friend to call 911 and, upon her arrival at Lincoln Hospital, she reported to emergency room personnel that she was “stressed,” did not want to hurt herself, and regretted her actions. Respondent also informed hospital personnel that she had been in a fight with her mother approximately three months earlier, during which her mother punched her in the head, and that a month prior she had dislocated her mother’s shoulder in an altercation. Respondent added that she had dropped out of school two months earlier because she was feeling depressed and was failing classes, and that the New York City Administration for Children’s Services (ACS) had an active case file on her. Respondent stated that on this occasion she was unsure whether she had wanted to die or not, but that she had at least intended to harm herself.

Once respondent had been medically cleared by Lincoln Hospital, her mother had her admitted as a voluntary patient to Payne Whitney Manhattan (the Hospital) pursuant to section 9.13 of the Mental Hygiene Law. Respondent’s initial progress [65]*65reports characterize her mood as, among other things, sad, sullen and depressed, and her behavior as sometimes aggressive and verbally combative, but later reports, including that of February 19, 2007, describe her as “friendly and polite upon approach. She has been social and engaged with peers.” The reports also reflect respondent’s doctor’s wish to begin treatment with various medications and respondent’s parents’ continuing refusal to consent. As a result, on January 16, 2007, the Hospital converted respondent’s admission status to involuntary based upon the certifications of two physicians that she posed a risk to herself and others. Dr. David Rubin, respondent’s treating psychiatrist, noted in respondent’s medical records that if ACS did not file a medical neglect petition, “further pursuit of [medication over objection] and retention is without purpose as [patient] will be discharged without psychiatric [follow-up] as requested by family that retains custody.” ACS, after an investigation conducted at the Hospital’s behest, declined to file a neglect petition.

Petitioner, on behalf of the Hospital, on January 23, 2007, commenced the within proceeding by the service of an order to show cause and accompanying petition, seeking an order permitting the involuntary drawing of blood and the involuntary administration of risperidone, lithium and Depakote to respondent. The petition, which was supported by two physician affirmations, including one by Dr. Rubin, alleged that respondent had been diagnosed with “mood disorder, n.o.s. [not otherwise specified]” and named only respondent as a party, but not her parents.

In opposing the petition, Mental Hygiene Legal Service (MHLS), on respondent’s behalf, argued, inter alia, that respondent’s parents had a fundamental right to determine the appropriate treatment for their daughter and that, if they abused that right, the proper vehicle for redress would be a neglect proceeding in Family Court; that neither the Mental Hygiene Law, nor its implementing regulations, provide for the administration of psychotropic medication to a child over the parents’ objection; and that the proceeding brought by the Hospital is unavailable when the child is under 16 years of age and the parents refuse to consent to the treatment. MHLS also sought respondent’s release from involuntary hospitalization.

The hearing court, by order entered February 20, 2007, granted the petition in its entirety, finding that “[u]nder New York law parents may not deprive their child of life-saving treat[66]*66ment.” The court, however, on March 2, 2007, vacated the February 20 order and declared it a nullity, having determined the necessity of a hearing.

The hearing was thereafter held on March 2, 2007, at the outset of which the parties disagreed over whether the court had jurisdiction, and whether Rivers v Katz (67 NY2d 485 [1986]), the case pursuant to which the hearing was purportedly being held, applied to children of respondent’s age. The court subsequently determined that it possessed jurisdiction, and proceeded with the hearing, at which the only witness to testify was respondent’s treating psychiatrist, Dr. Rubin. Respondent’s parents were present but, having not been made parties to the proceeding, declined to testify without the benefit of counsel.

Dr. Rubin opined that respondent’s diagnosis was mood disorder, n.o.s., which he described as a “catch-all” diagnosis given to children who have more than depression and show early signs of bipolar disorder, but do not follow the exact adult classification for bipolar disorder. Dr. Rubin noted that there was some possibility that the early treatment with psychotropic medications could prevent the full development of bipolar illness, but that this was “not clear.” Dr. Rubin further testified that through the use of behavioral management, respondent’s behavior had “absolutely” improved significantly over the course of her hospitalization without medication, and that she was in good behavioral control, was polite with the staff and pleasantly participated in group activities. Dr. Rubin also averred that respondent, while under his care, had not expressed any suicidal ideation and had not made any suicidal gestures, although he nevertheless felt that the administration of psychotropic medication was still necessary due to the fact that respondent felt chronically depressed and that, when under stress, her mood escalated quickly.

It must be noted that petitioner sought permission to involuntarily administrate risperidone, lithium and Depakote to respondent. The “[Reasonable foreseeable adverse” side effects of those medications include: weight gain, a particular concern to respondent, who weighed 208 pounds at the time of her admission; sedation; dystomia (prolonged muscular contractions or rhythmic jerks); akathisia (motor restlessness, inability to sit still); orthostatic hypotension (decrease in blood pressure upon sitting or standing, causing dizziness); tremors; thirst; gastrointestinal upset; increased urination; headache; acne; hypothy[67]*67roidism; cognitive impairment; dizziness; hair loss; and liver function abnormalities.

The hearing court, in an “Amended Decision and Order” entered March 12, 2007, granted the petition and held that despite the “importance of the parents[‘] rights,” “[u]nder New York law parents may not deprive their child of life-enhancing treatment,” citing Matter of Storar (52 NY2d 363 [1981], cert denied 454 US 858 [1981]). The court further found that petitioner had complied with Mental Hygiene Law § 33.21 (e) (2) (iii) in presenting the determination of two doctors that the proposed medications were in respondent’s best interests.

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Sombrotto v. Christiana W., 50 A.D.3d 63, 852 N.Y.S.2d 57 (N.Y. Ct. App. 2008).

50 A.D.3d 63 (Sombrotto v. Christiana W.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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