Drunk Patient Loses Lawsuit Against Hospital

In Kowalski v. St. Francis Hospital and Health Centers et al., 2013 NY Slip Op 04756, 21 NY3d 480 (N.Y. Ct. App. June 26, 2013), the Court of Appeals considered what, if any, duty a hospital owes to a drunk patient who decides, on his own, to leave.  While the health benefits of being drunk are open to debate, intoxication still presents obvious risks.

It being Friday and all, I thought I’d distill the case to the following haiku:[1]This is, obviously, not intended to comprise anything approaching a complete analysis.

Drunk patient gets hurt

Should not have left hospital

No duty, no win.

The plaintiff in Kowalski, who had been brought to the emergency room of a hospital in a state of “severe intoxication”, left the hospital and was later hit by a car.

He sued the hospital and a treating ER doctor, alleging that they should have prevented him from leaving the emergency room.

He lost.

The Court of Appeals agreed with the lower court that “defendants had no right, and therefore could have had no duty, to do so”, and affirmed the lower court’s decision finding that defendants were not liable.

The Court found that this situation was not one justifying a departure from the general rule of freedom of movement:

There are surely few principles more basic than that the members of a free society may, with limited exceptions, come and go as they please. Of course there are people so mentally impaired that they must be denied this right, but that category is a narrow one and does not include everyone who would be safer in a detoxification facility than on the street. Thus the common law permitted the restraint of people whose mental state might make them a danger to themselves or others only in extreme circumstances.

Given his voluntary arrival at the hospital, plaintiff conceded that the hospital had no authority, pursuant to Mental Hygiene Law § 22.09, to retain him.  Plaintiff cited “no other statute, and there is no principle of common law, that would permit the restraint of a patient on the facts of this case”.

The Court rejected plaintiff’s argument that “a duty to restrain him flowed from the hospital’s and the doctor’s common law duty of care” since “there can be no duty to do that which the law forbids” and that “[t]o restrain plaintiff on these facts would have exposed defendants to liability for false imprisonment.”

Plaintiff argued that defendants were at fault because (1) defendants failed to consult the record of plaintiff’s previous hospitalization, when he was contemplating suicide, and (2) the treating ER doctor’s rejection of a nurse’s suggestion to call the police.

The Court disposed of both arguments.  As to the first point, “[a] patient cannot be confined simply because he was having suicidal thoughts a month ago”, and as to the second, “the doctor had no duty to call the police; the police could not, on the facts known to [her] when plaintiff left the hospital, have forced plaintiff to return.”

Finally, the hospital’s failure to follow its own protocols did not supply a basis for liability, as there was no evidence of any “causal connection between any of the alleged departures from protocol … and plaintiff’s injury.”

1 This is, obviously, not intended to comprise anything approaching a complete analysis.
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