In the case ofDean v. Bowling Green-Brandywine, the Pennsylvania Superior Court addressed the issueof whether the trial court properly granted nonsuit based upon the application of the limited immunity provision of the Mental Health Procedures Act (“MHPA”). The MHPA at 50 P.S. § 7114 provides that those who are engaged in treating or examining a patient “under the act” cannot be held liable absent “willful misconduct or gross negligence.
Andrew Johnson was 23-years-old when he voluntarily applied for admission to Bowling Green Brandywine Treatment Center (“Brandywine”). Johnson was suffering from addiction to opiates and benzodiazepines, which had been prescribed for back injuries suffered in an ATV accident. Less than 10 days after he was admitted, he was found unresponsive on the floor of his room at Brandywine. He subsequently passed away.
Johnson’s parents filed a complaint alleging Johnson’s death was caused by medical malpractice on the part of Brandywine and associated defendants. Some of the defendants raised the qualified immunity provision of the act, while others did not, including Brandywine. The case proceeded to trial. The Johnsons presented their case through expert testimony, which showed that the defendants had breached their duty of care to Johnson by failing to recognize his risk for and signs/symptoms of sudden cardiac death, and that Johnson died from a cardiac arrhythmia caused by deficient potassium levels and side effects of the medications in his system.
The defendants moved for the entry of an involuntary nonsuit. They argued that the Johnsons had failed to present evidence capable of establishing willful misconduct or gross negligence. The trial court determined that the Johnsons had failed to present evidence capable of establishing that any of the defendants had been grossly negligent in their care of Johnson; therefore, the court granted the defendants’ request for nonsuit. It did not matter to the trial court that some of the defendants did not raise the issue of qualified immunity under the Act as an affirmative defense, since the Johnsons already knew it would be an issue.
According to 50 P.S. § 7103, the Act applies to the “voluntary inpatient treatment of mentally ill persons;” however the Act does not define the term “mentally ill person.” However, the Department of Human Services has issued regulations defining “Mental illness” as:
[t]hose disorders listed in the applicable APA Diagnostic and Statistical Manual; provided, however, that mental retardation, alcoholism, drug dependence and senility do not, in and of themselves, constitute mental illness. The presence of these conditions, however, does not preclude mental illness.
55 Pa. Code § 5100.2.
Here, the Superior Court determined that while Johnson was being primarily treated for substance abuse, the defendant psychiatrist and Brandywine were treating Johnson for co-morbid psychiatric conditions, therefore, nonsuit was proper. The Superior Court also agreed with the trial court that the Johnsons were not prejudiced by Brandywine’s failure to plead the Act as an affirmative defense since the Johnsons were put on notice of the claim through the pleadings of the other defendants. Finally, the Court determined that some of the defendants were not entitled to qualified immunity since their alleged substandard conduct in treating Johnson’s substance abuse occurred before the provision of mental health treatment.
Given this holding, it is incumbent that plaintiffs consider the higher standard of gross negligence when the circumstances of the case involve the provision of both physical and mental health services.
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