A Pennsylvania family is asking a commonwealth appellate court to OK their going forward with a lawsuit against a psychiatrist after a juvenile psychiatric patient in his care killed a member of their family and injured several others.
The family wants to bring the lawsuit even though the patient never told his psychiatrist that he would harm his neighbors.
The trial court dismissed the case that would impose a new duty for Pennsylvania’s psychiatrists and other mental health professionals if it were allowed to go forward. Now the family is appealing that decision.
“Appellants would have this court subject mental health professionals to liability anytime their patients harm anyone anywhere in the world,” the Litigation Center of the American Medical Association and State Medical Societies and the Pennsylvania Medical Society (PAMED) physicians tell the court in an amicus brief they filed in the case, Sinoracki et al. v. The Children’s Service Center of Wyoming Valley et al.
While the death and injuries in this case are tragic, the physician organizations’ brief in the case notes the longstanding law in this area—that it is a psychiatrist’s duty to warn only when a patient communicates “a specific and immediate threat of serious bodily injury against a specifically identified or readily identifiable third party and when the professional, determines, or should determine under the standards of the mental health profession that his patient presents a serious danger of violence to the third party.”
But patient Zachary Hockenberry, now an adult, never told his psychiatrist Muhammad A. Khan, MD, that he would harm his neighbors, court documents show. Holding a physician liable for a person’s actions when the patient hasn’t expressed an intent to harm another person would interfere with the patient-physician relationship, would discourage people from becoming mental health professionals, and would threaten mental health care in Pennsylvania, the AMA Litigation Center and PAMED tell the court.
Find out more about the cases in which the AMA Litigation Center is providing assistance and learn about the Litigation Center’s case-selection criteria.
Potentially harmful to patients
Pennsylvania law protects the rights and civil liberties of people living with mental illness. These laws are borne out of an era when mentally ill patients could easily be committed against their will to institutions that did not properly care for them.
If allowed to go forward, the Sinoracki lawsuit—which ultimately seeks to hold Dr. Kahn liable for what Hockenberry did in attacking his neighbor—would encourage physicians to go back to a time when patients were more likely to be committed.
“If a mental health professional owed a duty to anyone anytime a patient harmed them, rational professionals would seek more restrictive treatment of patients. When in doubt, lock up the mentally ill, so that the professionals cannot be sued if the patient harms someone. That potential result harkens from a bygone era,” the brief says. “If the least restrictive treatment means the highest potential for liability, mental-health professionals would be more likely to seek more restrictive treatment: voluntary or involuntary commitment, or involuntary outpatient treatment.”
Washington serves as warning
Only one state in the nation—Washington—has expanded liability for mental health professionals who provide outpatient care, according to the National Conference of State Legislatures. When the state legislature commissioned a study to assess how the court decision that allowed that to happen affected mental health treatment in the state, researchers concluded that it “harmed professionals’ relationships with their patients,” the AMA Litigation Center and PAMED brief tells the court.
The study showed 70% of mental health professionals considered making changes to their practices based on the court decision and 50% did make changes. Among the shifts:
- More screening of patients.
- Refusal to accept high-risk patients.
- Increased documentation.
- More calls, or plans to call, law enforcement.
“This court should take heed, and not follow Washington’s lead,” the brief says. “Uncertain, expansive liability will restrict treatment options, cause mental-health professionals to exit the field, and harm the patient-physician relationship. In sum, expanding liability on mental-health professionals will adversely affect all Pennsylvanians by degrading the quality of mental healthcare in this Commonwealth.”
