Claimant was in a private room at Nyack Hospital when a psychiatric patient from Rockland Psychiatric Center, in Nyack Hospital for non-psychiatric medical care, and ordered to be under continuous observation, entered her room and placed his hands around her neck, to choke her. The Rockland aide had left the patient alone while on a meal break, and the claimant alleges that the defendant was therefore negligent in its supervision, and that such negligence was the proximate cause of psychological injuries she continues to suffer as a result of the incident. Claimant asserts that since the incident, in 1986, she has been a "non-functioning person," has suffered anxiety attacks, has had a strained relationship with her husband, and continues to be "fearful". A psychiatrist who examined her testified that she suffers from Post-Traumatic Stress Syndrome.
Held: The State has a duty to use reasonable care in its supervision of mentally ill patients committed to its care, to prevent the foreseeable risk of harm to its patients and to others. The defendant in this case knew that the patient had behavioral problems and was negligent in not informing its aide or Nyack Hospital of his need to be under continuous observation while the aide was on a meal break.
However, the claimant failed to establish her claim of continuing psychological injuries and was awarded only $2,000 for the fear and anxiety that she suffered at the time of the incident. The Court cited these weaknesses in the post trauma stress syndrome claim: (1) The claimant's psychiatrist's conclusions were based solely upon a single hour to an hour and a half interview with the claimant that took place six years after the incident, wherein her psychiatric history was obtained solely from her own self-serving statements; (2) The expert conceded that for eight years prior to the incident she was anxious and frightened due to family problems; and (3) Despite claimant's assertion that she was a "non-functioning" person since the incident, since then she has married her present husband, given birth to two sets of twins, and moved to another state.
 | Michael Welner, M.D. Chairman The Forensic Panel |
Dr. Welner comments: If the same incident had occurred at Rockland—negligent supervision allowing a psychiatric patient to assault a fellow psychiatric patient—might the result have been different? The judge in Kylow said that it is "well settled that the State has a duty to use reasonable care in its supervision of mentally ill patients committed to its care to prevent the foreseeable risk of harm to its patients and to others," and cited Dunn v. N.Y., 29 N.Y.2d 313. But in Dunn, the injured parties were citizens killed while driving a car which was struck by another car driven by an escapee from a state psychiatric hospital. The fact is, most cases where the State has been found liable for failing to properly supervise a psychiatric patient have involved injuries, like in Dunn, which were suffered by third parties, or injuries suffered by the patient himself (see, for example, Killeen v. N.Y., 66 N.Y.2d 850, where the patient accidentally burned himself.) Yet, there have been some cases where psychiatric patients have successfully held the State liable for failure to properly supervise another patient who assaulted him. For example, in Goble v. N.Y., 123 A.D.2d 664, a patient at Rockland Children's Psychiatric Center successfully sued the state when an improperly supervised patient threw a chair at him which struck him in the eye, making it necessary to have the eye surgically removed.
While inpatient psychiatric units are not exactly scenes from battle royal wrestling matches, one or two patients at one time can wreak considerable havoc. What duty does an inpatient psychiatric unit have to supervise potentially assaultive patients? Is traditional supervision sufficient? If so, then assaults that occur when the perpetrator is supposed to be under continuous observation, as in the case of Kylow, would certainly suggest a standard of care was breached. A psychiatric facility has a clear duty to protect the rest of its inpatients, given that the milieu and the safety of it are essential ingredients to justify hospitalization in the first place.
Given that courts have often upheld the right of those committed to psychiatric hospitals to sue, it is most unusual that more personal injury lawsuits are not brought by patients. Assaults in psychiatric units are quite common, especially nowadays with budget cutbacks that limit the numbers of staff that would otherwise be available to calm and refocus agitated and disorganized patients.
Why don't we see more personal injury actions? Is the mental health consumer community ill informed of its right to be treated in a safe environment? Or is that the mentally ill simply choose to forget a humiliating chapter of their lives that included a stay in an institution? Perhaps those whose psychiatric histories lead them to hospitalization feel legal representation is beyond their socioeconomic reach. Many in the hospitals are isolated from supportive, advocate family members who would raise such issues or seek out legal advice.
Hospitals are generally acknowledged as the domain of Mental Hygiene Legal Service. MHLS, which provides services to patients during their inpatient stays, primarily addresses issues of involuntary commitment and treatment over objection, and few private attorneys, especially those with an interest in personal injury law, view the psychiatric inpatient services as a potential referral base. Perhaps there are untapped opportunities for the civil litigator in the decidedly unglamorous world of mental health treatment.
