A trial court that ruled that a Maryland hospital did not have a duty to prevent a schizophrenic man from leaving the emergency room and then jumping from a bridge was recently reversed by the Maryland's intermediate appellate court. The Court of Special Appeals held that a Circuit Court for Baltimore City judge should not have taken the case from the jury and that it was clear that Maryland General Hospital (MGH) owed Richard Crise a legal duty.
"We conclude that, as a matter of law, MGH, through its agent health care providers, owed Crise, a patient being treated in the ER, a duty of care; and the nature and scope of that duty was not an issue within the sole province of the court so as to be susceptible of determination under Rule 2-502," the Court of Special Appeals said.
Under Maryland Rule 2-502, if a question arises at any stage of a legal action that is within the sole province of the court to decide and if it would be convenient to have the question decided before going further, then the court may make the call.
Richard Crise was diagnosed with bipolar disorder at age 17. In December 2008, while living with his mother in the Baltimore city neighborhood of Remington, Crise was taken to Maryland General Hospital by his mother and his sister. Crise had been complaining of chest pain and heart palpitations. Ms. Crise told the emergency room nurses that Crise had bipolar disorder and was experiencing a psychiatric crisis. She told the nurses that for the past five days Crise had not taken his prescribed psychiatric medications, had not slept or had anything to eat or drink. Crise decided to walk home, clad only in a hospital gown, after several hours at the hospital. When the hospital staff noticed that he was gone, they asked the Baltimore City police department to find him. Officers saw Crise walking along a bridge close to his neighborhood. When Crise saw the officers, he jumped, injuring his pelvis, left wrist, right arm and right leg. Crise testified that he jumped off the bridge because he was "paranoid and delusional and he thought it wouldn't be such a big deal." He also said he wanted to "get away from the police."
Crise filed suit in the Circuit Court for Baltimore City against MGH for medical negligence after waiving arbitration and obtaining an order of transfer from the Health Care Alternative Dispute Resolution Office. He alleged that MGH owed him a duty of care, that it had violated that obligation by failing to assess his psychiatric condition and to closely monitor him and that the breach of that duty was the cause of the injuries he suffered; when, in a manic and psychotic state, he jumped off the Howard Street Bridge.
But, the trial judge, took advantage of Maryland Rule 5-502, to decide that the hospital wasn't negligent because he had voluntarily gone to the hospital. As a result, the judge ruled in the hospital's favor. Both Crise and the hospital appealed the decision. The appellate court reversed.
The appeals court pointed out that the committee notes accompanying Rule 2-502 made it plain that a legal question such as whether any duty of care existed in an action for negligence was not proper for decision under that rule.
The trial court had concluded that, because MGH had no legal authority to hold Crise against his will, it had no duty to prevent him from leaving the ER and therefore could not be viewed as negligent for the injuries the man sustained in jumping off the bridge after he voluntarily left the ER.
The appeals court said that Maryland law is clear that, as a patient in the MGH emergency room, Crise was owed a duty of care by the MGH health care providers who were assigned to his care. For example, the court declared, if one of the doctors had carelessly ordered a lethal dose of a drug instead of the proper dose and Crise had been given the lethal dose and died, any assertion that MGH or its doctors did owe Crise a duty of care would be ludicrous.
The trial court mistakenly viewed the legal question in the case as whether any duty of care was owed by MGH to Crise for the factually disputed and complicated question of the nature and scope of the duty of care owed, the court continued. In making its findings, the trial court rejected Crise's deposition testimony and that of his witnesses, as well as information contained in Crise's medical records. All of that evidence could support a reasonable finding that Crise was in a manic and psychotic state and was becoming increasingly agitated and detached from reality, the court said.
As a result, the trial court's decision was reversed and the case was sent back to the lower court for further legal proceedings.
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