Wrongful Death Appeal Focuses on Standard of Care for Determining Release from Massachusetts Hospitals for a Mental Health Stay

The Appeals Court recently evaluated a Massachusetts wrongful death action precluded by the medical malpractice tribunal from moving forward in state court. The deceased in Appeals Court case number 16-P-1715 was admitted to a hospital for mental health treatment following the death of her premature twins. She asked to be discharged, and she was released three days later after an evaluation by a physician, who presented her with an after-care plan. The woman died the next day in a homeless shelter due to an overdose of multiple drugs. The deceased’s aunt and personal representative of the estate filed a wrongful death lawsuit, alleging the hospital and physician were negligent in their discharge of her niece.

Like all cases involving medical malpractice, this lawsuit went before the Commonwealth’s tribunal for assessment. The estate was required to show the hospital provided health care as defined by G. L. c. 231, § 60B, the hospital failed to provide care that’s expected of the average member of the profession practicing the same type of medicine, and the failure to meet the standard of care was more likely than not what caused the death. The tribunal determined the estate’s offered proof was insufficient to show these things, and the case was dismissed after the estate failed to post the statutory bond.

The estate offered the testimony of an expert witness as evidence the hospital did not follow the standard of care in its discharge of the deceased immediately before her death. Case law requires an expert to have sufficient training, experience, education, and familiarity with the subject matter of the testimony. The tribunal cannot weigh the evidence as a fact-finder, and neither can the reviewing appellate court. Both are required to view the evidence presented by the estate in the light most favorable to them.

The Appeals Court agreed with the tribunal that the expert’s qualifications fell short of what’s needed to show that she could sufficiently determine whether the standard of care was met or not. The appellate court pointed out the estate only provided a document titled “forensic expert evaluation,” and it did not have any information about where the expert practiced medicine, nor any documentation of her education, experience, training, or area of practice. There was no indication that she was familiar with the standards she identified in her writing.

The court noted that even though the standards are “extremely lenient” for expert qualifications, the substance of her evaluation did not further the estate’s determination that the applicable standard of care was not met by the physician who examined the deceased before her discharge.

While case law avoids the use of “magic words” to determine whether or not an assessment passes muster, the appellate court found the evaluation did not address any absence of critical statutorily mandated criteria. The deceased had checked herself in voluntarily and executed the three-day waiver when she wanted to leave, as dictated by Massachusetts’ General Laws. The examining physician followed all of the requirements for the three-day waiver and could only choose to initiate an emergency petition for involuntary commitment. To commit someone involuntarily, the physician would have had to have a reason to believe the patient’s mental illness would likely result in serious harm, and no other alternative was appropriate.

The appellate court found the expert’s evaluation failed to illustrate how the doctor’s actions deviated from the standard of care in the practice of psychiatric medicine. The expert witness’ writing did not demonstrate how the patient’s actions, as documented, required an involuntary hospitalization. The appellate court concluded the offered evidence fell short of the necessary proof, and the tribunal’s decision to dismiss without prejudice was affirmed.

The attorneys of the Law Office of James K. Meehan have the personal injury experience an estate or injured party needs at their side in a wrongful death or medical malpractice action. Contact our office today at 508.822.6600 for a free, confidential consultation.

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