193 A.3d 157
Me.2018Background
- Randy Oliver was hospitalized at Eastern Maine Medical Center (EMMC) for ~2 months with hepatic encephalopathy, alcohol-related cognitive impairment, and neglect; family (daughter Jernigan and son Oliver) sought guardianship and were appointed limited co-guardians by Probate Court on May 7.
- Early evaluations (late March) found Randy lacked capacity to make health-care and financial decisions; a May 7 neuropsychological re-evaluation by Dr. Podraza found Randy had regained capacity.
- EMMC concluded Randy no longer needed inpatient care; on May 16 a certified nurse practitioner determined Randy had sufficient capacity and approved discharge with a plan (appointments, case management referral, substance-abuse recommendations).
- Guardians objected to discharge, asserting their authority under the guardianship order; EMMC released Randy over their objection after providing notice to family and offering community supports.
- Randy returned home intoxicated and later died that night in a house fire; his heirs sued EMMC for negligence. After a bench trial the Superior Court found EMMC not negligent; plaintiffs appealed and EMMC cross-appealed costs rulings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the guardianship order barred EMMC from discharging Randy over guardians’ objections | Guardianship order granted authority to act for Randy and thus precluded discharge without guardians’ consent | Guardianship was limited by its own language: guardians act only as necessitated by Randy’s actual limitations; if Randy regained capacity guardians’ authority was suspended | Court: Order limited guardians’ power; it did not bar EMMC from acting on Randy’s own capacitated decision |
| Whether Randy had regained capacity at time of discharge | Randy remained impaired; earlier findings of incapacity control; guardians relied on March evaluations and Probate’s appointment findings | Multiple clinicians (including Dr. Podraza on May 7 and the treating NP on May 16) found Randy regained capacity; records showed improved orientation, self-care, planning | Court: Factual finding Randy had regained capacity by May 16 supported by competent evidence; not clearly erroneous |
| Whether EMMC’s discharge plan met the standard of care | Discharge was unsafe given home conditions, prior fires, intoxication risk, and guardians’ objections | Discharge included outpatient appointments, case management referral, substance-abuse resources, and patient understood and insisted on leaving; hospital must honor capacitated patients’ choices | Court: Discharge plan was reasonable and met standard of care; EMMC not negligent in discharging him |
| Whether EMMC could recover expert fees from prelitigation screening panel under 16 M.R.S. § 251 | EMMC sought expert fees and expenses incurred for mandatory prelitigation screening panel | The screening panel is not a "trial" under § 251; that statute authorizes fees for trial attendance only | Court: Denial of fees for screening-panel experts affirmed; panel is not a trial and fees not recoverable under § 251 |
Key Cases Cited
- In re Evelyn A., 2017 ME 182, 169 A.3d 914 (cited for standard that trial-court findings are supported by competent evidence)
- Levesque v. Cent. Me. Med. Ctr., 2012 ME 109, 52 A.3d 933 (standard of review for legal issues)
- Dickau v. Vt. Mut. Ins. Co., 2014 ME 158, 107 A.3d 621 (statutory interpretation principles)
- Guardianship of Collier, 653 A.2d 898 (Me. 1995) (guardianship affects personal liberties)
- In re James John L., 601 A.2d 630 (Me. 1992) (limited guardianship purpose and flexibility)
- Gordon v. Cheskin, 2013 ME 113, 82 A.3d 1221 (deference to trial court credibility findings)
- Zablotny v. State Bd. of Nursing, 2017 ME 29, 156 A.3d 126 (clear-error review of factual findings)
- Young v. Lagasse, 2016 ME 96, 143 A.3d 131 (definition of clear error)
- Hill v. Kwan, 2009 ME 4, 962 A.2d 963 (purpose and procedure of prelitigation screening panels)
- Gafner v. Down E. Cmty. Hosp., 1999 ME 130, 735 A.2d 969 (screening panel as initial screening mechanism)
- Sherburne v. Med. Malpractice Prelitigation Screening Panel, 672 A.2d 596 (Me. 1996) (panel not an inferior court or quasi-judicial tribunal)
- Poland v. Webb, 1998 ME 104, 711 A.2d 1278 (statutory authority limits expert fee awards to trial attendance)
- Coastal Ventures v. Alsham Plaza, LLC, 2010 ME 63, 1 A.3d 416 (finality for appeals where multiple orders exist)
- E. Perry Iron & Metal Co. v. City of Portland, 2006 ME 52, 896 A.2d 956 (appellate timing principles)