386 P.3d 254
Wash.2016Background
- Jan DeMeerleer, an outpatient of psychiatrist Dr. Howard Ashby for ~9 years, murdered Rebecca Schiering and her 9‑year‑old son and attempted to murder her older son; DeMeerleer then killed himself.
- DeMeerleer had a long history of bipolar disorder, suicidal and homicidal ideation, medication noncompliance, and escalating behavior; he never explicitly named Schiering or her children as targets.
- Volk (Schiering’s mother) sued Ashby and the Clinic for medical malpractice/medical negligence, alleging failure to meet psychiatric standards (risk assessment, monitoring, follow‑up) and failure to protect foreseeable victims.
- The trial court granted summary judgment for defendants, finding no duty to warn absent an actual threat to an identifiable victim; Court of Appeals reversed in part, reinstating the Petersen‑based negligence claim but affirming dismissal of loss‑of‑chance and involuntary‑commitment theories.
- The Washington Supreme Court held that a § 315 “special relationship” between psychiatrist and outpatient can give rise to a duty to take reasonable precautions (consistent with mental‑health standards) to protect foreseeable third‑party victims in the outpatient setting; foreseeability is a fact question for the jury.
Issues
| Issue | Volk’s Argument | Ashby’s Argument | Held |
|---|---|---|---|
| Whether a Restatement § 315 special‑relation duty applies to outpatient psychiatric care | Petersen duty extends to outpatients; psychiatrist must take reasonable precautions to protect foreseeable victims | § 315 duty requires control (§ 319 take‑charge) and thus should not apply where psychiatrist lacks custodial control; no duty absent an actual threat to an identifiable victim | Yes: § 315 Petersen duty applies in outpatient setting once a special relationship exists; duty measured by standards of mental‑health profession; amount of control is not dispositive; foreseeability is for jury |
| Admissibility of plaintiff’s expert (Dr. Knoll) at summary judgment | Knoll’s affidavit shows breach of psychiatric standards and creates fact issues on foreseeability/causation | Knoll’s opinions are speculative and insufficient for summary judgment | Court rejects bifurcated speculation standard; Knoll’s opinions—grounded in records and expertise—were not overly speculative and raised genuine issues of material fact |
| Whether loss‑of‑chance doctrine applies to nonpatient third‑party victims | Volk asserted loss of chance of survival from negligent psychiatric care | Defendants argued loss‑of‑chance is limited to patient malpractice claims and requires specific proof | Loss‑of‑chance doctrine inapplicable here; Washington recognizes it in patient‑physician context, not as substitute for direct causation to nonpatient third parties |
| Scope of required protective steps (warning, commitment, treatment) | Reasonable care may include warning victims, notifying authorities, arranging treatment or commitment as professional standards require | Statutory confidentiality and involuntary‑commitment limits constrain any duty to warn or act absent an actual threat | Court: reasonable care is context‑dependent and informed by professional standards; disclosure exceptions exist when health/safety threatened; duty does not override statutory protections but may require steps consonant with profession and law |
Key Cases Cited
- Petersen v. State, 100 Wn.2d 421 (Wash. 1983) (recognizing Restatement § 315 duty for mental‑health professionals to take reasonable precautions to protect foreseeable victims)
- Tarasoff v. Regents of Univ. of Cal., 17 Cal.3d 425 (Cal. 1976) (seminal duty‑to‑protect decision imposing reasonable‑care obligation on therapists who know or should know a patient poses serious danger)
- Taggart v. State, 118 Wn.2d 195 (Wash. 1992) (discussing § 319 take‑charge duties and clarifying Petersen is not limited to inpatient settings)
- Binschus v. Dep’t of Corr., 186 Wn.2d 573 (Wash. 2016) (clarifying that § 315 duties implicate a duty to control and limiting overly broad readings)
- Mohr v. Grantham, 172 Wn.2d 844 (Wash. 2011) (recognizing loss‑of‑chance doctrine in medical malpractice between doctor and patient)