Bell & Bon Secours v. Chance
188 A.3d 930
Md.2018Background
- Brandon Mackey, age 23, was confined to Bon Secours after an application for involuntary admission following a suicide attempt; a statutory hearing before an ALJ was scheduled within 10 days.
- Dr. Leroy Bell, psychiatrist at Bon Secours, examined and treated Mackey during the interim and concluded two days before the hearing that Mackey no longer met the statutory criteria for involuntary admission; Dr. Bell authorized Mackey’s release. Mackey died by suicide the next day.
- Mackey’s mother, Patricia Chance, sued Dr. Bell and Bon Secours for medical malpractice, alleging negligent premature release caused the suicide. A jury returned a large verdict for Chance.
- The trial court granted judgment notwithstanding the verdict for defendants, relying in part on the Mental Health Law immunity provisions and this Court’s decision in Williams. The Court of Special Appeals reversed. The Court of Appeals granted certiorari.
- The Court of Appeals held that the statutory immunity for decisions under Part III of Subtitle 6 (involuntary admission) covers a physician’s good-faith decision during the pre-hearing observation period to release a patient who no longer meets the statutory criteria.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether statutory immunity under HG §10‑618 / CJ §5‑623 covers a physician’s decision to release a patient after initial confinement but before the ALJ hearing | Chance: immunity applies only to decisions to admit, not to post‑admission releases; Dr. Bell can be liable for negligent release | Bell/Bon Secours: immunity applies to the entire involuntary‑admission process, including interim release made in good faith and with reasonable grounds | Held: Immunity covers the entire process from initial confinement to the ALJ hearing; a good‑faith, criteria‑based release is immune from civil/criminal liability |
| Scope of “admission” under Part III: whether admission is complete on physical entry/acceptance or ends at ALJ hearing | Chance: admission includes the period after acceptance; release post‑acceptance is not part of the admission decision protected by immunity | Defendants: admission is a statutory process (includes entry plus ALJ determination); observation status pending hearing is part of the process | Held: “Admission” is a process including initial confinement and the ALJ hearing; observation status is not involuntary admission for immunity purposes |
| Meaning of “in good faith and with reasonable grounds” for immunity | Chance: defendants should not be immune if release was negligent | Defendants: immunity protects good‑faith decisions even if incorrect; “reasonable grounds” requires following statutory process and articulating decision based on statutory criteria | Held: “Good faith” is subjective honesty; “reasonable grounds” means a record linkage to statutory criteria (procedural/objective aspect), not a negligence-free standard |
| Whether expert testimony that discharge violated the standard of care can support jury verdict despite immunity | Chance: expert opinion that discharge breached standard of care supports negligence verdict | Defendants: where discharge is covered by immunity (good faith + reasonable grounds), an expert cannot convert that decision into actionable negligence | Held: Expert testimony that a good‑faith statutory release was negligent cannot sustain liability; if release meets immunity requirements, it cannot be the basis of malpractice verdict |
Key Cases Cited
- Williams v. Peninsula Regional Medical Center, 440 Md. 573 (2014) (statutory immunity for involuntary‑admission decisions extends to good‑faith decisions not to admit)
- O’Connor v. Donaldson, 422 U.S. 563 (1975) (civil commitment requires adequate process protecting liberty interests)
- Rite Aid Corp. v. Hagley, 374 Md. 665 (2003) (definition and analysis of “good faith” in immunity contexts)
- J.H. v. Prince George’s Hospital Center, 233 Md. App. 549 (2017) (historical/regulatory background on involuntary‑admission procedures and agency practice)