Another psychiatric malpractice suicide case is dismissed; this one in Sault Ste. Marie

This week, the Court of Appeals overturned the trial judge and summarily dismissed all aspects of a medical malpractice case filed by the family of a young man who committed suicide.  The family had sued War Memorial Hospital, where he was treated in the E.R. after an apparent vehicular suicide attempt, the local mental health agency and the social worker who had each interviewed the dead boy in the four days between his ER visit and hanging himself. 

Although the trial judge dismissed the claims against the ER and the agency, he refused to summarily dispose of the claim against North Care, based on it's social worker's failure to authorize the decedent's admission for inpatient care.  The family's retained psychiatrist expert had offered the opinion that the standard of care required the boy to be admitted for inpatient care and that psychiatric counseling would have prevented the suicide.  The parties appealed the trial judge's partial dismissal.

The Court of Appeals rejected the Psychiatrist's testimony, deeming it "speculative" and not adequate for a reasonable jury to accept.  Even though the expert concluded that hospitalization would have been "most likely" [or "more probable than not"], the judges criticized his failure to state that hospitalization was "invariable or inevitable."  The appellate court held the expert to a previously unrecognized standard of proof by concluding that he needed to eliminate any other possibility than hospitalization in order to criticize the failure to commence that process. 

Oddly, the Court also gave credence to the fact that the social worker accepted the boy's denial of suicidal intentions, even though he had just been taken to the ER for that precise evaluation, after telling police that he had attempted vehicular suicide.  Because he now admitted his suicide attempt was "stupid," he was deemed no longer at risk.  The Court  also suggested that the boy's problem was merely "anxiety" rather than the depression documented by other professionals that week.  The Court's opinion appeared to find it adequate that the social worker had "encouraged [the boy] to seek private care" and "provided him with a list of resources for private...services."  Although the Court gave no credence to the boy's prior expression of suicidal ideation, it relied heavily on his statement that he would not accept medications for treatment--a part of the recommended standard of care that the family's expert belived would have helped to prevent suicide.

 The Court followed several recent decisions that have basically exempted psychiatrists and mental health professionals from malpractice claims.  In each of the cases, the Courts have adopted a similar, unreachable threshold of proof that effectively prevents the decedent's family from proving that inadequate care in an emergent situation was "A" cause [the legal standard] of the death.