Florida Supreme Court extends the medical malpractice law to suicides
Florida courts have split over how to apply the medical malpractice law to suicide, treating it differently than death from diseases like cancer. But now the Florida Supreme Court gave some clarity to the law and how the medical malpractice law applies to suicides. Recently, the high court ruled a negligence case may be tried against a primary care physician whose patient killed herself. As a result of the ruling, a jury will decide whether Dr. Joseph Chirillo should be held liable in the death of Jacqueline Granicz, 55, who had a history of depression and hung herself in her garage Oct. 9, 2008. The day before, the Englewood doctor had prescribed a new antidepressant, Lexapro, for Granicz without seeing her and referred her to a gastroenterologist to treat her digestive complaints. He had switched her from Prozac to Effexor the previous month. After her death, Granicz’s husband Robert sued Chirillo for negligence. Right before the trial, Sarasota Circuit Judge Lee Haworth granted a pretrial defense motion for summary judgment. He ruled Chirillo had no duty to prevent Granicz’s unpredictable suicide. The Second District Court of Appeal reversed and said it was up to a jury to decide whether Chirillo’s care of Granicz caused her death. The Florida Supreme Court agreed in a 7-0 opinion.
Lead Counsel for Plaintiff finds the ruling will give guidance to many. Gary Fox of Stewart, Tilghman, Fox, Bianchi & Cain in Miami told the Daily Business Review that the decision has a broad stroke because the numbers are astounding. According to the Anxiety and Depression Association of America, in 2014, about 17.5 million adults suffered from at least one serious bout of depression, and it generally afflicts two of 100 young children and eight of 100 teens. The group’s website reports that every year about 6.8 million adults experience generalized anxiety disorder. Both anxiety and depression are triggers for suicide.
An old-fashioned view is that because suicide is self-induced, it’s also self-determined and beyond the reach of health care. Today clinical depression is defined as a disease like any other, but the law of medical malpractice is still catching up.
In 2001 the First District Court of Appeal decided in Lawlor v. Orlando that a psychotherapist had no duty to prevent the suicide of a patient who wasn’t staying in a treatment facility. Dr. Bryan Wood committed suicide more than three months after his last appointment with Dr. Jacqueline Orlando.
“There is evidence that Dr. Wood suffered from depression and met other risk factors, but that evidence does not necessarily create a foreseeable zone of risk of suicide for imposing a legal duty on Dr. Wood’s psychotherapist,” the court wrote in an unsigned opinion.
The First District rested its holding on the physical proximity of doctor to patient.
The court concluded, “Although Florida law would clearly impose a duty on a psychotherapist for failure to safeguard a patient from harming himself in a custodial setting … no Florida cases extend the duty of custodial supervision and care to the outpatient relationship.”
The inpatient vs. outpatient rule has the advantage of eliminating this question: When does the doctor-patient relationship end for purposes of suicide malpractice? Granicz’s case involved outpatient treatment. Fox was realistic and pragmatic that the ruling will not lead to extreme rulings. “Nobody’s going to hold a doctor liable if he discharges a patient and two or three years later the patient commits suicide,” he said.
In this case, the Second District rejected the Lawlor holding and agreed with First District Judge Robert Benton’s dissent, which deemphasized the classic description of suicide as unpredictable and therefore legally unforeseeable. He “correctly noted that because a legal duty existed, the issue of whether the doctor’s actions proximately caused the plaintiff’s suicide was to be resolved by a jury,” Judge Morris Silberman wrote and certified a conflict with the First District’s Lawlor opinion.
On appeal to the Florida Supreme Court, the panel found Chirillo’s lawyers were “misguided” when they argued there’s a difference between an action in general medical malpractice and one asserting a duty to prevent suicide, which can’t be predicted. Citing its own 1992 precedent, McCain v. Florida Power, the court said there are many sources of duty, and preventing an inpatient suicide is only one of them. The broader duty drawn from the malpractice law, Florida Statute Section 766.102, is to treat patients “in accordance with the standard of care.” On that basis the trial judge should have found Chirillo owed a duty of reasonable care to Granicz as a matter of law and allowed the trial to proceed, the justices decided.
Fox told the paper the decision will impact not just suicide malpractice but definitions of duty, foreseeability and proximate cause.
Read the entire opinion here: http://law.justia.com/cases/florida/supreme-court/2016/sc14-898.html
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