Dean, M. v. Bowling Green-Brandywine
192 A.3d 1177
Pa. Super. Ct.2018Background
- Andrew Johnson, 23, voluntarily admitted to Bowling Green Brandywine for opiate and benzodiazepine detox; he had a history of bipolar disorder and ADHD reported on intake.
- Within ten days of admission he was found unresponsive in his room and later died; plaintiffs (parents/co-administrators) sued for medical malpractice.
- Several defendants (psychiatrist Rana; treating physician Khan; Brandywine facility; ER physicians Duncklee and Plumb; Southern Chester County ER Associates) were sued; some timely pleaded MHPA limited-immunity defense, others raised it late.
- Trial evidence included experts who testified defendants breached standards of care (failure to recognize cardiac risk, failure to transfer to ER) and a psychiatric consult by Dr. Rana approximately eight days after admission.
- Trial court granted nonsuit for all remaining defendants based on Mental Health Procedures Act (MHPA) limited immunity (50 P.S. § 7114) because some defendants were treating Johnson’s mental illness or contemporaneous medical care tied to psychiatric treatment.
- Superior Court affirmed nonsuit as to Rana, Khan, and Brandywine (post-psychiatric-consult conduct) but reversed as to Duncklee, Plumb, and Southern Chester County ER Associates (their care was not necessarily psychiatric treatment under MHPA).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether MHPA limited-immunity applies to defendants | MHPA shouldn’t shield malpractice where care was medical, not psychiatric, and Johnson’s substance dependence alone isn’t per se mental illness | Defendants argue they were treating or contemporaneously aiding treatment of mental illness, so MHPA grants immunity absent gross negligence or willful misconduct | Court: MHPA applies to Dr. Rana; applies to Khan and Brandywine for actions after Rana’s psychiatric consult; does not apply to Drs. Duncklee and Plumb or their employer (reversed nonsuit for those defendants) |
| Burden/appropriateness of nonsuit on immunity defense | Plaintiffs contend defendants failed to prove absence of disputed material facts to justify nonsuit | Defendants assert record shows they were engaged in psychiatric treatment or contemporaneous medical care aiding psychiatric recovery | Court: Immunity is an affirmative defense; defendants seeking nonsuit must show no reasonable dispute. Applied that standard and granted nonsuit only where record showed psychiatric treatment connection |
| Timeliness of amending pleadings to assert MHPA immunity (Brandywine) | Plaintiffs argue permitting late amendment deprived them of procedural rights and was prejudicial | Brandywine argued other defendants (Khan) timely asserted the defense and plaintiffs had notice; amendment caused no unfair prejudice | Court: Leave to amend was properly granted as plaintiffs had notice via other defendants and no undue prejudice; rule favors liberal amendment |
| Whether contemporaneous medical treatment falls under MHPA (Allen precedent) | Plaintiffs distinguish Allen and argue ER/medical care here was independent medical treatment not ancillary to psychiatric treatment | Defendants rely on Allen: medical care contemporaneous with psychiatric treatment is immunized | Court: Applied Allen to bar claims where medical care was part of psychiatric treatment (post-consult conduct); but where there was no contemporaneous psychiatric treatment or notice (prior to consult), Allen did not support immunity |
Key Cases Cited
- Farago v. Sacred Heart General Hospital, 562 A.2d 300 (Pa. 1989) (MHPA limited immunity intended to protect those providing treatment to mentally ill)
- Allen v. Montgomery Hospital, 696 A.2d 1175 (Pa. 1997) (medical treatment contemporaneous with psychiatric care is part of psychiatric treatment and may be immunized under MHPA)
- Harvey v. Rouse Chamberlin, Ltd., 901 A.2d 523 (Pa. Super. 2006) (standard for nonsuit; evidence viewed in plaintiff’s favor)
- Heifetz v. Philadelphia State Hospital, 393 A.2d 1160 (Pa. 1978) (immunity from suit is an affirmative defense)
- Billig v. Skvarla, 853 A.2d 1042 (Pa. Super. 2004) (treating motion to remove a nonsuit as a post-trial motion)