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Psychiatric hospital not liable for the death of a patient following a struggle with hospital staff.

The Michigan Court of Appeals refused to impose liability on a psychiatric hospital for the death of a patient who had been admitted to its care. The man had been transported by the police to the psychiatric facility, where he was found to be in need of care but capable of giving informed consent. After he signed a voluntary admission form, the hospital admitted him, gave him medicine for back pain, and placed him in a "quiet room."

Overnight he became increasingly agitated, culminating in a struggle with hospital staff and the injection of a calming drug. The man stopped breathing, allegedly as a result of the staff's compression of his breathing capacity during the struggle, and subsequently died. A lawsuit filed on behalf of the man's estate argued that the hospital had failed to meet its contractual obligations to provide adequate treatment and violated the federal Emergency Medical Treatment and Active Labor Act (EMTALA).

The Michigan Court of Appeals began by dismissing the contractual claim. The court found that the signed voluntary admission form did constitute a contractual agreement between the hospital and the patient, but concluded that the contract only authorized treatment and did not impose any particular treatment obligations. Although Michigan law establishes a preexisting duty to provide mental health services under these circumstances, the court ruled that this contract did not establish such a duty and therefore the contract could not provide a basis for recovery of damages resulting from an asserted failure to provide needed care.

As for the EMTALA claim, the court determined that it requires hospitals (1) to afford an appropriate medical screening to all persons who come to its emergency room seeking medical assistance, and (2) to provide those services necessary to "stabilize" any emergency medical condition found to exist in these patients.

The court rejected the plaintiff's argument that hospital staff failed to meet the second requirement. The court ruled that that this provision only applies in the event of a patient discharge or the transfer of a patient outside the facility. Noting that EMTALA was not intended to provide a federal malpractice statute, because this patient was neither transferred nor discharged, but rather admitted, the EMTALA requirements were deemed inapplicable.

A dissenting opinion, while agreeing with the ruling on the contractual claim, asserted that EMTALA requires that a hospital either provide stabilizing medical treatment or transfer the patient elsewhere. The dissent noted that the federal courts of appeals have split on this issue and that at least one court (the Ninth Circuit) that had adopted the position held by the majority had qualified its ruling by adding that admission for inpatient care does not terminate EMTALA liability if the admission was not done in good faith. The dissert argued that an allegation, as here, that the patient had been provided no mental health treatment after admission called into question whether the admission had been made in good faith and thus did not terminate the hospital's EMTALA obligations. Lanman v. Kalamazoo Psychiatric Hosp., No. 263665, 2006 WL 73747 (Mich. Ct. App. Jan. 12, 2006).

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Title Annotation:Michigan
Publication:Developments in Mental Health Law
Date:Jul 1, 2006
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