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PA Superior Court Reverses Dismissal of Patient Escape & Suicide Suit Against Hospital

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Overturning the trial court's dismissal of the plaintiff's lawsuit on preliminary objections, the Superior Court recently held that while a hospital was entitled to the limited immunity protections afforded it by the Mental Health Procedures Act (MHPA), the complaint had pled sufficient facts that, if true, could be found by a jury to constitute gross negligence.

In Martin v. Holy Spirit Hospital, 2017 Pa.Super. 11 (on appeal from Cumberland County Court of Common Pleas), the decedent had attempted suicide and was pulled from a second-story window by police. She was taken to the emergency room at Holy Spirit Hospital. There, the nursing staff recorded the decedent's history of a suicide attempt and active suicidal thoughts, including a notation of "CRISIS; SUICIDAL." The plaintiff alleged that a mental health protocol was initiated, and the decedent's street clothes were removed and replaced with a hospital gown and slippers.

The plaintiff alleged that after about ninety minutes, the decedent still had not been seen or evaluated by a physician, and she was left unattended. She then walked past one nurses' station and one billing desk, opened two sets of exit doors in the emergency room, then passed another nurses’ station and exited to the outside through sliding glass doors, all while gripping her head and wearing a hospital gown and slippers. Soon thereafter, the police responded to an accident on US 15, where the decedent was pronounced dead as a result of a motor vehicle collision. Her death was ruled a suicide by the county coroner.

Pennsylvania's Department of Health conducted an investigation as a result of these events and found that this had been the ninth elopement of a mental health crisis patient from the emergency room without any crisis intervention evaluation in three and one-half months.

Plaintiff filed suit, and Holy Spirit Hospital filed preliminary objections on the basis of demurrer, alleging that it was entitled to immunity from this lawsuit in accordance with the MHPA, 50 P.S. §§ 7101-7503. The MHPA provides limited immunity to facilities providing mental health treatment absent willful misconduct or gross negligence. The trial court sustained Holy Spirit Hospital's preliminary objections and dismissed the lawsuit, finding that the allegations did not amount to gross negligence so as to overcome the immunity provision of the MHPA.

The plaintiff appealed on two bases: (1) that the MHPA did not apply because the decedent had not seen a physician and thus was not being treated so as to trigger the MHPA; or (2) the facts as pled were sufficient to show gross negligence under the MHPA.

First, the Superior Court found that the MHPA was triggered by the facts alleged because the decedent was seen by trained nursing staff and some medical care had been provided. The complaint alleged that the nurses had taken the decedent’s history and given her a bed, hospital gown and slippers, and orange juice. The Court distinguished this case from Fogg v. Paoli Mem’l Hosp., 686 A.2d 1355 (Pa.Super. 1996), in which it had held a decedent had not received treatment for purposes of the MHPA. In that case, the decedent had waited in the emergency room and then proceeded down a hallway unescorted. He then ran towards a window, crashing through it and landing on a concrete driveway two stories below. In Fogg, the decedent had not seen any healthcare professionals; in this case, the Court reasoned, the decedent was seen and evaluated by nursing staff.

Because the Court found that Holy Spirit properly invoked the MHPA, it reviewed the alleged facts to determine whether gross negligence was adequately pled to permit further discovery. The Court noted that gross negligence is defined as “flagrant, grossly deviating from the ordinary standard of care.”[1] The Court also noted that whether the facts amount to gross negligence is a question for the jury. A court may take the issue from the jury only when the case is entirely free from doubt, and no reasonable jury could find that the acts or omissions constituted gross negligence.

The Court then quoted nearly thirty paragraphs from the plaintiff’s third amended complaint, which described how the decedent walked past a nurses’ station, past the ER discharge and billing desk, through two sets of unlocked exit doors to the emergency room lobby, past another nurses’ station, and then through sliding glass doors to the outside, all while gripping her head and wearing a hospital gown and slippers. The plaintiff also alleged that the hospital had notice of a problem with mental health crisis patients eloping, according the Department of Health’s investigation, and failed to take any action to protect future patients.

The Court held that these alleged facts were sufficient for a reasonable jury to find the hospital was grossly negligent. The Court noted that the plaintiff alleged that the hospital failed to take adequate precautions, failed to follow its own protocols, failed to monitor the decedent, failed to evaluate the patient for ninety minutes, and that this was the ninth mental health crisis patient in three and one-half months to elope from the emergency room. These facts, upon further development, could be found by a jury to constitute gross negligence.[2] Therefore, the trial court’s order of dismissal was reversed and the case was remanded for further proceedings.



[1] Citing Albright v. Abington Memorial Hosp., 548 Pa. 268 (1997).

[2] The Court cited to its similar holding in Bloom v. Dubois Regional Medical Center, 409 Pa.Super. 83 (1991) (reversing dismissal of case on preliminary objections based on immunity pursuant to MHPA, finding pleading alleged sufficient facts that if developed, may permit jury to find hospital’s acts constituted gross negligence).


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