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No Justice for Suicidal Patients

On April 6, 2016, the Minnesota Supreme Court issued its decision in Binkley v. Allina Health System, holding that hospitals are immune from suit when they negligently but in good faith deny admission to a suicidal patient seeking voluntary admission to the hospital.

This case involved the death of Kirk Lloyd, age 17. On May 10, 2010, Kirk tried to commit suicide by wrapping himself in a blanket and setting it on fire. When his mother entered his bedroom, the fire was put out and Kirk assured his mother that the fire was an accident. The next day he admitted to his mother that he had in fact been attempting to commit suicide, and they went to United Hospital in St. Paul to have him admitted to the adolescent psychiatric unit.

Although both a counselor and physician determined that Kirk should be admitted to the unit, he waited for hours in the emergency room until hospital staff decided not to admit him and discharge him to home. Kirk committed suicide two days later.

Kirk's mother, Melinda Blinkey, commenced a medical malpractice lawsuit against Allina Health System and various healthcare providers alleging that defendants negligently failed to admit her son to the hospital. Defendants moved for dismissal, claiming that they were immune from suit under the Minn. Stat. 253B.23, subd. 4 of the Minnesota Commitment and Treatment Act (CTA). The district court denied the motion, and defendants appealed.

On February 9, 2015, the Minnesota Court of Appeals, in a published decision, held that Minn. Stat. 253B.23 immunized defendants from suit. The statute provides immunity to "[a]ll persons acting in good faith . . . who act pursuant to any provision of this chapter or who procedurally or physically assist in the commitment of any individual pursuant to this chapter . . . . " The court rejected the contention that the immunity provision applies only to involuntary commitment decisions and held that it extends to all acts covered the the CTA, including Minn. Stat. 253B.04, which addresses circumstances where patients seek voluntary admission to a mental health unit.

The Minnesota Supreme Court affirmed the Court of Appeals, holding that the CTA unambiguously immunizes healthcare providers from any lawsuit alleging malpractice involving the failure to admit a patient who voluntarily seeks admission to the hospital if the healthcare provider acted in good faith. The Court reached this decision even though it acknowledged in footnote 2 of its opinion that the immunity provision of the statute may only apply to claims based on a violation of the CTA but not to common law claims of medical malpractice. Indeed, as Justice Lillehaug pointed out in his concurrence, the immunity provisions of the CTA apply to "any civil . . . liability under this chapter," indicating the legislature intended only to immunize claims arising under the CTA and not medical malpractice claims arising under the common law.

So why didn't the Supreme Court explore whether the immunity provisions of the CTA did not apply to the plaintiff's common law claim of negligence? This very argument had been made in an amicus brief filed by the Minnesota Association of Justice, but not by plaintiff's counsel. The Court declined to explore the issue because plaintiff's counsel disavowed the argument at oral argument and the Court felt it had no obligation to decide the issue because of the disavowal.

From this writer's perspective, the Court's obligation here was to interpret the statute correctly whether or not counsel for plaintiff expressly disavowed an interpretation that was otherwise correct. If the legislature never intended to abrogate claims arising under the common law in the CTA, it makes no sense for the Supreme Court not to explore this interpretation and ultimately issue a decision that immunizes the defendants from a claim arising under the common law. It is more important to correctly interpret the statute correctly and render justice in the case than it is to punish a plaintiff because his or her counsel may not have correctly analyzed the statute.

This decision not to explore the issue ultimately resulted in a decision that does not correctly interpret the statute and denies justice to a family that was wronged by the defendants. This decision to leave open this question also will have an impact on whether attorneys will undertake representation in similar cases because attorneys may not be willing to undertake a very costly and lengthy battle that will ultimately require the Supreme Court to decide the issue it dodged here. The quickest way to undo the injustice of this decision is for the Minnesota legislature to amend the CTA to clarify that it does not provide immunity for malpractice claims arising under the common law.

When patients present to the emergency room with life-threatening physical illness requiring admission to the hospital, we hold hospitals and doctors accountable when they negligently fail to diagnose and treat these patients and send them home and the patient dies. When mental health patients present to the emergency room and provide the diagnosis to the doctor by telling the doctor that they are actively suicidal and need admission to the hospital, we cannot grant license to the hospital to turn these patients away and send them home. Granting immunity in that circumstance does nothing to promote patient safety or further our society's goal to provide equal treatment opportunities for the mental health population. If we want to reduce the suicide rate and treat mental health patients on par with other patients, we have to be willing to "walk the walk" and not simply "talk the walk." Our legislature should correct this injustice now by amending the CTA to clarify that the statute does not common law claims based upon a healthcare provider's negligent decision not to admit an unstable, suicidal patient to the hospital.

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